by Christopher Gruenberg, EM PGY4 and Carol Shih, EM PGY3
We are very privileged and thankful to be have been invited by Professor Giovanni Ricevuti to the University of Pavia as visiting professors. From the moment we arrived and were greeted by Miss Edona Leka at our dormitories at the Collegio Universitario Santa Caterina Da Sienna, we knew that our visit would be filled with warmth, reward, and growth. Meeting with Professor Giovanni Ricevuti, we together planned and orchestrated a series of didactic lectures, small groups, case discussions, and simulations that would both review essential concepts of emergency medicine, but also introduce key differences in American health care practices and systems compared to Italy. We designed over 30 hours of content given to a multidisciplinary group of medical students, residents, and faculty members from specialties such as emergency medicine, cardiology, orthopedics, and traumatology. We presented provocative topics such as the American opioid epidemic, gun violence, and out of hospital cardiac arrest management to present new cases to medical students and residents that they may not see in Italy, while also engaging senior faculty in controversial issues of public health, policy, and community leadership.
Although a majority of the legwork of the elective was devoted to the conference halls, most of the rewards were realized outside of it. Professor Giovanni Ricevuti unexpectedly and graciously made sure that we had every opportunity to integrate into the culture and lifestyle of Pavia. We toured the University of Pavia where Nobel Prize winners Golgi, Scarpa, and Volta taught centuries ago. We traveled to Milan to take part in an international conference attempting to detect patterns of dementia by employing the resource of smart cities and phones. We broke bread and grape with medical leaders from England, Ireland, Spain, and of course Italy. Although branded as “non-academic,” it was this cumulative experience that gave us the insight into not only the cultural values of Italian and European people, but also an appreciation for how those values guide the structure and function of their healthcare system.
The last night of the elective could not have been a more proper summary of the give and take of our time with the students, residents, and faculty at the University of Pavia. Professor Giovanni Ricevuti rented out a small farmhouse in the countryside with tables 30 people long. Together we reminisced on our times together and made plans for the future. We debated the overutilization of resources for end of life care in America, and possibly the underutilization in Italy. We discussed the EKG curriculum and how it was taught in a way that really challenged clinical thinking instead of route memorization which they had been accustomed too. We of course talked about Trump. We delved into the drawbacks of government health care in Europe. And at the end of it we each learned something about each other and ourselves, and thanked each other in one of best Italian traditions of all, singing all together. We are excited about the prospect of sending residents to Pavia again in the future, and hopefully we can return the favor and accept visiting students from Pavia as well. Sharing our experiences, perspectives, strengths, and weaknesses as people and societies through these ventures is what has impacted me most as a person and will make this elective live on as one of our most rewarding memories of residency.