House Job ---- An Important Milestone

House job is an important milestone in the life of a young doctor.  It is the  first and the last opportunity to lay a strong clinical foundation of your medical career.  Dedicate yourself professionally for this entire period of one year or so.

Do's:

1- Be punctual for your duty hours
2- Be passionate to learn new skills
( procedures,  etc )
3- Be kind to your patients and their attendants
4- Practice empathy and compassion while attending,  dealing and treating your patients
5- Treat the patient,  not the disease
6- Always adhere to the medical ethics.
 Make it mandatory throughout your life
7- Read Hippocratic oath, often, and follow it.
8- If you don't know something,  ASK. Never hesitate
9- Spend maximum time with your patients, if you really want to learn medicine
10- Make friends , who are hard working and sincere with their profession and patient
11- Be confident and committed
12- Believe in yourself
13- Read and learn one case daily,  thoroughly.  Keep Oxford Handbook of Clinical Medicine with you. At the end of the year,  you will be master of 365 cases or topics. Don't confuse yourself with so many cases,  in a single day.
14- ECG is very important to learn.  Find ways to learn it
15- Similarly,  you must know how to read  X Rays ( particularly chest X Ray )
16- Always come with neat, clean white coat, your name-plate with designation, shoes polished, a torch, a stethoscope ( preferably Littman )
17 - Take healthy diet.  Avoid junk food
18- Be respectful to your seniors,  colleagues, staff  and patients
18- During your working hours,  feel and behave like doctors
19 - Learn and understand,  what is infectien control  and strictly follow it.
20 - Learn and follow the standard protocols
21 - Spend maximum time in the emergency ward. You must know,  how to assess and manage common medical,  surgical,  orthopedic, gynae, paediatric and trauma emergencies,  independently ( by the end of your house job ). Get BLS, ACLS, ATLS certifications
22- Be proud of being a doctor but always be courteous and humble
23- Select and read only one book of any subject.  Don't mess with so many books on a single topic
24- Be honest with your profession and your patients
25- Be professional,  all the time

Don'ts:

1- Don't waste your time in gossips
2- Don't be lazy,  inattentive or lethargic
3 - Don't underestimate yourself
4- Never be impressed by senior nurse, your medical officer,  registrar or consultants, it will bring down your self-esteem. No one knows everything. All are doing mistakes, which others don't know.  
5-  Never do any procedure,  without taking all precautionary measures for yourself and for the patient
6- Never follow any senior who is careless about infection control or patient care.
7- Never sit with negative people who will tell you that you have chosen a wrong profession or nothing in this country and we should leave it as early as possible.
8- Never be arrogant with your patients or their attendants
9- Never read so many things  at a time. Master only one case, daily
10 - Never read so many books on  a single subject.  Select only one.  All standard books are same.  Only format is different
11- Never ever neglect your patient.  You have to pay the price in this world and hereafter
12 - Never come late for your duty and never leave early.  Stay for extra time to finish your cases.
13- Never consider your patients,  dummies or tools to be used for your house job or post graduate  exams or learning. Treat them as  human beings, with respect,  empathy and compassion
14- Don't compromise when it comes to patient care.

Challenges of House Job

No doubt, House-Job is very challenging,  indeed.  

Following are the the main challenges faced by the young doctors during their house job period .

1- Long Duty Hours, sometime spanning over 48 to 56 hours
2- Working under huge pressure: pressure of the  patient's care and management,  peer pressure and pressure from the seniors.
3- Expectations of the seniors, that you know everything or you must know everything
4- Fear of harassment of the female doctors,  if working at unsafe places
5- Working at very low stipend and managing daily life.
6- Preparation for the post graduate exams along with tough duty hours and personal commitments
7- Managing a critical patient, when you are alone and no seniors around
8- Reading and interpreting ECGs
9- Performing any procedure correctly,  particularly when no seniors around or they are not cooperative enough.  
10 - Doing Resuscitation of a cardiac arrest in the ward.
11. Facing and declaring death of your patient
13- No proper place for taking food or taking rest (  sleeping )
14- Having important ceremony at home but you can't leave the place
15- Pressure of the morning rounds
16- Pressure of the senior nursing staff,  particularly those who are not cooperative

Most of the things are managed with the passage of time.  Mostly,  first month of house job  is difficult.  Later on, we learn gradually, how to cope with these problems. Good thing is that you are not alone in your duty hours. Usually two to four doctors at a time.  

If someone follows the guidelines given above,  the journey not only becomes comfortable but enjoyable,  as well.

So, good luck youngsters for the new venture.

Written by:
Dr. Mohammed Tanweer Khan
Emergency Physician

Physician’s Advice Corner

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