As Khoo Teck Puat Hospital's (KTPH) Learning Oriented Teaching in Transdisciplinary Education (LOTTE) programme enters its fourth year, it continues to offer valuable experiences and memories for Year 4 students from the NUS Yong Loo Lin School of Medicine. Thanks to the collaborative efforts of dedicated mentors and partners, eight students thus far have had the opportunity to engage in learning journeys that enriched their understanding across various subspecialties.
Previously in 2023, LOTTE sent two students to the Faculty of Medicine of Siriraj Hospital in Bangkok, Thailand. In 2024, LOTTE is delighted to announce a new partnership with the University of Nottingham and Royal Derby Hospital (RDH), providing two students with the opportunity to immerse themselves in transdisciplinary breast cancer services in both Singapore and the UK. Authors of this article (Raphael and Jasmine) were fortunate to be the selected students visiting the UK.
Local exposure and learning
We commenced our LOTTE journey in Singapore at KTPH, where our mentor Adj Asst Prof Clement Chia and his team helped us to familiarise ourselves with the local approach to breast cancer treatment. Our activities spanned from shadowing local radiographers during screenings to assisting breast surgeons in the OT. In addition to clinical and surgical rotations with the team, a series of tutorials was meticulously organised for us. These tutorials covered a wide array of topics facilitated by dedicated tutors, providing us with a valuable opportunity to delve into subspecialties not typically covered in traditional clinical placements. These subjects included plastic and reconstructive aesthetic surgery, palliative care, radiology and oncology. Moreover, the curriculum incorporated teachings of core topics such as colorectal surgery, hepatobiliary surgery and emergency medicine, ensuring we received comprehensive teachings essential for our future endeavours in the medical field.
Learning from overseas experts
After spending two weeks at KTPH, we boarded a flight and departed for the UK. The journey was filled with excitement and anticipation, with a hint of anxiety. However, upon our arrival, we were greeted by the refreshing weather and stunning views of London, before travelling to Derby. The warm and welcoming British culture reassured us and helped us acclimate to the unfamiliar surroundings, gradually easing our initial apprehensions.
On our first day at RDH, we were welcomed by Prof Kwok-Leung Cheung who quickly introduced us to the hospital's Breast Unit. Prof Cheung thoughtfully planned for us to join his team in their schedule. The Breast Unit at RDH is renowned for managing a diverse range of conditions, including breast masses and lymphomas involving swollen lymph nodes in or near the breast.
While participating in clinics and observing surgeries, we noticed that the Breast Unit at RDH served a significantly larger patient population compared to what we saw in Singapore. The UK's substantial population size meant that patients of varying ages and conditions sought treatment at RDH. One notable experience we had was encountering a case of male breast cancer. Intrigued, we asked the patient many questions and were pleasantly surprised when he even took time after the clinic to share details about his condition. Despite learning about his diagnosis, his optimism was striking. He was very open about his experiences and shared thoughts regarding his cancer journey with us. His openness reflected the cultural differences between the UK and Singapore. We were heartened to witness the remarkable level of trust and comfort patients in the UK have with their healthcare providers and medical students.
During our time in the OT, we observed the latest technologies and techniques used at RDH. Notably, we learned about the Pintuition® system, which utilises magnets to pinpoint margins for wide local excision of the breast. Additionally, the surgeons at RDH demonstrated exceptional expertise in oncoplastics, frequently performing oncoplastic procedures, reconstructing the breast in various ways. We were pleased to have the opportunity to gain more insight into the field of oncoplastics during our time there.
Peer learning
Within the LOTTE elective, there is a distinctive feature of peer teaching. Students assigned to each subspecialty are given the responsibility of preparing a presentation on an intriguing case. This enables us to share and learn from distinctive cases from various subspecialties with our peers. As part of the Breast Cancer Service, we opted to present the previously mentioned case of male breast cancer. This provided us with an opportunity to further elaborate on our experience overseas and to learn from our peers at KTPH within the LOTTE programme.
Not "all work and no play"
Before our arrival at RDH, we seized the chance to explore London, eager to immerse ourselves in the local culture. Our ventures led us to Camden Market and Borough Market. The diverse array of food offerings, distinct from the Asian cuisine we were accustomed to, left us thoroughly impressed. Additionally, we could not resist visiting London's iconic landmarks, including Big Ben, Tower Bridge and the London Eye, which left us in awe.
Beyond our clinical duties in Derby, we embarked on a bus ride to the Peak District to witness its stunning scenery. Exploring quaint towns like Buxton and Bakewell, renowned for their local specialties such as the Bakewell tart, added a delightful culinary dimension to our experience. During weekends, we ventured to Nottingham, the birthplace of Robin Hood. Taking advantage of the spring bank holiday, we also made a day trip to Leicester which offered a vibrant atmosphere with its abundance of cafes and art museums. Needless to say, these experiences have left us with cherished memories that will last a lifetime!
Acknowledgements
We express our gratitude to Adj Asst Prof Clement Chia and Prof Kwok-Leung Cheung for facilitating this international collaboration and for supporting us as the pioneering cohort of students embarking on this elective with RDH. Additionally, we extend our heartfelt thanks to the healthcare professionals in the KTPH Breast Cancer Service as well as the dedicated KTPH tutors from different subspecialties for their gracious guidance and instruction throughout our participation in the LOTTE programme at KTPH.
We also sincerely thank the medical staff, including doctors, nurses and radiographers, of the Breast Unit at RDH for their warm hospitality during our time there.
Finally, we offer a huge thank you to Ms Fion Chee and Ms Sabrina from KTPH Education Development Office for their tireless coordination of our administrative matters, as well as to our fellow medical students in the LOTTE programme for being such a pleasure to collaborate with.