Exchange Semester in Georgia, Transcaucasia/Eurasia

1. August 2019 at 09:47

by Lisa-Maria Weissenbacher.

© Lisa Weissenbacher, Medical University of Vienna, Austria

During my 5th year of med school, I seized the chance to expand my horizon and risked a breakout into the wide world by doing a medical exchange semester. In the last third of studies (5th and 6th year), the Medical University of Vienna (MUW) offers specific programs to perform electives abroad either via Erasmus Plus within Europe (including grants), Free Mover for self-organized and financially non-supported internships all around the world or by getting selected for a so called “Cooperation Program” with international partner universities outside Europe.

As I haven’t done any medical training abroad before, I was looking for an organized option with already consisting connections to the foreign medical facility, and at best, supported by grants. I also didn’t want to have any problems with the accreditation of my electives subsequently to my study period abroad. In addition, I felt that I had to take the chance to go far away for my exchange. I was sure that I’d never have the opportunity again to get to know another country plus another health system in such an easy manner in terms of time and administration as during my studies. Therefore, the “Cooperation program” offer of extra-European medical electives with a prearranged structure and supported by MUW grants was perfect for me.

My whole journey started at the beginning of my 4th year of studies. Back then, I attended a very informative evening lesson organized by the MUW International Office explaining all the opportunities for med students to go abroad and experience medical teaching, culture and life in other countries. It was there, where I first heard about this strange country called Georgia surrounded by the Caucasian mountains as a part of Eurasia. I was very curious as I knew so little about this forgotten state of the former Soviet Union. Embarrassingly, I also have to admit that I had a completely wrong picture of this beautiful country and its profound medical system. In addition, I was told nightmares about crimes, corruption and discrimination against women. Beforehand, I want to emphasize that Georgia has proven the complete opposite to those stupid prejudices. However, I even got more curious about this jewel below Russia and encouraged to make my own impressions. But to be honest, my expectations were simple.

Application Process and Administrative Preparations – Easy Cheesy

The application process for my exchange semester during spring and summer 2017 started in November 2015 at the beginning of my 4th year of studies. Briefly after the MUW information evening, I had to decide and apply for my preferred destination. The selection process for grant-supported programs, meaning Erasmus Plus and Cooperation, takes place in some sections and by ranking favorite destinations by personal preference. Applicants are ranked by their average grade of passed exams and the overall period of completed medical clerkships. There is also the possibility to apply for Erasmus Plus as well as the Cooperation program. Therefore, you can improve your chances to get picked for one of your listed preferences. The only catch is that once you get assigned a seat in the Erasmus program, you won’t be nominated for the Cooperation program anymore. So, you have to choose wisely. For my part, I was completely convinced that I wanted to go to Tbilisi. That was why I only applied for the Cooperation program with Georgia as my top priority out of three indicated universities in ranking. During this first section, the application takes place online via the MUW student access homepage in the International Relations paragraph. Therefore, you have to be a properly enrolled student of the Medcial University of Vienna. Usually, you are notified about a successful match in the particular program at the end of December. If you are lucky, you get picked for one of your preferences during the first period of application. Then, you have to confirm your seat at the MUW International Office. If you are not nominated, you get another chance during the second period in February to reapply for the remaining seats. The whole possible application period terminates at the end of June when the third round of reapplication expires.

