Hema Subramaniam

Duties & Responsibilities

Full time,

This hospital is one of the major hospitals in Eastern Sri Lanka. In Out Patient Department is the first contact point of the Hospital. To the community, and more patients use its facilities than in patient care. We also receive transfers from peripheral hospitals those patients admitted to ward on casualty basis. Our ward admission rate is around 300-350 per Day including Medical, surgical, pediatrics,obstetrics, Gynecology, ENT, Opthalmology , Nephrology ext..

• Collecting patient information (including History , clinical examination, other reports) Record informations in electronic filling Systems
• Diagnosing communicable, Non communicable diseases.
• Analyzing images or test data to make diagnosis and developing treatment plans
• Treatment, Immunization/vaccinations(including Anti Rabies serum) and other medical care to treat medical illness, injuries and pediatric medical conditions
• Triaging and admitting the patients to the ward
• Primary care of the patient in view of pharmacological management, Reassuring, specialist referrals to meet specific needs.
• Monitoring and follow up of patients with chronic medical conditions with modification of treatments if needed or explaining test results and recommending procedures to patients.
• Conducting Awareness programmes regarding Communicable, Non communicable Diseases.
• Death Confirmation, Requesting inquest/ Postmortem
• Answering patient questions and use active listening skills to understand and address concerns. Providing emotional support and medical attention to others as needed, including patients, customers, and co-workers
• Counselling women on maternal, child, gynaecological well being & contraception.

The learning takes place mostly in the form of day to day routine work in a laboratory setting under the supervision of a consultant Chemical Pathologist. Regular case discussions, lectures, tutorials, seminars, laboratory based practical sessions, multidisciplinary meetings, journal clubs, annual academic sessions of the relevant fields of medicine will be the other opportunities for learning.

The aim of the lecture course and the laboratory based training in other disciplines is to ensure that basic knowledge of the services of all fields of Pathology is acquired to enable the use and interpretation of basic test results of those disciplines and to ensure sufficient basic background knowledge is acquired to proceed with a specialized training in Chemical Pathology.

One month of Lectures on Course Of Basic Laboratory Science (CBLS)

CBLS Assessment- Theory Component: The Knowledge gained during the Lecture course is assessed.

Laboratory training in Haematology Three weeks Training Centre : Teaching Hospital Kalubowila

Laboratory training in Histopathology : Three weeks Training Centre : Teaching Hospital Kalubowila

Laboratory training in Microbiology Two weeks Training Centre attached: Teaching Hospital Kalubowila

CBLS Assessment - Practical Component (OSPE): The practical Knowledge and skills gained in Haematology, Histopathology & Microbiology are assessed.

A learning portfolio is included as evidence of learning from the activities that the trainees are involved in during the training period. It recognizes and encourages autonomous and reflective learning that is an integral part of professional development.

Learning Outcomes in Chemical Pathology

1. Efficiently manage a Chemical Pathology service in a hospital.

2. Demonstrate adequate knowledge, skills and appropriate attitude in routine and specialized clinical and laboratory work.

3. Demonstrate responsibility in taking safe clinical decisions pertaining to Chemical Pathology services, acknowledge the limitations of competence and refer to other senior colleagues for advice where appropriate.

4. Interpret test result following technical and clinical validation.

5. Perform diagnostic techniques to become technically competent in practical work and master the underlying analytical and clinical principles.

6. Provide specialist advice in Chemical Pathology related to specialized areas such as clinical endocrinology, paediatrics, oncology, toxicology and molecular medicine.

7. Carry out activities of continuing professional development such as literature searches, case discussions and journal clubs.

8. Plan and implement new techniques and practices following adequate evaluation procedures.

9. Describe the bio-safety practices required in a Chemical Pathology laboratory.

10. Describe the ethical aspects of Chemical Pathology laboratory practice in relation to investigations, research, teaching and quality control.

11. Describe the principles of audit, internal quality control, and external quality assurance and accreditation of a Chemical Pathology laboratory.

12. Explain the value of information technology in Chemical Pathology service.

13. Acquire skills in history taking and arriving at a diagnosis for patients with renal disorders

14. Interpret laboratory results in relation to renal function

15. Acquire knowledge in renal replacement therapy and related biochemical changes

16. Acquire knowledge regarding biochemical assessment of donors and recipients of renal transplantation

17. acquire knowledge on natural history, pathophysiology, epidemiology, presentation, differential diagnosis, complications and biochemical investigations of common and rare paediatric chemical pathology disorders

18. advise clinical staff on patient preparation, appropriate use and interpretation of specialized biochemical tests (e.g. ammonia, lactate)

19. educate parents and relatives about the disease and lifestyle (patients with rare disorders)

20.gain knowledge in analytical chemical pathology in order to offer basic interpretation of results of neonates and children

21. Acquire knowledge regarding biochemical changes occurring in patients in the recovery unit

22. Interpret results of biochemical tests in patients in the recovery unit

achieved while undergoing laboratory based training at Cancer Institute of Maharagama/or in the trainee’s centre if an Oncology Unit is available under the supervision of the Chemical Pathologist

