A brief overview of the first few days

Shadowing program is a 2 week semi-internship cum work experience program by the King’s Hospital. It allows high school students, interested in medicine, to explore the field and take a feel for the practicalities involved and how it works on a real life basis. It’s centric towards educating the trainees about how various aspects of the medical sciences and, even the soft skills related to it.

Day 1

My first day at the internship program started with me filling loads of forms, for my entry into the program. It was a headache, but I somehow managed to fill it up. Luckily I wasn’t the only one there, struggling to fill out my every possible detail on that piece of paper. I was accompanied by 3 fellow highs schoolers, who were going to be joining me for the duration of the program.

The day was divided into 2 sections – visiting various lab departments, followed by a visit to the ETU (Emergency Treatment Unit).

Our first stop was the Haematology department. Haematology is the branch of medicine involving study and treatment of the blood. Since it was the first day, we were briefed on the basic ideas, for example determination of blood type using antigen testing. It was quite interesting to see how technology was integrated to check for various components and to find out any abnormalities involved. After the haematology department, we were guided to the biochemistry department wherein we learnt about lipid, liver and renal profile and their significance in testing. For instance in lipid profile, lipoproteins density (LDL or HDL) can help conclude if the patient is suffering from heart diseases. Past a lengthy yet informative biochemistry session, we next landed at the Endocrinology department where we looked into how various hormones play a role in body functioning, and how those hormones can be tested for to see if the body is suffering from any illnesses. Moving on, we paid a visit to the Pathology and Histopathology department. What was intriguing to me was how the urine sample was utilized (in Histopathology) to examine the patient’s renal system and the kidneys. We looked into how the sample goes through centrifugation, after which it’s tested for various different things (like Urine protein/UMA). We concluded our lab quest, with a session at the Microbiology department, which was in my opinion was the most relatable one. In MYP 5, we did experimental analysis on agar peri dish, wherein we looked at the factors that promote microbial growth. Using the same concept, various samples of tissue were tested for (if they showed any microbial growth). It was quite fascinating to see how various theoretical concepts we studied as part of school syllabus, come to life. Finally, we looked at incubators and their role in supporting growth of microbial cultures (blood sample based for example).

We ended day 1 by visiting the ETU section, and looking how patients are treated there. We were briefed by the head nurse over there, as to how the ETU unit at this hospital and in fact in Sri Lanka, is different from other countries. Unlike other places where only critical patients are attended at the Emergency Unit, here every patient has to first go through this department for their regular screening. Their job is to stabilize the patient, before being attended by the doctor. I think it’s a cool system, but simultaneously its effectiveness can be critiqued. This is because if every patient has to be attended, what happens to those who actually need urgent attention. Although there exists a preferential hierarchy of which patients are looked after first (based on their severity), I still think it’s a hassle and risky at the same time.

Day 2

Our experience on the 2nd day was dominated by the visits to the pulmonology department and attending live endoscopy sessions. Consequently, we also visited the nutrition department where we got acquainted with the struggles of planning a hospital meal system.

We kicked the day off with the pulmonary department wherein we were guided by Dr. Chathuranga on various aspects of the role of a lung and how its functioning can be tested. He began the session by briefing us regarding the soft skills a doctor should constitute of while dealing with a patient in the consultation room. It was riveting to know the intricacies with which the doctor examines a patient (for example just by the way the patient sits on the chair, the doctor can decipher whether they have back problems or weak legs). He also told us the importance of greeting a patient, and how the patient’s response is crucial in assessing their state. We further proceeded by having a discussion on the role of lungs (protective role, breathing and diffusion) and how the respiratory system is intricately connected with the cardiovascular system in the body. We then moved onto to looking at various lung function tests, and their role in examining the performance of the lung capacity and the respiratory system. Some of the tests include spirometry, impulse oscillometry, body plethysmography, DLCO, MIP and MEP, and CPET. But what caught my attention was use of other testing methods like 6-minute walking tests, which don’t require a lot of machinery to run with and hence can be used in the rural or smaller scale hospital facilities. We concluded this session by looking into some physiotherapy techniques, including pulmonary rehabilitation and chest compressions.

After concluding a meaningful session with Dr. Chathuranga, we had our next stop at the nutrition department where we met a dietician and learnt about how she plans the diet of a patient. For example, things like salt levels, potassium, fibre, etc. become important while figuring out the diet plan. She also told us how patients with CKD (chronic kidney disease) requirements might want to have a liquid based diet low on salts. Personally, it was great to finally know why the hospital food I got as a child (when I was hospitalized) was so bland.

We ended our day by visiting the endoscopy unit and looking at endoscopy being performed. We watched 2 endoscopies and 1 colonoscopy. Finally, we also looked at a mini cyst removal procedure, where Dr. Darshan extracted an infected wound and sewed the skin.

Overall, these first 2 days have been a bit of a challenge for me, but it’s been a real eye-opener and even great to perceive how the medical field I am aiming to go for, actually works.