For my elective placement in the final year of ScotGEM, I opted to visit Tromsø, a city in the north of Norway, to experience medicine in the Arctic. From skiing to work, sweet treats to celebrate the return of the sun and refreshing dips in the arctic waters, life in Norway’s north has much to offer.
I was based in Universitetssykehuset Nord-Norge (UNN), in Tromsø, a hospital which provides care to more than 400,000 people living in the north of Norway. I was in the Obstetrics and Gynaecology department for a period of 4 weeks. I was able to spend time in the labour ward, the antenatal clinic, the gynaecology clinic and on some gynaecology and obstetrics theatre cases. Pregnancy in a rural setting comes with its own set of challenges, from deciding where to give birth to accessing care when urgently needed. Equipped with a set of helicopters for patient transport and a patient-hotel available to all patients who need it, this hospital is well suited to the geographical spread of its patients.
During my time in Obstetrics I was able to be present for the births of 5 babies, all of whom received a knitted hat and sock combo shortly after birth to combat the freezing temperatures. One of the highlights of my time within obstetrics was watching a set of twins be born during a night shift; this brother-sister duo did remarkably well despite arriving 5 weeks early! In addition to this, I gained a lot of experience in antenatal care, including helping with inductions of labour, examining labouring patients and learning about ultrasound scanning in the antenatal clinic.
During my time in gynaecology, I saw patients in the outpatient gynaecology clinic, the gynaecology inpatient ward and the emergency gynaecology clinic. The outpatient clinic deals with all manner of gynaecological conditions and also covers minor procedures like uterine biopsies, cervical biopsies and colposcopy. The emergency clinic covers patients with acute gynaecological issues, and I saw a mix of patients presenting with bleeding in early pregnancy, ovarian torsion and even ectopic pregnancies. I had a lot of opportunities to assess and examine patients presenting with gynaecological problems, in addition to performing smears, biopsies, IUD removal and insertion, and minor surgical procedures. I was also able to scrub into some gynae theatre cases including hysterectomies and fibroidectomies. I also got to join the junior doctors in their laparoscopy training sessions.
The biggest challenge in this elective was the language barrier. Luckily, I learned some Norwegian before, so I was able to get the most out of the patient interactions. I even managed some consultations in Norwegian by the end of my time there. In addition to having some Norwegian language skills before the trip, it also helped that a lot of the assessment scores like NEWS and ABCDE are the same in Norway.
Norwegian working culture places a large emphasis on work-life balance, so the average hospital working day is from 8am-4pm. This system left me a good bit of time to explore Tromsø on the weekdays and weekends. Since I visited during the winter, from mid January to mid February, I was able to experience the end of the polar night, a period of total darkness where the sun never rises above the horizon, and witness the return of the sun, an event celebrated by the consumption of ‘Solboller’ or sun buns. Snowfall is consistent throughout the winter, with temperatures sitting around -10℃ on a good day. When the weather is clear, conditions are perfect for skiing. Cross-country skiing is an integral part of Norwegian society and for many, it’s their mode of transport to work. Tromsø is a city on the island of Tromsøya, where well-maintained ski tracks run up and down the island, allowing people to ski from the hospital straight into town. Between being in the hospital and skiing, I also managed to sneak in my other favourite winter activity, enjoying the floating sauna and cold swimming!
The gorgeous scenery and Aurora Borealis in Norway!
Overall, I had a fantastic experience in Tromsø. It was really interesting to see how they manage to deliver a high standard of care in the context of extreme climate and geographical challenges.
Amber is a final year ScotGEM student based in Fife