Pre-Clerkship Exposure Duty Rotations

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          Our exposure duty this year had been extended to 6 months instead of the usual 3 months as a result, I presume, of the first ever student consultation spearheaded by our first alumni dean of the college. The purpose of which is suppose to orient us and make us be prepared for our upcoming internship duties in a few months to come.
          One thing I learned about these duties are they are basically WORTHLESS. Basically we don't do anything and instead we answer to the whims of the residents on duty. We do whatever they say in the absence of real work that may prepare us for the grueling work we will do as interns. It's good for those like me who had hospital experiences during our pre-medical course but for those who haven't, it's totally a purposeless.
          For the benefit of those who would otherwise learn from these experiences, I will try to give out some tips to make it a rewarding and a learning one:

1. Emergency Room. The first thing that is done in the ER is triage. Triage is the science of sorting  and allocation of treatment of patients according to the urgency and type of care the patient needs. After the patient has been triaged into Pedia (patients aged 1-18), Surgery (all patients with wounds and would require surgical care), OB-Gyne (all maternal and pregnant cases), Psych (all psychiatric cases) and Medical (all patients older than 18 and are not classified into the other specialized area of the ER). The next step is to get baseline data including history taking and physical examination. Upon endorsement to the resident on duty, labs and procedures will be ordered and carried out until the patient is stable enough to be admitted into the wards or be discharged as an outpatient case.
2. Pediatric Ward. Work in wards are basically routine including admitting and discharging patients, taking vital signs, starting an IV line, inserting urinary catheters or nasogastric tubes and osteorized tube feeding. Pediatric patients are delicate cases as they require careful administration of IV fluids to avoid fatal volume overload or dehydration, pediatric doses of medications and sensitive reactions of pediatric patients to medications and procedures.
3. Medical Ward. Medical patients are more burdensome in terms of quantity as they make up the majority of admitted patients even reaching up to 80% of cases. Procedures are also same as in Pediatric wards but less in urgency of care (of course this is a relative statement). Following up IVF solutions, starting an IV line is more of the common procedures done in the medical ward.
4. Surgery. There's really nothing to do in Surgery as the Surgeon do the bulk of the work. Interns purpose usually is to help and be of assistance to the Surgeon in performing what he ought to do. One thing that should be in your mind is to observe what the Surgeon does and how he perform the procedure. Every surgeon has his own technique in doing the same procedures so it is worthwhile to note their technique and compare this to the standard practice of doing the procedure. One thing to note about surgeons is also their big egos, they do basically what they want (so one advice is to 'not be in their way in any way and just follow what they want'). Most interns are usually assigned to holding the retractors and standing most of the times so be sure to take your meals before your duty and bring some candies for some extra juice for the work. A pre-duty workout will also do you fine.

          One major advice I guess is to keep an open mind. No matter what you experience, welcome it with open arms and train your mind to treat it as an opportunity for you to learn. You will eventually experience these things and resisting will not only stress you out more but will make the process more difficult for you. Bear the hard work, ignore the nosy residents and nurses, and tolerate egos wherever you are. As they say, as an intern, you are the lowest animal in the hospital. Of course I am not staying that you tolerate mistakes when you see one even though they are committed by seniors but be discreet about it. You will bear the grunt of their anger if you get into their nerves and you will enjoy the benefit of their spoils when you get into their better sides.