Day Five: Medicine ward rounds and Dr. Mandel's medicine grand rounds

Joburg skyline - driving into the city.

Today we were reunited and attended intake rounds on the general medical ward with Dr. Nazeer Mohamed, one of the endocrine consultants (attendings). 

One of the unique features of medicine at Bara is that each medical subspecialist is an internist first and then a specialist, with primary responsibility as a general medicine ward attending (which includes neurology admits), admitting once every 5 days all year.  

We rounded on the 18 admitted patients from yesterday (a light day, typical is about 30 admits) with Nazeer, a 1^st year registrar, an intern, and two medical students. Unlike in the US, there are no caps on how many patients can be admitted.  Diagnoses included: HIV related illness (cryptococcal meningitis, Burkitt’s leukemia with new cranial nerve palsies), COPD, CHF, anemia, urosepsis, and Graves’. Medical rounds occur similarly at Bara, with the consultants quizzing the presenting registrar or intern about the finer details of the case, the team reviewing imaging, and then making a treatment plan for the day. We were reacquainted with the elegance of analyzing acid-base metabolism and detailed cardiovascular examinations.

As a special treat, Dr. Blohmson joined us to round on the last patient. After rounds, we discussed some of the cases we had seen in general endo clinic. Can you identify this structure??!? (and yes...this was drawn entirely from memory.)

(ps: please imagine this image rotated- I can't figure out how to do this!)

My reference books

In the afternoon, Dr. Mandel gave a lecture on the "Thyroid Nodule: a Contemporary Approach."

Dr. Mandel answering questions.