Gastroenterology Rundown
Team structure, wards and contacts
There is one gastro ward team consisting of one HO, reg and SMO (+/- 4th year students). The ward SMO rotates every 4 weeks. The 2 gastro registrars rotate between clinics and ward work every 4 weeks.
With there being no dedicated gastro ward, patients are generally spread between surgical wards 76 & 78 with outliers on a range of other wards.
Gastro HO phone (left on the charger in the gastro office) – 0211982955
On call gastro reg phone - 021884631 Endoscopy suite ward desk – ext 25577 (level 6 support building)
Endoscopy suite charge nurse (Cristina) – ext 25570. Cristina is very helpful if you need guidance for anything to do with endoscopy procedures.
There is a separate liver team/transplant service (which you are not involved with as a HO)
Core services provided
Upper GI Endoscopy (Diagnostic and Therapeutic)
Lower GI Endoscopy (Diagnostic and Therapeutic)
ERCP (Diagnostic and Therapeutic) and Spyglass
Bronchoscopy (Diagnostic, EBUS and other Therapeutic)
Rigid Bronchoscopy (Under GA)
Advanced endoscopic techniques including
Endoscopic mucosal resection and dissection
Radiofrequency ablation
Enteroscopy
PH and manometry
Infusion services
Daily routine
Meet at the gastro offices on level 6, just after the sky bridge as you head towards the support building (opposite lab plus).
You will need to ask for the 4 digit code to access the office.
There are 2 computers for the reg/house officer on your right as soon as you walk in the door.
Ward rounds generally start at 8am but it is useful to arrive 10-20 mins before this to catch up with the reg before the SMO arrives.
Print off ward lists for the inpatients on clinical portal (use code ‘34’ when searching for these). Generally there is no separate house officer list as the majority of the patients are short stays (but check with the reg).
Ward rounds are variable in length with large fluctuations in patient numbers all the time, however in general are quite brief compared to other med specs.
After the ward round, gastro specific house officer jobs (aside from regular responsibilities) can include consenting gastro inpatients for OGDs/C scopes and admitting patients pre/post elective scopes for a range of reasons (including inpatient bowel prep, overnight observation post EMRs etc).
You may also be called to review outpatients in the endoscopy suite pre/post procedures if the endoscopy nursing staff have concerns.
Weekly events
Friday 0800 Departmental teaching/journal club, in the gastro offices
Friday 1200 Gastro MDM, level 5 radiology conference room. You can sit in the back and eat your lunch (not compulsory for the HO to attend – only if you have time)
General
There is often a high turnover of patients contributing to the busy nature of the run
Re: consenting patients for OGDs/C scopes, there are useful patient information sheets under Gastro in the A-Z index on Hippo which you can print off for the patient. You are only required to consent gastro inpatients for these; other specialties will consent their own patients.
In the case of consenting for ERCPs, this is usually a gastro reg only job
Once weekly there will be prescriptions left on the gastro reg/HO desk for OP infliximab/iron infusions that require signing by a doctor. Please sign these after checking them and return them to Cristina in the endoscopy suite if able.
There is also an ever growing pile of D/C summaries for these OP infliximab/iron infusions left on the gastro reg/HO desk that you are expected to complete in your own time, on behalf of the gastro nurses that perform them. They usually only require 3-4 short sentences – refer to previous infusion D/C summaries for these patients.
As of 2021 it is no longer expected for the house officer to hold the gastro reg phone on Wednesdays.
On-call
On long days and nights you cover med specs. On long days there is a reg on for each medical specialty and overnight there is one reg covering all the medical specs.