Showing posts with label Khota Medical College. Show all posts
Showing posts with label Khota Medical College. Show all posts

Monday, 21 November 2022

The Bath and Wound Dressing

Something light and short this time

When Dr. Dev (fictional name) joined Khota Medical College (fictional name) as a faculty member there was a shortage of junior resident doctors in the surgery department. This led to their increased workload. Due to excessive work, sometimes the junior resident doctors were not able to go to their hostel rooms for days in a row.

In Khota Medical College, there was the practice of dressing of open wounds once in two days i.e. alternate days. The logic behind it was that the healing process of the wound will be disturbed if the doctor changed the dressing more frequently. Whereas in AIIMS, New Delhi, where Dr. Dev had worked before, the convention was to do twice daily dressing of infected wounds.

Once Dr. Dev became the unit head, he wanted that the cleaning and dressing of infected wounds should be done at least once daily.

While on the clinical round, Dr. Dev thought to drive home the point to the junior residents by the use of a simile. He told the junior residents, 'Dressing the wound is like local hygiene. For personal hygiene we take a bath daily, even in winter, similarly, we should do daily dressing of the infected wounds and not on an alternate day.’

One of the overworked junior residents asked, 'Sir, I have not taken a bath in the last three days. Does that mean that I can do dressing once in three days?'

— ND

(Based on allegedly true incident.)

© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient and students as foremost and according to NMC and other Board norms. 

 

Saturday, 2 July 2022

The Thesis Plans Incident

 

Dr. VK (fictional name) joined as a junior resident in the department of surgery at Khota Medical College (fictional name). Dr. Dev (fictional name) was allotted as his thesis guide. Dr. Dev asked Dr. VK to start searching for a suitable topic and start writing a thesis plan. With a limited number of junior residents in the surgery department, Dr. VK was busy with patient-related work most of the time and he was not able to find time to research and write the thesis plan. 

For Non-Medicos: After completing their basic medical degree of MBBS, doctors in India do further specialization in either Medical or Surgical specialties, the Master of Surgery or Medicine courses. They are then known as junior resident doctors (JR). These courses are of three-year duration with a final exam at the end. In addition to the clinical work, these junior resident doctors also do research work and write a thesis. They are allotted a professor to serve as a guide in their thesis work.

The residents have to identify a specific topic or disease and read up on what research has been done and published in the medical journals previously on that topic, known as the review of the literature. Based on this review of literature they make a detailed plan and submit the plan to the medical college's academic section and ethical committee for clearance and approval. This submission of the plan has to be done within six months of joining the course. 

Then the junior resident has to do the thesis research work in the next two years period and submit the finished thesis after approval of his thesis guide, at least six months before the final exam. If the junior resident does not submit his thesis in time, he/she is not allowed to sit in his/her exam and has to give the exam after a delay of six months. But some colleges did not strictly follow these guidelines in the past as due to the less number of junior resident doctors in the department, the JRs were busy with patient-related work and do not get time for research activities.

The ideal six-month time period has passed but not even the topic was decided by Dr. VK. Then nine months and finally one year had passed. Most of Dr.VK's batch mates had submitted their thesis plans, but Dr. VK had not even decided on his thesis topic. 

In fact, a new batch of junior residents had joined the medical college. Dr. AK (fictional name) joined as his junior in the unit. A few months later the guide allotment was done for this new batch and even they started searching for a suitable topic to do thesis work, still, Dr. VK had not decided on what topic he wanted to do his thesis on.

Finally, Dr. VK received a deadline from the college authorities; to submit the thesis plan within one month or he will be not allowed to give his final exam with his batch mates. He will have to give it six months later. On the prospect of his term extension, Dr. VK got worried and requested Dr. Dev to please search for a suitable thesis topic for him. 

With his one-year delay, things had become complicated. Now a thesis topic had to be searched which can be easily completed in the 1 year remaining, instead of the two years available normally.

On a Sunday afternoon, Dr. Dev switched off his phones, put a notice on his door for his patients that he has gone outstation and will not be available for consultation, and sat on his desktop searching for the topics for the thesis. After reviewing many topics he found a topic suitable for Dr. VK which can be easily completed within 6 months. In addition, he found one more appealing topic which he thought will be great for the first-year resident, Dr. AK to do.

He downloaded the previous research paper published on both topics and took a printout on his home printer. 

The next day, Dr. Dev handed over printouts to both Dr. VK, the second-year junior resident, and Dr. AK, the first-year junior resident, and asked to them consider them as a research topic for their respective thesis. Both took the papers gratefully and said they will study them in the evening and let Dr. Dev know their opinion.

