Clinical Rotation On General Internal

Following the other 14 rotations, finally I come to the end rotation, which is general internal medicine. The department of general internal medicine is the core of medical education itself. Treating various conditions in adult and geriatric patients, internal medicine ward covers 60% patients in the hospital besides pediatrics.

The internal medicine clerkship consists of junior and senior clerkship phases. Junior clerkship deals with internal medicine wards, assessing new inpatients with internal medicine residents. Student doctors performs various tests such as physical examination, electrocardiography recording and vital signs monitoring. We also assists residents to make sure various patients’ programs work, such as vital signs observation, nebulization, electrocardiograms etc.

Senior clerkship mostly focuses in emergency department, dealing acute disorders, and exacerbation of patients with chronic diseases. Sometimes attending physician comes and discuss diseases with the residents and clerkships.

In the morning, all senior and junior students gather with attending physician to have morning report. We discuss chosen case (mostly chosen by resident), from history-taking, physical examination, laboratory/ecg/radiology findings, and assessments. Assessments are the core of this morning report.

In the mid-day, students will have bedside teaching with each divisions

Cardiology: During this bedside teaching with cardiology fellow (a senior internist who undertakes cardiovascular medicine specialty), we discuss about cardiovascular examination in a patient with heart disorders. How to do an effective history-taking, and finding the appropriate disorder, choosing the right .

Pulmonology: Internist-pulmonologists introduced us to several kind of pulmonary patients such as COPS, pulmonary tuberculosis, pulmonary masses, and brought us to a discussion about how to diagnose a patient with pulmonary symptoms.

Gastroenterology and Hepatology: Internist-Gastroenterohepatologists explained to us about history taking of an icteric patient, how to do a physical examination to a chronic liver disease patient, and laboratory findings related to the liver function tests.

Nephrology: I was the only medical student in this bedside, I almost had 5 days in 3 weeks of bedside with a very senior nephrologists, she took me to all her patients and I was so touched to know this. At the end of the bedside, I asked her permission to have examination and she blessed me “good luck, and be a  good doctor!” she said.

Rheumatology This is also another interesting bedside, with discussion of arthritis, SLE, scleroderma and ended with a practical OSCE.

Hematology and Medical Oncology A big evening round in oncology ward

Tropical Medicine, Infectious Disease and Clinical Immunology I am assisting my professor to find Tetanus, HIV patient, due to an exchange medical student from Japan came. And we have a morning round together.

Geriatrics a case presentation with geriatric assessment

Endocrinology, Diabetic, and Metabolic  A day round about diabetic foot with a diabetic foot specialist. We were taught to measure ankle brachial index.

I am so happy to end this clerkship with all my passion, and continue to comprehensive clerkship in Karimunjawa Island and Donorojo Lepra Center/Kelet Hospital.

Clinical Rotation on Ophthalmology

Ophthalmology is a branch of medicine dealing with eye diseases and visual disturbances. The visual system is a complex integrated system from the refracted media to the neural circuit up to the visual perception.

During this 4 weeks rotation, student doctors were introduced with various clinical eye diseases and visual disturbances. Students worked in ophthalmology ward, Operating Room, Eye clinic and Gunung Pati Health Center.

In eye ward, students followed the in-patients conditions glaucoma, vitreo-retina, cataracts, corneal ulcer, and eye trauma. Students assisting residents testing visual acuity, slit lamp examination, measuring intraocular pressure also examining patient with slit-lamp.

In operating room, students are obliged to see lens extraction, and trabeculectomy operation.

In clinic students see how doctors treat ophthalmic diseases, visual disturbances, using slit-lamp, ophthalmoscope, measuring eye tone.

Every Saturday, Gunung Pati Health Center opens eye health consultation. Patients are mostly from Gunung Pati District with either eye diseases or visual disturbances.

My favorite station is eye infection and immunological clinic, where the attending always stand by the residents and medical students. Attending explains the importance of eye examination, various disorders of eye and how primary care physician should acts in order to give emergency treatment and refer the patient for further management by Ophthalmologist.

Pengajuan Ethical Clearance FK UNDIP

Informasi ini hanya membantu mempermudah mendapatkan informasi mengenai persyaratan. Untuk informasi lebih lanjut, harap menghubungi

Sekretariat Komisi Etik Penelitian Kesehatan dan Kedokteran FK UNDIP/RSUP Dr. Kariadi                                                                            

Kantor Dekanat Lama FK UNDIP/RSUP Dr. Kariadi Lantai III                

Jalan Dr. Soetomo No.16. Telp.024-8311523/Fax. 024-8446905            

Jam 08.00 – 15.30 (Jam 12.00-13.00 istirahat)

Check List

  1. Pengisian Form Ethical Clearance Ditandatangani Pemohon (rangkap 2) dilengkapi lembar informed consent dalam bahasa awam (Penjelasan Sebelum Persetujuan)
  2. Proposal 2-3 eksemplar (4 bila penelitian multisenter) dengan tanda tangan pembimbing, penguji/sudah diuji dan direview
  3. Surat Pengantar Permohonan Surat Ethical Clearance dari Bagian/Instansi Setempat Pemohon EC
  4. Formulir Penerimaan Dokumen (Bisa Didapatkan di Sekretariat)
  5. Laporan Telaah Penelaah (Bisa Didapatkan di Sekretariat)

