Internship,
June 12 th,2023
MY INTERNSHIP JOURNEY IN GENERAL MEDICINE
I'm an intern, posted in general medicine department for 2 months including 2 weeks of psychiatry.
First 2 weeks:
Posted in Department of Psychiatry:
Attended the OPD in department of psychiatry and observed various spectrum of psychiatric disorders in the patients. Studied symptomatology regarding various psychiatric disorder spectrums.
I got to know about the ICD-10 Classification of psychiatry disorders and also DSM Classification of diseases.
Done night duties for observation of psychiatry patients of withdrawal syndromes. And learnt how to manage them.
Attended the De addiction centre visits and observed the various types of medical, behavioural therapy going on there.
Learnt how to attend rounds for the patients and how to write repeats in the casesheets from post graduates.
Typed, studied and submitted the discharge summaries of various patients under department of psychiatry. From this I learnt how to discharge a patient with proper counselling required and proper instructions for medications for both patients and attenders.
4 WEEKS OF UNIT DUTIES:
I was posted in the unit-I in the successive 4 weeks.
My first day in unit was our op day. I learnt how to take op cases with proper history and examination and how to investigate and how to manage the treatment part with proper counselling.
Admitted patients who required further management under supervision.
All investigations required and recommended by post graduates, senior residents and faculty had been sent and samples drawn, collected and sent for laboratory.
Studied venous sampling. Performed venous sampling.
Learnt basics of ECG. Interpretation of chest x ray.
Foleys catheterization done for 4 patients.
Ryles tube insertion done for 6 patients.
Completed fever charts in the casesheets and filled investigation charts up to date everyday.
Updated SOAP NOTES for every patient in their PAJR groups created by us.
Created PAJR groups for every patient admitted
OP duties :
On Op day Night duties, I have Seen and experienced how a Case in casuality is managed before shifting it to ICU....I have learnt importance of Early Intervention and Early Reporting In case of an emergency
Have drawn Venous samples for Patients Admitted in ward and ICU
Monitored Blood transfusion and KCL infusion For patients
Done FCM transfusion for 2 patients
Created blogs of all patients with consent from patients and attenders and proper deidentified clinical images.
Blogs created under my blogspot address are as follows:
https://srisaipavan.blogspot.com/2023/05/70f-recent-hypoglycemia-2to-ckd-with.html
https://srisaipavan.blogspot.com/2023/06/year-old-male-came-with-co-occasional.html
https://srisaipavan.blogspot.com/2023/06/45-year-old-female-with-paraparesis.html
https://srisaipavan.blogspot.com/2023/06/50-year-old-male-with-weakness-in-left.html
https://srisaipavan.blogspot.com/2023/05/45-year-old-male-with-decompensated.html?m=1
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.
Monitored blood transfusion cases and done hourly monitoring got to know about transfusion reactions.
Nephrology Duties
Got opportunity to learn and closely observe the dialysis unit. Got to know the importance of dialysis, need to monitor the patients undergoing dialysis.
Important of AV fistulas
Seen cases which worsen during the dialysis.
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.
