MOHAMED IBRAHIM

Medical Officer (SHO) at Thaa Atoll health services where secondary medical care is provided.
The hospital serves a population of 14000 people from the same atoll as well as tourists. I work for 48 hours a week, achieved a wide range of duties that fall under clinical judgment, treating acute illnesses in line with GMC Standards/Good Medical practice and teaching the medical and non-medical staff.
My duties:

Emergency:
*Take part in rostered emergency work, manage a wide scope of emergency cases stabilizing them, ordering investigations, reviewing the treatment plan with the consultant and coordinate with medical professionals of different disciplines.
*demonstrate competency in Advanced Cardiovascular Life Support [ALS/ACLS] skills.
*Withdrawing bloods, catheterization, NG tube insertion, intravenous cannulations, providing medications.
*Clerking case history, records, and management plan, and arrange for follow up.
*Identifying safeguarding issues and report the suspected cases of non accidental injuries to the consultants and hospital authorities.

Inpatient ward duties:
* Be present and contactable within the hospital during periods of duty to provide continuous service in conjunction with other doctors in the hospital.
*Ensure following the treatment plan, receiving medications on time, liaising health care with the health team including nurses, junior doctors, patients, relatives and senior medical staff.
*Update the consultant on the patients condition and discuss any changes in the management plan.
*Clerk and assess all emergency admissions on the request of the admitting consultant and/or the senior nurse in charge of the ward.
*To liaise with the senior nurse in charge of the ward for a nursing handover at least once per day.
*Attend ward rounds, weekly teaching sessions for cases discussion.

Outpatient:
*Management of cases that include: assessment, ordering investigations, diagnosis, treatment, admitting, discharging, and referring under supervision of the consultant.
*Follow up chronic cases such as cardiac, hepatic, renal, pulmonary, neurology and psychiatric patients, and order the needed investigations and renew medications under senior opinion.
*Dealing with substance misuse cases and referring to misuse clinic.

Administrative:
*Keep updated knowledge of local policies, all health and safety regulations and guidelines regarding healthcare and make sure to involve healthcare team.
*Complete and submit forms as required; consents, referrals, discharge reports, medical certificates.
*Organizing junior doctor monthly roster.
*Look smart and presentable at all times, build a good contact and trust with the patients and ensure their privacy. Be aware of effective customer care and public relations in order to promote the good reputation of the hospital.

Teaching:
*Eduacting patients about their health and providing information about diseases, treatments and preventive measures.
*Arranging teaching sessions for staff members including community health workers and nurses about basic life support, minor injuries, first aid and ECG.

Public Health Service:
*Arranging health awareness seminars at school and island council regarding concerning health issues like endemic infection, dealing with minor injuries and basics of first aid.
* Share in the cylce of public health issues including Investigation, diagnosis, infection control and addressing health problems such as COVID-19,Dengue Fever, and hazards affecting the population.

Al-Helal Hospital is one the main tertiary hospitals in Egypt. The hospital serves a population of 2 million people. On average,Gastroenterology department sees 50 patients every month in inpatient and 350 patients every month in outpatient department. I work 48 hours per week and on-call duties.

My duties include:
• Attend to the day to day management of day case, out-patient and in-patients.
• Outpatient clinic and managing gastro intestinal and liver diseases including IBD, hepatotropic viruses, hepatic malignancy under supervision of the consultant.
• Follow up of general medicine chronic condition such as HTN, DM, thyroid diseases and asthma, COPD.
• Performing ascites tapping and some paracentesis procedures under supervision of the consultant.
• Attending upper as well as lower gastrointestinal endoscopy procedures.
• Shared in Egyptian Initiative to Eradicate Virus C Hepatitis and non-communicable diseases(NCDs) 2018 – 2019, and follow up patients receiving new antiviral medications for Hepatitis C ( Direct-Acting Antiviral Agents).
• Initial assessment and management to emergencies cases following ABCDE approach then discuss with my senior.
• Following up the admitted patient in the department to make sure that they are receiving the medical care as planned by the consultant.
• Ensure correct procedures are carried out in respect of patients discharging themselves, deaths in care and coroner's requirements.
• To keep up-to date with all administrative duties including admission and observation sheets, referral letters, results and discharge summaries, etc. Maintain comprehensive notes and treatment records of all patients attended.
• Attending weekly teaching meeting, in which the consultants teach us how to deal with different cases according to the latest guidelines.
• Supervise, monitor and assist the F1 doctors who were usually coming as volunteers to learn about endoscopy and colonoscopy procedures.

