From Medical Student to Doctor: My Elective in Pediatric Medicine in Tangier, Morocco
My name is Loubna Harroui and until recently I was a medical student at the Vrije Universiteit in Amsterdam. Born and raised in the Netherlands, I grew up with strong ties to Morocco, as my family is from there and I visit almost every year. When the opportunity came to complete my final elective abroad, it felt only natural to choose Morocco. Therefore, I decided to do my internship at the Centre International de Pédiatrie (CIP) in Tangier, a private pediatric clinic where I spent eight weeks working alongside local doctors. This internship was the last part of my studies, and it turned out to be one of the most valuable and memorable parts of my medical education that I will carry with me throughout my career.
The clinic works with an open-door system: no scheduled appointments, but instead an intake at the front desk where children are seen the same day. On average, we treated 40 to 60 patients per day, ranging from routine consultations to complex cases.
What impressed me most was the extraordinary variety of cases. Many were familiar from my training in the Netherlands, such as viral respiratory infections, asthma or gastroenteritis. But in Tangier I saw these conditions more often in their severe form. For example, dehydration was a daily reality. Due to the hot climate, socioeconomic challenges and sometimes delayed access to medical care, children arrived at the clinic severely dehydrated, often requiring intravenous rehydration. It was both confronting and educational to realize how context can determine the gravity of a disease that we in the Netherlands usually see in much milder stages.
Another striking difference was the prevalence of Helicobacter pylori. While in the Netherlands it is relatively uncommon in children, in Morocco it is endemic. I was surprised by the number of young patients who tested positive, often presenting with abdominal pain or anemia. This pushed me to study the local epidemiology and to understand better why some diseases play such a large role in one country while being less relevant in another.
What also stood out to me were the surgical procedures. Circumcision, for example, is a routine part of pediatric care in Morocco, performed frequently for cultural and religious reasons. In the Netherlands, circumcision is rarely performed in medical settings unless there is a clinical indication. At CIP, however, I had the chance to witness and assist in several circumcisions, which gave me valuable hands-on experience with a procedure that is far less common in Dutch pediatrics.
Besides the private clinic, I was also given the opportunity to spend time in the public hospital. The contrast could not have been greater. The clinic was modern, organized, and well-equipped, while the hospital had limited resources, overcrowded wards, and patients often from poorer, rural backgrounds. Here I saw children suffering from trauma after traffic accidents, complex infections, and acute surgical problems that required immediate intervention. The difference between the two settings offered me a sharp lesson in health inequalities – both within Morocco itself and in comparison to the Netherlands.
My time in Tangier was not only about medicine. It was also about communication, culture, and connection. Explaining preventive measures to parents, often across language barriers, required patience and creativity. I learned how to build trust quickly, how to reassure anxious families, and how to adapt my explanations to different cultural contexts. These communication skills, I realized, are as essential to good medicine as any clinical knowledge.
Looking back, I am grateful for the chance to combine my academic training in Amsterdam with my cultural roots in Morocco. The elective gave me a deeper understanding of global pediatrics, showed me the importance of adapting care to local realities, and reminded me of the universal challenges and joys of working with children and their families.
This was not just the end of an internship; it was the closing chapter of my medical studies. With this experience in Tangier, I have officially completed my program and can proudly say that I am now a doctor. Returning to the Netherlands as a recently graduated doctor, I carry with me medical knowledge, cultural insights, and a stronger motivation to dedicate myself to the health of patients from all backgrounds.
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