Learning experience in General Medicine postings

 I was posted in General Medicine from 14/4/23 to 13/6/23. During this time, I was lucky to learn alot of theoretical as well as practical skills that I'm sure will help me as my career advances.

Unit duty

I was posted in Unit 3 for a duration of 30 days. During this time, I saw OP, IP and Casualty cases.

IP and Casualty:

Practical skills:

•Insertion of iv cannula 

•Insertion of Ryle's tube

•Insertion of Foleys catheter 

•Procedure to insert central line 

•How to take an ABG sample

•Ascitic tap

•Pleural tap

•2D echo

Theoretical:

https://nehae-logs.blogspot.com/2023/06/case-discussion-on-42-year-old-male.html

https://nehae-logs.blogspot.com/2023/06/case-discussion-on-65-year-old-with.html

https://nehae-logs.blogspot.com/2023/04/case-discussion-on-50-year-old-female.html

https://nehae-logs.blogspot.com/2023/04/case-discussion-on-65-year-old-female.html

OP:

•Learnt how to begin examination of a patient even as they walk into the OP. For example, saw the high stepping Gait of a patient with foot drop.

• Learnt to understand how exactly to talk to a patient, how to establish a rapport, when to ask the correct questions and how to extract all the details while making the patient feel that he/she is being listened to.  

• Learnt how to come to a provisional diagnosis based on just history and examination 

Peripheral duty 

Nephrology learning points:

•Concept of hemodialysis

•Composition of ultrafiltrate

•Various antihypertensive drugs and their dosage

ICU learning points:

•Working and types of mechanical ventilation

•Cardiopulmonary resuscitation 

•Procedure of intubation 

•Management of cardiac arrest 

Ward learning points:

•Fever chart plotting

•Dawn effect and Somayagi effect 

Psychiatry learning points:

•Mental state examination

•History taking of a patient with depression

•Cognitive behaviour therapy in a young girl with anxiety

• Had an experience of night duty for a patient with delirium. She had an episode at 2 am where she demanded to go home, pulling out her iv cannula and refusing to listen to anyone. Stabilizing her and reacting to the situation was the learning experience.