1. The University of Kansas SOM
International Education Elective at Siriraj Hospital in Bangkok, Thailand
MS-4 Yasser Hassan
The University of Kansas SOM
January 29 to February 23, 2018

2. Bangkok, Thailand Capital and largest city in Thailand
City population over 8 million
Metro population over 14 million
Historical roots are a small trading post during the Ayutthaya Kingdom in the 15th century
View of downtown from Sky Bar
Grand Palace

3. Siriraj Hospital The largest and oldest hospital in Thailand
Founded by King Chulalongkorn in 1888 in response to the cholera epidemic
The hospital was named after his son who died of dysentery
The former King Bhumibol Adulyadej (Rama IX) was cared for at Siriraj before passing away in October 2016

4. Department of Anesthesiology
1 week in General
1 week in ENT and Cardio
1 week in Ortho
1 week in OB/GYN
First thing I noticed, all the sandals!
Intraop TEE during cardiac surgery
(Picture taken from their website)

5. Topic of Interest
The similarities and differences of Anesthesiology between The University of Kansas Medical Center and Siriraj Hospital.
I selected this topic because I am interested in anesthesiology and am going into anesthesiology residency (at UMKC this year).
I wanted to expand my perspective on administering anesthesia because the field is very personal, variable, and dynamic.

6. Interview With Faculty Member
Dr. Pichaya Waitayawinyu, MD, Anesthesiologist
Neuro Anesthesia fellowship training at Harborview Medical Center, University of Washington
Pediatric Anesthesia fellowship training at Children’s National Health System, Washington D.C.
Some key points during the interview:
Anesthesiology at Siriraj is actually quite similar to KUMC!
Not as much funding so expensive medications such as Sugammadex not used much
Reusable drapes, sheets, gowns used in the OR
Paper records in the OR
30 Baht program
MD requires 6 years of medical school, 1 year internship, 4 years residency
CRNA only 1 year training! 1 year ICU experience is not required

7. Some of the differences in Anesthesiology at KUMC vs Siriraj
Pre-Op
Intra-Op
Post-Op
KUMC
Patient comes in morning of surgery
Either CRNA or Resident present in the room
Anesthesiologist responsible for post-op pain
Siriraj
Patient comes in day before surgery and stays overnight
SRNA, CRNA, Resident all could be in the room
Surgeon responsible for post-op pain (Anesthesiologist can give guidelines)
Only 30 PCAs available

8. Adductor Canal Nerve Block
Dr. Nantthasorn Zinboonyahgoon, MD, Pain fellowship training at Brigham and Women’s Hospital
Assisted several of these nerve blocks one of the days of my ortho week – favorite clinical experience
Pure sensory nerve block (saphenous nerve) for postoperative analgesia after knee surgery
Avoids quadriceps weakness in femoral nerve block

9. Elephants near Chiang Mai
Favorite cultural experience Activities included feeding elephants, making vitamins for them, mud bath, and river bath
Facts about elephants:
Largest living land mammal
Life span similar to humans
Weigh tons
Eat up to 300 lbs/day
Diet consists of roots, grasses, fruit, and bark
Only sleep 2 hours per day
Faddy (fellow KU MS4) feeding an elephant
Making vitamins for the elephants, ingredients included bananas, tamarind, and sugar, wrapped in bamboo leaves
Mud bath

10. Our fellow Thai medical students took us out for dinner, dessert, and out on the town!

11. References https://en.wikipedia.org/wiki/Bangkok