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Internship Report
Phramongkutklao Hospital

Presented By
Vin Phattharasiriroj 1104 ID 5961122
Introduction

During winter break, Belle (Sumeta Vongpiphopmongkol) and me got an opportunity

to do an internship at Phramongkutklao Hospital, from 18-22 and 25-29 December. Doing an
internship also helps me figure out whether I want to do the job that I am interning in the
future as well or not. There were 4 ​Pharmaceutical-program ​college-juniors doing an
internship there too during our first week so the advisors tell us to split up and pair with them
to gain more knowledge and experiences from them as well.

Review of Literature

Phramongkutklao Hospital is a military hospital for the Royal Thai Army and a
teaching hospital for Phramongkutklao College of Medicine which trains doctors for the
Royal Thai Armed Forces, as well as the Royal Thai Army Nursing College.

Hospital History

At first Phramongkutklao hospital started from being a facility named ‘​Bangkok

Military District Medical Corps Division​’. The facility was opened on 26 November 1932
and was attended by Gen. Phraya Phahonphonphayuhasena and was used as the headquarters
of the medical corps. Then it was developed with ​assistance from the Faculty of Medicine,
Chulalongkorn University and Faculty of Medicine Siriraj Hospital. By 1933, the name was
changed to '​ Military District 1 Medical Corps Division'​.
During World War II, the hospital was closed for general patients and was used as
only for military hospital. After the war ends, the hospital improves its quality of care and the
education for military medicine. On 1 January 1946, the division became the '​Army
Hospital​' and operations were transferred directly to the Army Medical Department. The
hospital also reopened back for public use. On 8 August 1952, the hospital was renamed
'​Phramongkutklao Hospital​', in following the name of King Vajiravudh, who had built
Phaya Thai Palace.
Project Description & Methodology

According to the introduction, we were separated for the first week, we work from
8:00-16:00. This is my schedule for the first week(18-22 Dec):

Day 18/12/17 19/12/17 20/12/17 21/12/17 22/12/17

Division(s) 8:00 O
​ rientation Procurement Medical Out-Patient Medical
13:00 ​In-Patient Room Storage Department Procedure
Department Room Room

During 25-29 December our schedule are the same, since the college-juniors are done
with their internship. This is the schedule for the second week:

Day 25/12/17 26/12/17 27/12/17 28/12/17 29/12/17

8:00-12:00 Somdej Ya Somdej Ya Orthopedics

building building Ward Ward
Medical Ward and Orthopedics
Procedure Ward Out-Patient
Room Department
13:00-16:00 Medical Out-Patient Out-Patient
Procedure Department Department

Journal Entries

Day 1 - 18/12/17

Today is my first day for my internship at Phramongkutklao hospital. I’m doing this
internship together with Belle (Sumeta Vongpiphopmonkol) so we decided to meet up at the
hospital before the time that our work will be starting which is at 8:00 AM. Once we meet up
and get to where the pharmacist department of the office inside the building is, we found out
there are going to be 4 Pharmaceutical-program ​college-juniors doing an internship at the
same time as us too(but their internship will be only for 5 days, ours is for 10 days). We were
assigned to split up into 2 groups and be with 2 college-juniors to learn and gain better
experiences from the pharmacists in different sectors inside the Pharmaceutical department.
 After lunch, we went to the In-Patient Department(IPD). There, we learned how to
read and understand the prescription correctly to make sure that we don’t give them the
incorrect medicine. The drugs in the IPD are arranged quite neatly in shelves. The shelves
containing high-alert drugs will be red to be easy to recognize. Some of the prescriptions
have some signs/symbols to distinguish itself from the other prescriptions. For example,
prescriptions with a star stamp on it means that the patient is allergic to certain ingredients so
the pharmacists needed to double check on the medicine they are going to give them.

*These are real prescriptions in the hospital. We cover the patient’s information in order to
not reveal their privacy

Day 2 - 19/12/17

I went to the Procurement Room and learn about how the hospital ordered the
medications. They ordered new medications every quarters. The orders are divided into 2
types, medications and medical supplies. Medical supplies will also be divided into 2
sub-types; para and health; anyhow, the order can not cost over 5000 Baht per piece. If the
order is over 5000 Baht, it needed to be record on the hospital account book of the hospital or
the department of medicine. If they did not record the orders that are over 5000 Baht in the
hospital account book, they will not be able to withdraw cash to repair the product if the
product ever got ruined or damaged. For medical supplies, they also needed to ask the Royal
Thai Army (RTA) for the budget. The sources of medication orders varies too. They can
come from E-bidding, Monopoly businesses(some medications can only be ordered from one
place), general businesses, and E-market. In E-bidding, the buyer will provide the
description, spec, and quantity of the medication that they wanted to order. Then the
businesses that have the medications that the hospital wanted and if they are satisfied with the
price that the hospital have given, the bidding will start. Monopoly businesses are mostly
international businesses which we cannot made a copy of it yet, we are then, needed to order
from them with a little higher price comparing to the other medications we can find in our
country.
After that, they assigned us to organize the medication cabinet in the procurement
room which the college-juniors are in of help. I learned about different kinds of drugs from
them which is quite interesting. They let me help taking notes on the use of the medicines we
found in the cabinet then organize them into groups of their uses.

