Chapter 70-Ramanthpuram! Here I come

Jan 1998

1st Jan arrives and with that, I start Internship. We have to complete 365 days of Internship-a missing day, for whatever reason, will result in an extension for the required number of days. The end of Internship makes one a full fledged Registered Doctor but that doesn't really count for much in the real world. An MBBS degree merely makes one eligible to take the Post Graduate Entrance Exams, which, by all accounts are very painful and frustrating experiences.
One of these is the PGI Entrance Exam held in Chandigarh in June and December. I will be eligible for the December version but only if I finish Internship on the 31st of December. Chandigarh happens to be my hometown and I would love to do my PG there but if Internship carries over to the next year one is ineligible for that PGI Session. Which means that I cant afford any extensions. Which is rather frustrating.

Out of the 75 who joined Jipmer in 1993, about 45 of us have made it as Interns on time. Some failed in the 1st year exams and went into the Additional Batch and 23 were casualties of  Final Year Exams.
In practical terms this means more work per Intern and more frequent calls and duties. More stress and more hassle. Depending on how one looks at it, it is also a chance to get more chances to do procedures, operate and be more actively involved.

We have been divided into 4 batches and each batch will start a different posting. The sequence is Medicine, Surgery, OG and Community Medicine, each for 12 weeks. We also get a 4 week Elective posting where we are free to choose from the specialties available. Some, especially those destined for the US or the UK choose Psychiatry, while the lazy bums choose more benign ones like Forensic Medicine. I start with PSM-Community Medicine. This consists of 12 weeks of bliss, split between the Rural Health Centre in Ramanathpuram and the Urban Centre in town in a place called Kurchikuppam. This will then be followed by the Elective, which I have not decided on yet and the 3 major postings, finishing with OG in December.

In many Colleges, Internship is treated as a preparation ground for PG Entrance Exams. Coming to work is largely notional. Reading for PG Exams at the expense of Internship time is actively encouraged. But not here.Life as an Intern here is very very busy and I will just have to squeeze time in to read for PG Entrance. Internship here is all about learning basic hospital functioning by becoming a part of the system. It is being a Doctor in every sense, but since we are the bottom of the barrel, so to speak, our responsibilities and liabilities, while very real, are grounded largely in terms of personal ethics. In the ultimate analysis Interns are not responsible for any screw-up that might happen. We are in training after all. We aren't even registered licensed doctors.
There is always a choice. One can scoot off from work,  massage a few egos and goof off, scurry off to read for PG Exams or just bunk. One can shirk work and make excuses. One can extend vacation time for no proper reason and leave Co-Interns high and dry. One can "forget" to do things and make the 1st or 2nd Yr PG suffer the consequences.
There are no impressions to make, no exams to conquer.
But Jipmer has a culture and an ethos. Most people do their respective Internships sincerely because that's how it's done here and always has been. It's one of the many small things about Jipmer that make me glad I came here.

There are 6 of us who will start Internship in the RHC. We troop in to the Department at 10 AM and are given a briefing on what they expect from us and what we can expect from this posting. In a nutshell, we are expected to be residents in the RHC for the next 6 weeks and indeed, there is a fully functional Dorm with a cook, satellite TV and Aquaguard water to take care of us.
We will conduct an OPD in the morning and the Dept may organize some field trips to nearby villages etc  for Community Heath Camps. The Pulse Polio programme will be starting in 15 days and we will be expected to be an active part of it. We will be essentially the only doctors for Ramanthpuram and surrounding villages and that is a slightly scary thought.

But for the most part, though the PSM Dept does not see it that way,  it will be about spending 6 joyous carefree weeks in an idyllic rural hamlet away from books and the hospital. I have been looking forward to this day for a very long time and now it's here.

And I think I deserve it.