It is still tough to know all the roles and expectations for me as an exchange student but the consultants are getting better at guiding me along the way. Today I had gynecology ward rounds. I truly finally figured out the system here. I took me a while to figure out who to report to, who to give information to etc because I am used to working with the residents and interns. In the US it is usually a direct basic chain of command the lowliest being the third year medical student. 0.5 points ahead of the third year student is the fourth year student. Then the intern, then the junior resident, chief resident, fellow, attending. Usually, in the US, the intern and residents oversee the medical students by assigning patients to see, helping them figure out what to do, and then we report back to them. We then, typically, will present the patient formally to the attending on rounds. However, here there are two separate services for each department (gyn, ob, high risk etc). There is a business service with an consultant and he/she rounds only with the residents. The residents have a separate consultant that oversees their education called the post-graduate consultant. And then, there is a teaching consultant dedicated solely to teaching medical students and overseeing them. We report directly to him/her and really have no interaction with the residents. A different approach for sure. The positive side is that I have gotten a lot of one-on-one teaching from the consultants. Negative side: hard to figure out what to do/where to go because I am so used to our system.
Also of note! Successful taxi cab ride to and FROM the hospital. Go team me!
The gyn ward. This is the ward that all the gyn patients are admitted to. On the floor: ovarian cancer with ascites, endometrial cancer, vulvar cancer, ovarian dermoid cyst, tubal re-anastomosis, menorrhagia with galactorrhea, ovarian absess, iliofemoral thrombosis with a pregnancy at gestational age 12 weeks (not too sure why that one is here but it is) and probably about 10 patients with DUB.
I clerked a patient and presented to the attending today. Hand claps all around. (Note: when looking through the woman's chart to get her information there were receipts. Receipts that she paid for the CBC, pregnancy test, and other hormone profiles. No billing, no free service. Pay up front if you want it.)
There are patients at the hospital. I swear! Just protecting patients privacy from the nasty nasty World Wide Web.
After rounding I wandered, lost, helpless for a while. Trying to track down people I knew to see if they were leaving to give me a ride. (So here is the thing. Students cut clinical rounds like they cut normal class. Hard to figure out what to do/where to go when I am banking on a medical student to pity me and give some guidance when they are never around!) Alas, they were all busy.So I found my way to the cafeteria, got some lunch, hailed a cab and found my way home.
The cafeteria.
The menu for today. I passed on the mutton and fish and went with the chicken stew. $3.50. Not too shabby.
Lunch and dinner! Yum!Tonight I am going to yoga. Tomorrow is the OR day or OT day here (for operating theater). Today I also solidified (as best I could) my rotating at the public hospital on L&D next week. Dum dum DUM! That should be verrrrrry interesting.
PS: Alicia worked it out with Dr. Simmons-Stewart to give me permission to have off Thursday and Friday of this week to go to Montego Bay! Big Bonus! The Best Bonus! Jon is flying in! YAY! YAY! YAY! I really miss that guy.
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