Bivek Khatiwada

• Delivered rotational bank cover across acute medical specialties at Hull Royal Infirmary, including Acute Medicine, Short Stay, Ambulatory Care, and Emergency Department shifts, with dedicated placement in Elderly Medicine for the past six months.
• Conducted thorough clerking and initial management of acute admissions in generalised medicine wards, addressing presentations such as community-acquired pneumonia, acute heart failure exacerbations, and sepsis, with prompt risk stratification, appropriate investigations, and escalation.
• Managed complex cases in the Diabetes Ward, including diabetic ketoacidosis (DKA), severe hypoglycaemia, and hyperglycaemic hyperosmolar state (HHS), optimizing insulin regimens, fluid/electrolyte balance, and addressing precipitating factors like infection or non-compliance.
• Oversaw care in the Renal Ward for acute kidney injury (AKI) superimposed on chronic kidney disease (CKD), often secondary to dehydration, sepsis, or nephrotoxic agents; adjusted medications (e.g., withholding ACE inhibitors/ARBs), managed fluid balance, and prepared patients for urgent dialysis when indicated.
• Handled diverse acute presentations in generalised medicine wards, including COPD exacerbations, gastrointestinal bleeds, and stroke mimics, integrating multidisciplinary input for timely stabilization and transfer planning.
• Specialized in Elderly Medicine over the last six months, performing comprehensive geriatric assessments (CGA) on frail older adults to identify reversible contributors to decline, focusing on the “geriatric giants” of frailty, delirium, falls, incontinence, and immobility.
• Diagnosed and managed acute delirium in elderly inpatients (common triggers: infection, medications, dehydration), implementing non-pharmacological strategies (e.g., reorientation, hydration, minimizing anticholinergics) and judicious short-term use of haloperidol when required, reducing duration and complications.
• Led falls prevention and post-fall management in the elderly cohort, conducting multifactorial risk assessments (e.g., orthostatic hypotension, visual impairment, polypharmacy), initiating bone health reviews, and referring for physiotherapy/occupational therapy to improve mobility and prevent recurrence.
• Optimized polypharmacy in frail elderly patients through systematic medication reconciliation and deprescribing (e.g., stopping unnecessary antihypertensives or sedatives), reducing adverse drug events while maintaining control of comorbidities like hypertension, atrial fibrillation, and heart failure.
• Performed essential bedside procedures in both acute and elderly settings, including venepuncture, peripheral IV cannulation, arterial blood gas sampling, nasogastric tube insertion, and urinary catheterisation, with strict adherence to aseptic technique and patient safety protocols.
• Responded effectively to ward deteriorations and resuscitation calls, providing initial airway support, circulatory resuscitation, and rhythm analysis in cardiac arrest/peri-arrest scenarios, while escalating promptly to critical care teams and contributing to multidisciplinary debriefs.
• Coordinated safe, person-centered discharge planning for elderly patients, collaborating closely with physiotherapy, occupational therapy, social services, district nursing, and primary care to arrange packages of care, intermediate care, or rehabilitation, minimizing readmissions and supporting independence.

• Actively observed and participated in daily ward rounds and multidisciplinary team (MDT) meetings with consultant surgeons, gaining insight into management of upper GI conditions including oesophageal/gastric cancers, reflux disease, and benign pathologies.
  • Shadowed consultants in outpatient clinics and endoscopy sessions, observing patient consultations, diagnostic assessments, and therapeutic procedures.
  • Observed a variety of upper GI surgical procedures in theatre (e.g., laparoscopic fundoplication, gastrectomy, cholecystectomy), understanding operative techniques, team dynamics, and sterile protocols.
  • Assisted indirectly with patient history compilation and record accuracy under supervision, while monitoring post-operative vital signs and recovery.
  • Collaborated with multidisciplinary teams (surgeons, gastroenterologists, nurses, dietitians) to observe development and implementation of patient care and rehabilitation plans.
  • Maintained strict patient confidentiality and professional standards, while building knowledge of NHS clinical practices, surgical decision-making, and patient communication in upper GI surgery.

• Assessing the patients, evaluating the illness, doing relevant tests and examinations and ultimately discuss the treatment plan
• Airway management in critically ill patients who aren't able to breathe on their own including intubations.
• Monitoring and managing the fluids and electrolytes as well as looking for acid base balance.
• Changing the catheters and NG tubes regularly in critically ill patients.
• Talking to the relatives of the patients and provide them emotional support and sympathy.
• Arterial lines insertion and assistance in Central Venous lines.
• Draw blood samples from the patients, send them to lab and discuss the further treatment plans.
• Worked with multidisciplinary team of surgeons, nurses, radiologists to provide comprehensive care.

• Worked as a Research Medical Officer in the research project entitled "A multicenter, randomized, double blinded, placebo-controlled phase III clinical trial to evaluate the efficacy, safety and immunogenicity of the recombinant two component COVID-19 vaccine (CHO cell) in adults aged 18 years and older" at BP Koirala Institute of Health and Sciences
• I was responsible for screening and determining the eligibility of study participants, obtaining of informed consent and enrollment of participant in the study
• I performed physical examinations, collected participant medical history and concomitant medication information, and randomize patients
• I was also responsible for assessment, investigation, and reporting of outcome events

• Community Oriented Compulsory Residential Rotatory Internship including postings in teaching district hospitals for 135 days
• Community Oriented health counselling and education
• Actively participation in various case management including both emergency and OPD cases in every posting
• Diagnose Cardiac Arrest and initiate cardio-pulmonary resuscitation
• Maintain patency of airway, deliver oxygen by bag and mask, perform endotracheal intubation
• Perform venesection/venipuncture and administer intravenous infusion
• Diagnose, manage and evaluate common medical conditions: Diabetes Mellitus, Hypertension, Fever, Abdominal pain, dermatological and ophthalmology conditions
• ECG recording and interpretation of ECG for Myocardial infarction, common arrhythmias
• Abdominal paracentesis, local anaesthesia administration, wound debridement, incision and drainage
• Pediatric management of minor ailments, preparation of Oral Rehydration Fluid and institution of oral rehydration therapy
• Assisted major operating cases of Acute Appendicitis, Exploratory Laparotomy and Emergency Lower Segment Cesarean Section
• Assisted minor operating cases of incision and drainage, Surgical Abortion, wart excision using electrocautery, lipoma excision, minor suturing
• Nasogastric tube insertion and urethral catheterization
• IM, IV and SC injections
• Institute prophylactic measures for tetanus and rabies
• Interpretation of laboratory investigations