*These are the list of medication names that I help them noted down and the last picture is the
picture of few medicine in the cabinet

Day 3 - 20/12/17

Today is the third day of my internship, I was assigned to go to the Medical Storage
Room. They let me checked the stock of the medicines on the shelves whether the quantity
are correct or not, or does the medicine already expired or not, which lot are they in, and etc.
So I walk through the shelves and starting checking the stocks. The medications were
organized by their names in alphabetical orders on the shelves so it makes the process of
stock checking easier to be completed. The Medical Storage room also have many sections,
there are the place where the orders from OPD (Out-Patient Department) and IPD (In-Patient
Department) will be placed in the first zone you reached once you walk through the Medical
Storage Room door and near there, will be the place that the medicines that they requested
will be placed. Different kind of medications are put in different kind of places too, they are
organized by how they needed to be kept. Some are placed in a refrigerator, some are placed
on dry shelves, and etc.

Day 4 - 21/12/17
Today, I went to the Out-Patient Department and help out with the medications labels
that they wanted us to make to put on the front of each loops. Which loops, are basically
shelves of medicines, each loops consist of different kinds of medicines depending on its
uses. For example, the 1st loop is for Antipsychotic Drugs, the 2nd Loop is for
lipid-regulatory drugs and cardiovascular system drugs, etc.
They assigned us to take pictures of different types of medicines, including some of
the addictive drugs, such as miansenin. We also need to measure the size of some of the
tablets too. I have difficulties finding the drug names on the list at first, but then I started to
get used to it and feel more comfortable to ask some of the pharmacists there to find out
where some of the medicines are too.
The OPD also have their own storage room too. In case of emergency they would
stock some medications that are often ordered in their stock room.
Day 5 - 22/12/17
I went to the Medical Procedure Room on the fifth day. There, they made some of the
potions/medications and small doses that the hospital have alter some ingredients to
distinguish them from the other hospital or medical sources. I got the opportunity to make
special mouthwash too, the smell of mint is pretty strong in this one. We can also adjust how
pink we wanted it to be. However, we wanted to make sure the color look similar and the
scent is quite equally as strong as the other lot that they produced. I tried to help out with
closing the bottles of potion too, but my strength is not enough for me to close the bottle
tightly so I help with the sticking stickers on the bottles instead.

Day 6 - 25/12/17
The college-juniors have finished their internship since Day 5, so now Belle and I will
be together for this whole week. Today, we went to the Medical Procedure Room again and
help out more with the medicine making and packaging, including cold cream, the special
mouthwash, and etc. While they let us try making the potions, creams, and mouthwash(which
we needed to make around 250 bottles) they explained the instructions along the process too
and let us go get the ingredients from the other room. They taught us how the procedures and
the calculations are needed to be accurate/precise or else the efficiency may be reduce from
what the calculations actually needed to result. Which that would create a bit problem for the
hospital if the efficiency of their medications actually drop. If contamination also occur
during the process of making some important medications it might also affect the wound of
the patients or even the time it takes for the patients to heal(it will be healed slower than
expected), or it would not even work or helped the patient. So making a little mistake in
mixing some ingredients in the potion may result a big problem in the whole lot.

