Manoj Gurung

1. Emergency department: Assess and manage the patients and report to the consultant MDGP for further assessment if needed. The examples of cases I receive on the emergency are RTA, acute exacerbation of COPD or asthma, allergic reactions, DKA, acute pancreatitis, foreign bodies in the eye, ear and nose, AGE, unstable hypertension, cardiac arrhythmias, acute lower abdominal pain, ectopic pregnancy, fall from a height, fractures, MI Etc. I manage accordingly with the support and supervision of the Consultant MDGP, and we refer complicated cases to a higher centre.

2. General Ward: Run morning and evening rounds, coordinate with MDT for inpatient management, and perform required procedures such as ABG blood collection, abdominal tapping, ECG interpretation, ETC.

3. OPD: Consult patients and manage accordingly. Discuss the cases with the consultant MDGP if necessary.

4. Inpatient Department: Morning rounds with the consultant MDGP, discuss cases with the team (Consultant, House officers, paramedics and nursing staff), and plan the treatment of inpatients.

5. Minor Operations: Incision & drainage of abscesses, closed reduction of fractures under sedation and implantation of casts, suturing of traumatic wounds with the stable patient (major RTA will be referred to higher centres), and urinary catheterisation, foreign bodies extraction from ear and nose Etc.

I assist the consultant MDGP for surgeries such as hernia and haemorrhoids.

6. USG of abdomen & pelvis ( Emergency quick scan)

7. Run weekly teaching sessions for paramedics and nursing staff at the Polyclinic.

8. Co-ordinator of paramedics and nursing staff.

I was appointed as a medical officer at Ha Molhadhoo HC, which HC is under Ha Alif Atoll Hospital.
My duties and responsibilities were as follows:

- OPD (8 hours a day, five days a week); consult patients on OPD and manage accordingly. After the patient's assessments and if necessary, I would present the cases to consultants from the higher centre and facilitate patient transfer (discuss the case with the respective consultant, paperwork, update online patient details and send the patient to the higher centre) by sea ambulance.

- Besides 8 hours of duty, 24-hour on-call.
- Admission of uncomplicated cases to the health centre with assessment and management of the patients until discharge, with consultants' advice on telephone/video calls.
- Doing paperwork and updating and maintaining patients’ medical records in the system.

I would perform various clinical procedures as follows:
- Uncomplicated wound suturing and removal of sutures.
- Incision and drainage of uncomplicated cases (furuncles, abscesses).
- Wound dressing.
- IV cannulations.
- ECG recording, interpretation, and report to the respective consultant.
- Measurement of Fetal Heart Rate using Fetal Doppler and report to the consultant.
- Initial assessment of women in labour at the local island and send the patient to the higher centre.
- Per rectal glycerine enema insertion (paediatrics & adult).
- Covid-positive patient care. (Service provided to home-isolated patients, Covid-PCR sample taking).

1. Emergency department: Assess and manage the patients and report to the consultant MDGP for further assessment if needed. The examples of cases I receive on the emergency are RTA, acute exacerbation of COPD or asthma, allergic reactions, DKA, acute pancreatitis, foreign bodies in the eye, ear and nose, AGE, unstable hypertension, cardiac arrhythmias, acute lower abdominal pain, ectopic pregnancy, fall from a height, fractures, MI Etc. I manage accordingly with the support and supervision of the Consultant MDGP, and we refer complicated cases to a higher centre.

2. General Ward: Run morning and evening rounds, coordinate with MDT for inpatient management, and perform required procedures such as ABG blood collection, abdominal tapping, ECG interpretation, ETC.

3. OPD: Consult patients and manage accordingly. Discuss the cases with the consultant MDGP if necessary.

4. Inpatient Department: Morning rounds with the consultant MDGP, discuss cases with the team (Consultant, House officers, paramedics and nursing staff), and plan the treatment of inpatients.

5. Minor Operations: Incision & drainage of abscesses, closed reduction of fractures under sedation and implantation of casts, suturing of traumatic wounds with the stable patient (major RTA will be referred to higher centres), and urinary catheterisation, foreign bodies extraction from ear and nose Etc.

I assist the consultant MDGP for surgeries such as hernia and haemorrhoids.

6. USG of abdomen & pelvis ( Emergency quick scan)

7. Run weekly teaching sessions for paramedics and nursing staff at the Polyclinic.

8. Co-ordinator of paramedics and nursing staff.

I did clinical practice as a Master’s student from 17 September 2018 to 30 September 2019 in the Orthopedics foot and ankle surgery department under Professor Hui Zhang's supervision.

A brief description of my duties and responsibilities:

I had to practise/work for 8 hours or more five days a week.
- Attending morning handover meetings.
- Following the team in the morning ward rounds and presenting cases when necessary.
- Participating in taking patient histories on OPDs and discussing the cases for diagnosis and management of patients.
- Performing procedures such as IV cannulation, venipuncture, NG tube insertion, ABG sample collection, inserting Foley catheter, surgical wound care and dressing, requesting scans, and updating seniors.
- Preparing patients in a surgical theatre, draping, painting, holding instruments and helping to close the surgical site at the end. (Assisting surgeries on surgery day)
- Teaching medical students bedside manner.

I worked 8 hours/day, six days/ week, according to the duty schedule made by the hospital.

Emergency Department (10 August 2016 - 10 November 2016): Assess and manage patients and report the case to the senior/consultant whenever needed. Uncomplicated wound suturing, ECG recording, NG tube placement, Foley catheter, prescribing X-rays, blood investigations, and maintaining patient records.

Medicine department (11 November 2016 - 5 April 2017); OPD consultations in the presence of consultants. In-patient management of patients, such as physical examination, prescribed ECG, X-ray, blood investigations, and Foley catheter and NG tube placement. Conduct ward rounds with nursing staff and consultants. Update and maintain patients' records. Discuss cases with the junior and nursing staff and present the cases to consultants.

Surgical ward (6 April 2017 - 13 August 2017); post-op patient care, updating patients' records, surgical wound dressing, ward rounds with consultants and seniors, and teaching/ discussing cases with junior and nursing staff during the rounds. OPD consultation and case discussion with the consultant.

I had a chance to learn USG abdomen & pelvic under the supervision of consultant MDGPs. I have over six months of practice.