王盈方醫師瘋狂之旅 Dr Yvonne Wang's Blabberings

This was the first time for me to cover half of the hospital. In the first week, there were three interns, so everything was manageable…. Tonight, it was chaos! I kept having to rush from ward to ward, getting continuous strings of pages from various different wards, many patients became unstable… It was truly an intern’s nightmare! There were several “speaking o the devil” incidences. For example, I was revising about putting in a urinary catheter before the shift and asking the other intern about where to tape the catheter after I finish. The evening registrar overheard us and told us we don’t need to worry and can just get someone to supervise us…. Then there was a urinary catheter for me to do on the wards, for the very first time in the night shifts! Furthermore, the night medical registrar was much stricter than the one I had previously; even with unstable patients, she insists on me assessing the patient fully before talking to her, and only page her immediately if the patient is actually crashing right in front of me… Earlier on, the DCT have emphasized that we should ask for help whenever the we are uncertain about anything, so I was under the impression that I should page pretty early on, and it seemed alright with the last reg I had. Anyway, I’d better get even more independent now. Anyway, after her spill from when I first called her about a patient with pulmonary oedema, I was reluctant to call her early on for the next pulmonary oedema (which I thought seriously need MI excluded), and indeed he seemed to have MI so the registrar sent him to CCU. This was the man who needed a urinary cathether, and since I’ve done a few urinary catheters in theaters before, I didn’t get her to supervise me – I got it in right anyway. And this is the first shift I got called to assist in theatres by the surgical reg! It was a laparotomy for patient with small bowel obstruction, and the reg just kept removing adhesions. It took a long time! The other poor intern had to cover for me while I was assisting in surgery so her night is also extremely hectic! The night was so busy that I couldn’t get things done fast enough and got scowled at by some nurses…. It was hard to prioritize what to do first when there’s so much to do! A night to remember...  I shall come around to writing up this “new RPA series” when I actually get time to do so

I did a four-week elective in liver diseases at Mount Sinai Medical Center. This hospital is located in the upper east side of Manhattan. My main goal was to catch a glimpse of how things were like in US hospitals and compare this with Australia. I also wanted to see some high tech stuff. The liver diseases department at Mount Sinai deals mostly with liver transplant patients. Here is the hospital’s description about its liver transplant center:

Mount Sinai is one of the nation's leading adult liver transplant centers, performing more than 130 liver transplants yearly with outstanding success rates. The program began in 1988 when RMTI founder Dr. Charles Miller performed the first liver transplant in New York State. Since its fledgling days, the program has grown to become the third largest in the world.

I decided to do a 4-week internal medicine term and a 2-week radiology term at the National Taiwan University Hospital, since this is one of the most prestigious universities in Taiwan and many Taiwanese students from UNSW who went to NTUH for their electives gave positive feedbacks.