What is MBBS internship like?

MBBS internship I feel is the best Year in entire curriculum and

best thing that ever happens to a Doctor. I will divide it into my
experience in different departments to help you better
Understand.
Internal Medicine
Duration: 6 weeks
Work Hours: A Intern is expected to reach the ward by 9 in
morning and stay till 2 PM in afternoon followed by few hours
of lunch break, followed by evening rounds and work in ward
and finally reaching home by 10 PM.
Admission Day: We had one admission day per week with a
rotational every sixth Sunday. On admission day there use to be
two shifts for intern for 12 hours with no special lunch or food
break. Morning shift from 8 AM to 8 PM and night shift from 8
PM to 8 AM. The Interns doing night shift were allowed to take
the next day off in my unit but in other units they were
expected to working till 2 PM next day basically that means 8
PM to 2 PM.
Emergency Duty: We Had one emergency duty every week from
8 AM to 2 PM following which we got day off.
Work Intern Has to Perform :
Draw Blood from Patient’s vein and put them in correct vial ,
label and send to Laboratory.
Insert a IV Channel, Nasogastric tube, Foley’s Catheter.
Lumbar Puncture for both diagnostic and therapeutic purpose.
Start a General treatment in Acute Ward when patient is
serious.
Sit In OPD during Admission day and prescribe medicine. If You
suspect something serious or difficult then refer to senior.
Surgery
Duration : 5 Weeks
Operation Theater: There is a OT everyday in a week because
it’s Surgery !
Emergency OT on Admission Day suppose on Monday
Major OT one day after admission Day means Wednesday
OT at a Small Nearby Hospital next day means Thursday
Another OT on Friday but it may get cancel if we don’t have
cases to operate on
Minor OT on Saturday where small surgeries are performed like
circumcision.
Admission Day: Just like Medicine Admission starts from 8 AM
to 8 AM and there is no division of day shift and night shift.
Every Intern comes at morning 8 AM and attends the OPD
followed by Emergency OT. Duty Ends next day by 2 PM so it’s a
long continuous duty.
Duty As Intern: All Scutwork that I mentioned in Medicine
including pushing the stretcher of the patient, fixing light inside
OT as for some reason group D staff does not work.
Assist in all surgeries as a assistant which gets boring pretty
soon specially at night when a operation is going on at Morning
3 AM and your job is to retract Liver.
In Emergency Duty repair all laceration and if complicated then
refer to emergency OT.
Perform Dressing, remove stitches, perform small operation like
Incision and drainage, take biopsy from Breast and if Lucky even
perform a appendectomy as main surgeon.
Prepare the Patient for operation which includes getting
signature on Consent form, explaining the risk associated with
surgery.
Working Hours are much longer compared to Medicine.
OBSTETRICS and GYNECOLOGY
Duration; 8 Weeks
Labor Room Duty: We had two 12 Hour Labor room duty every
week which included one Night shift from 8 PM to 8 AM and a
day shift from 8 AM to 8 PM on two separate days.
Admission Day: One Admission day per week just like Medicine
and Surgery. Every Intern will come to OPD at 9 AM in morning
and see obstetrics case means pregnant female and do basic
examination and treatment. We also had PAP Smear
investigation which Interns use to perform in OPD.
After OPD, go home and come back for Night Labor room Duty.
Operation Theaters Duty:
One Major Operation Theater duty per week which included
cases like Hysterectomy( Removal Of Uterus), Complicated
deliveries like twin pregnancy and Gynecological cases which
mainly involved prolapse or Cancer.
One Minor Operation Theater for Minor Procedure like Biopsy,
Copper T insertion
Emergency OT on Admission Night
Work As Intern
Everything that I mentioned in Surgery and Medicine though we
never got any opportunity to assist or perform any surgery.
Deliver Babies by normal Vaginal Delivery along with episiotomy
and repairing the wound
For some reasons Nurses in Labor room wont administer any
drug so become a Nurse.
Administer Magnesium Sulfate and believe me this is most
hardest and difficult job with patient sleeping in their stool to
pulling out Catheter and rupturing urethra.
Bring Tea, Samosa and Snacks for Consultant.
Lots of Scutwork which was more then Medicine and Surgery
combined.
Pediatrics
Duration: 1 Month divided into 10 days for SNCU complex, 10
days PICU and thalassemia and 10 days Ward.
SNCU COMPLEX:
SNCU complex in my college is one of the best in entire country
having 300 Beds just dedicated for Neonates.
Duties in NICU and SNCU would be 24 hours and it use to get
really boring as we weren’t allowed to do much.
Work included siting and giving gloves and other items to
seniors while they performed procedure.
PICU
Same as NICU and SNCU with bigger children who won’t stop
crying .
Though I use to get really irritated as we weren’t allowed to do
much but sit or do some suction but many children whom I
thought won’t live did survive which made my faith in medicine
to grow stronger.
Ward
Again not much to do other then few routine work like drawing
blood.
Orthopedics
Duration : 1 month
Admission Day: Two Admission Day per week with a rotation
every 3rd week. Every Intern comes in Morning to OPD screens
hundreds of patient who come for PAIN management. After
OPD few Interns are allowed to go home who has night
emergency duty while rest of the Interns give evening
Emergency Duty.
Operation Theater :
One Emergency OT on Each admission day
One Major OT after admission Day
Work as Intern
Everything that I mentioned previously.
Other then that apply POP slab
In OT interns don’t get to assist
Interns are expected to operate and push a heavy machine
known as C arm which weights few tons in OT and take perfect
X-ray

