Archived from October 2013: https://likethechickenscratch.blogspot.com/2013/10/the-first-foot.html?m=1 as a mirror blog to preserve content as a backup.
ARCHIT JAIN, certified mountaineer under Indian Mountaineering Federation, presently dogged at sticking out an entrepreneurial venture propelled by short listing of the basic idea by the E-cell IIT-Bombay, A sportsperson at heart à claiming moniker at various fields (also bagged 2 bronze medals in table tennis at PULSE-2013) and thus the college sports’ coordinator. A gourmand and a sight-seer, inter alia; and writing here to share the experiences of my primal bailiwick-MEDICAL SCIENCE!
I am in my 2nd proff in Chirayu Medical College and Hospital, Bhopal. Presently I am working under the guidance of Dr. Rakesh Biswas with the object of drafting a case report for the British medical journal. And this writing here presents my experience from the same…
As it is a tendency of humans to assume what’s going to happen before setting foot on an unwearied path; I, in my heart, carried less doubt about the workshop I was going to attend. As especially in the domain of medical sciences, at metaphorically a young age, we doctors are sure to expect sessions of brainstorming and an unrelenting test of knowledge. But guess I was totally wrong this time!
Though the entire course was a bit lethargic considering it required a 7 hours run in order to cover 40 odd kms, changing 4 public transports each day and working like this for 14 consecutive days ; I am thankful it proved to be worth the effort!
I reached People’s College of Medical Sciences on 19th October at 9:00 am. Dr. Biswas was on his routine round when I first met him. It was in the casualty ward that I was introduced to him by Sumit, a friend of mine who took up the course with me. And then the training began.
Case discussions-
As I stated earlier, I was expecting loads and loads of lectures along with Power point presentations and a wall of tough questions to be put up by the doctor in-charge but it seemed I had a lot of air to keep!!
Dr. Biswas had this unique thing about his teaching prophecy whereby he discussed each and every little point about the patient with us. This was yet another experience in itself as being a 2nd Proff student it is not very often that we are exposed to such open discussions
After taking up the indoor patients, the round in the OPD began.
During this sir told us about a website called UDHC.CO.IN, how it was made and how it benefits not only the middle class but also the poor people. UDHC is basically a user driven health care website through which a patient can be followed easily without revealing his/her identity just by giving him/her a botanical name. All you need to do is to enter the history in the INPUT tab with the consent signed by the patient and share it. It is also a very helpful tool in taking a piece of advice or sharing a case with fellow doctors around the world. I personally found it to be a unique and an innovative step which has helped the sufferers to consult reputed doctors around the world now for free. But for us it undeniably became a platform to discuss our findings with experienced doctors.
In the OPD we came across a patient who was a 31 years old man with a complaint of vomiting, nausea and a non-radiating pain in the right upper abdomen from past 30 days. During those 30 days he had an apparent loss of weight with marked anorexia. There was a decrease in his bowel movement and an increase in flatulence.
The patient had no difficulty in swallowing and the vomit contained recognizable food particles eaten several hours back. Neither black stools nor rectal bleeding was observed. He told us that he used to be
The patient had no difficulty in swallowing and the vomit contained recognizable food particles eaten several hours back. Neither black stools nor rectal bleeding was observed. He told us that he used to be
a non-vegetarian and used to consume 250 gm of meat thrice a week previously but has had been a pure vegetarian for the last 6 years. He also consumed tobacco (gutka) 8-10 packs daily and alcohol (180ml) once or twice a week.
He had neither a past history nor a family history of such a problem.
Endoscopy showed: deformed, shortened bulb with inability to push scope into 2nd part of duodenum.
Blood report:-Mild anemia.
R.B.C showed: mild anisopoikilocytosis with microcytes.
W.B.C showed: normal total count & normal.
From his complaints of the last 30 days and considering the endoscopy report findings I proposed that the possibility of duodenal ulcer was pretty less. According to me it was a case of obstruction due to polyps of GI tract. Biswas sir and I discussed for a while and he was then extended a treatment for ulcers. But due to a difference of opinion we have asked him to visit us over the next fortnight to track the success of the treatment.
One-on-one interaction with the patients has been one of the major benefits of this program. Sir gave us complete freedom to examine the patient up till our will and to spend as much time as required to extract all the information in order to solve the patient’s problem. It was as if we were the pilot of the Boeing loaded with the passengers, with total authority and in charge!
Sir also gave us the permission to utilize the research lab in which we could perform basic yet very important hematological and biochemical tests. Through this we realized how even a small lab with minimal resources can be used to make powerful diagnoses.
The routine we followed, for creative learning, under the BMJ program was as follows:-
Taking PATIENT’s HISTORY
UPLOADING IT IN UDHC
INTENSE DISCUSSION (ON WEB CBBLE at that time in tabula rasa)
This pattern of learning was new but I had to quickly adapt myself to it. The best thing about this approach was the ease with which we could discuss each case with sir as well as it gave us enough practice. I spent more time thinking about various cases-first in the ward/OPD, then in my hostel while preparing the case report and later discussing the problem and raising queries. This made the course and the studies easy and immensely interesting as now I could correlate my anatomy and physiology quite well on the basis of the various practical cases I dealt with.
And the subsequent elective ProJR data can be accessed here: https://medicinedepartment.blogspot.com/2021/03/medicine-department-training-programs.html?m=1
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