Queen Elizabeth University Hospital, Birmingham,United Kingdom:
Queen Elizabeth Hospital, Birmingham: Staff Grade Physician: Renal Medicine:
I was working as a Staff grade physician in the Renal Unit of this hospital (10 sessions a week). This involved doing regular rounds on the acute and outpatient haemodialysis units assessing various aspects of patient care, including transplant listing. I saw new and follow up cases in the outpatient clinics, which include: general renal, special renal, low clearance, haemodialysis and peritoneal dialysis, transplant, and combined diabetic renal clinic. I was allotted 3-4 renal biopsy lists a month. I was assigned teaching sessions of undergraduate students, nurses and house officers. I also participated regularly in multidisciplinary meetings, journal clubs, seminars and audits. I was involved with a number of research projects.
Queen Elizabeth Hospital, Birmingham: Registrar: Renal Medicine:
I received training as a Visiting Specialist Registrar in the busy Renal Unit of this University Hospital (with about a thousand patients on the programme
Care of Inpatients:
I was responsible for the care of on average 30 inpatients at any one time. This involved doing daily ward rounds, planning the work up and management of these patients.
Assessment of Referrals:
Every month, for one week, I was assigned to take all renal referrals from other hospitals in the region, GPs and other departments within the hospital including ITUs. I was responsible for the initial appraisal of these patients.
ITU / CCU cover:
During this period, I did daily rounds twice on the general and the three superspeciality ITUs, in an advisory capacity with my consultant, on fluid and electrolyte management, renal problems and continuous modalities of renal replacement therapy.
Dialysis Unit Cover:
For one week every month, I was in charge of dealing with all the acute problems arising on the acute and chronic haemodialysis and peritoneal dialysis units.
Care of Transplant patients:
The Unit has an active renal transplant programme- about 140/ year (cadaveric & live related). I was involved in the pre- operative work up of donor & recipient & the post- operative care and long term follow up of these patients in the Transplant clinic. Once a week, there was joint Transplant meeting of the Nephrologist’s & surgeons where status of work up of the live related transplants & post- operative complications, if any of the patient’s recently transplanted were discussed,
Dialysis access procedures:
Besides establishing temporary central venous access for dialysis regularly I inserted about 6-8 semi permanent Tesio lines a month. Temporary PD catheters is another form of access I am familiar with.
Out patient clinics:
Daily out patient clinics included general renal, special renal, combined diabetic-renal, low clearance, dialysis and transplant follow up clinics. Once a month I attended the combined renal maternity clinic. In these clinics I dealt with new and follow up cases.
I also had the opportunity of managing all non-renal medical problems in our patient population.
I have done on an average 120 native and 40 transplant biopsies per year, under ultrasound guidance with a Biopty Gun.These were reviewed at a later date with our nephro histopathologist.
Once a week we had a joint meeting with the Urologists and the Radiologists for discussing our common problems.
A joint meeting with dieticians, physiotherapists and occupational therapists helped us focus in on all aspects of patient care, on the unit Grand round once a week.