Psychiatry:
I slept 80 hours of 90 hours that was allotted to me so can’t
comment much. Anyone need cool life do PG in Psychiatry.
Anesthesia:
Sit In OPD and do PAC
EYE:
Attend OPD and check visual acuity of patient.
Blood Bank:
Go to random Blood donation camp as medical officer and
measure blood pressure.
ENT: Same as Orthopedics but without C arm in OT and less
patients
CTVS: Sit in OPD and see Your professors who are treated as
GOD by their patient.
PSM:
Divided into Urban and Rural posting
Rural Postings are Punishment (Overview of rural healthcare)
Location: I was posted in Madhyamgram Rural Hospital and
Banspool sub center. They are around 30 kilometers from
Central Kolkata where MCK is situated.
Accommodation : Look at the 5 star facilities
There was no fan or light in the room,no water in bathroom and
beds were filthy. We protested to the department that we will
not stay and as a result we were allowed to return to Kolkata,
everyday after work. ( No batch before us I guess ever stayed
and you can understand the reason)
No Digital X-ray, CT scan,USG,
No Pathology Laboratory
No good Minor OT to do give sutures and dressing. There was
no blade or instruments. Being Young Doctors full of
enthusiasm we tried to explore few wounds but were only
partly successful.
No scope of management of any medical and surgical
emergency
No device to measure Capillary Blood Glucose or Keto-stick.
Very less variety of medicine and absence of essential drugs.
No delivery room
Only a Pediatrician and a Gynecologist present that also for few
hours.
Duty in Rural Hospital
Sit in OPD and prescribe medicine (Prescribing medicine is
mandatory irrespective of it’s indication)
Sit in Emergency and refer most of the case or prescribe
medicine.
Good Points
You get to sit in OPD and be a Doctor
You can form the management plan
Freedom to do things as you seek fit
First Few days were good.
Bad Points
Refer the cases again due to lack of facillites
Measure Blood Pressure and feel like a Paramedical staff.
Gundas threatening You to make injury reports.
Fear of getting beating from MOB
Patient blaming that all you do is refer
Only symptomatic treatment as no scope of diagnosis
Use the Five drugs that Pharmacy has. After sometime using
antacids and Paracetamol you start questioning yourself about
the knowledge you gained during 4.5 years.
No big Application of medical knowledge.
Banspool Sub-center : This place had already failed multiple
times by MCI during their inspection. During our duty next MCI
inspection had been scheduled and I don’t think it will pass
even this time. There was lot of pressure on us to do something
to make it pass by department. This center did not even have
washroom.
There was no medicines available here except for Paracetamol.
The place was complete village where even a shop with chips
was not available forget about Pharmacy. We saw few patients
everyday and we use to write them advice on piece of white
paper. There was no ticket provided to us. I don’t know how
ethical it is to write down advice on white piece of paper.
People were very poor and did not had money to buy
medicines. One old lady had COPD and I advised to use MDI (
Meter Dose Inhaler) and she replied she doesn’t have money.
How to do management without medicine should be question
in professional exams
Frustrated Medical Officer: The Medical Officer was frustrated
as sub center had failed multiple times and department had put
pressure on her but due to lack of funds she could do nothing.
She had to run the sub center paying some money from her
own pocket. She had to spend money to reach the center
everyday and arrange food and believe me anyone who has to
travel so much from Kolkata will get frustrated as it is difficult to
reach there and no money from government to support the
work.
Good Experience: The only good experience was exploring the
village and talking with local people. Its been many years that I
visited a village and it feels good to breath pure air. We cooked
food which was fun
Sorry State of Healthcare
The nurses told me the condition is worse in remote places
compared to Madhyamgram, I can at least refer the case as
District Hospitals and Medical Colleges are near. In remote
places one can not even refer.
There is also no Ambulance and we need to take writing from
patient in which the patient states that they had called on 102
and but got no response as a result they are taking the patient
to a higher center in a private vehicle and hospital will not be
responsible for any problems that may occur in road.
Being Young Doctor who had just passed professional exams,
one feels confident and enthusiastic about using the knowledge
to do something good but soon reality strikes sadly.
Doctor can't do anything in such setup which made me very
sad. Even someone who has DM in cardiology can’t do much if
patient has Myocardial Infraction. There is no point in asking
and forcing doctors to work in such hospitals.I had patients with
Myocardial Infraction and all I could do is give a antacid and
refer it as neither I had ECG or Aspirin or GTN.
While the Modern Indian present on social media fight against
corporate hospitals located in big metro cities, no one discusses
the failure of government. Real poor people sadly suffers as
health is not a agenda for any political party. I never see
debates or answers on improving health care. All I see is
outrage against the doctor who is helpless in current situation.
Also the failure is also due to bad roads with no ambulance
which makes transport of serious patients difficult
General Emergency
Work Hours: In my Hospital the duty hour was 18 hours. It starts
from 2 in afternoon and ends at 8 in Morning. I did not sleep
even for one minute during my duty as the room for Intern is
dirty and bed sheet have not been changed for I guess months.
Patient Load: Being a big government Hospital the Emergency
was always filled with patient so much so that there are times
when no beds or chairs were available to make new patient sit
so I can examine the Patient though I had few nights in which
the Emergency was empty for few minutes. We took pics of
empty ER as sign of victory.
Managing Patient: I have managed at times 15 patients
simultaneously as the load is something which can not be
described. I was fortunate enough to see a wide spectrum of
cases but most common cases were either Myocardial
Infarction or Brain Stroke along with Diarrhea and Vomiting.
Confidence: General Emergency was my second posting,first
being Ophthalmology and I had very less confidence as I did not
know dosage of any drugs, neither I could inject any drug by IV(
Intravenous route), insert a IV canula or channel in Vein.
Even though I had attended my posting of general emergency as
MBBS but things were different this time.

