Name: Julian A.

Gordon
I.D.: 620039519
Program: MB BS
SSM Reflective Essay.
I did fifty six (56) hours of service at the Cornwall Regional Hospital from May 18, 2016 to May 27, 2016. I
assisted in the Orthopedics Department under the supervision of Dr. Don Gilbert, consultant orthopedic surgeon
at that hospital. My voluntary hours included: Ward rounds, classes with senior medical students, interviews
with patients and viewing of surgeries. There was a lot learnt from each aspect.
There was a structure on the ward. Each patient was assigned a consultant physician, a resident an intern and an
attending nurse. All these posts had specific roles. The consultant set the treatment regimen for the patient, the
resident along with the intern carried out the necessary procedures and the nurses did other essentials such as
changing bandages and intravenous accesses. Ward rounds were done daily and every patient was inspected
thoroughly for improvement or decline in health. Despite this organization, the inadequate space and
dysfunctional equipment led to sub optimal care of patients. Limited space led to the apposition of General
Surgery and Orthopedic patients, causing the transfer of bacteria from one patient to another eg Pseudomonas
aeruginosa infections on the skin. Bad equipment led to a longer stay of the patients on the ward as well. In
dealing with this crisis, the doctors had a criteria to decide in- patients vs out- patients.
A bio psycho social approach was used in administering patient care. For patients who were admitted to the
ward due to forms of violence, they were asked the question “If you go back home, will you be safe?”. There
was also a homeless man on the ward. Physically and physiologically he was healthy but none of his family
members had yet been contacted so he remained on the ward. These examples demonstrated to me that the
biological well- being of patients is only part of health care and a good physician must consider other aspects of
the patient’s life. The principles of medical ethics were applied as well. Physicians had to respect the autonomy
of patients when they refused surgical procedures. Patients who needed surgery but did not fit the criteria eg
low haemoglobin were kept on the ward and monitored instead. This demonstrated the balance between non
maleficence and beneficence. Established legislation re the giving of blood was adhered to, showing concepts of
justice.
I had a satisfactory grasp of pre- clinical concepts taught to me in year 1 and they helped me greatly in the
clinical setting. I answered questions in classes with fifth years and I could properly diagnose some patients on
the ward. In particular there was a man with prolonged immobilization, non- productive cough, a mild fever and
crepitation in his lungs. I could easily recognize that he was developing an atypical pneumonia. This experience
hammered home the importance of Stage 1 of the MB BS program and how it sets the foundation for all clinical
aspects. I look forward to Stage 2.
The operating theatre was an exciting phase. I saw how orthopedic surgeons, anesthetists and nurses worked
together in surgery. Great detail was paid to the patient’s vital signs and the number of sterile gauzes used were
counted to ensure that none were left inside the patient. In a nutshell, orthopedic surgery can be defined as the
“Construction of Medicine” due to the lengthy drilling and hammering heard and seen in OT. Most importantly
however was that patients were properly informed of the surgical procedures and the possible disadvantages
they would encounter. This reminded me that patients are the most important individuals on any medical team
and must be treated as such.
From my experience I took one important thing- Medicine is not “hocus pocus”. You must know exactly what
you are doing for the patient’s sake. This lesson will make me a better and effective physician in the future.