• 1. Explain biochemical changes associated with malignancy and therapeutic agents (renal functions, liver functions and electrolyte changes) and methods of overcoming adverse effects.
• 2. Outline the principles of prevention and management tumourlysis syndrome
• 3. Outline the principles of managing hypocalcaemia and hypercalcaemia in patients with disseminated malignancy
• 4. Assessment of half-life and doubling time of tumour markers in the management of malignancy.
• 5. Discuss the clinical utility of CSF examination in malignancy.
• 6. Demonstrate knowledge on adverse effects of chemotherapeutic agents on certain biochemical assays.
• 7. Explain biochemical effects of certain paediatric malignancies

Training Period

28.01.2020 - 28.02.2020 : Lectures on Basic Laboratory service In Post Graduate Institute Of Medicine

29.02.2020 - 30.04.2020 : Haematology, Histopathology, Microbiology Labs : Colombo South Teaching Hospital

01.05.2020-30.09.2020 : Biochemistry Lab, Colombo South Teaching Hospital

01.10.2020 - 31.10.2020: Biochemistry Lab :National Hospital Sri Lanka

01.11.2020 - 30.11.2020:Radio-immunoassay Lab : National Hospital Sri Lanka

01.12.220 - 07.12.2020 : Neurosurgery : National Hospital Sri Lanka

08.12.2020 - 14.12.2020 : Nutrition : National Hospital Sri Lanka

15.12.2020 - 21.12.2020 : Nephrology : National Hospital Sri Lanka

22.12.2020 - 31.12.2020 : ICU : Teaching Hospital Kalubowila

01.01.2021 - 28.02.2021 : Medical Research Institute :

01.03.2021 - 14.03.2021 : National Cancer Institute Sri Lanka

15.03.2021- 31.03.2021 Colombo North Teaching Hospital

01.04.2021- 31.05…2021: Metabolic , Biochemistry Lab Lady Ridgeway Hospital For Children

01.06.2020 - 14.06.2020 : Colombo South Teaching Hospital

15.06.2021 - 30.06.2021 Department of Clinical Pharmacology

01.07.2021 - 14.07.2021 : Microbiology

15.07.2020 - 20.12.2020 : Biochemistry Lab : Colombo South Teaching Hospital

Duties & Responsibilities

Full time

• Identifying Blood grouping of the patient and doing crossmatch for transfusion
• Identify the group discrepancy and group confirmation
• Antibody identification and proper Anti natal clinic follow up
• Performing difficult crossmatch during emergency need
• Handling mass casualty/Disaster needs of blood and blood product
• Recognizing sexual transmitted disease through screening
• Preparing Platelet Rich Plasma
• Conducting Mobile blood donation campaign in view of arrangement,Donor selection, Post donation care
• Actively participating in massive transfusion
• Managing blood stock
• Managing adverse effects of blood transfusion

Duties & Responsibilities

Full time.

• Current competency in Advanced Life Support
• Complete a targeted patient history by obtaining details from the patient others (Ambulance crew, relations)
• Document a full history and physical examination with progress notes
• Formulate a plan of management
• Order and perform required investigations and procedures and alter management as appropriate.
• Perform specialized procedures and intervention including Advanced Life support, Intubation and Airway management, Intravenous Cannulation, Venepuncture, Draw blood culture, Blood gases, Urethral Catheterization, NG tube Insertion and management.
• Managing Isolation Unit Patients including Infectious Disease (Influenza H5N1)
• Managing Dengue High Dependency unit patients a part of Emergency Treatment Unit care
• Taking part in Anti Rabies Vaccination
• Communicating and coordinating care with the team and arranging consultation with senior staff
• Work independently in a supervised Environment and work effectively apart of a multi-disciplinary team of trainee doctors and nurses.

Duties & Responsibilities

Full time,

• Assisting the Consultant Obstetrician & Gynaecologist in major obstetric, gynaecological and laparoscopic surgeries.
• Conducting obstetrics, gynaecology & sub fertility clinics.
• Counselling women on maternal, child, gynaecological well being & contraception.
• Planning on induction of labour & monitoring patients during labour.
• Performing normal vaginal deliveries, instrumental/assisted vaginal deliveries & neonatal resuscitation in case of an emergency.
• Repairing perineal tears including episiotomy site repairing.
• Ultrasound scans assessment of the obstetrics & gynaecology patients.
• Post natal caring of mothers
• CTG Montoring

Duties & Responsibilities

• Full time.
• Daily assessment of patients during the ward round.
• Triaging & admitting patients to the ward.
• Initial assessment and initial management of surgical emergencies.
• Performing minor surgeries & assisting major surgeries.
• Facilitating patients for the upper & lower G.I endoscopies.
• Participating in Medical workshops & seminars.
• Conducting general surgical clinic & conducting chronic wound management clinic.

Duties & Responsibilities

• Fulltime
• History taking & clinical examination, requesting relevant Investigations
• Providing Basic, Advance Life Support
• Daily assessment of patients during ward round and attending clinics
• Initial assessment & management of medical emergencies.
• Counselling patients regarding Health issues.
• Performing intravenous cannulation and lumbar puncture, Blood drawing.
• Performing Pleural, Ascites fluid aspiration
• Performing Arterial blood Gas analysis, Intramuscular Injections.
• Accompanying patients on transfers to a tertiary medical care unit for further management.
• Notifying communicable disease
• Certification of Deaths