The next day, both the junior residents met Dr. Dev and agreed that they indeed want to do the thesis research work on the topics suggested by him. Dr. Dev asked both of them to start working on their thesis plan.

Within a week, Dr. VK had submitted a rough draft of his thesis plan to Dr. Dev for checking. After 2-3 rounds of checking and corrections, Dr. VK submitted the final thesis plan within the one-month deadline to the college authorities for approval. When Dr. Dev asked Dr. AK about his thesis plan, he replied I am searching and reviewing the literature on the topic you suggested.

After approval, Dr. VK started work on his thesis and within four months had completed the clinical work related to his thesis and started compiling the data in tabular form. When Dr. Dev asked Dr. AK about his thesis plan, he replied I have started writing it and will show you the first draft copy in a few days.

In a few days, Dr. VK fed the data to a computer and started the statistical analysis of the data. After the final result arrived, Dr. VK started writing the rough draft of his completed thesis. When Dr. Dev asked Dr. AK about his thesis plan, he replied I have started writing it and will show you for checking in a few days.

Even with multiple revisions to satisfy the fastidious checking of Dr. Dev, Dr. VK submitted his completed thesis copies in faux-leather binding with embossed gold letterings, along with his other batch mates even though he started one year later than most of them. And Dr. AK? He was still working on his thesis plan.

Then one day, Dr. AK received a notice from the college authorities to submit his thesis plan within one month or his term will get extended. A week later, Dr. AK bought the printout of his plan for Dr. Dev to check and submitted the final thesis plan along with the rest of his colleagues within the month.

The two junior residents, Dr. VK, the second year JR, and Dr. AK the first year JR, got the thesis topic at the same time. In the time in which, Dr. VK wrote the thesis plan and submitted the final printed copy, Dr. AK was not able to write just the thesis plan. This is an example of Parkinson’s Law which states: 

"Work expands so as to fill the time available for its completion."

Dr. VK had just one year to complete his thesis work, so he did it, whereas Dr. AK knew that his batch mates will submit the thesis plan in one year so he took one year to write just the thesis plan.

Cyril Northcote Parkinson was a British economist who wrote the above law in an essay published in ‘The Economist’ in 1955. He derived this aphorism from his extensive experience in the British Civil Service.

One corollary to Parkison’s Law is:

Work complicates to fill the available time.

Another well know corollary is the Stock–Sanford corollary to Parkinson's law: 

If you wait until the last minute, it only takes a minute to do.

Another corollary is (Mark) Horstman's corollary to Parkinson's law: 

Work contracts to fit in the time we give it.

 For example, Dr Dev was able to find a suitable topic for thesis in one afternoon, which Dr VK. was not able to find in a year

So put a definite deadline on your work, so that you finish your work in time. Don’t wait until the last minute to finish your work.

— ND

(Based on allegedly true incident.)

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to NMC and other Board norms. 

Thursday, 12 August 2021

The Next Week Classes

 

Dr. Dev (Fictional Name) had joined as Professor in the Department of Surgery in Khota Medical College (Fictional Name). There were junior residents doing post-graduate specialization in surgery posted in his unit. The junior residents do the work of patient care and also study as they have to clear the MS (Master of Surgery) final exam at the end of their three years training period.

Once on a ward round, Dr. Dev asked an academic question to Dr. Vincent (Fictional Name), the second-year junior resident posted in his unit. Dr. Vincent did not give a proper answer. After some time Dr. Dev asked another academic question to Dr. Vincent. Again he was not able to give a satisfactory answer. 

Sometime later Dr. Dev asked another academic question to Dr. Vincent. With his poor performance in the previous questions, Dr. Dev asked him an easy question this time which could be answered well even by a good MBBS (Medical under-graduate) student. Surprisingly Dr. Vincent did not answer even this question completely.

As Dr. Vincent was in his second year of junior residency it was expected that he would have started studying and achieved at least some level of expertise in his subject by now. A disappointed Dr. Dev remarked, ‘Dr. Vincent, it is high time that you start studying something!’

Dr. Vincent promptly replied back, ‘Yes sir, I had already planned to start studying something. In fact, I am joining classes from next week.’

Dr. Dev was surprised on hearing this answer. With his poor academic standard up till now, he did not expect Dr. Vincent to start studying so expeditiously. Also, he was not aware of any classes teaching surgery outside of their Medical College in the city. A curious Dr. Dev asked, ‘Which classes are you joining from next week?

Dr. Vincent replied, ‘I am starting Guitar classes from next week.’

— ND

(Based on an allegedly true incident.)

© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board norms. 

Monday, 18 February 2019

The GI Surgery Viva


Dr. TP (Fictional Name) who wanted to do Mch [super-specializing after Master of Surgery (MS) exams] appeared for the AIIMS, New Delhi pre-Mch Gastro-Intestinal (GI) Surgery selection exam.

He was the top scorer in the theory paper and had first rank on the basis of theory marks. He was called for the practical and viva exam which had equal marks as the written exam.

Please note that the number of candidates called for the practical and viva exam is usually three times the seat available. As there was three seats available in the Mch GI Surgery course in AIIMS, New Delhi, at that time, the top nine candidates on the basis of theory marks were called for the practical exams. The final merit list was to be made after combining the marks from the theory and the practical exam and only the top three students were to be selected.

During the viva when the AIIMS, New Delhi’s GI Surgery faculty learned that Dr. TP has done his MS in General Surgery from Khota Medical College (Fictional Name), the atmosphere of the viva changed.

The examiners told him as he had not been exposed to the complex and advanced GI surgeries being performed at AIIMS, New Delhi, during his MS residency, he is not a fit candidate for Mch in their department.

Dr. TP’s effort to convince them that he is a quick learner and he has the requisite theoretical knowledge as he had already topped the theory exam, did not cut the mustard with the examiners. Dr. TP realized what Charles Caleb Colton has so aptly said: 'Examinations are formidable even to the best prepared, for the greatest fool may ask more than the wisest man can answer'.

When the results were declared, as expected Dr. TP was not selected for the Mch course. On the basis of the combined marks in the theory and viva exams, he was ranked fifth in the merit list.

A similar thing happened to Dr. Robert (Fictional Name), who had again done his MS degree in General Surgery from Khota Medical College. He appeared for the AIIMS, New Delhi’s pre-Mch exam for Neurosurgery. He was first in the theory but after the practical and viva when the final results were declared, he was last in merit and therefore rejected.

Where we have studied or worked previously may cast a black shadow on our personal achievements. We may not get our dream job because the examiner or selector is not impressed by our previous college or company. We may not get a chance to show our capabilities closing the door of future growth for us.

The reverse may be also true. Many have reported that undergraduates from AIIMS, New Delhi are preferred candidates in the various medical colleges in the USA as compared to other colleges from India.

We will discuss some solutions to this problem in the next post.

(Based on allegedly true incidents)
— ND
© Author. All rights reserved. 
 
Please Note: Original post was updated/Edited on 7th Dec 2022

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 DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 
DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 
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Friday, 3 August 2018

The Ear-Ache


Dr. Sunny (Fictional Name) was junior resident in Department of surgery in Khota Medical College. Dr. Sunny was busy in OPD on Saturday and emergency surgery on Sunday and was not present during the unit-head Dr. Jolting’s (Fictional Name) clinical ward round.

On Monday again he was absent from the clinical round.

Next day when Dr. Jolting saw the resident in the operation theatre, he asked him where he had been the last 3 days.

The resident replied, “Sir, I was busy in OPD minor OT on Saturday and in emergency surgery on Sunday and I had severe ear-ache (pain) on Monday, therefore, I did not come for the ward round.”

A surprised Dr. Jolting asked, “When you had not listened to my scolding on Saturday and Sunday, how did you develop ear-ache on Monday?”

 (Based on true incident)

— ND
© Author. All rights reserved. 

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 DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 
DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 
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Sunday, 29 July 2018

The Marriage Leave


The junior resident (JR) in surgery working at Khota Medical College, asked Dr. Jolting (Fictional Name) for leave to go for the marriage of his friend. Dr. Jolting gave permission for it.

A few days later the same junior resident asked leave to go for the marriage of another friend.  Dr. Jolting gave permission.

Again, a few days later the same junior resident asked leave to go for the marriage of his cousin. Reluctantly Dr. Jolting gave permission as due to the shortage of residents the work of the unit used to suffer when one of the junior residents used to go on leave.

A few days later the same junior resident asked leave to go for the marriage of his wife’s friend. An exasperated Dr. Jolting remarked, “If you like attending marriage’s so much, why don’t you leave surgery and become a marriage party caterer? You will be able to attend plenty of marriages while working at the same time.”

Frequent leave of absence even if for ‘justifiable’ reason will make you unpopular both among your superior or boss and among your colleague. Do try to be judicious when taking leave for any reason.

(Based on true incident)

— ND
© Author. All rights reserved. 
If viewing from Mobile, switch to Webpage view to see a list of popular posts and index of topics of previous posts.
 DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 
DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 
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