Medicine SIP AAR – Battle Gear

Having done 4 weeks of Medicine SIP, J. is looking back through his retrospectroscope regarding useful things to bring along on the posting.

  1. References – J. carried around a stack of cards held together by a single ring . On these cards were antibiotic sensitivities, normal ranges of common laboratory results, drug dosages, common clerking investigations, fluid and calcium level calculations, Ranson’s/Glasgow/Child-Pugh scores (J. was rotated to Gastroenterology). He later converted these into a small notebook that fit in his breast pocket. While some of these things should be second nature after a while, it’s useful to have a handy reference at hand. After all, who can remember off-hand the correct dose of IM vitamin B for pernicious anaemia?
  2. SIP References

  3. Comfortable Clothes – Comfortable clothes are a must. J. favours 100% cotton shirts because they’re very comfortable and dry quickly (you will sweat, given the 32°C, 90% humidity weather). High polyester percentage (e.g. 40%) shirts stick to the body and take forever to dry. Shirts should come with a breast pocket, these are fabulous for putting many things.
  4. Comfortable Shoes – A lot of walking is done. For instance, the gastro team at ward 46 also has to cover overflow patients at ward 11, located away from the main building. Then there are the histopathology rounds at the National Cancer Centre. And we’re not even talking about the multiple ward rounds. You’ll be on your feet all day. Get comfortable shoes. Don’t save on these. J. is amazed when he sees HOs/MOs/SIP students of the feminine persuasion walking around in heels.
  5. Neurology KitNot needed. Usually consisting of tendon tappers, toothpicks, tuning forks, cotton wool, and the like, this is only for the neurologists. Most other departments won’t see many neuro patients, and when they do, a simplified neurological examination usually suffices. Most wards also stock tendon tappers and fundoscopes for the few patients these examinations are required.
  6. Handy Stamp – See dedicated post. It’s handy!
  7. Stationery – A pen, preferably contributed by a drug rep, is usually sufficient. J. carries two, in the event that one of the pens is lost. Rulers are optional, because many practising ward doctors use the art of “guestimation” or use the new standard unit of “fingerbreadths” when it comes to measurements. Some of the more conscientious ones also use a retractable measuring tape hung from their lanyard.
  8. Lanyard – From where the matriculation card and name tag are hung, it’s also a useful place to hang pentorches, pens, for some people the handy stamp, as well as clip the ward list (particularly for the ladies who have fewer pockets). Don’t underestimate this handy tool.
  9. Stethoscope – Ah, the sign and tool of physicians all over. The stethoscope grants one the power to confidently write in the case notes “H S1S2 no murmurs, L clear, BS +ve” (Heart first and second heart sounds present, no murmurs heard, lungs clear, bowel sounds present). Not only can it be used to actually listen out for heart sounds, bruits, and whatnot, it can also be flourished as a symbol of identity. Patients often mistake the female physicians for the “missy” (nurse) and can be corrected by brandishing the doctors’ brandishing of the stethoscope. Always have one around the neck.
  10. Waistpouch/Slingbag – While it may look unprofessional, in particular for the gentlemen, the convenience factor such a bag cannot be underestimated, especially for those who need to carry a neuro kit (see above). A Snellen’s eye chart doesn’t fit well into the breast pocket. “Is that a tendon hammer in your pocket, or are you just happy to see me?” Furthermore, for the busy HO/SIP student, a bunch of gloves, KY jelly, butterfly needles, alcohol swabs, plasters, IV cannula covers ensures that repeat trips to the preparation room are reduced in number.
  11. Ward List – Printed out every morning, it’s worthwhile to make a few notes regarding the patient, e.g. “67/C/♂, GE – IV Abx” on the sheet of paper. As the ward rounds go by, note down changes that have to be made at the side. J. draws a box followed by the task (e.g. □ D/S [for discharge summary]) beside the patient’s name/bed number so that he can tick off the changes as he accomplishes them.
  12. A Ready Smile – If patients like you, they’ll be more willing to consent to blood taking. If the nurses like you, they’ll be more willing to help you. If your team likes your attitude, you’ll have a more pleasant day (and possibly free coffee).

Alright! Hit the wards!

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