Friday, August 29, 2008

Auf Wiedersehen (literally) from Bern!

Unfortunately, my final day in the lab was last Friday, and I had to leave during the weekend in order to make it home to start another clinical rotation Monday morning. I was not yet ready to leave! and my colleagues threw me a small going-away party on Friday evening, complete with sparkling wine from the Valais, cheese from Gruyeres, Swiss beer, and of course, chocolate, which made it even harder to say good-bye! At least the good-byes were tempered with the knowledge that I will be visiting again relatively soon, so it wasn't permanent.

I, too, will answer the questions from Muriel's email:

· Overall impression – Did your stay meet your expectations?

My stay more than met my expectations - I was able to learn many new techniques of immunohistochemistry, immunofluorescence, western blotting, ELISA, etc. - all of which are used extensively in the US as well, but this was my first experience with medical or biological research, since all my previous experience had been in engineering. I found my lab to be very well-equipped, comparable to what I have experienced here in the US. Outside of work, I absolutely loved living in Bern. Of course, I have a unique situation in that my significant other lives and works there, so I had somewhat of a built-in social support system. Although I have lived in large cities for my entire life, I really enjoyed the size of Bern, and that everything was easily accessible by bus, bike, or on foot. And how can one not appreciate the beauty of such a picturesque city? I already miss all of the streetside and riverside cafes, and how everyone appreciates sitting outside as much as possible during the summer months, as that is virtually impossible here in hot, humid Houston. I am also fortunate in that I speak the language, and even though I had difficulty understanding the Swiss dialect, when people switched to speaking high German with me, I was easily able to communicate. I can understand, however, that the language barrier could be a bit frustrating for English-only-speakers, as there were more people than I originally expected that did not speak English.

· Three positive points?

1. Quality of work environment - as I said above, my lab was extremely well-equipped, had very knowledgeable staff, and was working on several very interesting and cutting-edge projects.

2. Accessibility of travel - the Swiss transportation system is the best that I have ever experienced. It was always amazing to me to see the trains leave on the SECOND of the minute for which they were scheduled. And with the half-fare card, it was relatively affordable to travel throughout most of Switzerland. Due to its central location, it was also easy to travel to neighboring countries.

3. Swiss culture - I loved experiencing the variety of cultures that exist within Switzerland. Before traveling to there, I never would have known the diversity that exists within such a small country, with a relatively small population. Not only do differences exist within the various language-dominant regions, but from town to town. The appreciation for quality of life, of the working to live, not living to work mentality was really a fresh outlook, especially for an American with a guilt complex for taking time off. My PIs encouraged me, almost forced me :), to take time off and enjoy life and the country while I was there. When I came in on a weekend to make up some time that I took off, they all thought I was crazy! But it is good to realize that work and a personal life can be balanced, without sacrificing success in either. This is especially true for me as a 4th year medical student, who is looking residency, with its modern slavery-like hours, in the face.

· Three negative points / challenges?

1. Money - as everyone has said before, Switzerland is a very expensive place to live, and $700 US/month (especially with current exchange rates), makes living in Switzerland almost impossible without an extra funding source. Not to mention an additional $1000 for the flight. I'll leave the funds summary for below.

2. Bureaucracy - although things seemed to go smoothly with most people, because I worked in a hospital environment, security was a little more tight and so obtaining all of the proper badges and IDs as a "guest researcher" without a visa, even with all the proper documentation from the Swiss embassy, was rather difficult. It took multiple attempts, and my PI speaking with various bureaus, to finally establish my position and that, as originally said, I did not need to register with the foreign police. For anyone going to a hospital in the future, some of this should be arranged ahead of their arrival.

3. Meetups - I agree with what Erin said in her final post, that it was wonderful to meet everyone in Bern, and I would have liked to be able to meet people more than once, to share experiences, thoughts, etc. Perhaps future groups can organize more, or also smaller ones for people located closed to one another (ie. Bern and Thun!). I have an idea about that, but I'll post separately so that it doesn't get lost in this really long post!

· How well were you coached and integrated in the research team?

