French students learn by volunteering
in local clinics
by Mary Helen
YarboroughPublic Relations
Three French medical students attending MUSC decided they needed more direct contact with patients, and they wanted to experience a type of American health care that France doesn’t have. So they went off campus to volunteer at the free medical clinics downtown and in Mount Pleasant.
Isabelle Gengler, Lucy Di Marco and Nadia Roessler all are third-year medical students at Claude Bernard University in Lyon, France; which translates into a second-year medical student level at MUSC.
Second-year medical students in the United States spend more time in labs and lectures and spend less time working directly with patients as do class equivalent French medical students.
During the first semester, American medical students meet four times with their preceptor when they learn about getting a patient’s medical history and conducting a physical exam.
French exchange
students Nadia Roessler, Isabelle Gengler and Lucy Di Marco have lunch
with Dr. Philippe Arnaud.“In France, we see patients in our first years of medical school. We also study things like immunology and ethics. But, we learn that while in front of patients, you have to act as doctor,” said Gengler. “The second-year students here don’t see enough patients.”
Some MUSC second-year students responded to the French students’ interests and introduced them to the free clinics, Crisis Ministries downtown and CARES (Community Aid, Relief, Education and Support) in Mount Pleasant, where they could get hands-on experience with patients. “The spots for these clinics fill up fast,” said Di Marco referring to the popularity among students to work in the clinics here.
Roessler explains why they were eager to volunteer. “We wanted more direct work with patients,” she said. “Plus, we don’t have free clinics in France, because our social system is different. We wanted to see what it was like.”
In France, third-year medical students learn more by doing. They go to the hospital in the morning and attend lectures in the afternoon, Di Marco said.
“I like the fact that we can learn from patients and preceptors and experience our learning in France. (We call this ‘compagononnage,’ from the word ‘compagnon,’ which is translated as ‘companion.’)”
At the same time, Di Marco said she appreciates the way lectures are organized in America. “I find them interesting and the exams are made in a clever way to make students think,” she added.
Back on campus, Di Marco said she is anxious to meet medical experts in the fields that interest her, including neurology and physical therapy. She also is hoping to meet with doctors of osteopath to learn how the fields differ between France and the United States. (Though MUSC does not have an academic degree program in osteopathy, many of its physicians have doctor of osteopathy degrees, which offers equal access in health care as medical doctors. In France, D.O.s are not recognized the same as M.D.s, and lack equal access and authority, Di Marco said.)
Keeping friends, making connections
Philippe Arnaud, M.D., Ph.D., is the students’ host and mentor extraordinaire. He recently treated the new arrivals to lunch at his favorite local eatery, Hominy Grill. The internationally acclaimed research endocrinologist has worked with Jeff Wong, M.D., College of Medicine senior associate dean, to develop the French exchange program.
That first year (2001), Marina Bontron became the first exchange student from Lyon to participate in the MUSC program.
“I loved it here. I love Charleston,” said Bontron, who currently is completing her second year of residency at a teaching hospital in Clermont-Ferrand, France.
She was visiting South Carolina where her boyfriend works for Michelin in Greenville. She came to Charleston to visit MUSC on her way to Edisto Beach recently.
“I learned a lot here. I learned to do my first physical exam here,” she recalled. “The way they teach here is much better, I think. In France, you have to memorize everything, all of these details. Here, you learn the big things first then you learn the details later. It was much better for me.”
Bontron soon must decide whether to pursue either internal medicine, which requires five years of residency; or whether she will go into general family medicine, which requires only three years of residency. Once she decides, she cannot change her mind, she said, since it is difficult to switch medical expertise in France once you’ve committed.
Meanwhile, she would like to return to MUSC for a semester, but her performance would be limited. “I would not be able to prescribe drugs. I would have to pass the board first, and I would not have the time,” she said. “I will come back to visit, for sure.”
In addition to her boyfriend in Greenville, Bontron also maintains contact with friends from MUSC. When her MUSC roommate, Thanh Vo, PharmD, got married in Florida, recently Bontron was a bridesmaid in her wedding. And when she was visiting her boyfriend in Greenville, she called her friends Greg Johnson, M.D., who is in residency in Greenville; and Casey Engen, M.D., who is in residency in Charlotte, and they all got together. “I still keep in touch with my old friends I made here,” she said.
Euro to dollar
While she may share a lot of interests with her friends, Bontron will not have the financial burden associated with medical school that her friends may have.
In France, the average six-year medical education is virtually free, other than the 500 Euros a year (~$707), plus books and housing. She will not have any loans to repay, but she also will earn less than her American colleagues.
A doctor in France will earn about 4,000 Euros, or about $5,660 a month to start. They will earn about 50,000 Euros (roughly $71,000) a year, and may attain earnings of 80,000 Euros (about $113,000 in U.S. dollars equivalent) if they excel professionally.
If Bontron decides to become an internist, she could work only in a hospital, and would become like a hospitalist here. A career in family practice is a bit more flexible, she said.
While she continues her residency, Bontron will have to select her medical profession then plan to serve an additional two years as chief resident of a hospital before she will be able to find a permanent job. But, at least in France, she will not have to master accounting and insurance law, or worry about who will pay for her services. In France, doctors all get paid roughly the same, and everyone gets medical treatment for “free,” courtesy of the French taxpayer.
Friday, Oct. 12, 2007
Catalyst Online is published weekly,
updated
as needed and improved from time to time by the MUSC Office of Public
Relations
for the faculty, employees and students of the Medical University of
South
Carolina. Catalyst Online editor, Kim Draughn, can be reached at
792-4107
or by email, catalyst@musc.edu. Editorial copy can be submitted to
Catalyst
Online and to The Catalyst in print by fax, 792-6723, or by email to
catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island
Publications at 849-1778, ext. 201.