Duties of a house surgeon / Foundation Doctor

Pre-registration house officer (PRHO), often known as a houseman or house officer, is a former official term for a grade of junior doctor that was, until 2005, the only job open to medical graduates in the United Kingdom who had just passed their final examinations at medical school and had received their medical degrees. The term "house officer" is still used to refer to FY1s and FY2s.

1. DUT IES OF A HOUSE SURGEON By Dr. Muhammad Saifullah House Surgeon Surgical Unit V, DHQ Hospital Faisalabad

2. OBTAINING INFORMATION from the patients, COMMUNICATING such information to the appropriate person

3. SMOKING Doctors should set an EXAMPLE by not smoking. NEVER SMOKE especially in front of the patients.

4. QUIT SMOKING Any patient who is going to have a general anesthesia should be encouraged to stop smoking completely.

5. TIME KEEPING Check your duty roaster. Be punctual…… …means being in the ward at least 30 min before the consultant is expected and assess the patient’s recent condition.

6. RESPONSIBILITY AND CONSULTATION Important LINK-MAN in the team. SEEK ADVICE from senior member of the staff. Informing about THE UNUSUAL HAPPENING e.g., sudden death, unexpected complication or threatening relatives.

7. RELATIONSHIPS With FAMILY DOCTORS ………..can provide valuable information about the patient’s disease and his calls must be answered promptly. It is good practice to call the family doctor at the time of operation and if he visits the patient afterwards, he should be provided all the valuable information. When the patient is discharged, he should be given a note which provides all the information like Diagnosis, Treatment, Drug dosage and Follow-up/After-care.

8. With NURSING STAFF ……….should be good because they can provide valuable information regarding patient’s diet and current condition. With RELATIVES ………..is important and they should be given a short, simple account of the medical condition and prognosis. Any close relative should be informed about any sudden deterioration in condition.

9. AUTOPSY Breaking bad news If the cause is unknown then consent should be taken for autopsy. If the consent is not given then the house surgeon should refuse to issue a death certificate and should notify the consultant at once.

10. NOTE TAKING DETAILED HISTORY COMPLETE PHYSICAL EXAMINATION DAILY PROGRESS REPORTS INVESTIGATIONS DIFFERENTIAL DIAGNOSIS PROVISIONAL DIAGNOSIS

11. LABORATORIES Avoidance of any unnecessary investigations. Ordering a Radiograph with necessary information Provisional Diagnosis Relevant clinical findings Details of operation on the relevant part Dates of previous Radiological studies Name of relevant investigation required

12. RADIOLOGY PLAIN RADIOGRAPH: Fractures and Acute abdomen CONTRAST STUDIES: Esophageal stricture and GI obstruction USG SCANNING: Fetal anomalies, masses, cysts and biliary or pancreatic disease CT SCAN: Intracranial lesions, abdominal masses and retro-peritoneal lesions MRI SCAN: Hepatic tumors and Posterior cranial fossa tumors ISOTOPE IMAGING: Thyroid uptake, bone mets, pulmonary emboli, MI and Intra-cardiac shunts INTERVENTIONAL RADIOLOGY: Aspirating renal cysts, embolizing bleeding vessels and percutaneous biopsies

13. PRESCRIBING DRUGS On the drug prescription card commence with; Date Pharmaceutical name Dosage Route Times of administration Sign the entry

14. PRESCRIBING DRUGS When a drug is discontinued, date should be written down and signed. Any unusual reaction to drug is noted and mentioned.

15. WARD ROUNDS Noting the NUMBER OF EMPTY BEDS especially if the ward is to receive emergency cases that day. When the consultant goes round, the house surgeon should have case notes and latest results available for inspection and discussion.

16. DISCHARGING A PATIENT Anticepating a patient to be discharged when he is medically safe to go. If a patient wants to go early then he/she should sign a form and then he/she is allowed to go. If he refuses to sign then doctor and a witness should sign, noting down the refusal.

17. OPERATING LIST Requirements include Consent Marking Timing

18. CONSENT Informed consent Patient must know that which part is diseased and what is to be removed. Options available Possible risks of not being operated Operation complications

19. MARKING In paired structures, side should be marked which ever is to be operated upon.

20. TIMING Time available Facilities available Ensure that the list could be completed in the given time.

21. DEATH CERTIFICATES PART I 1 ST line shows immediate cause of death e.g , septicemia 2 ND line shows the reason of immediate cause e.g , peritonitis 3 RD line represents the reason for line # 2 e.g , DU perforation

22. PART II Represents the generalized diseases e.g , Chronic bronchitis, HTN and DM. The death certificate must be issued as early as possible.