Reflections from a Two-Month Observership: Clinical and Cultural Insights 

My name is Deniz Kaya Bilir. I completed my anaesthesiology residency approximately two years ago and currently work as an anaesthesiologist in Turkey. Between the first week of February and the first week of April, I had the opportunity to participate in a two-month observership at Amsterdam UMC through the ESAIC Exchange Programme. This experience provided me with valuable clinical and cultural insights. 

The hospital is easily accessible by metro from the centre of Amsterdam. Despite its large size, the hospital was exceptionally clean and well-organised. On my first day, Professor Benedikt Preckel warmly welcomed me, took note of my background and experience, and asked about my expectations. He gave me a brief tour of key areas such as the operating theatres and meeting rooms—though it was impossible to see everything due to the hospital’s vast size. I completed the necessary administrative procedures, and my access badge was issued. 

Given the department’s structure, staff rotate daily across different specialities. I was added to this rotation list, which allowed me to observe various anaesthesia practices across multiple disciplines. I was also included in the hospital’s email system, enabling me to see my assigned area a day in advance and prepare accordingly. I was informed that I could request specific rooms or cases, but I preferred to experience the general workflow rather than focusing on a particular field. 

From the very beginning, I was impressed by how smoothly I integrated into the clinical environment. Colleagues were welcoming, fluent in English, and encouraged me to ask questions and participate in discussions, which made me feel included and confident throughout the programme. 

Having previously worked only in Turkey, I was particularly interested in practices that differed from those in my home country. Sustainability is clearly prioritised in anaesthesia; volatile agents like sevoflurane are minimised, with TIVA using propofol being common. The presence of an active ‘green team’ committed to minimising anaesthetic gases and promoting sustainable practices inspired me to reflect deeply on the environmental impact of our clinical choices. Opioid preferences also differ—while fentanyl and morphine are common in Turkey, sufentanil is frequently preferred here, and methadone has been recently introduced in specific cases. Regional techniques, especially peripheral nerve blocks, are frequently and effectively integrated into routine care. The calm, well-structured recovery areas—with dim lighting, low noise levels, and child-friendly environments in paediatric sections—seemed to reduce the need for anxiolytics, as patients appeared noticeably more relaxed. 

These clinical approaches are supported by the healthcare system’s structure. The referral-based family medicine model results in fewer patients per clinician per day. Elective surgeries often involve waiting periods of several months, which patients generally accept. Night shifts are shorter, and daily workloads are lighter compared to Turkey, where higher patient volumes demand a faster pace. 

Outside the hospital, Amsterdam exceeded my expectations with its livability and charm. Acquiring a second-hand bicycle was perhaps my best decision during these two months; cycling through canals, quiet neighbourhoods, and parks became a daily joy. After my observership ended, I stayed a few more days and was lucky enough to catch the beginning of tulip season, which gave me the chance to visit the beautiful tulip fields. The city’s vibrant culture, world-renowned museums, and easy access to other Dutch cities for weekend trips enriched my experience. While Dutch cuisine may not be globally famous, Amsterdam offers a wide range of excellent cafes and restaurants for food enthusiasts. The Dutch people were exceptionally friendly and spoke perfect English, which made social interactions effortless. 

I am deeply grateful to the ESAIC Exchange team and Professor Preckel for this opportunity. Living in Amsterdam, not as a tourist but as part of the local community – commuting to work, observing healthcare practices in a different culture- was truly invaluable. I actively encourage younger colleagues worldwide to pursue similar experiences. I would be happy to assist anyone interested in joining this programme or seeking insights about Amsterdam. 

I have also included a few photos capturing moments from both my observership and daily life in Amsterdam. 

Author

• Deniz Kaya Bilir, Anaesthesiologist, Yerköy State Hospital