INTERNSHIP ASSESSMENT
UNIT DUTY
I was posted in unit-6 under Dr. Sushmitha , Dr. Shasikala, Dr. Keerthi, Dr. Nishitha, Dr. Nithin, Dr. Ajay
Unit duties mainly consist of OP days, along with looking after casualty cases and overall monitoring and treatment regimens of the patients that get admitted under your care.
These are the blog links of some interesting cases that I saw admitted during my time in unit-
https://sudhamshireddy.blogspot.com/2023/02/68year-old-female-with-shortness-of.html
https://sudhamshireddy.blogspot.com/2023/02/63-year-old-male-with-back-pain-under.html
https://sudhamshireddy.blogspot.com/2023/02/sudhamshi-reddy-m-this-is-online-e-log.html
https://sudhamshireddy.blogspot.com/2023/02/50-year-old-male-with-swelling-of-upper.html
https://sudhamshireddy.blogspot.com/2023/02/45-year-old-with-complaints-of-back.html
https://sudhamshireddy.blogspot.com/2023/02/26-year-old-female-with-spasm-of-both.html
https://sudhamshireddy.blogspot.com/2023/02/60-year-old-male-with-pain-abdomen.html
https://sudhamshireddy.blogspot.com/2023/04/14-year-old-female-with-fever.html
https://sudhamshireddy.blogspot.com/2023/04/reddy-this-is-online-e-log-book-to.html
Unit duty was a great opportunity to be able to learn how to handle a multitude of patients and about treatment and evaluation of different cases.
Our OP days are on Saturdays , and we see around 80-100 cases per day. We were able to learn how to take patient history and do clinical examinations for many patients.
With the help of our PGs we had the opportunity to look at different clinical cases and do real time application of evaluation and coming to a conclusion about the diagnosis and treatment regimens of the patients.
Learned how to interpret different ECGs, 2D ECHO’s, X-rays during evaluation of each case.
By taking patients for referrals I understood the true essence of multisystem problems and the importance of interdepartmental coordination in arriving at a diagnosis and treating the patient.
WARD ROTATIONS
I started my peripheral postings with ward rotations. Ward postings were one of my favourite postings, because you get to see patients from all units of general medicine.
During my time there, I was able to see different cases in the ICU/AMC/Ward that were taken care of my other units and was able to take my own history for some patients.
Ward rotations gave me the opportunity to follow up and be in constant touch with my patients with the help of PAJR groups.
Learned about constructional apraxia charting, through this I could assess day wise improvement of my patient.
ICU ROTATION
Following ward, I was posted in Intensive care unit(ICU) for 5 days.
It gave me a first hand experience into critical care and helped me understand the importance and necessity of timely intervention.
Even though the ICU duty only last for a short amount of time, it is an opportunity to learn a lot of clinical skills.
However, even though it was initially a struggle, the PGs made it an easy transition, and I was able to learn a lot in my time there.
I got the opportunity to learn how to draw ABG samples, taking around 15 radial and femoral samples as well as drawing regular blood samples for to send as lab samples.
I learned how to place a nasogastric (ryles) tube, and was able to place it for 4 patients. I also learned how to insert a foleys catheter for both female and male patients in the ICU.
I was able to assist the PGs with the placement of a central line for a nephrology patient that got shifted to the ICU.
I was able to Assist during active management of a patient who went into cardiac arrest.
During my ICU postings we intubated 4 cases and I was able to assist for 2 of them.
One of the cases was a 70 year old male, brain dead, was on ventilator for 4 days. Tracheostomy was done on day 5, I was able to assist and it was my first experience with the procedure. Despite all the above the patient didn’t respond well and succumbed two days later. There was a sudden fall in BP and pulse was not recordable.
I monitored patients during blood transfusion and learned about transfusion reactions.
NEPHROLOGY ROTATION
After ICU, I was placed into nephrology duties for the next five days. Nephrology was by far my most challenging posting, just for the sheer amount of work as well as the condition of the patients.
In nephrology, we are expected to take care of all the ICU/AMC nephrology cases and CKD ward patients who are our inpatients, as well as the patients who come daily for maintenance hemodialysis.
During my nephrology rotation, I monitored 2 PRBC blood transfusions and was able to learn about the use of cross matching samples, figured out donors, and learned about transfusion reactions.
I also assisted Dr Pavan sir in the placement of two central lines.
One of the best opportunities was to sit in for the dialysis sessions and be able to learn how the equipment works and how patients react to hemo dialysis. I monitored around 10 patients in different sessions of hemo dialysis and was able to do vital monitoring, learn about different complications that could arise, the benefits or disadvantages of placing a patient on hemo dialysis etc.
It was a great learning experience, and even though nephrology was an intense posting, I really enjoyed it.
PSYCHIATRY POSTINGS
I was posted in the department of psychiatry for 15 days.
Psychiatry is a subject that I’m very interested in, and it was a great opportunity to be able to look at different cases and watch the PGs evaluate each case, because it’s a different approach than what we’re used to in medicine.
Some cases I saw included schizophrenia, panic attacks, depression, bipolar disorder, substance abuse .
We learnt in detail about classifications of different psychiatric conditions, and the treatment for each case, along with patient compliance and how to follow up different cases.
We also got a chance to observe cases in the deaddiction centre, and see patients undergoing therapy.
Psychiatry posting helped me really understand how many people are dealing with mental ill was which otherwise is overlooked.
Mental health cannot be ignored and I also attended a couple of counselling sessions with my patients wherein we did music therapy, mediation etc..
Overall, the general medicine posting was a great learning experience, and taught me important clinical and social skills that will hopefully help be better evaluate and treat patients in the future.
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