[Shared] A Day in the Life of a Houseman

Dr Muhammad Amir Ayub, a houseman at Hospital Kuala Lumpur, shares a typical day on call in this important training period.

A houseman is the most junior doctor in the healthcare system. You will have to work in a rotation of six postings - internal medicine, surgery, paediatrics, obstetrics and gynaecology (O&G), orthopaedics and emergency medicine/anaesthesia (either of the two) - before becoming a full-fledged medical officer.

This is a typical day at work during the fasting month when I was 'on call'.

5.00am

I wake up and eat sahur (pre-dawn meal) with my wife.

7.00am

I reach the ward and start my rounds. This means reviewing what happened during the night, followed by the current status. The review must be concise enough so it gives a clear picture, yet it must have enough details so that peers and seniors can understand the specific intricacies regarding patients.

On a normal working day, there are many colleagues, so you'd only have to cover a few patients. These days, this might be as few as two to three patients! However in the not-too-distant past, it would have been more like 10.

A morning review also requires looking at past investigations of relevance to the patient. This also means tracing results of previous investigations done by colleagues. Once I finish reviewing, I'll need to perform investigations that were missed during the previous 'on call', such as taking blood.

8.30am

The specialist round starts. Sometimes a medical officer (MO, a senior) does rounds first (about half an hour before the specialist comes), and sometimes the specialist does rounds first. Housemen have to present cases they've reviewed. If the specialist has seen the patient before, the review will be quicker.

Sometimes there are multiple 'teams' and the housemen will split up to present their cases. Lots of scolding occurs here.

10.00am - 12.00pm

We carry out specialist orders. Some housemen will be assigned to emergency operations so they'll go to the operating theatre (OT). Some will head off to the radiology department to order special radiological investigations like CT/MRI scans. Some will refer cases to other departments. it's basically 'action' time.

This is also the time to do administrative work like discharge summaries, or memos and prescription slips. Some scolding may also occur here.

12.00 - 2.00pm

Afternoon review starts. it's usually less elaborate than the morning one, focusing on the issues/plans discussed during the morning rounds. (When it's not fasting month, I try to fit in my lunch break here.)

2.00pm

My ward is assigned to the surgical outpatient department (SOPD) clinic on Mondays and Thursdays. So the housemen will see patients in the clinic along with the MOs and specialists. After we've seen the patients, we'll discuss the patients' files with MOs or specialists.

4.00pm

The afternoon rounds with specialists and MOs. Lots of scolding occurs here.

5.30pm

For my ward, housemen are required to punch in by 7.30am and punch out only after 5.30pm. Sometimes, I finish all of the work assigned during the office hours after that.

Before punching out, I pass over any blood tests/work/issues to be dealt with to the person on call. This is to make sure that the doctor on call knows what to do during the night rounds.

'On call' starts now. For my ward, only two doctors are on call at any one time. The number of patients might range from 12 to 30 on any night.

6.30pm

When there are a lot of patients, the night review starts now, if not already at 5.30pm. On the days that I have to care for multiple wards (I'm assigned to the burns care ward as well on some days), I have to start my rounds early.

7.30pm

I break my fast here while doing my rounds. I check especially for things not finished by colleagues before they punched out. If my colleague is called to the OT, I'll have to settle everything yourself.

9.30pm - 1.00am

At any time, the specialist/MO will come for the night rounds. Lots of scolding occurs here.

Afterwards, I complete any unfinished reviews and carry out the night orders. On days I have to care for burn patients as well, this is the time I go to the burn ward and check on things.

1.00 - 4.45am

I take a rest.

4.45am

I wake up and rush through sahur. Afterwards, it's straight to taking blood for the morning review later. I turn on the lights and wake up the patients.

7.30am

The morning review for a new day starts again. it's Merdeka Day, so it's just me and the people on call during the holiday (two housemen).

9.00am

The morning rounds. Lots of scolding occurs here.

11.00am

I finish the morning rounds with the people on call for that day, carrying out orders during the rounds.

12.30pm

Once everything is settled, I can go home.

Dr Muhammad Amir Ayub graduated from International Islamic University Malaysia in 2010 with a Bachelor of Medicine and Bachelor of Surgery (MBBS). He is currently completing the first of his two years of compulsory housemanship.

This article was first published in doctorjob's CoursesNOW! Health & Sciences 2011.

Retrieved at 04/09/2014 on 12:40 a.m. from http://doctorjob.com.my/article/a-day-in-the-life-of-a-houseman.aspx