Ahmed Osman Hassan Noureldin

• Similar responsibilities as previous post, details outlined below under 'SHO Cardiology.'

Duties included evaluating patients in oupatient clinics, discussing with seniors and formulating management plans. Assessing inpatient rheumatological referrals, cases including gout/pseudogout, septic arthritis, and vasculitis. Performed knee arthrocentesis.

Out of hours cross covering cardiology inpatient and A&E referrals, as well as assisting on the acute medical take.

Worked under cardiology department, consisting of ward and CCU.

Daily review of patients, while simultaneously holding referral phone, which covers ED referrals, inpatient cardiology referrals and GP advice line.

Out of hours consists of holding cardiology referral bleep, as well as managing acutely unwell CCU and ward patients. Also assisted on acute medical take.

Performed procedures such as DCC, transcutaneous pacing, and initiation of inotropes and NIV.

• On-calls and night shifts which include cross-covering acute medical patients
• Assessing and managing inpatients with chest pain, new oxygen requirement, electrolyte disturbances.
• Performing consultations with several sub-specialties including orthopaedics, neurology and cardiology.
• Using hospitals electronic healthcare record, for jobs such as discharge summaries, requesting relevant investigations.
• Interpretation of ECG's, x-rays and CT imaging.
• Performing common bedside procedures including IV cannulation, nasogastric tube and urinary catheter insertion.

I was mainly working in the High Dependency Unit, alongside the attending physician and nurses. After rounding on patients with the attending in the morning, I would manage patients according to their needs. This included but was not limited to patients with acute exacerbation of COPD, sepsis, acute decompensated heart failure, pneumothorax, and malignant hypertension. As the team consisted of only the attending, the clinical pharmacists, nurses, and myself, it was my job to regularly evaluate patients throughout the day, consult the attending with any new findings/investigation results, and arrange transfer to the nearest hospital's ICU for the acutely deteriorating patients. On-calls and night shifts included cross-covering general surgery patients. It also taught me the basics of NIV, intubation, and the physiology of acutely unwell patients.

• Clarked in newly admitted patients.
• Outlined risks and benefits regarding surgery to address expectations of patients.
• Ordered radiology tests to assess diagnostic images.
• Communicated with other departments, including different subspecialties, social workers, protective services etc to optimise patient health care.
• Presented presentations among peers and seniors on the latest medical advancements and treatment guidelines

I was responsible for evaluating patients in the clinic, as well as examining them and forming an initial management plan, under direct supervision of the attending. I have become familiar in dealing with general health issues such as congestive heart failure, DVT, pulmonary embolism and thyroid disorders.

This externship was done at Dr. Vishnu Gaiha's cardiology clinic, which is a busy clinic located at the Ascension St Francis Hospital. I have accomplished how to interpret ECG's, echocardiography results, stress tests and gained a basic understanding of cardiac catheterization. I have also learned how to manage common cardiac conditions, such as heart failure, atrial fibrillation, as well as how to identify faulty pacemakers.

I rotated at an outpatient clinic in Tampa, Florida, that is affiliated with Tampa General Hospital. I was exposed to patients with a variety of issues, including COPD, asthma, lung cancer, alpha 1 antitrypsin deficiency, sleep apnea, narcolepsy, and pleural effusion. I evaluated on average 10-15 patients daily, and I would receive feedback on my plan and notes. I would then counsel patients on their health, answering questions and explaining questions within my limits. I learned how to interpret pulmonary function tests, sleep study results and evaluation, and basic reading of CT/PET scans

I participated in defining and requesting the appropriate resources required to manage patients, discussing with patients treatment options, and answering inquiries, within my limits. I also assisted in the OR, including emergency and elective C-section lists, as well as in the delivery room. I performed regular follow-ups of in-patients, as well as pre-rounds and rounds. I have also assisted in outpatient duties. On-call shift duties entailed assessing acutely ill patients and formulating management plans after discussion with the senior residents and consultants.

King Saud Medical City is one of the largest and busiest hospitals in Saudi Arabia, having a capacity of 1500 beds, including 200 ICU beds. It is a ministry of health teaching hospital, and is a level-I trauma center. Under the supervision of my seniors, I would manage an average of 10-15 patients daily, where I would assess patients, and review the latest investigations. Clarked in newly admitted patients.

In the Surgical department, I was required to be continuously present in emergency department during my on call shifts, where I assessed patients who present with acute abdominal cases, such as acute diverticulitis and appendicitis.

This rotation was done at a busy central ministry of health teaching hospital in Saudi Arabia, which has 500 beds. I have learned how a major hospital is run and how to treat acutely unwell patients with a wide variety of health issues, including liver failure, heart failure, ESRD, and MERS-CoV. I have evaluated over a dozen patients a day under the direct supervision of my attending. I have learned to perform several standard care procedures, such as nasogastric tube insertion and urinary catheterization placement. The hospital uses the Cerner EMR system, of which I have mastered its use, as I was responsible for the documentation. I also had the pleasure of teaching rotating medical students about the approach to clinical medicine.

• Attended training sessions to enhance clinical skills.
• Oversaw junior staff, promoting efficient hospital operations.
• Demonstrated leadership skills in mentoring medical students during their rotation periods.
• Managed patient care by coordinating with multidisciplinary teams.

• Collaborated with senior consultants for complex case management.
• Provided compassionate bedside manner to ease patient anxieties.
• Attended training sessions to enhance clinical skills.
• Engaged in ethical decision-making whilst dealing with sensitive cases.