Surgery SIP at NUH: Upper GI

6 weeks after the Medicine Student Internship Programme (SIP) at SGH, J. went to National University Hospital (NUH) for one month of Surgery SIP with the Surgery Department, split into 2 chunks of two-weeks duration. The first two weeks he’s spending with the Upper GI (Gastrointestinal) team, the second two weeks will be with the Plastic Surgery team.

Other teams in the Surgery Department, which J. colleagues joined, include Breast & Trauma, Colorectal, Urology, Neurosurgery, Hepato-pancreatico-biliary (HPB) and Endocrine & Laparoscopic. Vascular surgery, unlike in SGH, is under the CTVS department (Cardiac, Thoracic and Vascular Surgery).

J. thinks it’s very fortunate for him to be on the Upper GI team. The consultant, an Associate Professor, and the registrar are both incredibly enthusiastic about teaching. It led to very stressful situations in the first few mornings, when J. and friends were bombarded with questions like, “What are the causes of post-op fever?”

The answer should be “Causes of post-op fever can be classified into < 24hrs post-op, 2-7 days, and late causes. Within 24hrs, the most common cause by far is atelectasis. Within 2-7 days is when the various infective causes would come in, such as urinary tract infection (2-3 days) and pneumonia. There’s also deep vein thrombosis (5-7 days) to look out for.” A common and convenient mnemonic is Wind, Water, Walk, Wound, Wonder drugs = Atelectasis, UTI, DVT, deep wound infection, drug reaction.

Besides that, there’s the clerking of patients, examinations, discharge summaries… but the emphasis of the day is to survive the first 2 hours (i.e. morning ward rounds). When there are interesting patients, we get to go down to clinics (very, very interesting) or endoscopy room (very interesting) or the A&E (very gross… trauma patients). Anyway, J.’s with two CG mates who are hardworking, yet not too overly enthusiastic, so it’s all good.

Let’s hope the next two weeks in plastics turn out equally awesome!

P.S. There’s one minor problem with the upper GI team that stops it from being super-duper awesome.

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