Working in a Hospital in Solomon Islands

Special information for students

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17.06.2015

Before you apply:
Please read all general information first, then read the rest of this document!

Professional requirements:
Quoting an English guide: You must be a medical student who is registered for and attending a course of study leading to a degree or diploma from a university.

Different terms are used in different countries for what is called an elective on this web site. It comprises practical work in a hospital under varying degrees of supervision, depending on the level of your training and experience. Some applicable terms are: clinical clerkship, student on attachment, student assistant, Famulatur, Praktisches Jahr (PJ, PJ-Tertial), Wahlstudienjahr (WSJ). You are welcome to supply us with more terms.

Check with your tutor or your university for the necessary prerequisites for a medical elective abroad. (Some links for Swiss students can be found here.) It is your responsibility to make sure the place you select for your elective is recognized by your university. The NRH in Honiara is teaching hospital for the Fiji School of Medicine in Suva, Fiji and the University of Papua New Guinea in Port Moresby. Unless you bring along a special form, the confirmation of your elective will be written on hospital letterhead stationery and carry a hospital stamp.

Important note for German students: Many (most?) German universities seem to refuse to accept an elective at NRH (or another hospital in Solomon Islands) as part of the PJ because the confirmation of your elective will neither be written on university letterhead stationery nor will it carry the seal or stamp of a university. Please check with your university before you apply for an elective. On the other hand, a student from the University of Mainz, supported by his prof, did manage to get his elective accepted in the year 2002. So, who knows, with enough determination, support, and some luck you may be able to convince your authorities that doing an elective at NRH is a good thing, even though Solomon Islands does not follow German rules.

Selecting a place
The normal choice for students would be NRH in Honiara. However, for the time being, students are encouraged to apply at provincial hospitals. Right now (Oct 2014), 20 new local graduates are going through an induction program, followed by a six-month bridging and a 24 months internship program. Another 35 new graduates will follow next year and therefore NRH will be very crowded in the years ahead. When applying at a provincial hospital please consider:

  • Provincial hospitals do not have specialized departments, so doing e.g. an elective in surgery is not an option, but a Swiss student who spent two months of his elective at Gizo Hospital thinks this is not necessarily a disadvantage:
    I guess it all depend on your interests and expectations, but I just loved the fact there are no specialized departments at Gizo Hospital. Because of the multitude of problems and syndromes I was able to do and learn a lot of things. I assisted women in childbirth, drained abscesses, assisted with amputations, did night duty for the whole hospital (always with a phone number at hand to call help if needed), and looked after the outpatient department with all the various patients who show up there. I saw a lot of different cases and learnt associatively. Of course, it was always "basic" medicine, within the possibilities of the given constraints, but it was something I have not experienced again in all those specialized departments during the rest of my elective year. I would not hesitate to choose Gizo again.
     
  • Sometimes there is no doctor at all in a provincial hospital, naturally this rules out an elective in such a place.
     
  • Some places (e.g. Lata) are rather remote, in case of transportation problems (not uncommon in Solomon Islands) you might have to stay longer (up to months!) than you initially wanted to.
     
  • Gizo Hospital is probably the most popular provincial hospital among students. Sometimes there are more students than doctors, which might affect how much you are able to learn. The same student already cited above begs to differ:
    I do not think the ratio of doctors to students is important, it's the attitude of the ones who take care of you that counts, be it in Solomon Islands or another country. I, for one, started in the Gynecology Department at NRH. At the time I was there, there was exactly one registrar who now and then found time to explain something to me in more detail. I often had to bug him again and again to get information or to discuss something. This (for me) not quite satisfactory situation and not being able to explore the countryside outside Honiara on my own (considered too dangerous in 2002) made me start looking around for alternatives and eventually move to Gizo.

    The four of us with our mentors Dr Divi and Dr Mundi
    The four of us with our mentors Dr Divi and Dr Mundi

    At Gizo Hospital we were four students and "only" two doctors, but they were cheerful and taught us a lot of tips and tricks and let us do a lot of things. They always found time to explain something or test our differential diagnostic knowledge. It was also interesting to discuss cases with the other three students and get insight into other training approaches. I gained plenty of theoretical knowledge, but also learnt a lot about the practical side of being a doctor. I am presently getting ready for the final exams and find my experience in Gizo really helpful in many ways.


    Asked about the situation in summer 2004, a student who visited Gizo, but did not work at the hospital wrote:

    When I arrived, there were five students at the hospital. They said five were too many, about two would be ok. Most of the time they simply shared their jobs. They either did not go to the hospital at all or just for half a day.

    In summer 2005 a student wrote:

    There were too many students at the end of my stay, at Gizo Hospital there should be a maximum of four medical students, otherwise you can't do anything!


