A Month of Growth in Valencia 

This report summarises my one-month exchange experience in Valencia, Spain, undertaken through the European Society of Anaesthesiology and Intensive Care (ESAIC) Exchange Programme. My primary goals were to enhance my professional skills, particularly in regional anaesthesia, and to gain a broader clinical perspective. 

My journey started during a draining night shift as a young specialist, searching for a way to reinvigorate my clinical practice. Coming across the ESAIC Exchange announcement felt like a timely opportunity, and I applied almost immediately. The excitement of being accepted for a month in a new country was mixed with the natural apprehension of stepping far outside my comfort zone. This initial unease was quickly tested when my first visa application for a February start was rejected. I am profoundly grateful to the ESAIC Education Department and Dr Belaouchi, Head of Anaesthesia at IMSKE in Valencia, for their understanding and flexibility. Instead of cancelling, they supported postponing my placement to November. While navigating the required administrative steps was demanding, their support made the process manageable and the ultimate outcome incredibly worthwhile. 

I had deliberately chosen IMSKE for its strong focus on regional anaesthesia, and my decision was fully validated. As an orthopaedic hospital, approximately 95% of cases utilised regional techniques, providing extensive exposure to upper- and lower-extremity peripheral nerve blocks. The high daily caseload, facilitated by a double-shift system, meant constant and varied learning. 

A particular highlight was the hands-on experience with structured serial block protocols for total knee arthroplasty. Observing and performing combinations of genicular nerve blocks, IPACK blocks, intra-articular injections, and superficial infiltration to achieve both profound analgesia and pharmacological bleeding control was immensely educational. The protocol-driven, meticulous nature of this approach left a lasting impression on me. 

The team’s exceptional patient care and respectful, well-coordinated professionalism were exemplary. The importance of preparedness in a high-volume regional anaesthesia centre was underscored when I witnessed a case of Local Anaesthetic Systemic Toxicity (LAST). Observing the team’s calm, protocol-adherent, and efficient response was a powerful lesson in clinical competence and emergency preparedness. 

Although I joined as an observer, obtaining professional liability insurance within the Spanish system allowed me to participate actively in procedures. I cherished this opportunity to perform invasive techniques under direct supervision—a valuable practice I had not experienced in some time. It was a humble reminder that learning is a continuous journey, regardless of seniority. 

Valencia itself was a revelation. The city’s relaxed atmosphere, historic charm, sunny streets lined with orange trees, and vibrant markets created an environment where it was easy to imagine building a life. The excellent transport links allowed me to explore further, including a memorable weekend trip to Granada to visit the breathtaking Alhambra¬,a truly profound experience walking through centuries of history. 

In Valencia, I accumulated some of the most meaningful memories of my life. I was welcomed by wonderful people, supported by inspiring colleagues, and immersed in a rich culture. Returning home, I felt a tangible sense of growth on both professional and personal levels. As a woman travelling alone in Europe for the first time, feeling safe, independent, and welcomed throughout was empowering and transformative. 

This exchange was far more than a clinical observership; it was a holistic experience that broadened my medical practice and my worldview. I extend my deepest gratitude to the ESAIC for this opportunity, to IMSKE for their hospitality, and especially to Dr Belaouchi and his team for their unwavering guidance. I wholeheartedly recommend this programme to any colleague seeking to advance their skills and embrace a transformative experience. 

Author

• Ümra Gökçe Demir, Rize Recep Tayyip Erdogan Training and Research Hospital- Rize, Türkiye