I was a very lucky girl and received a positive notification for Tbilisi at the beginning of 2016. When confirming, I had to finalize the period of my stay as well as the number of clinical rotations I wanted to do abroad. I scheduled the summer semester of 2017 and decided to complete five out of seven clinical clerkships in Tbilisi. As a medical student in Vienna, you have to be careful regarding your future plans as you cannot spend your whole last two years of studies abroad but only ¾ of it. Through the set structure of the Cooperation program, I was referred to the Georgian contact person, an adorable woman with perfect German knowledge who was incredibly helpful with everything. She first got in touch with me in May 2016. After that, I was able to sort out all remaining issues with her, which was a real lucky strike regarding all the administrative matters. She even helped me and my close fellow student, who got selected for the second out of two seats for the exchange in Tbilisi, to find an apartment. During preparations, I had to write a letter of application to the Georgian rector of the medical university – just for formal purpose. As Georgia has its own language and scripture called ქართული (spoken Kartuli) and learning it is a lifetime project, the required language for the exchange in the hospitals is English. Therefore, I had to prove a B2 proficiency in English which was kind of cumbersome as transcribing my graduation certificate from school was impossible. So, I had to surrender and took an English preparation class at the Language Center of the University of Vienna during the winter semester of 2016/2017. I graduated with a competency evaluation certificate for English level C1 at the beginning of 2017. Looking back, I highly recommend doing a beginners’ course in Georgian or at least in Russian for basic communication in daily life as well.

Journey and Accommodation – Don’t Forget

Regarding my clinical rotations in hospital, I started early with updating my vaccination status. I additionally obtained information about the required vaccines for the Transcaucasian region and the visa for Georgia from the website of the Austrian State Department for Foreign Affairs. To sum up, you do not need a visa for a maximum stay of 12 months.

In addition to the medically required immunization, I got vaccinated against rabies which, was really expensive, and to be honest, I’ve never been in a really dangerous situation with animals. I did not have to pay any fees or taxes neither for university purpose nor for my 5-month stay in Georgia. I booked my flight to Tbilisi 3 months before my departure, which was at the end of February 2017, after having compared and tracked the best offers for about 2 months. At the same time, I started looking for an accommodation in Tbilisi together with my fellow student. As I already mentioned, we were very lucky that the Georgian coordinator helped us with our search. We first tried to find a student dormitory, but figured out quickly that Tbilisi only provides flats to share.

Regarding the big language barrier and the “southern mentality” of Georgians, it was really hard to find an apartment on our own by operating from far away. Therefore, we went with the overpriced but most convenient option which was the coordinator’s offer including a full organization and mediation of contract and payment. After we consulted about the last important topic – health insurance abroad (I decided against an extra travel insurance in addition to my Austrian one and my credit card coverage) – we were ready to take off.

Hello Georgia! გამარჯობა საქართველო! (Gamarjoba Sakartvelo!)

Old Town of Tbilisi © Lisa Weissenbacher

The first days on Georgian ground, I had to struggle my way through this foreign city without speaking one single word of ქართული (Kartuli). Some weeks later during my stay, I took some Georgian lessons to at least be able to decipher the Georgian alphabet and express some basic requests. It also turned out that it was a clever idea to take some Euros with me. The usual way to get cash in Georgia is by exchanging Euros or Dollars to GEL (Georgian Lari) from the ATM at one of the many exchange offices.

The public transportation system in Tbilisi is really cheap but a disaster for strangers. The bus stops have no names. The destinations on the displays are written in Georgian. And to go by taxi always included a senseless debate with the cab driver about the price leading nowhere without – again – at least ცოტა (tsota = a little) Georgian. I survived the first month by tracking myself with Google Maps and by downloading a taxi app (called Yandex, Georgian Uber) until my orientation skills and skills in Georgian  improved. After the first month, I was even brave enough to go by mashrutka (“minibus” in Russian), where I had to wave my hand to jump in and yell “Gatsheret” to get out again.

Medical Science Post-Soviet Style

On the first official day of my stay, I had to visit the dean of the Tbilisi State Medical University (TSMU) to introduce myself. I was welcomed warmly by the whole team. The structure of TSMU is very similar to the Viennese system. Students complete their six years of medical studies with clinical electives during their final two years. I planned to do five clerkships in three months which was not an easy effort. In advance, I had already discussed my schedule with the dean’s office via e-mail. We agreed on a certain timetable. Upon my arrival, of course, I received a completely different schedule. At least, I managed to do all five electives in the intended time, so I did not care about the sequence. I was assigned to a different hospital for each one of my clerkships. Therefore, I moved around Tbilisi a lot and got to know the city and its various public and private medical institutions pretty well. Given the monthly clerkship rotation, I joined another group of 10-15 foreign students every 4 weeks. Most of the international students at TSMU come from Nigeria, India and Sri Lanka, some from Turkey or Syria. So, I came in touch with a lot of completely different people and cultures which highly contributed to my personal progress. Conversely, my Austrian fellow student and I sometimes felt like popstars regarding the load of attention we obtained as the only visiting students from Central Europe.

