INTERNSHIP ASSESSMENT

 This is my internship assessment blog, where I got an opportunity to put what I’ve learnt in these 2 months of my rotation in General Medicine department all together in one place. 

I’ve been posted in General Medicine rotation from 11 December 2022 to 11 February 2023 which also includes working in ICU, Nephrology and Psychiatry.

OP DAYS and NIGHT DUTIES:

Took the histories and wrote them in OP cards for hundreds of patients as our OP day was on Monday with full influx of patients.

Did CNS, CVS, Respiratory, and Abdomen examination. 

Saw emergency cases such as myocardial infarction, Diabetic keto acidosis etc

Learnt how 2D echo works and how to do it. 

Leant how to identify and MI in ECG.

UNIT DUTIES:

Did research for a patient who was diagnosed with acinetobacter infection in order to check sensitivity and choose the drug of choice for her. We came with up colistin and sent if for sensitivity but unfortunately before the results came she passed away.

Case 11: 

https://vignatha45.blogspot.com/2023/01/this-is-online-e-log-book-to-discuss.html?m=1 

 

Saw a bone marrow aspiration for a 19yr old boy with anemia done by Pathology department and Dr. Raveen sir

https://vignatha45.blogspot.com/2022/12/20-year-old-male-with-massive.html?m=1

Did pleural tap on a male patient under the guidance of Dr. Raveen sir (PGY3), Dr. Haripriya mam (PGY2) and Dr. Navya mam (PGY1)

Case 7:  

https://medhakesani.blogspot.com/2023/02/70-yr-old-male-with-sob.html?m=1

Bought medicines for a patient who couldn’t afford them. 

Case 1

https://medhakesani.blogspot.com/2022/12/chronic-pancreatitis.html?m=1 

Learnt how to do Urine Dipstick test

Other blogs: 

Case 2

https://medhakesani.blogspot.com/2022/12/57-yr-old-female-with-fever-and-sob.html?m=1

Case 3

https://medhakesani.blogspot.com/2022/12/65yr-old-male-with-cva-secondary-to.html?m=1 

Case 4:

https://medhakesani.blogspot.com/2022/12/hemoptysis.html?m=1

Case 5: 

https://medhakesani.blogspot.com/2022/12/80yr-old-male.html?m=1 

Case6:

https://medhakesani.blogspot.com/2023/02/fever-with-thrombocytopenia.html?m=1

Case 8:

https://medhakesani.blogspot.com/2023/02/pyrexia-with-acute-diarrhoea.html?m=1

Case 9: 

https://medhakesani.blogspot.com/2023/02/47-yr-old-female-with-hypoglycemia.html?m=1

ICU DUTIES: 

Learnt how to take ABG samples and to do Alleys test before taking ABG. 

Did sleep studies for 2pts (one female and one male) for Obstructive Sleep Apnea (OSA)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379160/ 

https://www.sciencedirect.com/science/article/pii/B9780124201682000168

http://52-santoshkumar.blogspot.com/2023/02/68-yr-old-male-with-intermittent-fever.html 

Monitored all the patients of AMC and ICU

Learnt how to fix Insulin dose after charting 7 point GRBS profile. 

Learnt how to set NORAD dose.

Learnt how the ventilator works and the ventilator settings.

Learnt how the infusion pump works and how to fix the dose in it.

Learnt how the BIPAP and CPAP works 

Assisted in giving CPR.

Learnt how to intubate under Dr. Charan sir

(to tilt the head back and open the mouth with non dominant hand and pass the ET tube into the trachea after visualising the vocal cords with the other hand and connect it to Ambu bag and check for breath sounds later to the ventilator)

Assisted in placing a central line with Dr. Haripriya mam in AMC. 

NEPHRO DUTIES:

Learnt about management of hypertension in CKD patients

Importance of timely dialysis

Learnt how the dialysis machine works.

Assisted in placing a central line with Dr. Deepika mam in Nephrology. 

Learnt about flash pulmonary edema and its clinical presentation and management and how it’s most common complication seen in CKD patients after dialysis. 

Learnt about hypoglycemia induced by OHA in CKD patients

WARD DUTIES:

Updated SOAP notes and took histories of all the ward patients 

Learnt what is diffusion weighted MRI

Did apraxia charting. 

Did MMSE (Mini Mental Status Examination) for a CVA patient. 

Case 10: 

https://manaswinibhootharaju153.blogspot.com/2023/01/50yf-presented-with-slurring-of-speech.html 

Was very interested in this case and I followed up and learnt the above points.

PSYCHIATRY DUTIES:

Took history of patients with:

Substance abuse

Alcohol dependence syndrome

Schizophrenia 

Anxiety disorder 

Depression 

Monitored a case of 20 year old female with catatonic schizophrenia which was very challenging, and I could empathise with the family how difficult the situation was for them and their what emotions played through them. I’m glad she got psychiatric help.

OTHERS:

Attended CME on 25/1/23.