Day 7 - 26/12/17
Today, we got the opportunity to go up to the special patient ward in the Somdej Ya
building. At first, we thought we will get to follow the doctors into the patients rooms for
their daily check-ups but sadly, we did not get to do that on that day because the check-ups
are already over once we get their(they did the check-ups very early in the morning). One of
the pharmacist explained to us about the paper of patient’s record which would basically
record the information of the patients after taking medications or after a surgery and
check-ups. For doctors, they will have a folder for each patient’s record, including their
history or surgery, medications, check-ups in order to analyze on what more should they do
to be able to help the patient.
One of the nurse also taught us about the how different kind of samples are kept in
different kinds of containers. The containers comes in 5 different colors which are Red, Blue,
Green, Purple, and Grey. Different types of liquid substance are contained in different kinds
of container for laboratory. The red container contains nothing, the blue container contains
Sodium Citrate 3.2%. The green container contains Lithium Heparin, the purple container
contains EDTA and K2 chemical, and finally the grey container contains lactase (for glucose
test) and farting plasma glucose. The container color is not the only difference but the shape
of the container is also different as well. The first type of the container is the one with a long
lid called the Hemoculture. The second type of the container is the one with short lid and a
little bit fat bottle, which is called the Fungus bottle. Last type of container is the fat one with
no handle on the lid, it is used for collecting sample such as urine (red lid), fece (green lid
with stick inside), and phlegm (green lid with no stick inside). Then after that we went to the
orthopedics ward, we get to follow one of the pharmacist that explained to us about the
patient's record paper to give out the medicine to the patients that are going to leave the
hospital and go home that day. We get to know how she calmly explains to the patient about
each medications they need to take about when and how should they take it. She also asks
them whether if they have had any weird symptoms after consuming some medications after
their surgery.
We went to the procurement room again today in the afternoon, the cold cream was
made yesterday and was left sitting in a closed container(just to make sure there won’t be any
contamination during the day), to prevent much air mixing in with the cream. So for today,
our tasks here are basically just packaging. We manage to pack the cold cream around the
amount that we expected which is around 200 containers. The packaging part is somehow
painful to me since I do not have enough strength to close the lid of the bottles properly, and
it is a repetition of mixing the same kinds of medications over and over again just maybe in
different orders or ways. I like mixing the potions but if I would think about making it over
and over again for so many times, I would feel so bored.

*This is the picture of the cold cream we made

in the Medical Procedure room the day before.
Day 8 - 27/12/17
In the morning, we went over to the special patient ward in the Somdej Ya building.
Today, we get to followed a doctor while he was doing the daily checkups with his patients.
Each room pressure are totally different, some room feel so heavy and some room feels so
normal, it actually makes me started to feel dizzy. When we reached the last room, I almost
fainted so I decided to ask them to please excuse me then I stayed in front of the room until
they come out. The daily check-ups that the doctor did was that he ask the patients about how
they feel right at that moment or after having their surgery,is there anything they felt that it
was a bit weird or not and many other stuff. Then, we went over to the orthopedics ward
again today. We get to follow the pharmacist to give Home Medications to the patients again
before they leave to go home. She asks similar questions according to yesterday’s questions
which is just to final check the patients before they leave the hospital.
We got assigned to be in the Out-Patient Department today in the afternoon. They told
us to make a brochure for foreign patients that may come to the hospital. By brochure, I
mean, a guide for foreigners to be able to understand what they need to do since they first
step into the hospital. One of the pharmacists takes us out, during her break time, to see the
steps of how patients comes in to have check-ups and where to go and what to do after their
check-ups with the doctors.We gathered as much information as possible and ask as many
questions that we think is useful and started brainstorming on the design of our brochure.

Day 9 - 28/12/17
It is almost the last day of our internship, for today, we will be in the Out-Patient
Department for the whole day. We did not quite get what we wanted the design of our
brochure to be like yet, so we brainstorm a little more. At last we come up with some ideas
and started working on it. We listed out the steps that we have been told yesterday by the
pharmacist and finds additional information like the map of the hospital from the internet.
The hospital map in the hospital website itself cannot actually be used since it is an old one.
So we need to go over to the other room to ask for the picture of the newest map of the
hospital. We got that from them and put it in the brochure.
This is the picture of the brochure:

Day 10 - 29/12/17
Today is the last day of our internship. We were assigned to write a reflection for the
Out-Patient Department about what we’ve learned so far from the department. This is the
content of my reflection:

