Gesu Ahmad

• Assessing and clerking patients referred from A&E, Urgent Treatment Centre (UTC), and General Practitioners (GPs), including history-taking, clinical examination, and subsequent discussion with the registrar or consultant.
• Attending daily multidisciplinary trauma meetings to review cases from the previous day, discuss operative plans, and determine further management strategies.
• Coordinating ward rounds with consultants, ensuring that management plans are implemented, including follow-up arrangements and discharge documentation.
• Conducting independent ward rounds when required, formulating and executing management plans.
• Assisting in surgical theatres with procedures such as Open Reduction and Internal Fixation (ORIF), joint replacements, and arthroscopic procedures, with experience in over 40 cases as either first assistant or independently performing procedures.
• Assisting with the manipulation of displaced fractures and application of casts.
• Leading and contributing to audits and Quality Improvement Projects at regional, trust-wide, and national levels, with findings presented at audit meetings.
• Engaging in case reports and research articles, with ongoing work in the process of publication.

As a Rotational Junior Clinical Fellow at Bedford Hospital I had exposure to a wide variety of patients and situations which I believe has immensely helped me grow as a clinician. The departments I worked in include

1. Colorectal Surgery: (also covered GENERAL SURGERY, BREAST & UPPER GI, and UROLOGY during on-calls)
-Independently performed surgical procedures such as Cyst Excision, Incision & Drainage of Abscess
-Assisted in surgical procedures such as Laparoscopic Cholecystectomy, Appendectomy, Hernia Repairs, Diagnostic Laparoscopy and Adhesiolysis, Colostomies & Ileostomies, Hemicolectomy, APR & Hartmann's procedure etc
-For general surgical & urology patients referred from A&E and GP, I independently clerked patients (including detailed history taking, examining them & performing basic blood investigations) then presented the case to the consultants/registrars, and carried out management plans after discussion.
-Carried out pre-operative preparations for patients going to theatre, including explanation of procedure and helping sign consent forms -Following up on patients' progress during Ward rounds and writing daily progress reviews on the wards
-During oncall ward cover, performed acute assessment and immediate management of unwell surgical patients based on primary (A to E) survey -Wrote GP letters, case summaries and referrals to other departments, other hospitals and to specialty clinics
-Attended & Presented Papers at the weekly Journal Club
-Participated and presented cases in the Morbidity & Mortality meetings held once every 2 months

2. Acute Medicine:
-Independently clerked patients (including detailed history taking, examining them & performing basic investigations) then presented the case to the consultants, and carried out management plans after discussion.
-Performed general and systemic examinations performed for various acute medical conditions such as acute coronary syndromes, pulmonary embolism, subarachnoid haemorrhage, migraine, exacerbation of asthma & COPD etc
-Reviewed patients and wrote their progress reports.
-Assisted in procedures such as Lumbar Puncture, Chest Drain insertions
-Helped deliver stabilising and life-saving treatments during medical emergencies.
-Participated in departmental teaching sessions.
-Wrote GP letters, case summaries and referrals to other departments, other hospitals within the trust and to specialty clinics.

3. Care of the Elderly (Orthogeriatrics)
-In addition to oncall duties which included covering medical wards and clerking patients referred via A&E/UTC or GP, I covered the Orthogeriatric patients and my duties included:
-Performing OG assessments for patients above the age of 60 who have sustained a Hip fracture
-Taking handover from T&O team for the above after 72 hours of operation, addressing and managing their medical problems i.e. Pulmonary Embolism, chest infection, urinary tract infections until they are medically optimised
-Investigating and treating for Vitamin D deficiency and Osteoporosis if found on tests (bloods, DEXA scans)
-Liaising with Physiotherapists, Occupational Therapists and discharge planners for adequate mobility and smooth transfer of care once patient is ready to be discharged
-Ensuring follow up in the community to assess progress by coordinating with Fracture Liaison Services

Apart from the above I have also covered Acute Assessment Unit, Endocrinology and Coronary Care Unit when these wards were short-staffed and rearrangement of personnel was needed. These experiences have further strengthened by ability to adapt and improvise, and have expanded my learning horizons.

• Developed an understanding of NHS system.
• Familiarised myself with the medical documentation and the IT system used for ordering investigations and viewing past medical records.
• Gathered history, assessed patients under supervision and guidance of seniors.
• Keenly discussed the cases which I observed by being in the Acute Medicine Department with the consultants and registrars on duty.
• Observed general and systemic examinations performed for various acute medical conditions such as acute coronary syndromes, pulmonary embolism, exacerbation of asthma & COPD, subarachnoid haemorrhage, migraine and so on.
• Learned to clerk admissions, write patients' progress reports.
• Observed procedures such as Lumbar Puncture, Chest Drain insertions
• Helped deliver stabilising and life-saving treatments during medical emergencies.
• Participated in Quality Improvement Project and Audits.
• Participated in Departmental teaching sessions and delivered Case Presentation.
• Learned to formulate discharge letters, case summaries and making referrals to other departments, other hospitals within the trust and to specialty clinics such as Rapid Access Chest Pain Clinic.

• Advised on dietary, nutrition and illness prevention.
• Handled patients' hygiene needs in support of personal dignity and optimum wellness.

Rotated in various specialties where I gained invaluable clinical knowledge and practical experience
Medicine - 2 months
Surgery - 2 months

Anaesthesiology - 15 days
Obstetrics & Gynaecology - 2 months
Community medicine - 2 months
Paediatrics – 1 month
Orthopaedics – 1 month
Ophthalmology – 15 days
ENT – 15 days
A&E – 15 days

Dermatology - 15 days

Diagnostic Laboratories- 15 days
Forensic Medicine – 15 days
My main duties and responsibilities as an intern included:
• Taking detailed clinical history and performing relevant physical examination.
• Monitoring vital signs of the patients and maintaining proper record.
• Attending ward rounds with consultants and following their orders to provide optimum management to the patients.
• Arranging necessary haematological and radiological investigations including chest x ray, CT scan and MRI.
• Medical record keeping according to the hospital protocols.
• Attending patients in Outpatient Department.
• Assessing and managing acutely unwell patients in Emergency Department.
• Performed detailed discharge planning tasks including preparing discharge summaries, ensuring cohesive handover of care.
• Performed diligent surgical care tasks including pre-operative evaluation, operative management and post-operative care.
• Took thorough patient histories within 15 minutes average.
• Ordered and interpreted investigations, utilising exceptional
communication skills to provide relevant findings to patients.
• Provided detailed referrals for specialist medical services.
• Safely prescribed and administered medications including analgesia,
intravenous fluids and medications.
• Advised patients on post-treatment care options, at-home plans and
effective rehabilitation.

During my rotation in Medicine Department, I was further posted in Endocrinology, Psychiatry and Critical Care Unit. Some of the cases which I have managed are Ascites, Hemiplegia, Paraplegia, Dengue, Malaria, Liver diseases, Diabetes, hypothyroidism, and hyperthyroidism.
Apart from my posting in General Surgery, I was also posted in Urology & Plastic Surgery and Orthopaedics I was responsible for wound suturing and dressing of patients. I was also responsible for pre-operative assessment of patients before elective surgeries. I attended the operation theatre with my seniors and observed various surgeries including laparoscopic cholecystectomy, hysterectomy, internal femoral fixation by nailing, appendicectomy, hernia and hydrocele.
I performed duties in labour room during my rotation in Gynaecology and Obstetrics, where I assisted in normal vaginal deliveries and Caesarean Sections. I also monitored and managed patients in HDU and ICU.