Aravind Nair

• My work is divided between 3 clinical sites- The Acute Medical Unit, Short Stay Ward and Same Day Emergency Care. The role has on-call and night commitments. More details include:
  
  Acute Medical Unit and Short stay unit
  1. Review patients with consultant. I prepare patient files and present the cases to consultant before ward rounds by analysing clinical history, examination, bloods, relevant imaging and formulate a working diagnosis and plan.
  2. Communicating diagnosis and treatment plan with patients and next of kin and documenting the conversation.

3. Collaborate with consultants, registrars, nursing staff and other specialties to deliver high quality patient care and ensure safe discharges following recovery.

4. Provide acute patient care, including identification and management of emergency presentations and ward based medicine with sound clinical reasoning and evidence based practice

Same Day Emergency Care
1. Ensure same day discharges of acutely unwell patients by assessing patients independently, ordering relevant investigations and formulate a working diagnosis before presenting case to consultant.
2. Communicate diagnosis and treatment plan with patients and next of kin and documenting the conversation.
3. Liaising with other medical/ surgical specialties for patient care.


On-call Duty & Night Duty
1. I provide on-call cover for medical wards
2. Adult cardiac arrest and medical emergency team member.

Labour Ward:
1. Participated in Handover where the night team explained about the in-patients and any Obstetric emergencies that transpired in the night.
2. Participated in ward rounds.
3. Assisted in a category 3 C-section with the registrar.
4. Learned about pharmacological and mechanical methods of cervical dilation.

Colposcopy Clinic
1. Observed colposcopy procedures and learned grading of cervical intraepithelial Neoplasia
2. Performed one colposcopy under supervision

Gynaecology
1. Attended Handover where gynaecological emergencies of the night were discussed.
2. Participated in ward rounds where I learned about surgical management of ectopic pregnancy and endometriosis.
3. Assisted in theatre for a Laparoscopic ovarian cyst removal and observed a Hysteroscopy for endometrial cancer biopsy.
4. Shadowed Gynaeecology registrar when attending referrals.

Post-Menopausal Clinic
1. Took clinical history regarding post menopausal symptoms.
2. Learned about sequential and continuous HRT.

Infertility clinic
1. Learned about semen analysis and criteria for IVF referral.
2. Learned about the factors affecting female and male infertility.

Antenatal Clinic
1. Attended the first trimester clinic, learned about ultrasound applications in pregnancy.

1. Provide pre-operative assessment of all elective and emergency patients by liaising with other departments (Anaesthesia, Cardiology, Pulmonary, Internal Medicine, etc.) and preparing the theatre list.

2. Attend ward rounds with consultant and follow up plans.

3. Assist consultant in surgical theatre.

4. Provide post-operative care for patients- assess wound dressings, recovery and management of post operative complications under supervision.

5. Take surgical referrals from emergency department and other specialties.

6. Perform minor wound debridement under supervision.

- Observe ward rounds with the consultants.
- Observe Endocrine surgery clinics- learnt how to diagnose pheochromocytomas, Thyroid and parathyroid malignancies.
- Attended General Surgery clinics- learnt how to diagnose Hernias, gall stones and surgical wound infections.
- Took histories and performed supervised clinical examinations.
- Learned about the 'Time out' , 'Sign in' and 'Sign out' protocol observed in surgery.
- Observed surgical procedures like Thyroidectomies, Parathyroidectomies, laparoscopic hernia repairs in the Theatres. I also got the chance to assist in a few procedures.
- Learned about the Getting it right the First time (GIRFT) guidelines and Day case surgeries.
- Observed robotic surgeries like robotic cholecystectomies and adrenalectomies.
- Attended journal clubs with the junior doctors.
- Conducted a clinical audit under registrar supervision and presented in a departmental meeting.

• This is the compulsory rotatory medical internship which I had to complete before I am awarded my degree. My work was centred around 3 tertiary referral teaching hospitals (24/7 trauma and imaging), the Wenlock District Hospital (1500 Beds), Lady Goschen Hospital and the Regional Advanced Paediatric Care Centre which are Public hospitals serving the city of Mangalore (population of 620,000) and its south India.
  
  Postings include:
  Anaesthesiology (15 days)
  - Observed endotracheal intubations and Epidural anaesthesia.
  - Assisted in Pre-Anaesthetic assessments.
  
  General Surgery (1.5 months)
  - Assisting in Major and Minor Surgical procedures.
  - Perform pre-operative assessments of patients by liasing with anaesthetic and medical specialties.

- Performing wound dressings and minor debridement under supervision.

- Attend ward rounds and follow up on ward jobs.

Paediatrics (1 month)
- Worked one month in Neonatal intensive care unit.
- Performed Phlebotomies and ABG’s in neonates.

- Identifying acute pediatric emergencies and management under senior supervision.

Orthopaedics (1 month)
-Performing manual reductions and cast applications under supervsion.
-Assisting in operative theater.

- Attending ward rounds and following up on ward jobs.

Emergency Medicine (15 days)
- Performing the ABCDE assessment and participating in initial management of acutely unwell patients under supervision.


Internal Medicine (1.5 months)
- Identify and manage acute medical emergencies and chronic disease management under supervision.
- Worked in COVID ICU in second wave of covid.

Community Medicine (2 months)
- Worked in a Community Health Centre and Primary health centres in rural India as a duty doctor.
- Conducted immunisation and health camps.
- Participated as a team member in the COVID tracing cell of Mangalore City-corporation.

Obstetrics & Gynaecology (2 months)
- Assisted in normal vaginal deliveries.
- Perform minor surgical procedures like closure of Episiotomy wounds under supervision.
- Learned about diagnosis and management protocols of pregnancy induced medical disorders.
- Attended antenatal clinic and learned about risk stratification of pregnancies.

- Performed ward duties in post natal ward, labour ward and high risk pregnancy wards.
- Assisting in Caesareans, tubectomies, Hysterectomies and laparotomies.