My attendance times and tasks during electives varied widely. But I quickly recognized one common factor that turned out to be one of the most important unspoken rules in Georgia: Appointments are a rough guide – nothing else. Finally, a country where being a little unpunctual is no crime. We usually started around 10 a.m. The persistent major problem during all my rotations was communication. Only a few doctors were able to speak a few scraps of English. I was lucky that the other fellow student from Austria had the same schedule, so we struggled our way through the language issue together. Despite the language barrier, the doctors and the nursing staff were overwhelmingly caring. I started my rotations at a private clinic in Gynecology and Obstetrics. As one of my favorite subjects, I was very curious about their standards and methods. There, I was invited to join all the surgical interventions like cesarean sections and laparoscopic procedures which they recently started establishing more and more. Furthermore, I was allowed to participate in many deliveries by supporting the moms in labor. In the afternoon, I was offered to additionally attend a supplementary GYN lecture in English if I needed a refreshment of the topic of the day.

Then, I continued with Emergency and Intensive Care which was more like acute visceral surgery. This elective was way too crowded and not entirely the right subject. Sometimes there were about 20 people in one OR. As I had concurrent electives in Ophthalmology and Otorhinolaryngology every second morning in alternating manner to Emergency Care, I focused on those. In Ophthalmology I was very lucky as I was taught in a very modern private clinic and my attending even spoke proper German. After that, I concluded my clerkships with Pediatrics where I rotated through all the subspecialties and was able to catch a great overview of the wide pediatric field. Apart from a few lucky chances to scrub in for second surgical assistance, I was not allowed to perform invasive tasks. My duty as a visiting student was more the observe-listen-and-ask-part. This fulfilled my expectations as I knew that the language barrier would be a big issue.

To sum up, I was positively surprised by the medical standards in Georgia. Although the doctors partly have to get along with simple equipment and little means, they practice really good medicine. In addition, you have to consider the country’s history only two decades ago. Therefore, their rapid technological rise was very impressive to me.

Accreditation – Easy Cheesy again

After I successfully completed my clinical clerkship, I went to the dean’s office again to express my gratitude and to get a signed confirmation of my time as a visiting student at TSMU. My time at Tbilisi State Medical University ended with a little surprise, as it was not enough to just speak out my thankfulness but to “be invited” to write a whole letter of gratitude which covered the first page of the TSMU website one week later (“yei”). Now the letter is still available in the archive of the website.

Back at home, I had to hand in my logbook and the signed confirmation of studying time abroad for the accreditation and grant of my exchange as well as the bill and certificate of my English class to get the refund. That was when my exciting journey came to an end.

Costs for 5 months of exchange and travel

Flights  280€ x 2 (1x transition) Most flights are via Ukraine (UIA), Poland (LOT) or Turkey (Turkish Airways); I booked 3 months prior to my departure

Direct flights Vienna – Tbilisi (~350€)Cheapest option: Wizzair Vienna Kutaisi (~80€) + bus to Tbilisi

Vaccination 300€ Rabies and typhoid fever, refreshment of FSME
Language class 270 € Language Center (University of Vienna) – 25% off for students

Refund by MUW International Office (for costs up to 400€)

Accommodation 350€ per month Big shared flat (total 700€/month), expensive for Georgian rates

Regular rates for flats (with ~70 m2) 400-500 €

No student dormitories (at least as far as I know)

Public Transport Max. 50€ per month Incl. bus (50 Tetri), mashrutka (1 GEL) and taxi (5-10 GEL)
Fees and Taxes None Also: no visa needed for a max stay of 12 months
Food and Drinks Max. 50€/month for groceries + ~ 100€/ for eating out Almost didn’t cook at home because the traditional food in restaurants was so delicious and super cheap

A lot of supermarkets are open 24/7, many restaurants are also open until late at night.

