While on a routine patrol in Afghanistan in 2010, Piotr Wójciak, a chief warrant officer in the Polish army 25th Air Cavalry Brigade Air Assault Detachment, was severely wounded in an enemy attack. The injuries he sustained required immediate medical evacuation and Wójciak was transported to Landstuhl Regional Medical Center in Landstuhl, Germany.

Wójciak would spend nearly three weeks at LRMC for care and recovery before returning to Poland.

Eight years later, his daughter, Aleksandra, who was only 15 years old when he was injured, came to LRMC not as a patient, but rather as a medical student.

Currently in her fifth year of studies at the Medical University of Bialystok, a town close to Poland's eastern border, Aleksandra earned a two-month paid scholarship to participate in a short internship to any European medical center of her choice.

She chose LRMC.

"[My father] became really impressed with the quality of care not only given to him, but also to all of the other patients no matter what country they come from," said Aleksandra.

From July to September, Aleksandra worked in a variety of departments at LRMC including preventive medicine, surgery, emergency medicine and virtual health (tele-medicine). She immediately picked up on differences between American and Polish health care.

"In Poland, we don't have so many different types of nurses so the job specification is different," she said. "We also don't have a lot of specialized clinics. Honestly, I was pretty surprised at so many different kinds [of specialties] LRMC has."


IT'S IN THE BLOOD
Aleksandra was raised in Tomaszów Mazowiecki, a medium-sized city in central Poland about 100 kilometers from Warsaw. While her father was in the Polish military, Aleksandra's mother is an anesthesia and intensive care nurse and her sister is a dentist.

From a young age, she knew medicine was her calling.

"I can't imagine [doing] something else in my life," said Aleksandra. "Even my little brother wants to be a doctor one day."

Aleksandra's diligence with her medical school studies - coupled with her participation in student scientific associations, volunteer work with a pediatric oncology department at her university and research presentations during medical conferences - earned her the scholarship to intern at LRMC. She even grew her hair long for several years so that she could finally cut it this year to give to one of her pediatric cancer patients.


INTERNATIONAL STUDENTS AT LRMC
LRMC offers short internship opportunities to international medical students, most of whom come from Germany since the security process has already been established. For a Polish student like Aleksandra, additional assistance was required.

"LRMC normally only accepts medical students in their fourth year who are interested in an internship, and even then we are talking about a short time period," said Anne Heinrich, a health systems analyst at LRMC who oversees the coordination of international medical students. "Because we learned of Aleksandra's story, we were willing to make an exception."

After a review of security requests, school transcript translations and other administrative requirements, Heinrich was successful in bringing Aleksandra to LRMC.


LEARNING THE AMERICAN WAY
Aleksandra began her internship at LRMC with Dr. Rick Snyder, an occupational health provider. He introduced her to the concept of occupational health, something not taught in Polish medical schools.

"She learned a lot about things that are routine for us in America and military medicine, but not necessarily in Poland," said Snyder. "For example, she learned about heavy metal surveillance, like lead, that is normal in industrial environments, but there is also a potential risk for soldiers who work on the ranges or in cleanup operations. Identifying potential health risk factors was a fascinating thing for Aleksandra."

While at LRMC, Aleksandra was also able to obtain certification in three courses: pediatric advanced life support, advanced cardiac life support and advanced trauma life support. Snyder said that while these courses are routine for military medicine providers, it isn't the case for many international medical students like Aleksandra. Having these certifications and skills sets her apart from her peers, Snyder said.

"I read all three [course] books during my two-month visit," said Aleksandra. "It took a while as English is not my native language, but it helped me to become successful during hands-on practice and testing."

Following her three weeks in the occupational health clinic, Aleksandra transitioned to clinical medicine like the surgery, emergency medicine and tele-health departments.

"Having Aleksandra in occupational health first before going to the other clinics gave her the book knowledge she needed to apply to the real world," said Snyder. "She would always come back to visit me and would say that things made more sense."


A SUMMER TO REMEMBER
"There is one case I will never forget and probably will never see again," Aleksandra said. "I had a patient who was injured in Afghanistan. It was an invaluable experience for me and I will never forget the experience of taking care of an American wounded warrior."

Throughout her two months at LRMC, Aleksandra made friends and travelled around Germany and France.

"In Poland we have this phrase 'walking smile,'" she said. "That's how I felt every day coming to work mainly because the entire LRMC staff, doctors, medics and nurses made me feel like part of a military family."

Aleksandra's presence also made a positive impression on her sponsoring providers.

"She medically grew," said Snyder. "She's mature enough that she's going to be able to absorb all the demands of training that can be years long in the making. I don't think she'll have any trouble being very successful in whatever field of medicine she decides on."

For now, Aleksandra is happy to be back in Poland applying the skills she learned while at LRMC and is fairly certain that she will study to become either an anesthesiologist or a critical care flight doctor. The opportunity to care for combat-wounded patients who were medically evacuated to LRMC like her father was a dream come true.

"My father truly loves [LRMC]," said Aleksandra. "Now, so do I."

============================

LRMC is the largest American medical center outside the United States that serves as the strategic evacuation center for wounded, injured and ill U.S. troops and coalition forces from 56 countries, including Poland. For more information, visit http://rhce.amedd.army.mil/landstuhl/.