Internship Assessment
Internship Assessment
M Abhignya
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 which were admitted during my time in unit-5
https://abhignya83.blogspot.com/2023/04/35-yr-old-male-with-loss-of-sensation.html
Learning points:
*How to differentiate peripheral neuropathy due to Diabetes mellitus and Chronic alcoholism
*How can we assess the prognosis of Diabetes mellitus and how to prevent the complications
https://abhignya83.blogspot.com/2023/04/38-yr-old-male-with-chronic-liver.html
Learning points
*Differences between decompensated and compensated liver disease
*Cause of esophageal. Varices in this case
* Role of hypertension in acceleration and prognosis of Chronic liver disease
https://abhignya83.blogspot.com/2023/04/80-yr-old-female-with-vomitings-and.html
Learning points:
*Can Chronic use of antibiotics decrease the gut flora
*The prognosis of gastric ulcer and it's effects on long-standing
https://abhignya83.blogspot.com/2023/04/60-yr-old-with-abdominal-distension.html
Learning points:
*How to differentiate the cause of portal HTN
*Does Chronic Help B have effect on liver functions and development of portal HTN
* Role of hep B infection in development of hepatorenal syndrome
https://abhignya83.blogspot.com/2023/04/38-yr-old-male-with-right-sided-chest.html
* Till what grade of liquifaction can liver abscess be managed medically
*Does smoking effects the prognosis of liver abscess in this patient
https://abhignya83.blogspot.com/2023/02/35-yr-old-male-with-altered-sensorium.html
https://abhignya83.blogspot.com/2023/02/49-yr-female-with-burning-sensation-in.html
https://abhignya83.blogspot.com/2023/02/18-yr-old-female-with-seizures_14.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 Fridays , and we see around 70 to 1110 cases per day. We had a great opportunity to take history from the patients and evaluate them and come to a diagnosis with the help of PGs and SR. I got to know what are the specific history to be asked to a particular case and the importance of history taking in diagnosing the case. As there would be lots of patients waiting,OP days are great opportunity where we learn how to assess the patients in short time efficiently.I also learnt what are the real essential diagnostic test required for a particular case to diagnose it.. instead of sending some random routine investigations. I had a great opportunity to do clical examination of patients which plays a very vital role in diagnosis.
I got to know how to interpret different ECGs, 2D ECHO’s, X-rays which help us in evaluating each case.
After the investigations , here comes the ultimate part for which patient comes to the hospital to get relief from their I'll health,that is treatment ..In the OP days I had opportunity to learn what is the. treatment given for each case
Sometimes patients used to come with different problems related to DVL , orthopedics, Surgery.... not only related to General medicine, During the OP days , I had opportunity to evaluate the patient and what is the reason for the problem and take them to the concerned department for examination and treatment.Here I got to know the importance of multi system approach and it's importance in treatment of patients.
I realised,Treating the patient just once is not enough , because some of our patients come to the OPD with the same complains again and again or sometimes the problem may even worsen then I understood the importance of follow up of patients. So we created pajr groups for the OP patients , which is a great initiative by our HOD sir
ICU and AMC duties
Worked in ICU and AMC for 5 days under Dr.Nishitha and Dr.Kranthi .
Normally even during the other duties I used to go and attend rounds in ICU and got the cases .But only during the 5 days of posting in ICU I got to the importance of ICU and the care the patients here need. I got to know how to differentiate between seriousness of cases and which cases to be shifted to ICU and AMC and which ones to ward.
It was a great learning experience where , I we get both knowledge and gain clinical skills which are really essential.
I got opportunity to draw many blood samples and the vacutainers which are used . I got opportunity to draw ABG samples , intially PG helped me in drawing ABG samples,later I got opportunity to draw around 20 to 25 samples during those 5 days.
I got opportunity to learn, how to place and Remove ryles tube and placed ryles tube to 2 patients . Observed what are the feeds given and the timings of the feeds through NG tube.
Got opportunity to learn life saving skill CPR and Done CPR for 3 patients in ICU who went into cardiac arrest.
Got opportunity Insert foleys to 6 patients
Assisted in placing Central line for 2 patients
Done 2 ascitic taps under the guidance of PG
Nephrology Duties
I have done nephrology duties under the guidance of Dr.Pavan and Dr.Bharath
Got opportunity to learn and closely observe the dialysis unit. Got to know the importance of dialysis and the need to monitor the patients undergoing dialysis.
Importance of AV fistulas
Seen cases which worsen during the dialysis
Ward duty
During unit duty I used to take care of only unit patients even if I know what are all the cases present. Ward duty is a great opportunity to learn about all the patients.
I got to know about different types of cases in the ward. Collected the detailed history of patients. Here I realised the importance of history taking in diagnosing and treating the patient.
Created paJr groups for following the patients even after the got discharged.
PaJr groups:
https://chat.whatsapp.com/FSkVCGWqzZG5X2Qt5h3Rda
Psychiatry postings
I was posted in the department of psychiatry for 15 days.
During my UG days when I attended postings I used to think that Psychiatry is very fascinating ..as the history of the patients is very interesting and each patient has a different story and history.
But during the internship I realised the depth of the subject. Got to see many cases of Schizophrenia.,but each of them have different approach of diagnosis and treatment.
Saw cases of Depression, Generalized anxiety disorder, Panic attacks, Bipolar disorder, Delirium, Substance abuse, Alcohol dependency
Used to go to de addiction ward and saw what are the activities they make the patients do and their treatment.
Monitored patients in ward with delirium
But what I observed is even now Many patients donot approach psychiatrist due to lack of awareness and social stigma. Patients What we see in OPD are just tip of the iceberg...many patients who are really in need of psychiatrists needs to get treated.
In this 15 days , I also learnt how to diagnose and counsel the patients with psychiatric disorders and the treatment given.
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