In the Out Patient Department(OPD), I’ve learned about the working system and
management in this department. The patients would bring their prescription with them to the
10th or 11th counter which the staff would accept it and input patient’s information into the
computer. Then, the patient’s medication list stickers will be printed out there at the printer.
Both the prescription and the medication list sticker will then be handed over to the basket
staff. The basket staff need to put both of them into the baskets based on their numbers and
special conditions.
Special conditions:
● handicaps or papers with the emergency stamp
○ their medication will be put in purple basket(so-called the "emergency"
basket)
● patients who have official titles
○ their medication will be put in the red basket
● General patients’ medication will be put in baskets based on their number.
 ○ Pink basket : 1-99, 400-499, 800-899, 1200-1299
○ Green basket : 100-199, 500-599, 900-999, 1300-1399
○ Blue basket : 200-299, 700-799, 1000-1099
○ White basket : 300-399, 700-799, 1100
*These numbers will be printed on the medication list sticker and will be hand-copied
onto the prescription by the counter staff.
On the other hand, the basket staff can also receive patients’ prescription and their
medication list stickers from other floors/departments from the printer inside the dispenser
room. Also, if the prescription or the medication list stickers aren’t printed out properly, the
basket staff will need to contact or call the floors/departments to reprint or re-check the
prescription and the medication list stickers once again.
After the papers and stickers are all good and was put in the right baskets it will be
handed to the medicine organizer staff in the Loop, the place where the medicine are kept and
and organized to be ready for dispensing. Each loop will contains different types of medicine
which will be ordered then organized by pharmacopoeia.
There are 4 Loops in total:
● 1st Loop : Antipsychotic drugs
● 2nd Loop : lipid-regulatory drugs and cardiovascular system drugs
● 3rd Loop : Vitamins, antibiotic drugs, antiviral drugs, analgesic drugs, and
gastro-intestinal system drugs
● 4th Loop: Parenteral and medical supplies
After getting the all the medicine needed in the basket, the medicine organizer will
hand the basket over to pharmacists. Pharmacists will do the last check to ensure that the
medicine are given at the right amount/quantity to the patient. If the pharmacist doesn't think
it's right, she can call the doctor or check in the system about the patient's check up info and
their medical history by inputting the VN or HN number into the computer to search.
When the recheck are done and the pharmacist thinks that it's right they will hand it to
the patient that will be called to receive their medication. Which the numbers won't be much
in order, the earlier it's done with the whole process the faster the patient will receive their
medication. However, they tried to keep it as close as the number order as much as they
possibly could though.
 For the work, we get to help out as the basket staff. It was a not-too-difficult but
not-too-easy work to do since mistakes can easily happens with the basket colors or the
basket numbers. At first, there's not so many patients entering or coming in the morning so
we can take it easy but when more and more patients started to pour in, the situation is kind
of tough to handle since we're like a newbie to this kind of work. However, the work is not
confusing since there's a poster about which number would go to which colored basket. Also,
when there's not so many patients we manage to put the basket in the proper Loop but when
there's so much to handle or too less time are available we can sent the basket to the 2nd
Loop and the medicine organizers will organize the basket themselves.
There's time when some of the pharmacists come over to us and told us that we put
the prescription in the wrong color basket, so we tried to be more careful about the basket
colors and the types of basket.
Overall, we did learn quite a lot about the system in OPD and gain some experiences
in during helping the basket staff out. This information will also become very useful to us
when we write down our report and when we're doing the presentation for our capstone
project since we actually get to be involved in the situation.

Conclusion
After doing the internship at Phramongkutklao Hospital, I have learned and gained
new experiences on different types of work in different divisions in the Pharmaceutical
department. I have realized that pharmacists works their hardest to give the patient the most
suitable medicine for the patient at times, they developed good teamwork skills due to how
different divisions need to depend on each other, and they have to stay calm in front of the
patients, just like doctors, so the patients won’t feel insecure around them while they are
giving the patients their medications. Also, by going to the Procurement room, I realized that
being a pharmacist sometimes you need to be sharp too, to decide quickly with a reasonable
reason and get the best result out of their work since they are the ones who needed to find and
deal with the prices of the medications that have been going in and out of the hospital. I
respect the job of pharmacist and how dependable they seem to be. I do respect pharmacists
and how dependable they are.
Reflection
I thought that it was going to be interesting to get to come over to the hospital to do
the internship in the pharmaceutical department, and now, it never makes me regret thinking
like that. Doing an internship here sure is very interesting to me, I get to learn stuff that I
wouldn’t have learned if I’m not in certain positions that I’m in during my internships. I
wouldn’t just normally get to mix medicines or casually touch addictive drugs in other
general places. However, despite how dependable and good pharmacists seem to be, I still
think that I still want to be an architect since I would get bored so easily from repeating my
actions everyday like in the Medical Procedure Room, all you need is to make the medication
like what the hospital’s instruction said. You can’t really be creative, the information and
instructions are mostly fixed and any small mistakes could lead into a huge problem for the
whole lot of medicine that you made.

ESLO Reflection
Doing this internship help me learn and gained more experiences as for the ESLOs of
Strategic Learner and realize how important teamwork skills is in the world or career. We
need to design a brochure which that would match with the ESLOs of Innovative thinker of
how we wanted to create new things that would improve something in the society at least for
a little like how the brochure we make would help a lot of foreigners to be able to understand
easier about how to get through the hospital without needing so much more help from the
hospital staffs anymore.