Saturday, July 20, 2013

The registrars!

Hello all! I was hoping to post yesterday but unfortunately my internet has been a bit shotty. I am feeling much better over the last couple of days thanks to a benadryl induced sleep; first time I slept without waking up at night!

As I mentioned at the end of my last post, I wanted to tell you guys about the registrars I am working with. A registrar is roughly equivalent to a resident. The two I am working with right now just started their second year as registrars. They are very smart, like many of the doctors here. This is in large part due to their method of testing that requires the ability to recall details instead of just the ability to identify the correct answer through multiple choice questions like our system. But that being said our system has many other advantages: a focus on evidenced based learning early on and patient centric care, to name a couple. Because of these differences I have found ways to be useful!

I have been discussing with the registrars the differences we have in managing similar diseases, especially in terms of antibiotic choices and sharing various scholarly articles with them. I am also going to work with them on doing case presentations, which they are just starting to do here. I am happy to contribute and even happier that they find my opinions and thoughts useful even if they eventually do things differently. I have in turn been learning a great deal from them.

For example, my prior confusion over antibiotic use. Some of it is Attending dependent, as mentioned before, but I also learned that they are conservative because they want to prevent people from ending up in the ICU of which there are only 5 beds in the entire southern region of Sri Lanka. Also, many people live out in the community and far from hospitals so they want to prevent them from getting sick at home. There are also few epidemiology studies done here so sometimes treatment is based more on experience then evidence. They also have to use stronger antibiotics and have lots of resistance not just due to their frequent antibiotic use but also because the quality and potency of the antibiotics is variable. We owe lots of thanks to our FDA for regulating our system!

One of the registrars is my Sri Lankan equivalent! Here name is Dinesha Magagi and she has the same set of earings as me! I think partially because of our similarities, she has taken me under wing. She frequently shares her meals with me and helps make sure I am seeing the interesting patients, as well as getting a varied experience. The other registrar is Nuwan, and he also helps keep me included and helps me get a sense of how things are in the hospitals around Sri Lanka as he has worked in many different places. I am really enjoying my experience even more and am learning a ton!

Now for some pictures on my day trip to Hikkaduwa today! Rode the public bus for the first time, and it wasn't as scary as I expected! As many things in life :o)


 Sean found an awesome tea shop with the best tea I have had in Sri Lanka! I definitely spent $20 on tea today! The cake store I found when we got off the bus. Really yummy cake for only $1 of which I still have much left over. Cake and tea are a perfect combination!

 I really want to buy a Sri Lankan mask but I spent too much money before arriving here. They are all handmade.

We couldn't go in the water because of the bad tides. Red means stop!

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