Mark Wilson gives handy hints on organising an elective in the Caribbean

An elective in the Caribbean will, not surprisingly, raise suspicions of a plan for a big holiday. A fascinating variety of medicine can, however, be found even within one island: because of its wide variation in wealth for example, Jamaica has both excellent private and severely underfunded public health care. Outside hospital work there is plenty to do on all the islands--diving, sailing, eating, drinking, dancing.

The Caribbean as a whole has a subtropical climate with very mild winters. It's hottest between June and September (30°C), but this is also when rainfall tends to peak.

This article will go through the islands from north to south, so look at the map.

The University of the West Indies, Faculty of Medical Sciences, The Registry, Kingston, Jamaica, WI (Tel: +1 876 927 1297, Fax: +1 876 927 2556) has affiliated hospitals on Antigua, Dominica, St Vincent, St Lucia, Grenada, Martinique, Jamaica, Guadeloupe, St Joseph, St Martin, and Barbados. You can apply for an elective by writing directly to the hospitals.

Island hopping - a map of the Caribbean

Bahamas

The Bahamas are a group of over 700 islands, although only 30 are inhabited. The main government hospitals are in Nassau and Freeport.

The Princess Margaret Hospital, Nassau--This 484 bed hospital has accident and emergency, medical, surgical, maternity, paediatrics, intensive care, eye, and chest medicine specialties (stay at Sunshine Guesthouse as no accommodation is provided).

Sandilands Rehabilitation Centre, Nassau--This is a 477 bed geriatric and psychiatric hospital. It also has a drug and alcohol abuse centre.

Rand Memorial Hospital, Freeport, Grand Bahama--This is a government owned 92 bed hospital providing medical care broadly similar to that of the Princess Margaret.

Cuba

This is the Caribbean's largest island and it is also the only communist one. Although sanctions imposed by the United States are still making life tough, it has not stopped the Cubans from developing a world class healthcare system.

The Medical School in Havana is called the Instituto Superior de Ciencias Médicas de la Habana, Calle 146 y Avenida 31, Playa, La Habana. (There are 12 other medical schools; check out the website at www.medicstravel.com for more details.)

One of the main hospitals is the Hospital Nacional Ameijeiras, Havana.

The Cayman Islands

These three islands are 280 km north west of Jamaica. Tourism and offshore banking are their major sources of incomes. The main 120 bed hospital is on Grand Cayman: George Town Hospital, PO Box 915, Grand Cayman, Cayman Islands (Tel: +1 345 949 8600, Fax: +1 345 945 1754).

Jamaica

The University of the West Indies and its associated teaching hospital, the University Hospital West Indies, sit on adjacent sites on the outskirts of Kingston, the capital. With two murders per day, Kingston understandably has a reputation for violence. The university area, however, is relatively safe, especially in daylight hours. The university address is given above.

The University Hospital of the West Indies, Mona, St Andrew, Kingston 7, Jamaica, is a busy 400 bed hospital with most specialties. There is also a Medical Research Council (MRC) sickle cell laboratory on campus.

Jamaica has several other hospitals, but for psychiatry the Bellevue Hospital, Kingston, provides care in very difficult circumstances. It is a state funded hospital in deepest downtown, with 23 wards containing 1500 patients. Think very seriously before going here--especially if you are white.

Bird's eye view of the islands

Haiti

The Medical School is École de Médecine et de Pharmacie, Université d'État d'Haiti, Rue Oswald Durand 89, Port-au-Prince Haiti (Tel: + 509 220 488, Fax: + 509 573 974).

Dominican Republic

There are several medical schools, but the only one that takes foreign students is Universidad Iberoamericana (UNIBE), Escuela de Medicina, Avenida Francia 129, APDO 22 233, Santo Domingo (Tel: + 1 809 689 4111, Fax: + 1 809 686 5533).

St Kitts

The JNF Hospital, St Kitts, is a small friendly hospital that sees its fair share of tuberculosis, HIV, diabetes, and hypertension.

Antigua

Holberton Hospital, PO Box 2797, St Johns, Antigua, (Fax: +1 283 462 6073). This 60 bed hospital is located in St John's, the capital.

NB: Write to the hospital administrator months before you intend to go, preferably by fax.

Dominica

Princess Margaret Hospital, Roseau, Commonwealth of Dominica--This is the main hospital for the island with 800 beds. The staff comprises those trained at the University of the West Indies and some Voluntary Services Overseas workers.

Martinique

Service de Médecine Interne (4B), Chu de Fort-de-France, 97 261 Fort-de-France, Martinique--This is a pretty large hospital with accident and emergency and helicopter service. Most specialties are catered for.

St Lucia

St Jude Hospital, Vieux Fort, St Lucia--This is a charity hospital run by the Sisters of Mercy and staffed almost exclusively by volunteers. It's busy, and students get heavily involved.

The Pitons - dormant volcanic peaks on St Lucia and also the name of the local beer.

St Vincent

Kingstown General Hospital, Kingstown, St Vincent. This 210 bed hospital serves St Vincent and the Grenadines with accident and emergency; medical; surgical; paediatrics; obstetrics and gynaecology; eyes; ear, nose, and throat; and radiology specialties. Many American students attend this hospital.

Barbados

Queen Elizabeth Hospital, Bridgetown, Barbados, (Tel: + 1 246 429 5112, Fax: + 1 246 429 6738) This is the main hospital for the island, just 10 minutes, walk from the centre of Bridgetown. It has a well organised elective system (US$50 admin fee, then another US$150 on arrival) in medicine; surgery; orthopaedics; ophthalmology; accident and emergency; pathology; radiology; ear, nose, and throat; paediatrics; psychiatry; community health; and anaesthetics. Write very early.

Grenada

Grenada has an offshore American preclinical medical school. The main hospital is Grenada General Hospital, St George's, Grenada. This is a friendly medium sized hospital overlooking the harbour. It's very popular with Australian students.

Trinidad and Tobago

Right at the bottom of the chain of islands that make up the Caribbean is Trinidad and Tobago just 60 km off the coast of Venezuela.

Both islands have several hospitals, but the main, government funded one on Trinidad is Port of Spain General Hospital, Charlotte Street, Port of Spain, Trinidad (Tel: +1 809 623 2951). This is a 900 bed busy hospital, and electives here have been highly recommended.

The main hospital on Tobago is Tobago Regional Hospital, Fort Street, Scarborough, Tobago (Tel: +1 868 639 2551). This is a much smaller hospital with 30 beds, but most specialties are catered for.

So the Caribbean has plenty to offer, but write early if you are planning your elective on one of the islands. Hospitals can be slow to reply, and electives here are becoming increasingly popular.