Last October I worked at the psychiatry clinic of Hospital Sao Joao, in Porto. What I applied for and was accepted to was an eating disorders programme, which is one of the subspecialties in psychiatry that in my country very few number of clinics follow patients or provide educational opportunities.
Hospital Sao Joao is one of the two university hospitals in Porto and has a fairly big campus. I caught a glimpse of how med-school life looks like there, including the extraordinary initiation rituals of freshmen students, the “Praxe”. Actually it was my first day at the clinic when I came across their parades, with students under their black cloaks.
So, on a rainy Monday, very typical for Porto, I was welcomed by two psychiatry residents, who took me to the three-floor building of the psychiatry clinic. Marco and Mariana gave a clear explanation of how things work at the clinic. Then I found out that we were going to work with Mariana for the next ten days which turned out to be life-saving, as she helped me getting used to their system, understanding the interviews thoroughly – she even did translations for me writing on her notebook when I couldn’t catch a phrase. Working with her is very inspiring and enjoyable at the same time. I’m glad that we had many long talks about life, psychiatry, future, politics, eveything throughout that month.
They introduced me to Dr. Isabel Brandao, whom I now admire both as a psychiatrist and a human. I learned a lot from her, not only eating disorders and their treatment, but also many other skills on how to approach people, to express your empathy, to lead a group of psychotherapists in a peaceful manner. I am really inspired by her elegant and encouraging behaviours. Also, I am indepted to the two other speacialists Dr. Patricia and Dr. Sertorio, who precisely handled the workload of the programme.
The eating disorders programme runs under the adoloscent and young adult unit which is one of the five units of Sao Joao Psychiatry Clinic. Patients are followed with a variety of therapeutic options, individual psychotherapy, family therapy, group therapy and psychodrama. In addition there is a day hospital where patients with a chronic or treatment-resistant condition can attend to occupational therapy sessions. Inpatient treatment options are available for eating disorders patients where the team works with an experienced staff including psychologists, psychiatry nurses and dietitians. They have an authentic approach to eating disorders focusing on the autonomy of the individual. I believe it has some roots in Portuguese society and way of living. The approach appears to be successful with a relatively higher rate of remission, however their data is not very well published. I’m sure the next generation psychiatrists will complete the task.
The organizing team did an absolutely great job, from day one to the farewell. I received a mail on the day I arrived about what to do/where to see in Porto – very exclusive recommendations. I had a weekly working plan, enjoyed a warm welcoming dinner, was invited to psychiatry meetings and visited other psychiatry hospitals.
I had many observations from how abstracts are prepared for submission to the Portuguese National Psychiatry Congress to how medical students organize their annual meeting and discuss their careers, the future of medicine in Portugal and Europe. What’s more, Mariana arranged a meeting and I found the chance to speak to other psychiatry residents on a weekend trip to Lisbon. I even joined a pharma-meeting and dinner. So, the life of a psychiatry resident, all included.
Language was not a big obstacle, I had some knowledge of Spanish and basic Portuguese. But more importantly, everybody at Sao Joao were speaking English fluently, and tried their best to translate the daily language of patients with different accents any time I asked. There, I discovered the significance of non-verbal language and facial expressions for a robust psychiatric interview.
Last, but not the least, I feel very lucky to have discovered at least some parts of the beautiful city of Porto. I celebrated my 26th birthday drinking Port wine with my lovely Portuguese friends.
Everything went perfectly smooth during the exchange. Many thanks to all my colleagues in Porto who did their best for me to get the most out of this exchange. Thank you Mariana, Catia, Marco and others. I am also thankful for the EFPT Exchange Working Group for this remarkable experience.
To end with, there is a unique Portuguese word for longing for something or someone beloved which has been lost: Saudades…
Marmara University School of Medicine, İstanbul, Turkey
Acknowledgements: I would like to thank to Dr António Roma Torres, Dr Isabel Brandão, Dr Patrícia Nunes, Dr Sertório Timóteo and all the staff of the Psychiatry Department of Hospital São João for their hospitality and support.