Sim Centre Opening: Bittersweet day

From Patty:

It was a bittersweet day. The residents have made great progress in a short time. The discussion this morning at academic day demonstrated a more nuanced and less formulaic understanding of anesthesia. But we are sad this is our last day with all the residents.

It is extraordinary that the residents can keep focused through such a long day. The teaching day included: morning report at 7 AM, core teaching on sepsis, cardiomyopathy and malaria in pregnancy, a resident case presentation, quiz, grading the quiz over buffet lunch at Camillia’s, simulated scenario, debate on whether general anesthesia or spinal is best for C-section in patients with mitral stenosis in this context, feedback, discussion of resident research projects and review of the quiz questions. Paulin and I also met with the new Minister of Health. It doesn’t seem possible to fit all that in between 7AM to 5PM but the residents were engaged and energetic throughout. This is all the more remarkable when we learn that one of them was on call last night and had to deal with two maternal deaths. We continue to be amazed at the resilience in such difficult circumstances.

We are becoming conscious that our time in Rwanda is almost over (this visit). It goes much too quickly. I will miss the warmth of the people – always time for a hug, handshake, conversation, good manners. I will not miss the noise of Nyamirambo. As Amélie said, it’s like sleeping in the middle of a bar. They turn the music off at 6 AM, just in time for the church bells and call to prayer.

Kitt and Kyle are out for a night on the town. Are they at the “Selfie Club” or the “So What Club”? Stay tuned…

From Kitt:
Hi everyone!

Our final academic day was exceptionally rewarding. It was jam-packed with the following:

- morning report at 7am

- our senior resident teaching on obstetrical sepsis and peripartum cardiomyopathy

- resident teaching on malaria in pregnancy

- resident case report on HIV in pregnancy

- senior resident quiz

- simulation station on postpartum sepsis

- debate on anesthetic technique for severe mitral stenosis in pregnancy

- resident research project discussion

The level of discussion of complicated anesthesia considerations, goals and conflicts was impressive. I am amazed by the keen attitude of these residents. Their willingness and enthusiasm to learn is without bounds. Their clinical experience as PGY1s and 2s is definitely above where mine was at the time. When I asked if anyone had heard of a patient with severe mitral stenosis in pregnancy, all of them raised their hands and said they had given an anesthetic to one!

I felt sad when saying goodbye to the residents yesterday. I'm definitely going to miss them. I was clinging to the fact that at least we will see Eugene and Alcade in Halifax in a few weeks.

Kyle and I have worked hard this last month. Teaching, however, is far less stressful than the work Patty is doing behind the scenes as she tries to advocate on behalf of an entire country for better anesthesia training and practice. She was invited to meet with the Minister of Health today, and it sounded positive! Her work is never done though, and she takes both the struggles and the joys (and the endless emailing) of Rwanda home with her for the rest of the year. I have now seen the impact of her hard work here first hand.

Thank you for this exceptional opportunity Patty!

Kitt