My roster for a week looks like this:
- Two 6 hours OPD posting in a week
- One 12 hours ER &
- One 24 hours IPD posting in a week

• During this period I was able to allocate more time to attend and work as an assistant at a private clinic for Dr.Muhamad Sakr who is a professor in Tropical, Gastroenterology and Hepatology Department of Ain Sams University Hospitals. I was attending for 3 hours per day, 3 days a week to increase my experience in GIT and Internal Medicine.
My duties was clerking patient history and previous records before the specialist assessment then shadowing the specialist treating multitude of gastro intestinal and liver diseases according to the latest guidelines.
Also I was providing assistance for his lectures, research preparations and conferences that he was sharing in and arranging like United Conference of Hepatogastroenterology and Infectious Diseases ( UCHID).

It is one of private hospitals in Cairo, Egypt. It has 40 beds covering most of surgical & medical specialities, an ICU, radiology department, fully equipped laboratory department, Endoscopy unit & 5 operative theaters. I was assigned to work in the Internal Medicine department as a ( part-time) doctor for one or two duties per week according to my timetable. During that period, I gained good hands-on experience in internal medicine through assisting many of the high quality professor doctors.
My job was:
• Reviewing and management of patients in A&E. I'm responsible for all emergencies for Initial management. I review the patients, make sure they're stable, order the relevant investigations and review the management plan with the consultants and follow their orders.
• Inform consultants of any changes in the condition of their patients and any emergency procedures undertaken.
• To assist in the management of patients and provide back-up support to the consultant.
• To be part of a team providing 24 hour medical cover and immediate first line management and resuscitation to any patient as required.

I worked as SHO/FY2 General Practice at Nekhel Central Hospital, North Sinai,Ministry of Health of EGYPT.

EMERGENCY DEPARTMENT SKILLS:
1-As an ER doctor in a tertiary hospital: I did 6 hours daily in the A&E. So, I have acquired extensive experience regarding dealing with multi-trauma patients, injuries, different emergencies like hypoglycemia, DKA, Internal bleeding, heat strokes, hypovolemic shock, and fits.
2-Worked as part of the code blue team.
3-Mastered medical histories and general physical examinations as well as emergency management.
4. Performed many practical procedures as:
•IV blood sampling.
•IV cannulation.
•Different kinds of stitches.
•Catheterization
•Arterial Blood Gases ABG sampling.
•Performing and interpretation of ECG


CLINICAL SKILLS:
1-The rate of the OPD ranged from 30-50 consultations a day managed by myself and 2 other colleagues under the supervision of the head of the facility.
2-Seconded for 3 days a week to another primary health care unit as a general practitioner and a family health physician to be trained on:
a.Different family planning methods such as (IUD-Implanon) insertion and removal).
b.Obstetrics and Gynecology Ultrasound course.
c.Maternal care.
d-Vaccinations.
e-counseling on breastfeeding.
3-Competent in managing a wide range of general practice patients like hypertension and diabetic patients, taking medical histories, safe prescribing, managing asthma and hypertension.

• I saw new and follow-up patients, including both adults and children.
• I often treated the common cold, pharyngitis, diabetes, hypertension, gastritis, and diarrhea. I took patients' full histories and completed physical examinations.
• Doing all the minor procedures and first management of surgical emergencies. Most of these are wounds abscesses, in growing nails, removal of sutures, wound dressing and other simple procedures.
• Managing fractures and stabilize them.
• Following up pregnancies and Normal deliveries.
• Refer patients to other higher healthcare facility when necessary.

