Understanding what it feels like to go through the hard, challenging life as a young house officer equipped with knowledge but with zero experience, we strive to come up with the best tips and important highlights to ensure your journey through housemanship is less painful. Chapters covers all the major postings as well as providing useful insights into radiology, anaesthesiology and pathology-related matters. We have also incorporated a chapter on how to cope with housemanship. Knowing how stressful it can be – fear of the unknown, unexpected, unfamiliar working conditions in the hospital may be detrimental to those who do not posses good survival skills. This book is specially dedicated to our students who are just about to venture out into the thrilling and challenging world of housemanship.
A good informative book for houseman students. It is a mini guide for you to pass through your journey as a houseman. Let me share with you few of the tips that might came handy when you encountered the real situation.
SURVIVING THE MEDICAL POSTING
“Whenever a doctor cannot do good, he must be kept from doing harm” – Hippocrates
When starting in any speciality, there are always key elements that will define you as either a superb or a substandard house officer. From any housemanship rotation, the first impression of your performance usually gives one a general idea on how you may perform or be perceived for the duration of your residency. So it is of paramount importance that you start your posting fully prepared.
Medical posting has always been viewed as one of the more difficult departments to work in as a house officer. A myriad of patient presentations, social challenges that often accompany certain patients or even the daily workload often overwhelm the underprepared, so it is important to be ready and to accept the fact that in the coming 4 months your social life will be virtually non-existent. It is also important to note that medical departments vary from hospital to hospital. The bigger teaching hospitals will usually have dedicated subspeciality wards, where as the smaller ones will have a diverse patient profile in their wards.
The purpose of this guidebook is not to (re)teach you the minute details of diseases, nor to tell you the steps of doing a procedure, but to arm you with enough knowledge and “know how” to ensure your time as a medical houseman is bearable, if not enjoyable.
GENERAL OVERVIEW/BLANKET RULES
Medicine posting is very wide. You can see a stable patient to the very ill one sits next to each other. Quite often, that you have to attend collapsed patients whom you saw stable few minutes previously. Thus, it is not easy to provide guideline on all cases in medical posting.
However, generally all patients who are admitted to medical department need daily assessment of few common parameters to help in monitoring the progress and stratify the risks of the patients. In general, these are things that are a MUST in all patient in medical wards :
Vital signs – Blood pressure (BP), pulse rate (PR), temperature, weight and oxygen saturation level (SPO2).
The fluid balance charting (input-output chart).
Electrolytes balance – mainly all the blood parameters from investigations, arterial blood gases (ABG).
Sugar monitoring – which always been forgotten if the patient is not diabetic.
Infective parameter mainly from full blood count (FBC), C-reactive Protein (CRP) or erythrocyte sedimentation rate (ESR).
One of the core business in medical posting is also abundant blood taking and procedures. Therefore, standard universal precaution should be routinely practised everytime you need to do it!
Always refer to your senior or supervisor if you are not sure or you already failed few attempts on the procedure especially blood taking. Please do not try to be hero by doing things you are not capable of. Sharing is caring! And please know your limit.
We listed some common cases and common do’s and don’ts for your guide.
Enjoy your medical posting!
“The physician should not treat the disease but the patient who is suffering from it” – Maimonides
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