We started the day at 7, which after two flights, a day exploring Madrid, and a five hour train ride, felt super early. We had an amazing breakfast with freshly pressed juices and wonderful pastries. By 8, we were all in the lobby and ready to start the day. We quickly set off to the Hospital Universitario de Bilbao, where we watched many different presentations, including one about the differences between Spanish and American health care by the director of the hospital, Jesús Larrañaga Garitano, and another one about the history of the hospital.

The hospital is made up of 22 pavilions, and it is inspired by other hospitals such as the Ependorff Hospital in Hamburg, which was designed to stop the spread of plagues and diseases. Each pavilion has a specific focus, such as oncology, surgery, etc. We were given the opportunity to talk with different members of the hospital staff, including a nurse who shared her knowledge about the process of becoming a nurse in Spain, and how it differs from the US.

We then headed to BioBizkaia Health Research Institute. In the Basque region of Spain, in which Bilbao is located, their healthcare system is called Osakidetza. As apart of Osakidetza, they have different research institutes, including BioBizkaia, which is located right outside the city limits of Bilbao.

We split into two groups to learn about different research projects headed by the institute, and I was able to tour the 3 printing lab. They have many different printing machines, including 2 using thermo-plastics, another machine using resin, and a third that is able to combine the two and create models with different stiffnesses and colors. They also have a biopolymer printing machine, which was extremely interesting. Using scans they receive from the hospital, they are able to print copies for doctors to practice different surgeries on.

While at the research institute, we also got to speak to the head of one of their main research projects. We learned that once a paper has been published, it can take 15-17 years for the ideas to be implemented into clinical healthcare. Researchers are using implementation science to try and minimize the time between discovery and implementation, so that healthcare workers are able to provide the best treatments possible as soon as they are able.

Throughout the entire day, we learned about the differences between the Spanish and American Healthcare System. One main difference that I saw in healthcare is that in Spain, you don’t have to pay for as much as you do in the United States. Everything is paid through taxes, and as stated by one of the nurses, the only time you have to pay for ambulance services is if there was an alert sent out saying not to do something (like climbing a mountain due to extreme weather conditions) and still choosing to do it. Another difference is the access to medical information. In Spain, they have an app that was created during COVID that can be used to schedule appointments with a doctor, or to access medical reports. Everyone is also given an identity card that has their medical file attached, and when they go to a doctor, even if it’s not their primary care physician, or to pick up a prescription, they just have to scan the card. Any doctor can access that information and allows for accurate diagnosis and no confusion in medication.

Overall, even though today was a very busy day and we were constantly moving, I feel as if I learned a lot. I am so excited to be in Bilbao and I am looking forward to the other learning opportunities we will have in this trip!