Reflection Essay Example

8MEDICINE

Elective Training in Internal Medicine

Faculty of Medicine and Health Sciences-UAE University

Submitted to Dr. Sulaiman Bharwani

Paediatric Department-FMHS

Aims and Objectives

Having gained substantial interest in internal medicine, I chose to pursue the area of study during my elective training course. Tawam Hospital turned out to be the institution of choice. The selection of the field of study emanated from the desire to either restore or maintain the health of an individual. The expertise of the healthcare institution that has an affiliation with Johns Hopkins Medicine in the delivery of efficient medicine services motivated me towards selecting it as the institution of choice. The organisation works towards realising all the unique aspects contained in the definition of internal medicine. These include diagnosing, treating and preventing diseases. The facility applies medical technology, genetics, biomedical research, and biomedical sciences in the diagnosis, prevention and treatment of diseases and injury. During the elective training placement at the institution, everything worked out perfectly for me because of the significant input of my supervisor and healthcare providers that were ready to acquaint me with the hospital services that take place in the department.

The Tawam Hospital

Tawam Hospital is a tertiary care facility situated in the city of Al Ain, Abu Dhabi. The hospital has a capacity of 440 beds and suffices to be one of the largest healthcare facilities in the United Arab Emirates (UAE). The objective of the hospital is to provide cost-effective medical services of the highest quality besides ensuring that the delivery of the services takes place in a caring, safe, and friendly environment in accordance with the JCIA care standards. The average daily occupancy rate of the institution stands at 68%. The hospital serves 300 inpatients on a daily basis. Its provides specialised services in areas such as intensive care, family medicine, urology, surgery, emergency medicine, neonatal care, oncology, nephrology, pain management, paediatrics, neurosurgery, fertility services, gynaecology, obstetrics and internal medicine. Tawam Hospital acts as a regional and national referral centre for specialised medical care and oncology services respectively.

The hospital boasts of a team of renowned surgeons that perform approximately 7,000 surgical operations every year. The dental department serves approximately 72,000 patients on an annual basis. The facility also records about 4,000 births on a yearly basis and performs in excess of 20,800 MRI/CT procedures. The hospital sources it nurses, doctors and other healthcare professionals from the national workforce. Currently, 16% of the healthcare staff are citizens of the UAE. The hospital is a constituent of the SEHA Health System whose ownership and operation is under the Abu Dhabi Health Services Company. Rather than sourcing its medical team from the UAE, Tawam Hospital also has international healthcare professionals that exhibit the highest levels of expertise in their respective medical fields (Tawam Hospital, 2016).

The hospital is also at the forefront in providing the required support to staffs that are undergoing medical training in various fields. The support extends to students that are undergoing continuous medical training. The institution also holds a conference aimed at bolstering the expertise of healthcare professionals. One of the supportive areas that I noted at the facility is the availability of proper residency programmes that enables internists and other learners to enjoy one of the best residency programmes in the emirate of Abu Dhabi. The existing affiliation between the hospital and Johns Hopkins Medicine has enabled the hospital to benefit from vast transfer of knowledge and resources associated with healthcare. The result of such an affiliation is the ability of the hospital to provide a friendly and caring environment for patients thereby guaranteeing the best patient outcomes and feedback. The medical team exhibits passion and dedication to the delivery of effective and appropriate healthcare services. This raises the level of trust among patients thereby assuring them that the hospital allocates first priority to their medical interests.

Elective Clinical Setting

During the four weeks of my elective training at the department of internal medicine, Dr. Daniel Nagi was my supervisor and mentor in all areas of the department. I give credit to the doctor for his endeavour to ensure that I gain the best learning experience from the institution.

The Rounds

The department primarily comprises of physicians tasked with the responsibility of providing medical care. The team of physicians encompasses professionals such as nurse practitioner, physician assistants, physicians, hospitalists, physical therapists, social workers, bedside nurses among other professionals whose combined effort ascertains that the medical care is effective, collaborative, thoughtful, and safe. The department receives patients following their referral to the facility by other hospitals, primary care doctor or the emergency department of the hospital. The department provides 24-hour services in general medicine, telemetry, cancer cases, and consultation services particularly for patients that had to undergo surgical operations. It is the responsibility of hospitalists to provide general supervision of resident services of the department. Hospitalists also taught medical students about the different areas of the department. The objective of the staffs in Tawam’s Internal Medicine Department was to combine thoughtful consideration and the latest evidence-based medicine of the presented patient case to guarantee the healing and wellbeing of the patient.