If you stay longer than 6 weeks it might be possible to split your stay into say three weeks at NRH and three weeks in a provincial hospital. This should be arranged well in advance.

Here is what NRH's student information sheet says:

We would like you to spend the first 3-4 weeks at Central Hospital, (if you are only here for 6 or 7 weeks then 3 weeks will be acceptable. If you are only here for 4 weeks, then you will have to spend all your time either in Central Hospital or in the Provinces, attached to one of the Clinical Teams and Directors in the Provinces, and supervised by the Head of the Team. The specialties available are:

Paediatrics, General Medicine, General Surgery, Anaesthetics, Obstetrics and Ophthalmology.

During this initial period you will then be able to arrange what you would like to do for the remainder of your elective. There are only two Provincial Hospitals to which you may go and they are:

  1. Kilu'ufi Hospital in Malaita Province
  2. Gizo Hospital in Western Province

Whilst at the National Referral Hospital or at the Provincial Hospitals you are directly under the supervision of the Chief Executive Officer in the case of the National Referral Hospital or the Provincial Director of Provincial Health Services in the case of Gizo and Kilu'ufi.

Minimum duration of stay:
4 weeks (6 weeks minimum for Lata), preferably 8 weeks or longer

Reasons for a longer stay:

  • Depending on where you come from, the journey to Solomon Islands may be long and rather expensive.
  • From experience it takes about eight to ten weeks until you are of any help in the new working environment.
  • Every student needs support and supervision, at least in the beginning, and thus puts a strain on the limited resources. The shorter your stay, the less help you are for the hospital. In other words: it may be a great experience for you, but for the hospital it is just a waste of time.

Remuneration:
none, i.e. you will have to pay for your travel costs, accommodation, food, etc. but there are no charges for an elective.

Vacation:
none, i.e. you have to plan your vacation separately, either before or better after your elective.

Please do not apply for a three-month elective and then tell them you need at least four weeks off to travel around. Be honest to the hospital and yourself. Depending on availability of time (and money) you will probably want to have at least an additional 7-10 days to explore the Solomons, so plan accordingly.

Why can't I just take a day off here and there?

Hmm, you came to the hospital for a purpose, didn't you? Ah, right, you wanted to learn something! The superiors (usually senior registrars) are willing to teach students and give them responsibility, in return, they expect them to take the initiative, show interest, and be around and available to help them, if there is a need. This includes the time the registrars are "on call" (which may be on a weekend). If they find you lacking in this respect, they will soon more or less ignore you.

Accommodation:
At NRH the Jubilee House if a room is available, otherwise (and at provincial hospitals) you have to organize something on your own (see General Information).

Usually people just select a suitable place after their arrival. You may get some ideas from the answers to our questionnaire. If you have horror visions of ending up without a place to sleep in Honiara, you could just book a few nights (or even just one night) at a motel or hotel in advance and once you are there, look for something that suits you and your purse. See Solomon Islands Visitors Bureau or a travel guide for ideas and contact information.

Choosing a time:
When applying, indicate the month (or range of months) and year you would like to start your elective.

Apply early, the general rule is: first come, first served.

As mentioned before, Gizo Hospital is very famous for elective attachments, so you should book early (i.e. one or two years in advance) if you want to go there.

The rainy season starts about November-December.

December/January can be a problem, especially at NRH: after the beginning of the month many staff are taking their annual leave (6 weeks or sometimes more). Therefore little elective surgery is to be expected. However, the Accidents and Emergency Department is busy and understaffed at the same time.

Where and how to apply:

If you have decided you want to do part of your medical elective at the National Referral Hospital in Honiara send your application with full details (time, length of elective and field of interest) and a short CV to the Medical Superintendent at NRH.

For contact details see Contacting the hospital.

Clearly indicate whether you are willing to organize (and pay for) your own accommodation if there is no room available in the Jubilee House. Otherwise you may get turned down simply because the records do not show an available room in the Jubilee House at the desired time of your stay.

Contact us for details, if you want to work in a provincial hospital. The National Referral Hospital will not arrange placements at provincial hospitals for you (even if you want to spend part of your elective at NRH), you have to apply there yourself.

Notes:

  • Please include e-mail addresses of references (referees) if available, Solomon Islands cannot afford long distance calls.
  • Please be patient. Communication with the hospital can be difficult. If you just have a week or two left to hand in the list of your electives, you better look elsewhere.
  • Please let the hospital know if you decide to cancel your elective.

Documents to bring along:

  1. A letter (in English!) from your university stating you are a student "in good standing".
  2. Any necessary form(s) required by your university to have your elective confirmed at the end of your stay. Sending forms back and forth by mail is not reliable.
    Students from Germany: see important note above.

Travel documents required:

Passport, visa, etc.

Links to more Travel Information

Recommended Literature:

Do you have specific questions? Doubts? Contact us.

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