I was one of the very fortunate candidates to receive a WFSA Research Grant in 2016. However due to personal health problems, I could not pursue the research fellowship immediately. Now after 3 years, I have begun my project on predicting difficult by airway ultrasound. According to the grant agreement, I was required to travel to a foreign land for the research fellowship. The land I chose was the lion city “Singapore” where I have begun the fellowship under the supervision of Dr See Kay Chong, Respiratory and critical care medicine (RCCM), National University Hospital (NUH).
As I landed in Singapore, I was taken by the charm of the city, such sophistication but at the same time very humble. The city had traditional Asian values, which I could relate to, yet it was very modern in technology and thoughts. Singapore is vibrant, yet very green. Amongst the modern artistic buildings were trees and canopy. The city has such good networks of public transport and major attractions for tourists. And of course, the city was starkly clean. The people of Singapore were kind and very welcoming and since English is the official language in the country, I had no problem with communication.
My research project entitled "Predicting difficult airway in pregnant patients using airway ultrasound" studied obstetric patients more than 36 weeks pregnant and posted for elective caesarean section. At NUH, Dr Chong had attached me to one of the ICU teams. He familiarized me with the ultrasound machine. He took me around the huge NUH complex. With each passing day I learnt more about critical care and a very different approach of patient management than is prevalent in my part of the world. Their data was all computerized; their team consisted of residents, registrars and consultants. They had all the services required in the ICU such as dialysis machines, ultrasound machines, respiratory therapists, and even pharmacists accompanied the team during rounds! In addition to daily rounds, there was a teaching session 4 days a week. All the cases and topics were very useful and informative and the team have such healthy discussions at the end of each session.
I had a daily ultrasound teaching session with Dr Chong or with one of registrars in the team. I learnt not just airway ultrasound but also critical care ultrasound, which included blue protocol for lung ultrasound and critical care echocardiography. While Dr Chong was away, I would perform the scans and discuss the video clips with him later or even by email or WhatsApp. Dr Chong had created an online Performa that I had to complete after every integrated scan including the airway, lungs and the heart.
Overall my learning experience in NUH was a once in a lifetime. I learnt so much more than I had ever expected and on top of that I made so many friends. I travelled within Singapore like a local, worked in one of the best hospitals in Asia under the supervision of the best teacher I could have ever asked for.
Since returning home I have applied the skills that I learnt in Singapore in critical care and also in the operating room, which has benefited not just my patients but also my residents. I am forever indebted to WFSA, NUH and Dr See Kay Chong for the experience of a lifetime. However, I am even more thankful to our department of anaesthesia and my Head Prof Bisharad Man Shrestha for always encouraging me to make our practice better and to learn more.
I have now begun my project analysis of predicting difficult airway with airway ultrasound and I hope that the project will be completed within 6 months, and will hopefully be published in an indexed journal within one year.
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