Typical Case

The case of a 54-year old woman that presented at the hospital with a 2-week history of back pain and fatigue as well as a history of hyperthyroidism is one of the typical cases that I encountered in the department. According to the patient, the slightest movement of her body aggravated the pain. The patient reported that the aching back pain was worse in the morning with a rated severity of 6 out of 10. Laboratory studies conducted by her primary physician revealed a serum calcium level of 16.7 mg/dL. Results from the chest radiography conducted on the thoracic spine showed mild curvature. Other findings included increased thirst, strong cancer history of the family that included myeloma, lung cancer, testicular cancer, and ovarian cancer. After obtaining the vital signs of the patient, the department of internal medicine was responsible for evaluating the patient’s back pain and controlling pain. The patient’s presentation of hypercalcemia necessitated the use of fluid resuscitation as the initial treatment. The likely cause of her condition was hyperparathyroidism. Conducting a skeletal survey of the patient was the next step in the diagnostic work-up of the patient’s condition. The induction therapy that prepared the patient for HCT encompassed dexamethasone and lenalidomide. A follow-up study conducted on the patient after 3 months revealed that she had recovered from the condition and had returned to full-time work once again.

Duties of the Elective Medical Student

Being an elective medical student at the department of internal medicine, my duty was to promote, restore, and maintain the patient’s health while exhibiting strict adherence to the procedures and guidelines offered by the hospital. It was also my duty to follow instructions given by the clinical instructor in dealing with a patient. In essence, it is the duty of the elective medical student to gain hands-on-experience about the medical knowledge gained from the school. These include researching on the patient’s needs, administering medications after researching their effects, providing nursing care to the patient and charting vital patient information.

Ethical Considerations

Besides adopting the necessary medical interventions as stipulated by the hospital guidelines, the freedom of the patient also turned out to be an area of concern for all healthcare professionals. Health professionals also encounter the challenge of deciding between pro-life and pro-choice arguments associated with reproductive rights. Battling with beliefs sufficed to be the other ethical dilemma that healthcare professionals encounter in their practice. Management of resources based on the status of patients also turned out to be an ethical issue to physicians and other healthcare providers in the department.

Role of assuming more “Physician” Responsibilities

Assuming more “physician” responsibilities enabled me to gain first-hand experience in the maintenance, promotion and restoration of the patient’s health. Having a designated patient to my learning experience enabled me to read and comprehend all the diagnoses associated with the patient thereby being on the same level with experienced physicians on understanding the needs of the patient, proper medication and nursing care. However, I encountered difficulty in having an instant understanding of the implications of the patient diagnosis and associated patient needs. As a result, other students undertaking the elective medical training should have a comprehensive theoretical understanding of different diagnoses and associated patient needs before embarking on the practical side of their course.

Academic Achievement

The elective training boosted my academic career since it enhanced my understanding of surgical procedures, human anatomy, physiology, radiology, biochemistry and pharmacology among other pertinent areas. The understanding of the different interrelated aspects of internal medicine emanated from the fact that the hospital admitted patients having different conditions that required specific intervention measures.

Personal Growth

Having first-hand experience in dealing with the patient that presented at the facility with multiple myeloma and other patient cases enhanced my career life as an elective medical student. The experience enhanced my understanding of different conditions of life as well as the recommended intervention measures including the diagnosis, treatment, discharge and follow-up procedures. I also had a first-hand experience on the challenges that health professionals encounter while dealing with emerging ethical issues such as religious beliefs, patient’s resistance of medication guidelines among other aspects.

Conclusion

In accordance with the objectives of the elective medical training programme, I managed to meet the desired objectives. These included researching on the individual needs of patients and understanding their diagnoses, medical conditions and medical technologies used in the diagnosis process. From the training programme, I was also able to research on the effects of medications and administer medications under the supervision of a physician. I also managed to provide nursing care to patients by assisting them to bathe and eat as well as charting real-time patient information.

Reference

Tawam Hospital. (2016). About Us. Retrieved from: https://www.seha.ae/tawam/English/aboutus/Pages/default.aspx