TB or not to TB? 😅

After seven long, arduous years; two degrees; living in two different cities and one rural town; multiple exams twice a year for seven years, I finally have no university classes/placement this year. Instead, I will be walking through the wards and working as an intern at a metropolitan hospital!

I have now been an intern for six weeks- how time flies! Internship is definitely an eye-opener. It’s interesting to see the operations of a large metropolitan hospital, the ins and outs, and how exactly one makes it from the streets of Melbourne onto a ward and then back out into the community again. There is so much that medical school doesn’t teach- there’s only so much that can be taught in university. Although being a medical student and on placement in a hospital is meant to place you in an environment that is conducive to what you will experience, it’s not the same when you are actually employed and working as part of a large team. I am finding that the majority of learning is on the job, and it is not the university’s fault for not teaching these day to day experiences. Things like: Who do I contact to make an outpatient booking for a patient? Where do I take these prescription medicines for a patient before discharge? How do I dictate a letter to the patient’s GP? It comes from exposure, repetition and seeing things done for the first time, and trying to emulate that the second, third, and consecutive times after that.

I’d be lying if I said that internship was easy- it’s challenging. Challenging in a growth way. The last six weeks though, have been formative. Although I am more familiar with things, I still have imposter syndrome. For example, calling the PBS for approval of a medication and the operator greeting me with: “Hi Doctor, can I grab your prescriber number?” I was ready to look around me and give the phone to my registrar, but I was the doctor now and I was asking for approval from PBS! Was this really me now?

There is so much new learning- it’s great. So many new procedures, infections and antibiotics. It can be overwhelming. With experience, it will be less overwhelming, and that’s okay. I find myself checking what dosages for medications and other seemingly trivial decisions with my registrar and consultant, as I don’t want to do/change anything that can harm my patients. The more comfortable I get, the more I will be aware of which things to escalate and which things to proceed ahead without immediately running it by my registrar. At the end of the day, it’s all about safety, and making the right decisions for your patient’s best interest. In fact if you went into an internship making decisions on a whim, all guns blazing, that would be over-confidence and that can be potentially detrimental for a patient. One thing I have improved over the last six weeks is my communication with seniors and other teams. It was daunting for me at the start to pick up the phone and call another team and be greeted by the big consultant of another team. The hierarchy thinking made me think that there is no way a consultant would want to speak to an intern, just fresh out of medical school. All the consultants are genuine and eager to help. They know that interns are new and don’t expect a whole lot, because they’re here to learn. Being in an environment where learning, especially from mistakes and growth is encouraged is enriching.

My first term is Infectious Diseases- all things from fevers of unknown origin, to HIV, and tuberculosis (TB). TB didn’t make much sense to me in medical school, but seeing it weekly, it has now clicked a lot more. Every week I help in the TB clinic and consult on patients by myself. In week one, I only saw two patients and by now, I am comfortably seeing ten to twelve patients in the TB Clinic. Every plan that I make with the patients, I run it past the Infectious Diseases consultants and then document it. For those that do not know what TB is, it is bacterial infection by mycobacterium tuberculosis. It can infect your lungs (pulmonary TB) or it can spread to other parts of your body (extra-pulmonary TB). It is not prevalent in Australia, so the majority of cases are from people migrating/visiting to Australia from TB endemic areas. Most of the time, TB is latent and just chilling out, but with immunosuppression or a concurrent infection like HIV, TB can flare and become active. Active TB is where there are symptoms, like persistent cough, haemoptypsis (coughing up blood), fevers, unexpected weight loss and many others. The drug regimen often lasts between 6 to 9 months. In the TB clinic, I would be explaining all of this to a patient, as well as the side-effects, and prescribing the necessary drugs to them. It’s a great clinic, and I have learnt so much from it.

I’m still finding my feet during internship, but I’m finding my feet well- on firm ground, ready for the other terms this year.

Look out for the upcoming series where I will be interviewing Black medical professionals in Australia, about all kinds of things related to their pathway and journeys in medicine. Stay tuned!