Sagun Aryal

Assisted in gaining clinical exposure to multidisciplinary management of critically ill patients in tertiary NHS hospital.

Supported participation in consultant-led ward rounds, case discussions, and multidisciplinary team meetings.

1.Observed management of complex conditions, including sepsis, respiratory failure, and multi-organ dysfunction.

2.Aided in developing understanding of advanced critical care interventions, including mechanical ventilation and vasopressor therapy.

3.Helped gain insight into NHS clinical governance, patient safety protocols, and evidence-based clinical practice.

4.Enhanced clinical reasoning through active discussions of complex patient management strategies.

5.Contributed to clinical audits and quality improvement activities, strengthening understanding of clinical governance and patient safety protocols within NHS.

My responsibilities while working primarily in the Emergency Department (ED) and Outpatient Department (OPD) included:

1.Receiving and assessing patients presenting with urgent and acute conditions, including medical emergencies, trauma, poisoning, pediatric illnesses, respiratory distress, cardiac complaints, and obstetric and gynaecological emergencies.

2.Independently clerking patients by taking structured histories, performing focused examinations, formulating differential diagnoses, and initiating appropriate management in a high-pressure, resource-limited setting. 3.Managing a wide range of acute and general medical cases, often as the first point of contact, ensuring timely decisions when senior specialist support was not immediately available.

4.Stabilising critically unwell patients using the ABCDE approach, initiating oxygen therapy, establishing IV access, administering fluids, managing shock, and performing Basic Life Support when required.

5.Performing essential emergency procedures including suturing, wound management, IV cannulation, urinary catheterisation, splinting fractures, nebulisation, and initial trauma care.

6.Participating in emergency triage, prioritising patients based on clinical severity, especially during peak hours when the department was overcrowded.

7.Reviewing and monitoring admitted patients through regular ward rounds, identifying early signs of deterioration, and arranging timely referral to higher centres when advanced care was required, as there were no on-site consultants in the hospital.

8.Working closely with nursing staff, paramedics, and senior medical officers to ensure coordinated and safe patient management.

9.Counselling patients and relatives regarding diagnosis, treatment plans, prognosis, and follow-up, maintaining clear, calm, and and compassionate communication even in stressful situations.

10.Maintaining thorough and accurate clinical documentation, updating progress notes and medication charts, and requesting and interpreting relevant laboratory and imaging investigations.

11.Participating in ambulance duties, home visits, and satellite clinics, providing acute and primary care services to patients beyond the hospital setting.

12.Representing the hospital in clinical training programs and workshops to update knowledge and practical skills, and incorporating this learning into daily clinical practice

Completed rotatory internship program in Department of Internal medicine, Psychiatry, Dermatology, General surgery, Neurosurgery, Orthopedics, Obstetrics and Gynecology, Maternal and Child Health Care (MCH), Ophthalmology, ENT, Emergency, Anesthesia and Pediatrics. Awarded as best intern for sincerity and hard work during internship in obstetrics and gynecology.