LARAIB FATIMA

During my stay here, I performed Indoor (Ward), General Surgery OPD and Operation Theater duties.

Indoor duties:

- Attending admitted patients for daily progress notes.

- Performing detailed assessments of the newly admitted patients.

- Attending morning round by consultants and carrying out the round orders including

necessary investigations.

- Addressing acute complaints.

- Maintaining patients' records and files .

- Pre-op and post-op management in coordination with relevant surgeons.

- Formulating discharge plans, preparing discharge summaries, and planning follow-up arrangements.

- Counseling patients and addressing their concerns regarding the details of their relevant surgeries and possible outcomes.

General Surgery OT duties:

- Preparing patients for elective surgeries including getting fitness for anesthesia after proper investigations.

- Assisting consultant surgeons in major elective surgeries including hernia repair,

open/laparoscopic cholecystectomy, appendectomy, anal fistula repair.

- Performing minor procedures under senior supervision such as debridement, stitching minor wounds, incision and drainage, excision biopsy, ingrown toe nail removal and circumcision.

General Surgery OPD duties:

- Taking history, performing relevant examinations including thyroid, per rectal, abdominal, inguinal and testicular examinations.

- Prescribing relevant investigations and treatment under the supervision of consultant.

- Counseling patients and addressing their concerns.

Administrative teaching responsibilities:

I was made the Admin Registrar of medical officers and nursing staff to manage their rota. I was also assigned to teach them routine ward based procedures.

During my stay at General Medicine Department at Shifa Medical Centre, I rotated in Internal Medicine, Gastroenterology and Respiratory Medicine Ward along with performing the OPD clinic duties

Inpatient duties:

- Assisting the consultants during the ward round by preparing for the ward round notes, flagging up abnormal investigation results

- Attending and participating in the ward handover and MDT meetings for the complex or interesting cases

- Executing the ward round orders including sending relevant bloods, requesting scans, prescribing medications, sending referral to different specialities & following their advice.

- Preparing the discharge summaries and arranging follow ups

- Working as a team with the nursing and paramedical staff for efficient and comprehensive patient care

- Performing ward based procedures like IV cannulations, ABGs, VBGs, catherizations, etc.

- Performing Night- on calls as per General Internal Medicine on.- call rota.

Outpatient duties:

- Taking history, performing relevant examination and prescribing required investigations and

treatment under the supervision of consultant.

- Referring to tertiary care setups or emergency after proper assessment and opinion from

consultant.

- Counselling patients regarding their medications & follow-ups.

As a RMO in the Obstetrics and Gynaecology Department at this prestigious hospital, I carried out following duties and responsibilities;
- Performing Normal Vaginal deliveries and Normal Deliveries with
Episiotomy in the Labour Room

- Performing procedures like CTG, Abdominal and Pelvic ultrasound, Doppler, ECV, Tocolysis, Induction of labour

- Handling patients with great care, taking history in detail, diagnosing the critical condition, preparing patients for operations, taking verbal and written consent, and educating and counselling them
- Assisting the elective C-sections, Dilatation and Curettage,
Laparotomy, Hysterectomy, MVA and Ventouse in the Operation
Theater. Owing to my zeal, I was given the opportunity to perform
many C-sections independently

- Diagnosing and managing patients with Gestational diabetes, Gestational hypertension, Pre-eclampsia, Hyperemesis Gravidarum, Ectopic pregnancies, IUGR, APH, PPH, PROM, etc.
- Managing Gynecological Outpatient issues including menstrual
irregularities, Fibroid, Peri- menopause, Menopause , PCOS, etc
- Attending ante-natal clinics and performing Obstetrics scans
- Actively managing and supervising junior medical and
paramedical staff

- Attending seminars, Arranging ultrasound and Doppler training, and undertaking quality improvement projects

Jinnah Hospital is one of the largest tertiary level hospitals in Pakistan where all the patients with co-morbidities are managed in a multi-disciplinary approach. As a House Officer at Jinnah Hospital Lahore, I rotated through four departments (Anaesthesia/ICU, General Surgery, General Medicine, Obstetrics and Gynaecology), each rotation lasting three months.

Some of my general duties and responsibilities in all wards were:

1. Attending the morning handover.

2. Reviewing in-patient beds allocated to me.

3. Presenting cases in the morning round.

4. Following up round orders.

5. Maintaining patient files and records.

6. Requesting and chasing patient investigations.

7. Making discharge summaries.

8. Making Death Certificates.

9. Attending weekly teaching class and monthly case presentations.

10. Performing duties in ER twice a week and ward-call duty once a week.

DUTIES SPECIFIC TO EACH WARD:

Anaesthesia/ ICU

1. Peri-operative evaluation

2. per-operative monitoring for routine and emergency cases

3. Critical management of patients

4. Performing procedures like CVC line insertion, Endotracheal intubation, Spinal and General Anaesthesia under supervision.

General Medicine

1. In the ER we worked in teams led by a Consultant which included a batch leader and Trainee residents. I had the opportunity to see a wide range of medical emergencies

2. Teaching medical students about patient consultations, clinical

examinations, drug prescription and the basics of formulating a management plan.

General Surgery:

1. Preparing patients for surgery in ward and Emergencies.

2. Performing Wound cleaning, suturing and dressing in Minor Operation theaters.

3. Observing and Assisting consultant surgeons in Major theaters

Obstetrics and Gynaecology:

Attending Labour room, Major Operation theaters, Outpatient clinics to assist seniors with

1. Normal & Assisted Vaginal deliveries

2. Elective and Emergency C-sections & hysterectomies

3. Running ante-natal, post-natal and Gynaecology OPDs