Internship in Ophtha

Internship Day 1 to 14

Weeks 1 to 2

From July 1 to 14, 2016

The sign at the back of SOJR: The setting for this awesome two-week rotation!
(Grabbed from Mike Mondragon :) will replace this once I get a better photo)

General Info:

Duration of Rotation:	2 weeks
Number of students:	10-13 (depends on number per block)
Important hours:	Time in: 7:00 AM Time out: 5:00 PM
Wearing coats	REQUIRED on OPD! Allowed to be removed when on ER/Ward Duty.
Duties:	Two posts: One Ward Intern-on-Duty (WIOD) and one ER Intern on Duty (EIOD) from 7AM to 7AM the next day.
How often?	Depends. We were 10 in our block, and there were only 2 interns on duty per day, so we have 5 pairs rotating “duties” every 5 days. So chill!
True Posts?	Nope. But post-duties can go home early (12noon) if allowed by consultants/residents.
SIC work:	Only WIODs do the SICs of 12-20 patients in the ward.
With clerks?	Yes. But we were the unfortunate (or fortunate) interns who had no clerks yet on our first month in internship.
Residents/Fellows	Very approachable (most of them save one particular resident—I won’t name him/her! Haha!) They really teach if you ask questions. Very notable are sir Tonici, sir Babs, and sir Chan (fellow).
Call room	Yes. Pretty decent. (+) 1 double-deck bed (only the one below is used). (-) aircon but with lots of electric fans (donated by previous batches). Wi-fi is not always accessible. Rest-room is at the other end of the hallway.
What’s unique?	·  Half-day duties if with clerks (depends on your agreements) ·  You have a separate building that does not feel like PGH at all!!! ·  SOJR is love! ·  No more senior endorsements! Yeay! ·  No more subspecialty rounds. *sad*
What to watch out for:	Conducting patients from ER to SOJR is always exhausting. But consider it the least thing you could do for your patients :)
Required Paper works:	·   Index card/attendance ·   SGD Grading sheets and Consultant evaluation
Expected/Required Skills and equipment	·   The 5-point eye exam (see video below) ·   Basic PE skills ·   IV line insertion and blood extractions ·   Ophthalmoscope ·   Penlight, pinholes, Jaegger charts
Other activities	·   2 graded SGDs, 1 each per sub-group with a consultant. ·   Written examination by the end of the rotation. Non-MQS non-samplex (for higher learning! Yeay!)
Toxicity level	5/10 Make the most of your time/stay in SOJR!!!
Trivia:	Ward duty in SOJR is among the notorious places of common “sightings” of supernatural beings. So watch out for a running child/lady along the hallways… Just don’t follow them! Enjoy sight-seeing!

The Index Card:

Kindly prepare the following:

One 8x5 Index card with 1x1 Recent ID picture.

Written on it are: The intern’s complete name, Block, and date of rotations/posts with another column saved for the residents’ signatures. This will also serve as their attendance. [See photo below]

PS. I was the LO in ophtha both last year and this year :D Not that I am considering the specialty already, it just so happened that fate made it happen that way. QadaraAllah.

Pre-Duty

Call time is 7AM at General Clinics (GC). All preduty interns will examine the new patients (7AM to 12NN) and follow-up patients (1PM to 4PM). Everyone is expected to at least conduct a short yet concise history and brief systemic PE, coupled with the 5-point eye exam as described and taught in this video:

The 5-point Eye exam by Dr. James Abraham Lee

After charting, the papers are for evaluation by the residents. A patient interviewed by the intern/clerk will be called and re-examined by the resident for further evaluation (usually for IO or indirect ophthalmoscopy). There are times that an intern/clerk will be called in for other questions regarding his/her patient, so still be ready.

Clinic Manager. Every day, there will be one Clinic manager who will—well—"manage" all the extra paperworks in the GC. Patients asking for Clinical Abstracts, laboratory and imaging requests, and other “teach me how” things are all under the responsibility of the Clinic Manager. He/She is actually exempted from charting both new and old patients, but he is free to do so whenever he is free. The LO can assign who will be the Clinic manager for each day or the group can agree on this matter beforehand.

