My elective as a medical student in South Africa

I’m done. Final year is over. Twelve weeks at Bara — over.

Where do I even start? It’s been one and a half weeks since I got back home, and everything feels a bit numb. Life was so intense, so stimulating, that it almost feels strange to just… exist in normal surroundings again. I don’t really understand certain everyday problems anymore — I guess that’s what happens when you’ve spent months staring at the darker side of humanity.

Before I came to South Africa, I was terrified of so many things. I reread my very first blog entry today, and it feels surreal — because every single thing I was explicitly worried about turned out so much better than expected.

I mastered ICDs to a level I could never have imagined (of course, there’s always room to improve). But if I ever find myself in a situation where my patient needs one — I’ll do it, without hesitation. In total, I did 14 ICDs, and honestly, it could have been a lot more. Towards the end, I started sharing or supervising the procedure, because it’s really not that difficult once you understand it. After the first few, it becomes almost “simple” — in fact, I think IVs are harder to master.

Speaking of IVs — I did well over 300, probably close to 400–500, mostly large bores (grey and orange). I was told multiple times that I’m the best IV taker in the ER, including among the doctors — and I think that’s a massive personal win.

I also did over 100 sutures — starting with small scalp lacerations, and slowly building confidence. By the end, I was suturing ears, lips, facial wounds, layered closures of chest injuries, and much more. I came to Joburg as a total beginner and somehow left with a solid skill set. Another huge win.

But the most important skills weren’t the technical ones. I learned to assess critical patients on my own, to speak up loudly when I was worried, and to insist on supervision when I needed it. Sometimes I got tricked by patients — but more often, my assessments were right. I learned to trust my gut.

I gained confidence in high-stress situations, pushed my limits, and — when necessary — asked for help. I took around 15 ventilated patients to CT, about half of them unstable, some with ventilator issues that forced me to make immediate decisions. And somehow, it worked. I’m a bit afraid that my confidence might now be too strong for someone who isn’t officially a doctor yet — but I don’t feel like I ever crossed a line. Everything I did was within my skill set and training.

Safety was another big concern before coming. In the end, I had maybe one or two sketchy moments in twelve weeks. Other than that, I felt safe — though I was constantly on high alert. It feels oddly unfamiliar now to walk through a city without checking who’s behind me every few minutes.

And yes, there was potentially traumatic stuff — probably daily. But I don’t struggle with flashbacks or nightmares. When I think back, I only feel joy and gratitude. I was way outside my comfort zone, but I knew what I was getting into and was prepared for most of it. The only things that truly stuck with me are the burn patients — especially those with >50% body surface burns, or the ones doused in petrol and set on fire. Those memories will never fade. It’s controllable — but unforgettable.

All in all I think I have seen about 250 Gunshots, way more stabbings, amounts of MVAs and PVAs that are just mind-blowing, many burn patients – including kids :(. Many many dead and dying patients. Procedure wise I saw 7 sternotomies or thoracotomies, 2 lateral canthotomies. The ONLY two procedures I “hoped” to see which I didn’t see were surgical airways and clamshell thoracotomies. Other than those two, I have seen basically everything that emergency medicine has to offer.

HIV was another big worry. And yes, I’m still on PEP. I had two real and one minor needle stick injury. I’m very sure I didn’t contract HIV, but I’ll get tested again soon. I never missed a single dose — and adherence is everything with PEP. I’d estimate that 30–50% of my patients were HIV positive, based on how often I heard, “Yes, I’m on ARVs.”

Language turned out to be the least of my worries. My English improved more than I ever expected — not just medical English, but through endless deep talks with people from all over the world. That’s another unexpected win.

Before leaving for Joburg, I was terrified. My mum told me the night before that she’d never seen me that nervous — not even before major exams — and she was right. But somehow, everything I learned and experienced before came together.

Yes, there were days I hated everything — when I was exhausted, frustrated, and sick of being “just” a student. But overall, these twelve weeks were the best time of my life. I grew into my role, I found friends I never expected to find, and I discovered what kind of doctor I want to become.

I think I can confidently say: I won.

What’s next for me?

I’ll probably start in Internal Medicine, ideally moving towards Emergency and Intensive Care later.
And in ten years? Maybe Doctors Without Borders or a similar organization. Doing what I always wanted to do: being the best doctor I can be, never stop learning, and truly listening to my patients.

Working at Bara prepared me for a lot — hopefully also for my first months as a doctor in Germany. Let’s see how that goes.

Thank you all for following my journey through these weeks — this is my final post on this blog.
And in 30 years, I want to come back, reread this, and show it to my kids. ❤️