I was extremely well-coached, with my PIs taking time to explain things to me, show me techniques (especially when involving microsurgery), and were always accessible for answering questions or discussing ideas. I worked very closely with one of the lab techs, who I had a wonderful time working with, and she was an invaluable resource for me, showing me where everything was located and taking time to train me on a wide range of techniques. Our lab group also always ate lunch together and took a post-lunch coffee break, so I got to know everyone very well, in a more personal as well as professional role.

· Comparison (advantages and disadvantages) between your Swiss and your U.S. research lab, research mentality and team.

· Do you consider going back to Switzerland for studying, a Ph. D. program, work or on vacation?

I already have a trip planned back to Switzerland! Again, I have different circumstances than most, but I am happy to have the opportunity to return to Bern at least 2-3 more times during this school year. Although 2 of those times (over the Christmas break, and likely again in Spring) will be for vacation, I hope to return to Inselspital for a month in February to do a clinical rotation. I would love the opportunity to do some of my post-graduate medical training in Switzerland; however, in order to practice medicine in the US, I must complete my entire residency here. So after this year, I will likely have to say good-bye to Switzerland for a few years while I complete my residency, but I hope to return after that and visit some of the good friends I've made during my time spent in Bern!

Part 2:

· Visa: Did you or your institution apply for a visa for you? If yes, what kind of visa and was it difficult to obtain?

As I was staying for just less than 3 months, I did not require a visa.

· Accommodation: Was it difficult to find a place to live? And did you get support by your Swiss institution?

Again, I have slightly different circumstances in that I lived with my significant other, who has his own apartment, during my stay, so I was lucky not to have to pay for housing. However, I know that Inselspital has dormitory-style accomodations for visiting students and residents, which are located directly next to the hospital, so I would have been able to stay there had I not already had another housing option.

· Budget: How much money did you spend monthly on average during your research stay? Did you get extra support from your Swiss or U.S. institution? Or did you have to come up for the part exceeding the ThinkSwiss Research Scholarship yourself?

As I stated earlier, Switzerland is a very expensive country to live in, especially given the dollar to frank exchange throughout the summer. The dollar has devalued about 20-25% throughout the past year, because when I was in Bern last September, it was about 1.25 Franks per dollar, which meant our money went a lot further previously. Although you could theoretically live on $700/month, it would be very, very difficult and even start to interfere with social interaction. For the dorm-type room I talked about above, it costs about 500 CHF/month, which I think is pretty standard for most cheap housing, even if you also find a room in a shared apartment. For me, lunch at the hospital cafeteria was part of the daily routine of the lab, and I spent about 50 CHF/week just for lunch. Groceries are priced somewhere in between a regular grocery store (ie. Kroger or Safeway) and Whole Foods, so for breakfast and dinner, which I almost exclusively ate at home, probably cost another 50 CHF/week. And although the HalfFare card made traveling through Switzerland much more affordable, it cost 150 CHF for a year, and then you have to pay for the train ticket on top of that. Public transportation within Bern was also relatively expensive, with a 1-way bus ticket (with the HalfFare) to the hospital being almost 3 CHF. Luckily, I was loaned an extra bike by an ENT attending, so I rode to work most days, but even if I bought a month bus pass, it would have cost about 70 CHF/month.

So, for just the extreme basics of living (without budgeting for social coffees, beers, travel, extraneous expenses), it would have cost me about 1000 CHF/month if I hadn't had the extraordinarily lucky situation of free housing and a free bike loan. Thankfully I had the situation I did, or I would have had to supplement my stipend from ThinkSwiss with loan money, as I received no financial support from my university or from Inselspital. As it was, the $700/month was just enough to provide food (400 CHF/month), transportation costs (150 CHF HalfFare + bus when raining), and a small budget for day-trips outside of Bern and a few social outings with colleagues. I also had to pay the $1100 for my plane ticket on my own. Again, I think the exchange rate really hurt people taking part in the ThinkSwiss program this summer, as 1000 CHF was about equal to $1000, whereas last year, 1000 CHF = approximately $800, which is closer to the stipend provided by the Swiss embassy. Perhaps that can be taken into consideration for future participants.

In summary, I had an absolutely wonderful summer: I learned a lot, I saw a lot, and I experienced a lot. I would definitely do this program again, and I would recommend it to anyone interested in seeing how research is conducted in another country. It is an extraordinary opportunity to further your own research experience, as well as get to know a new culture and travel through a very beautiful, very culturally-rich country.

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