The General Clinic.
Someone's pretty busy catching up on his patient charts.

The pre-duty team is expected to stay until all patients (especially follow-up) are seen and examined by the Residents in GC. If they are done charting, they are free to ask their residents to teach them how to use the IO or the slit-lamps. They are free to go once all patients are seen and their attendance sheets are properly signed.

Duty

The duty team will be divided into two: one WIOD and one EIOD. The WIOD is expected to be at the Charity Ward (3^rd floor, SOJR) at 7 AM to receive the endorsements from the previous WIOD. He/she is expected to do chart rounds at least 4 times: two times in the day, one in the evening and one in the next morning before shifting. All backlogs from previous duty should be carried out immediately. There is a Ward Logbook where the WIOD will write down all new orders and their status for every rounds.

The WIOD is expected to do the usual SIC works for all patients. That includes: Preparing lab requests, referral forms, clinical abstracts and discharge papers. Most procs are now done by the phlebotomists except stat labs. He/she also helps in inserting IV lines once in a while.

EIOD on the other hand will stay at the ACU-Ex (Acute Care Unit-Examination room) in the ER complex. Their “territory” is the rightmost (leftmost when inside) of the three “O-Departments” found in ACU-Ex: Ortho-ORL-Ophtha. The EIOD will receive all referrals and admissions from the ER, see and examine all patients referred/admitted, then if needed, conduct these patients to SOJR for further evaluation or examinations (usually slit-lamp and IO). Aside from that, we all do the usual stuff.

Tip#1: Text your ER ROD whenever you receive a new patient, especially if they are toxic or really emergent. There are only two ophthalmologic emergencies. Study them and learn to detect and manage at an acute setting, then call your ROD ASAP.

Tip#2: It’s hard to conduct your VA tests (Snellen) when your patients are bed-ridden, so always prepare to bring a Jaeger as an alternative.

SPECIAL: Ophtha Interns on Duty (WIOD only or both IODs) will be in-charge of the Adult ER Triage from 10PM to 1AM.

Post-Duty

Post-Duty WIOD will be assigned in Eye-Instrument Clinic (Opthalmic UTZ, etc.) at the 2^nd floor while the Post-Duty EIOD will be assigned in the OR at the 4^th floor. They are expected to participate or/and in the procedures. Some fellows/consultants would conduct teaching sessions once in a while so it’s always helpful to be prepared. So read ahead when you have free time.

IMPORTANT TO HAVE:

1. UP-PGH Self-Instructional Material in Ophthalmology (or simply the "Ophtha SIM") – this is a lifesaver! If you have the money to buy, do not hesitate to do so! This is among my greatest mistakes in medschool! I didn’t purchase one in LU3 as I consider it too expensive! It may be so, but it is so helpful from LU3 to LU7!

2. An Ophthalmoscope – It is not required but it is always better to have your own.

3. Penlights and a set of spare batteries – You do not want to further blind your patients with your phone’s LEDs! (Technically, they won’t get blind by it, only irritated.)

 I think that’s all I can share about my experiences in Ophtha. It is really awesome with high-yield learning while being chill. So make the most of it. Everyone loves the Ophtha rotation :D

Memoirs:

Photos

Orientation day = first day meeting our PGIs!!!
The awesome team is finally complete (oh wait, may absent pala!)

Preparing my 'weapons'.

First day high! (May absent na naman sa group pic!)

Observing a very delicate operation on-screen. Captured with permission.

Alone in the dark. Tried searching for ghosts, but failed.

When they left a 'toxic-magnet' intern manning the Adult Triage... Wrong move guys... wrong move...

When there are no more patients... Interns are just chilling around.

 

Last day Block Pic right after exams! With our course coordinator Dr. Tonicci Paulino!
(Guess which of the guys here is the real deal)
And we are still NOT complete! haha
yeah it was my turn to be late that day -_- Sorry!