Activities 100€ per month Activities (hot baths, going out) and trips in and around Tbilisi

Skiing and hiking in the Caucasus

Journey to the Black Sea

Traveling 1000€ in 1.5 months Trips around Georgia and Armenia

Including food, activities, rental cars, fuel

Grants – 250€/m I got support for a 3-month period of electives. I tried to apply for additional grants but was not successful.
Total 4500 € in 5 months for living and traveling Costs for living are cheap and without the extensive travelling you could easily survive with less expenses.

 

Georgia – Melting point of Europe and Asia

To conclude this report, I want to give some fun facts and secret tips about this unique country I totally fell in love with.

Georgia is a manifold country and its capital Tbilisi perfectly represents this diversity. “Tbi-lisi” means “warm-water”, therefore the sulfur baths are one figurehead you definitely have to enjoy on a rainy evening. Tbilisi’s architecture leads you through almost 1000 years of life in an incomparable manner. You find decrepit Soviet residential areas next to ancient orthodox churches and former royal property as well as modern buildings from the last decade.

Ushguli (2500m) and Mt. Schchara (4350m) in the Greater Caucasus © Lisa Weissenbacher

Georgia is the country of change. After the Russian occupancy, Georgia struggled with corruption and low economic standards. It was president Micheil Saakashvili who revolutionized the whole system and led to Georgia’s economical rise again. Today, Georgia is a really safe country.

Georgia is the country of churches. The country’s namesake and supreme saint is Saint Georg. Almost 85% of Georgians are orthodox Christians. Despite the political open-mindedness, religion still is a very conservative topic with a great importance in Georgian life. But contrary to the prejudices, Georgians honor women a lot. Mother’s Day is a real holiday in Georgia and the protector of Tbilisi is a huge metal statue of an armed woman called “Mother of Georgia”.

Georgia is the country of Khinkhali. I still miss the taste of those delicious traditional dough balls filled with meat or potatoes. The Georgian cuisine offers a great assortment of traditional dishes containing meat, vegetables and white bread with a flood of spices and herbs.

Georgia is the country of wine and honey. Georgia’s nature bears more than 300 types of grapes. Its wine region is called Kakheti. You need to get used to the sweet and bitter wine but after some time it tastes totally delicious. I was told that the oldest preserved honey on earth was found in caves in Georgia.

Georgia is the country of water. Similar to Austria, Georgians are very proud of their water. They have many fresh springs of mineral water like in Borjomi where the water tastes like the inside of a mountain. You have to try it to know what I mean.

Georgia is the country of glaciers. Surrounded by the Great and Southern Caucasus, Georgia offers incredibly beautiful areas to hike (like in Kazbegi, Ushguli, Tusheti) and ski (like in Bakuriani, Gudauri). Besides the impressive glaciers, Georgia also offers a desert area with canyons, access to the Black Sea and deep woodlands. I truly admired the pristine nature.

And last but not least – Georgia is the country of hospitality. Although the Georgian people seem very serious at first sight, they are incomparably hospitable and sociable. Wherever you go, whatever you need, they will help you even though you cannot speak one single word of their language.

მშვიდობით და ნახეთ მალე, საქართველო! (Mshvidobit da nakhet male, Sakartvelo! = Goodbye and see you soon, Georgia!)

Ureki Beach at the Black Sea © Lisa Weissenbacher

Interesting Websites

 

Old Town of Tbilisi © Lisa Weissenbacher

 

 

 

 

 

 

 

 

 

 

 


Here you can download the experience report as PDF file.

If you are interested in working abroad as a medical student or doctor, click here for more information.


Published in GI-Mail  08/2019 (German & English edition). Sign up for GI-Mail here.  

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