INTERNSHIP ASSESSMENT

 Hello there! This is Dr. Meesum Abbas, an undergraduate posted in the department of medicine and welcome to my blog.  

This blog highlights my learning experience and the skills that I’ve acquired during my time in the department of medicine which was from 14-04-23  to  12-06-23. 

NOTE: This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This e-log book also reflects my patient centred online learning portfolio and your valuable comments on comment box is welcome

PSYCHIATRY (14/4/23 to 28/4/23): 

During the initial 15 days, I was posted in the department of Psychiatry.

Here I learned about the importance of  taking a detailed history of a patient from what they remember of their childhood to the current time to draw a definitive diagnosis. 

A few cases that I’ve come across during this period include:

•  Psychosis in alcohol withdrawal
• Alcohol dependence syndrome 
• obsessive compulsive disorder
• Schizophrenia 
• Adjustment disorders
• panic attacks
• Depression

 

We learnt in detail about classifications of different psychiatric conditions, and the treatment of choice in each case.  

We also got a chance to observe cases in the de-Addiction centre, and counsel the  patients undergoing therapy.

UNIT DUTY (29/4/23 to 28/5/23): 

The following 4 weeks I was posted in the general medicine unit 3. Here we would have OP days and casualty duties with an occasional Sunday duty which made me realise that a good clinician has no days off. 

On my first day of Unit duty, we had started a new trend of auditing the OP cases and Dr. Rakesh Biswas sir had given me the instructions as to how to begin with it and I had taught all of my co-interns how to do it. 

We were given an opportunity by Dr. Rakesh Biswas sir to make blogs on the cases which we would personally find fascinating. Hence this assessment includes links to multiple blogs of cases which I found interesting. 

I had come across several patients during this period. Some critical coming from casualty and some not as much. We would take the critical ones to the ICU after stabilising them in the casualty and monitor them closely. 

I had one such patient that had come to the casualty during one of our OP days which I found particularly interesting so I took the responsibility of making her PaJR. 

Given below is the patient’s blog:

https://meesumabbas82.blogspot.com/2023/06/a-65-f-with-status-epilepticus-and-kco.html

Another interesting case was of a 24 year old female with Anemia and CSOM who was admitted in our AMC. Coincidentally we had another student, 21 year old female, who had similar complaints of CSOM with Anemia sent by our ENT department whom we admitted in our ward. During rounds, we had a discussion about how there may be a link between anemia and CSOM. 

Given below is the patient’s blog: 

https://meesumabbas82.blogspot.com/2023/06/is-online-e-log-book-to-discuss-our_23.html

Blogs of some of the other interesting cases I had come across and documented them have been listed below: 

https://meesumabbas82.blogspot.com/2023/06/50-year-old-female-with-chronic-heart.html

https://meesumabbas82.blogspot.com/2023/06/42-year-old-male-with-altered-sensorium.html

https://meesumabbas82.blogspot.com/2023/06/is-online-e-log-book-to-discuss-our.html

PERIPHERALS : ( 29/5/23 to  12/6/23)

ICU DUTY

These days were particularly challenging as you are surrounded with critical patients and you never know when one may deteriorate. 

It was an amazing experience spending time here. What I learned here includes: 

• How to draw samples from radial and femoral artery and read an ABG
• Learned how to resuscitate a cardiac arrest patient by performing CPR
• Learned how ventilate the patient and learnt various modes of ventilation
• Secured multiple cannulas
• Inserted Foley’s catheters, condom catheter, Inserted Ryle’s tubes
• Observed insertion of central line 
• Monitored vitals of all patients either hourly or as per the necessity to condition of the patient
• Learned how to manage in critical situations and not stress out or lose your cool
• Did bed sores management( dressings) 
• Attended rounds for ICU and AMC cases.

NEPHROLOGY DUTY

Nephrology duties were slightly calmer than the ICU days but we did have a few emergencies coming in at odd hours. 

A list of things which experienced and learned here include: 

• Learned about how to secure a central line 
• Learned about the AV fistulas
• Read up about the dialyzer machine and its settings
• Learned about how NSAIDS damage kidney both functionally and structurally
• Give IV injections
• Put cannula
• Seen the complications of dialysis 
• Took ABG samples.  
• Monitored the patients undergoing dialysis
• Observed insertion of central line 
• Observed multiple CKD cases requiring dialysis.

WARD DUTY

Ward days were relatively easy going days during the peripherals as we had all of the stable patients here. 

What I learned here includes: 

• Secured cannulas
• Gave IM/IV Injections
• collected blood samples
• Learned how to read chest X-rays
• Did some brushing up of my history taking skills
• Helped my colleagues in updating  SOAP notes.
• Monitored patients in the ward.