MANAGERIAL SKILLS:
1-Worked as in-charge manager of a primary health care unit, I was managing 35 staff Previous employer 4 of 4 members including, junior colleagues, nurses, paramedics, midwives, laboratory technicians, and infection control specialists.
2-To keep up-to date with all administrative duties including letters, results, issuing of birth and death certificates and discharge summaries as required.
3- To co-operate with members of the HR department when monitoring hours of work.
4-Ensuring infection control measures are up to the standards around the clock.


TRAINING AND EDUCATIONAL SKILLS:
1-Training of the staff nurses and junior colleagues on providing Basic life support and safe prescribing.
2-Ensuring infection control measures.
3-I have used every day to teach the health center team about topics that would reflect on the quality of the service provided to the patients.


COMMUNICATION AND MULTIDISCIPLINARY TEAM SKILLS:
1-Learned to be aware of my limitations, to escalate and delegate whenever needed.
2-Learned to cope with the stress of facing the death of critically ill patients every day and
1-sympathizing with their families and providing the needed support.
2-I worked as a part of a multidisciplinary team.
3-Learned how to proceed further in any case of vulnerable group abuse.

I rotated in different departments of Ain Shams University Hospitals, a tertiary referral service. I spent 2 months in each discipline: Internal Medicine, General Surgery, Obs/Gyn, Anaesthesia and Emergency Department, Paediatrics and Geriatric and Chest/Cardiac Surgery.

The main overall responsibilities in all departments are the appropriate communication skills with colleagues and patients to get the appropriate information to be able to order the appropriate investigations and give the appropriate treatment and document this information.
Being able to introduce a case study in the form of teaching and discussion sessions with other colleagues and seniors as a part of teamwork.
Documentation of everything with legal considerations, being able to discuss cases with the consultants, teaching colleagues. I had the opportunity to learn both acute medicine and long-term management of medical conditions.

* Internal medicine (2 months):
- taking history, doing the relative examination, reaching definitive diagnoses, deliver information to patients, helping in admitting patients, follow up on the patients with their vitals, learning to manage acute situations like DKA, hematemesis, ascetic tapping, hypertension, and loss of consciousness. managing and treating common health problems such as infections, influenza, and pneumonia as well as serious, chronic, and complex illnesses in different age groups.

*General surgery (2 months):
- In the emergency settings, take a history, order investigations for surgical emergency cases like appendicitis and intestinal obstruction, performing sutures, knots, and nasal packing. In the ward, doing preoperative and postoperative assessments, being able to explain surgeries for patients, and performing minor procedures: abscess drainage and lump excision

* Gynecology and Obstetrics (2 months):
- doing the prenatal, natal, and postnatal assessment, doing supervised bimanual and per speculum examinations, taking cervical smears, inserting urinary catheters, follow-up with admitted patients. doing urine dipstick, attending normal vaginal delivery and caesarian sections

* Anesthesia and emergency (2 months):
- stabilizing critically ill patients, inserting supervised cannulas, giving iv fluids and medications, reading ECG and Arterial Blood Gases ABG, doing CPR, and attending tracheal tube insertion.

* Pediatrics (2 months):
- assessing the health, growth, and development of neonates and
children, being able to take a history, do investigations to reach a diagnosis, teaching parents how to deal with their children from the medical point of view, advise parents about vaccinations of children, and calculating fluids for dehydrated patients.

* Geriatric (1 month):
- providing comprehensive medical care to older people through a patient-centred, compassionate and holistic approach.
- Diagnosis and management of acute illness as well as chronic disease and disability.
- Providing rehabilitation after an illness.
- Working with other professionals in multidisciplinary teams, GPs, social workers and many others involved in caring for elderly people including families and carers.
- In line with GMC ehical guidance, we were applying the ethical issues with elderly people, including appointment of power of attorney, guardianship, mental health legislation and resuscitation.

* Chest/Cardiac Surgery.
- Reviewing patient history and involving the cardiothoracic surgeons to determine treatment and the method of the appropriate surgical procedures.