Centrals Wrap Up: Honest Thoughts About the First 6 Months of My Internship

-Written by Dr. Anjali Mediboina, House Surgeon, ASRAM

(TW: Death)

So, I began my life as a house surgeon/medical intern in April and come September, I’ll officially be done with the central departments: OB-GYN, Pediatrics, General Medicine and General Surgery. I thought it would be fun to look back and do a wrap up of my internship so far. And thus, here’s the article nobody asked for: Honest Thoughts About the First 6 Months of my Internship. 

1. OB-GYN

My first posting was in the OB-GYN department for 7 weeks straight. As Interns, it was our job to follow the cases, make sure all their lab investigations are up-to-date, and get the pre-anesthetic checkups (or PACs) done, for those cases of C-Section deliveries/gynecological surgeries. We also did pre-op prep: catheterization, cannula (if we were brave enough), etc, etc. 

Labor room duties were pretty cool. It gets a bit hectic when a woman is close to delivery, but when the baby comes out safe and sound- the look of relief on everyone’s faces is something I’ll always remember. But I’ll be honest: NVDs (normal vaginal deliveries) are terrifying to watch (How does a baby the size of a watermelon fit in there????). C-sections are just as high-adrenaline: one minute the doctor’s making an incision, and another minute they’re pulling out the baby! 

What I Loved: I feel like there’s always something to learn in OB GYN- interns usually end up getting to do a lot of the pre-op work and even get the chance for episiotomy sutures. And honestly we did get to see a lot of variety in our cases, so that was a plus. 

What I Didn’t Love: Being in a rural area, we get a lot of young women- like, 18 years old girls- giving birth. And the problem is a lot of them go into delivery early, with some gestational complications, which is honestly kind of sad to see. What’s worse is the total lack of knowledge they have, and no efforts made to correct it; for example, a lot of our patients used to ask for C-sections because they were under the impression that it would be less painful. But they don’t realize the post-op complications. 

2. Pediatrics

We get posted in pediatrics for 3 weeks, and each week we get to choose our duties in the wards, NICU, PICU, post-natal or OP. I did 1 week each in the NICU, OP and the PICU.

Of all three I think I liked OP week the most- a bunch of (adorable) kids came in where we would take their anthropometric measurements and give vaccines on vaccine days. 

What I loved: Because of COVID, we didn’t have many cases in the pediatrics department during our final year; pretty much everything we learnt was theoretical. Now, our census has been going up, which was cool because we got to correlate what we read so far with the actual cases. Of all the cases, the most memorable would be one kid with Sickle Cell Anemia, and another who had Guillain-Barre Syndrome. 

What I didn’t love: My NICU duty was a bit rough- there were a couple of baby deaths that week, which wasn’t so great on my mental health. I don’t think I’ll ever forget the sight of the baby’s saturation levels dropping to 0%. 

3. General Medicine

Oof. 6 weeks of Medicine went by in a blur for me. We had our college fest, which we were organizing, going on at around the same time, so now that I look back on it, those 6 weeks felt like a flash. Interns honestly don’t have much work here- we basically divided the patients among us, and made sure that their investigations and medications were happening on time. 

What I loved: I think what I liked the most about medicine is the routine of the job. A patient comes, we send in all the investigations needed, get them the referrals required, etc etc. By the 3rd week or so, my co-interns and I felt like a well-oiled machine. We also had a great rapport with our PGs (who are amazing btw), so even though our unit had a heavy caseload, it didn’t feel like much work. Again, it was also interesting to see the patients and correlate whatever we read so far, while also learning about the treatment given to each case. 

What I didn’t love: I’ll be real and just say it- Medicine is NOT for me. I mean, all one can do is order the lab investigations, analyze said investigations, start the medications and wait and watch. I mean, yeah, I guess you could say that medicine is sort of like solving a puzzle; you need all the pieces in order to see the big picture. Every piece of patient information is vital, and I really do commend all the general medicine practitioners. BUT, as a pretty impatient person in general, I do not see myself in this field at all. 

4. General Surgery/Neurosurgery

So, it’s only been 2 weeks into the posting, and so far, it’s been alright. Interns take care of the PACs, post-op dressings, and do a LOT of suture removals. I will say that being in a rural area the variety of cases is a bit less- we tend to get a lot of diabetic foot/ulcers, hernias and varicose veins with the odd cholelithiasis (gallstones) cases every now and then.

I’m in the 1st unit, and the interns of this unit have to do 1 week of neurosurgery as well. Now let me just say, the one week of Neuro was hands down one of the best so far. 

What I loved: So, in our college, the Neurosurgery Department doesn’t have any PGs. Which means the intern takes care of everything- from admissions, to writing the case files, to interacting with the patient and their attenders; we even scrub in for ALL the OTs (talk about major doctor vibes). Also our professor, Dr. Satish Sir is AMAZING. He explains all the cases really well, and working with him was definitely the highlights of the year so far. 

While I don’t really have much interest in neurology in general, it’s not everyday you get to see cranial/spinal surgeries, much less scrub in for them, so Neurosurgery really was a blast. 

Final thoughts

Internship so far was…well, there are days where you feel really good, and there are days where you just need a good cry. Also, I’ve come to realize that the people in your unit really make or break your entire experience. Coordination is EVERYTHING. There will be people who slack off and while that gets on your nerves, you’ll need to find a way to work it out. 

Is it difficult? Yes. Are we overworked and underpaid? Also yes. But… looking at the ‘Dr.’ in front of my name gives me a lot of pride, so silver linings, I guess?

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