 

Attachments

Lampiran Form Ethical Clearance

Lampiran Informed Consent

 

Komponen Suatu Informed Consent

  1. Purpose of research project
    • A clear explanation of the reason for doing the study and why is it important.
    • Reasons for selecting this particular individual.
  2. Procedures
    • A clear detailed explanation of what will be done to or by the individual.
  3. Risks and discomforts
    • Truthful and inclusive statement of risk that may result and discomfort patient that can be expected.
  4. Benefits
    • A descriptive of potential benefits to the individual participant, to the general knowledge, or to future administration of healthcare.
  5. Alternative to participants
    • A description of reasonable alternative procedures that might be used in the treatment of this individual when a treatment/intervention is being studied.
  6. Confidentiality
    • Statement of the procedures used to ensure the anonymity of the individual in collecting, storing, and reporting information and who (persons or agencies) will have access to the information
  7. Request for more information
    • A statement that the individual may ask question about/discuss participation in the study at any time, naming an individual to contact.
  8. Refusal or withdrawal
    • A statement that the individual may refuse to participate or discontinue participation at any time without prejudice.
  9. Injury statement
    • A description of measure to be taken if injury occurs as a direct result of the research activity
  10. Consent statement
    • A confirmation that the individual consents to participate in the research project
  11. Signature
    • Participant, parent or guardian (for the care of minors), assent of minor age 7, witness

Reference: Portney LG, Wlkins MP. Foundation of Clinical Research Application to Practce 10th Edition. Toronto. Appleton & Lange. 2002. P 32

 

 

Clinical Rotation on General Psychiatry

Psychiatry is a branch of medicine, which makes the WHO other health goal, is approached. The WHO defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. And without mental health, one is not considered to be “health”.

In this clinical rotation medical student introduced with emergency psychiatric cases, outpatient department, psychiatric ward, substance abuse-related disorders and various psychiatric cases including schizophrenia, bipolar, depression, neuroticism, personality disorders and many other.

The core part is mental examination, in order to create a psychiatric diagnosis, doctor must be able to check the mental status, to determine the patient’s mood, perception and mind ability to differentiate real or non real.

The diagnostic approach is known as mutiaxial diagnoses, covering phsychiatric condition, personality disorder, medical condition, stressor and life quality of the patient.

In the end of the rotation we had posttest, OSCE, oral exam, patient exam, and UKDI-like Test.

Clinical Rotation on Forensic and Legal Medicine

Forensic and legal medicine is the branch of medicine to determine lawsuit with medical approaches. Forensic doctor release a letter of examination proof regarding corpse, organs, body fluids which is involved in a law court.

The medical approaches vary from performing visum physical examination, autopsy and also medical lab procedures related with law court case. DNA analysis is purposed to solve paternity or to determine the person in charge for a criminal case. Disaster Victim Identification is a method purposed to do rapid identification of victims during a massive disaster or accident.

Medical students were introduced with clinical forensic of assault cases in emergency department, and introduction to autopsy techniques to determine the cause of death especially in forensic autopsy.

In the end of this rotation, we have written examination and OSCE.

Clinical Rotation on Radiology

Radiology is a vital diagnostic approach in medicine. In general, it is divided into radiodiagnostic, radiotherapeutic and nuclear medicine. Radiodiagnostic is an imaging procedure in approaching patient’s diagnosis. It includes X-Ray, CT-Scan, MRI, USG, Bone Densitometry, Mammography and nuclear scintigraphy.

In general practice the two main important radiodiagnostic approaches are X-Ray and USG.

Medical students were introduced with various radiologic techniques including X-Ray principles and interpretation particularly CXR and Bone X Ray. Working in emergency department forces GP to understand and distinguish emergency cases from non-emergency causes. CT-scan of neuroemergency is also an important radiologic approach.

We were also introduced with the principles of therapeutic using radionuclides for end-stage cancers or metastatic cancers. This kind of therapeutic is mainly for palliative care reducing pain, hemorrhage and prolonging patient’s life 5-10 years ahead.

In the end of this clinical rotation we had oral examination and OSCE.

Clinical Rotation in General Pediatrics

Children are the most precious world treasure and they are not little man. It is the motto of pediatrics. Yes, but it’s true, diseases of the children somehow are different from diseases of adult. The turning point, their diseases are mostly affected by genes (hereditary or congenital), prenatal (infection/underdevelopment), and during development (nutrition, immune status).

There were 13 subspecialties in my medical school including tropical infectious disease, pulmonology, gastroenterology, nutrition, neurology, child development, hematology oncology, allergy immunology, perinatology, cardiology, endocrinology, emergency pediatrics and nephrology.

During the 8 weeks of clinical rotation, the first 4 weeks were junior clerkship in outpatient department, child development dept, perinatology neonatology section and emergency department. The last 4 weeks working in infectious and non-infectious ward.

In the end of the clinical rotation, we had oral examination, and OSCE examination.