After completing my General Emergency posting I had

successfully managed many critical cases and had managed at
times the entire emergency alone and it had provided me lot of
confidence. I can stabilize a patient, perform emergency
procedure and understand when to call for help and when I can
manage myself. It is a excellent learning experience as you
never know what the next patient may bring.
Good Patient: I had lot of good patients. Many Patient blessed
me after getting treatment. Few even asked that they would
love to visit me in my personal private clinic and I laughed and
said that I am a junior doctor with no private clinic but it made
me very happy. One Patient was having Myocardial Infarction
whom I stabilized successfully their family members even
brought sweets for me. Few patients brought Tea for me finding
that I had not sat even for a minute. Few Patient who were
abusive and angry when they entered ER at end became calm
after I managed their cases and it is something that made me
most happy.
Bad Patient: This category of patients always asked
saline,unnecessary medications and annoyed me to core. I was
tired explaining that only ORS for diarrhea and nothing more.
Few patients directed me management and when I told them
Paracetamol will damaged Liver and Pantaprazole also had side
effects, they were shocked to core.
Many Young boys I saw drank poison,cut their hands because
they had setbacks in love life
Fake Patient: There were many patients who were faking their
conditions. One particular patient was a 17 year young girl who
claimed her legs have become paralyzed. She complained so
many different things from being unconscious, chest
pain,abdomen pain. The sad part was she was chatting on
Whatsapp while her mom crying. After 6 hours she suddenly
became fine and went home. ( Her mother already gave us
history of similar episodes in past and had visited multiple
doctors across country)
Genuine patient appearing fake: There are two examples that I
remember. One was a Young 16 year girl complaining of
abdominal pain. She was laughing and giving history and was
accompanied by her boyfriend. It was busy evening hence I just
wrote a Paracetamol but that was a case of Renal stone and the
patient was telling me that her pain only reduces by injection
but I did not pay any importance as ER was filled but later I felt
bad because I did not take her case seriously.
Second was a elderly female patient telling her head is moving
with history of loose stools and vomiting. I gave ORS and anti-
emetics but her complain did not stop but vitals were within
normal limit and I thought she may be faking it but upon doing
CT of brain edema was detected and again I felt bad
Seniors: I had excellent seniors who guided me and helped me
to learn many important things and I am thankful to them.
Overall Experience: It was excellent. I never thought I will love
being a doctor so much and interacting with patients because I
talk less and Shy in nature. Even after 18 hours of duty, I did not
use to feel tired and sometimes use to work a hour more. I use
to wait for my duty to start because in those 18 hours I use to
forget all my personal problems and I felt something which I
don’t have words to describe.
Tips: If you are MBBS student then do visit the emergency of
your hospital as you will learn lot of things which chronic wards
wont teach you.
Always be compassionate towards the patient and understand
they have come with a problem and it is your job to solve it. It
may be sometimes be very small and you may face bad patients
but don’t let it kill the doctor inside you.
In Government setup your good work may not be
acknowledged much but still You are Professional hence keep
the interest of the patient above all. Try to be calm and carry a
smile, it helps lot in stressful conditions