Information for Medical Offers/Interns
District level hospital guidelines applicable for interns and comm service doctors. Published in 2016
Duties - official work day hours
The department usually functions with about 15-17 interns and 5-7 Medical officers.
There will be 2-3 medical officers/interns per unit, 4-5 medical officers/interns in newborns, 1-2 medical officers/interns in HIV Clinic and 1-2 medical officers/interns in POPD.
Interns
Rotation
Each intern will usually spend 2 months in the wards, 1 month in neonates, and 1 month in HIV & POPD concurrently (Generally mornings in HIV and afternoons in POPD).
Leave
Each intern is entitled to 7 working days leave. Each intern will be requested to submit their leave dates prior to starting their block. Specific leave slots have been created and interns are requested to choose one of these slots. Failure to submit a leave slot will mean that a slot will be randomly assigned to you. A maximum of 2 interns are permitted leave at any given time. Leave carried over from other departments will not be granted during Paediatrics. Likewise, leave accumulated during Paediatrics must be taken whilst you are doing Paediatrics as other departments will not allow you to carry your leave across. You are also not guaranteed the weekend off before your leave starts, although every effort will be made to include 2 weekends around the 7 working days leave. Please complete a leave form prior to your leave dates and submit to Mrs Karen Marshall.
Medical officers
A 6 month block usually entails 3-4 months in the wards and 1-2 months in neonates depending on staffing levels. If fully staffed, we will attempt to offer you exposure to POPD, Specialist clinics, HIV clinic and ICU. MOs are entitled to 11 days leave per 6 month rotation. Leave requests for the 6 month block should be given to Mrs Karen Marshall within the first 2 weeks of your block, but preferably prior to starting your rotation.
DUTIES – OFFICIAL WORK DAY HOURS 08H00-16H00, PLUS OVERTIME
Normal working hours are from 08h00 to 16h00 on weekdays.
Unit Intakes (D1)
All unit staff are expected to stay at least until 16h00.
The first call MO/Intern works in ward 17 from 8h00 to 8h00 the following day.
The second call MO/Intern works from 08h00 to 22h00. Red flags are done from 20h00 to 22h00. The second call person is allowed to go home once red flags are done. Please check with the registrars on call before leaving. A sleepover room for the second call person will be provided should they wish to stay over. The second on call person should check outstanding results before they leave.
The second call person must go to POPD for the afternoon only at 13h00 and remain there until 15h30, unless released by senior POPD staff.
All blood results etc. results must be entered in the patient’s records (and acted on) before the first call MO goes to sleep. Abnormal results must be discussed with the registrars; and if necessary, bloods will need to be repeated before the PIWR. Outstanding results must be updated if possible, before the PIWR.
All patients seen in ward 17, MUST be discussed with, and/or seen by the registrars who will then decide whether the patient can be sent home, slept over or admitted. The first call MO in ward 17 remains for the night.
MO sleeping rooms are on the 3rd floor. (Rooms 6, 7 and 8 are designated Paediatric Sleepover rooms) Intake Stats Forms to be handed to data capturers by day 4.
Post-intake (D2)
PIWRs will start at 8-9h00, unless otherwise arranged and interns/MOs must try to see all their old patients before this. All unit staff are expected on the PIWR. (Excludes weekends)
The person who did not work the previous night (2nd or 3rd call) must cover the post-intake afternoon. Red flags should be handed over to the registrars on intake and not only to the MO who will be doing the red flags. This handover needs to be a written list with a quick verbal account of the cases.
Weekend Duties
There is 1 MO/Intern assigned for the Ward intake, and 2 interns/MOs assigned to neonates. In addition the post-call MO/intern is responsible for seeing their own unit’s old patient Red Flags. The day 3 and day 4 units will each have an intern/MO come in for their unit Red Flags.
Neonatal Unit
1st call: Works from 08h00 in the morning to 08h00 the following morning. (Neonatal MOs must be dressed in their theatre clothes ready to be called for Caesars by 08h00). Allowed to leave soon after 08h00 the following day, once a thorough handover has been done with the following day’s staff, including the consultant on cover.
2nd Call: Sees all the red flagged patients, as well as any new admissions from the previous day in the neonatal unit. Assists 1st call person. Allowed to leave the following day soon after 08H00, once a thorough handover to the new team coming on duty, has been done as described above.
Wards
1st call: Works from 8h00 until the post intake round is completed the following day. The day’s duties usually starts with seeing red flagged patients in the MO/intern’s Unit, and then proceeds to seeing patients in Ward 17 Admissions.
Day 3 (D3)
All patients are to be seen by the interns/MO and presented to the unit registrars. Difficult cases will be discussed with the unit consultant. If the unit is quiet and the work has been completed, then one or two persons from the unit is permitted to have the afternoon off. Of the remaining staff, one person should remain to do afternoon red flags and one person has to assist in POPD. Please note than afternoons off are a privilege and not a right, and that you may from time to time, be called upon to assist in other areas. (e.g. POPD, Clinics, Neonates/Intake Unit). Afternoons off must be arranged with the Unit’s registrars and the other MOs/Interns , preferably done well in advance and posted as a written record on noticeboard.
Day 4 (D4)
A ward round with the consultant will be held on Day 4 at 11.00hrs i.e. after tea. Each unit may differ in the way they conduct this round but it is essentially a teaching round. Typically junior staff would have been allocated topics by the Consultant or Registrars to read around in preparation for discussion on D4.
UNIT Follow up Day
Monday morning is the time for the unit follow up. All members of the unit are expected to be in the Specialist Clinic by 09h30. This means that ward patients need to be attended to prior to this, and those not seen by 09h30 will need to be seen only after the follow up which usually ends at 11h30. Day 3 rounds on Mondays will only be done after the follow-up has been completed. Hence the Day 3 round on Mondays may commence on occasion at 13h00 – 14h00.
NB. ** Do not book follow up patients on post-intake days!!
Teaching - Try and attend as many meetings as possible. Teaching will take place on the D4 rounds as well as post-intake if possible.
DCH Teaching
The Paediatric department at Rahima Moosa MCH have for a number of years now offered assistance to candidates sitting the Diploma in Child Health (DCH) exam. The DCH is an exam set by the Colleges of Medicine of South Africa and is held twice a year (March/April and Sept/Oct). The teaching is offered to anyone who is keen; it is also open to the Medical Officers from the other hospitals. We encourage all our MOs to sit for this exam and undertake to support them with their efforts. We have a proud record of several successful candidates under our tutelage. For more details contact the Department or any consultant