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Internship

Logbook and Guidelines


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The logbook is the record of your activities and the progress that you have made during your one year of pre-registration internship.

The guidelines for you and your supervisors are to assist you in achieving comprehensive clinical experience to become a competent and caring doctor.

The Central Internship Committee expects you to undergo this period of practical training successfully; based on educational objectives laid down by the Medical Faculties of the University of Hong Kong and the Chinese University of Hong Kong.

It is well recognised that your first rotation may appear to be heavy on clerical and routine clinical duties. However, it is anticipated that as you progress through your rotations and gain experience and confidence, your clinical and practical responsibilities will increase.

Please make sure that you have entered the information regarding your activities as neatly and legibly as possible. It is anticipated that your supervisors will formally discuss your progress and provide guidance (at least once a month) during your rotation.

At the end of the rotation, please submit your logbook via the on-line system.

Guidelines

A. Responsibilities of Interns

  1. Communication Tasks
    • Good working relationship with other staff
      – nurses
      – senior doctors
      – other departments e.g. diagnostic department, anaesthesiology etc.
    • Communication with patients and their relatives.
    • At discretion of senior doctors – breaking bad news.
    • Gain informed consent for frequently undertaken procedures.
    • Case presentation on designated ward rounds.
    • Performing effective “hand-over”.
    • In consultation with seniors – making referral to coroner and gaining consent for post-mortem.
  2. Clinical Tasks
    • Good history taking and physical examination.
    • To institute the management of common clinical problems in both elective and emergency situations.
    • To recognise the complications/ deterioration in patient’s condition and ask for help from the appropriate senior.
    • To attend ward rounds and out-patients and present the cases as per senior’s discretion.
    • To report adverse drug reactions.
  3. Clerical Tasks
    • Learn to write good and legible
      – admission notes
      – patient progress notes
      – investigation forms
      – blood transfusion forms
      – discharge summary
      – notes of seniors’ instructions
  4. Practical Tasks
    • I.V. infusion
    • Blood collection
    • Blood transfusion
    • C.P.R.
    • Urethral catheterization
    • Assisted, supervised or delegated procedures as per seniors’ discretion, e.g.
      • Medical Rotation
        – CVP insertion
        – intubation + ventilator setting
        – abdominal tapping
        – bone marrow aspiration
        – pleural tapping + biopsy
        – lumbar puncture
        – chest drain insertion and removal
      • Surgical Rotation
        – simple suturing
        – excision of lumps and bumps
        – proctoscopy and sigmoidoscopy
        – incision and drainage
        – direct laryngoscopy
        – chest drain insertion and removal
      • Paediatric Rotation
        – lumbar puncture
        – neonatal drip setting & blood collection
        – urethral catheterisation
        – urine microscopy
        – peripheral blood smear (microscopy)
      • Obstetrics & Gynaecology Rotation
        – normal/ instrumental delivery
        – episiotomy and suturing
      • Orthopaedics Rotation
        – closed reduction of Colles’ fracture + POP
        – closed reduction of dislocation (shoulder, elbow)
        – wedge excision of in-growing toe-nail
        – incision and drainage
        – simple suturing

B. Responsibilities of Departments

  1. Chief of Service (C.O.S)
    1. To provide the specific guidelines for supervision of interns by both senior and junior staff.
    2. To ensure that interns have adequate protected time for educational activities.
    3. Appropriate interaction, counselling and advice including career development.
    4. To ensure fair assessment of intern’s performance.
    5. To inform the Faculty of intern’s progress.
  2. Supervising Consultant/ S.M.O
    1. To have at least one ward round a week where interns will have opportunities to present the patients to S.M.O. or Consultant.
    2. To ensure that intern attends at least one out-patient clinic a week.
    3. To ensure efficient on-call arrangements.
    4. To make sure that sufficient protected time and opportunities for educational activities are provided.
    5. To provide reliable access to seniors available as and when necessary.
    6. Evaluations of performance to be discussed with the intern personally and provide guidance; particularly for those who need help.
  3. M.O.
    1. To ensure that intern has reliable access to M.O. at all the time.
    2. To make sure that intern is not given the task beyond his/her abilities.
    3. To be directly responsible for patient care.
    4. Be aware of intern’s limitation and be ready to help.

C. General Reminder for Routines Not Recommended for Interns

  1. Locating beds for new admissions.
  2. Obtaining consent for major procedures without briefing by the senior of potential risks of the procedures.
  3. Collecting and delivering requests and results of investigation.
  4. Undertaking portering duties.
  5. To act as a phlebotomist at all the times.
  6. Administration of I.V. drugs, eg. cytotoxic agents, contrast media without proper training.
  7. Undertaking secretarial duties which could be carried out by a ward clerk.
  8. Performing investigations without adequate training or supervision.
  9. On-call less than 1 in 3.
  10. More than 50 discharge summaries a week (it is anticipated that M.O.s should help to clear the large volume of discharge summaries).