My Internship Journey in General Medicine

30/01/2024

INTERNSHIP ASSESSMENT

Name: Sanidha Singh

Roll no.- 98

Hello everyone! Welcome to my blog I am intern posted in the Department of GENERAL MEDICINE. This blog highlights my learning experience and the skills I have acquired during my time in the department of medicine from 1/12/2023 to 31/01/2024.

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 our 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-centered online learning portfolio and your valuable inputs on the comment.

          1/12/2023 —— 15/12/2023 :  UNIT DUTY

            16/12/2023 —— 31/12/2023 : PERIPHERALS 

            1/01/2024 —— 15/01/2024: UNIT DUTY                            

          16/01/2024 —— 31/01/2024: PSYCHIATRY POSTING                

UNIT DUTIES:  

(1/12/2023 - 15/12/2023 & 1/01/2024 - 15/ 01/2023)

I started my General Medicine journey by getting posted to fourth unit which was lead by Dr Manoj, Dr Nithin, Dr Venkanna and Dr SreeTeja.

Unit duties were a great opportunity to widen our knowledge and patient care and also handle a multitude of patients.               

Unit duties mainly consisted of OP days, along with looking after casuality cases and overall monitoring and treatment regimes of patients that get admitted under our care. Our OP days are on Thursday, and we would easily see around 50- 60 cases.                       

On OP days as an Intern I have :

1. Checked vitals of every patient.   

2. Examined for reflexes, postural hypotension, Romberg’s sign, joint position.       

3. Have learnt basic management protocol for SOB, chest pain, headaches, Diabetes Mellitus type II. 

I have come across several patients during this period but one patient  with Diabetes Mellitus Type II that I found particularly interesting because of the case’s chronicity and uncontrollability. So I took the responsibility to make her blog and PaJr where we actively kept checking on the daily activities, diet, blood sugar levels (Fasting, post prandial) and modifying the dose accordingly.

I’m humbled by how I got a chance to experience telemedicine as an Intern where the daily tele-monitoring, telephone based care and follow up has helped the patient sitting at home control her blood sugars via technological advancement where healthcare is one call away especially in rural areas that too free of cost. 

Given below is the patients blog:

CASE 1 

https://sanidhasinghrollno206.blogspot.com/2024/01/141223-151223-161223-171223-181223.html

Given below is the patients PaJr:

https://chat.whatsapp.com/F691Ysd8QihDBdqlu44WZR

Blogs of some other interesting cases i have had come across and documented them below:

CASE 2:

https://sanidhasinghrollno206.blogspot.com/2023/12/chief-complaint-abdomen-since-4-days.html

CASE 3:

https://sanidhasinghrollno206.blogspot.com/2023/12/burning-sensation-over-left-ul-and-ll.html

CASE 4:

https://sanidhasinghrollno206.blogspot.com/2023/12/a-35-year-old-male-with-kco-epilepsy.html

CASE 5:

https://sanidhasinghrollno206.blogspot.com/2023/12/40-year-old-male-patient-with-diabetes.html

CASE 6:

https://sanidhasinghrollno206.blogspot.com/2023/03/1801006162.html

CASE 7:

https://sanidhasinghrollno206.blogspot.com/2023/01/this-is-online-e-log-book-to-discuss.html

CASE 8:

https://sanidhasinghrollno206.blogspot.com/2022/12/a-60-year-old-male-with-knee-pain.html

CASE 9:

https://sanidhasinghrollno206.blogspot.com/2022/12/a-70-year-old-male-with-uncontrolled.html

CASE 10:

https://sanidhasinghrollno206.blogspot.com/2022/12/a-55-year-old-male-came-to-opd-with.html

CASE 11:

https://sanidhasinghrollno206.blogspot.com/2022/12/20-year-old-female-with-headache.html

CASE 12:

https://sanidhasinghrollno206.blogspot.com/2022/03/a-29-year-old-female-patient-with.html

CASE 13:

https://sanidhasinghrollno206.blogspot.com/2022/03/33-year-old-male-with-acute-gastritis.html

CASE 14:

https://sanidhasinghrollno206.blogspot.com/2022/03/40-yr-old-male-with-viral-pyrexia-with.html

PERIPHERALS:

ICU and AMC DUTY:

(16/12/2023 - 31/12/2023)

These days were particularly challenging as surrounded by critical patients and you never know when a patient detoriates.

My first and foremost work was to monitor vitals of the patients hourly.

I have assisted in intubation of 1 patient. 

I have learnt how to draw samples from radial and brachial artery and have drawn 5 ABGs and also about how to interpret them.

I learnt how to resuscitate a cardiac arrest patient by performing CPR. 

Secured multiple cannulas.

Inserted 3 foley’s catheter per ICU duty.

Inserted 2 ryle’s tube 

1 Dipstick test 

NEPHROLOGY DUTY:

Monitored patient who came for dialysis.

Learnt about AV fistulas.

Learnt how to maintain patients BP and GRBS while the dialysis is still going on.

Have learnt about the drugs used in hypotension and hypertension.

Took ABG samples.

Observed and learned about how to insert and secure a central line.

Observed patient showing complications of dialysis.

WARD DUTY:

Attended HOD Sir’s rounds.

Helped my colleagues in updating the SOAP notes.

Collected blood samples.

Gave IM/ IV Injections.

Monitored patients in the ward.

PSYCHIATRY POSTINGS:

(16/01/2024 - 31/01/2024)

Here I learned about the importance of detailed history taking and has also taken a biopsychosocial history of a patient.

A few cases that i have come across during this period:

Alcohol dependence syndrome

Obsessive compulsive disorder with Bipolar disorder 

OP poisoning patient with delirium 

4 cases of schizophrenia.

Recurrent Deepression with Panic Atttack

Psychosis in alcohol withdrawal.

Thank you.