This clinical training activity was attended by two internal medicine consultant specialists, two residents of the internal medicine program,1 Cardiology specialist, and 1 cardiology program resident from Universitas Sumatera Utara (USU). The Clinical Training participants were dr. Taufik Salman Sungkar, SpPD, K-GEH, dr. Radar Radius Tarigan, SpPD, K-GH, dr. Rizka Maulidia, M.Ked (Cardio), Sp.JP, dr. Juang Idaman Zebua, M.Ked (Cardio), dr. Chaira Alkanzi Djeni and dr. Anita Ratnasari Tantri.The six doctors conducted Clinical Training from July 31, 2023 to August 25, 2023, at Far Eastern Memorial Hospital in Taipei.
This activity was carried out in three departments: the Department of Gastroenterology and Hepatology, the Department of Nephrology and Transplantation, and the Department of Cardiology. Each department has different activities.
The Department of Gastroenterology and Hepatology is headed by Dr. Cheng-Kuan Lin, who is responsible for assigning tutors to each participant. Most of the training was conducted in the Ultrasound and Endoscopy Center headed by Dr Chen-Shuan Chung, who provided guidance regarding gastroscopy, colonoscopy, ERCP, and other procedures. In addition, every day, they were taken to outpatient clinics and inpatient wards to observe patients with very different demographics in Indonesia. Actions, strategies, and patient treatment also have modifications that are adjusted to international guidelines, and several research journals conducted by these doctors have been published internationally. Once a week, there will also be a joint conference between departments such as Surgery, Radiology, and Anatomical Pathology to discuss fascinating and comprehensive cases. Once a week, lectures will also be conducted for all department staff, including nurses, regarding active knowledge improvement (demos) or passive lectures.
For the Department of Nephrology
The head of the hemodialysis center, Dr. Shu-Kai Hsiang, gave guidance ranging from discussing kidney transplant cases with related living donors, unrelated living donors, and deceased donor patients with moderate to high risk to post-transplant complications, complications related to immunosuppressant drugs, surgery, and infection. He also provides guidance on renal pathology and hemodialysis with specialized techniques. What is also very important is how kidney transplant organizations can work well together to deliver good services.
For the Department of Cardio
"This experience is a precious thing for the six doctors. The implementation of this activity cannot be separated from the collaboration between the Faculty of Medicine, Universitas Sumatera Utara, and Far Eastern Memorial Hospital Taipei. We hope that this knowledge can be shared with other colleagues and can be useful for developing medical science and improving health services to the Indonesian people".
The Department of Cardiology is led by Dr. Hsu Jung-Cheng, the department chairman, and Dr. Wu Yen-Wen, the director of the cardiovascular division. During our clinical training, we participated in 4 weeks of cardiology activities in different divisions. In the first week, we were assigned to follow interventional cardiology procedures such as coronary angiography, percutaneous coronary intervention, temporary pacing, ventriculography, and aortography in the catheterization laboratory (Cath lab). These interventional procedures are one of the flagship procedures at Taipei Far Eastern Memorial Hospital. The hospital has become the first team in Taiwan to promote cardiac catheterization through the radial artery comprehensively. In the second week, we attended the clinical training program in the division of arrhythmia and electrophysiology. The other notable intervention procedure was non-invasive, using the 3D mapping technique to guide ablation in patients with persistent AF and in Premature Ventricular Contractions. In addition to ablation with 3D mapping, EP study, and conventional ablation, LAA closure using an occluder in patients with atrial fibrillation and renal artery denervation in patients with resistant hypertension are also actions carried out quite frequently.
On the third week, we participated in a clinical training program in the cardiac intensive care unit (CCU). The CCU room has a capacity of 20 beds and is devoted to critical patients in the cardiology department and post-heart surgery patients, including post-heart transplant patients. This week, we were given the opportunity to follow up on patients in the CCU, starting with hemodynamic monitoring and ending with the installation of Mechanical Circulatory Support devices.
In addition to invasive interventions, we underwent a training program in the non-invasive department in the fourth week, including echocardiography and nuclear imaging. This hospital is also the only national health center in Taiwan with EECP, which can provide effective treatment for patients with coronary heart disease and congestive heart failure.
In addition to attending every procedure with interesting cases, we were also involved in the cardiovascular department's scientific activities, including morning meetings, weekly case discussions, and joint conferences between departments.
The clinical training program was closed with a closing ceremony and certificate awarding, which were carried out in a hybrid manner at Far Eastern Memorial Hospital in Taipei and attended by both parties, namely Dr. Chang, Shu-Wen as Vice President of Far Eastern Memorial Hospital, Ms. Jolene Huang as Chairperson of the International Medical Center, department heads from related divisions, and also attended the closing ceremony Dean of the Faculty of Medicine USU Prof. Dr. Aldy Safruddin Rambe, Sp. S (K), Vice Dean of the USU Faculty of Medicine dr. Inke Nadia Lubis, M.Ked (Ped), Sp. A, Ph.D, Head of the Department of Internal Medicine dr. Dina Aprillia Ariestina, M. Ked (PD), Sp.PD-KGer, Head of the Department of Cardiovascular Diseases dr. Anggia Chairuddin Lubis, Sp. JP (K), Head of the Heart and Vascular Disease Study Program dr. Cut Aryfa Andra, Sp. JP (K), and Lecturer of Heart and Vascular Disease dr. Hilfan Ade Putera Lubis, Sp. JP (K).