Alfaisal University

College of Medicine

Medical Internship Program Office

Alfaisal University

Dr AbdulKarim S. AlMakadma College of Medicine Internship Manual

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Contents:

 DEAN’S MESSAGE---------------------------------------------2
 INTERNSHIP DIRECTOR’S MESSAGE--------------------4
 OBJECTIVES OF INTERNSHIP------------------------------6
 INTERNSHIP ACTIVITIES------------------------------------7
 GENERAL RULES FOR INTERNSHIP PERIOD:
 Starting date------------------------------------------------------------------8
 AFFILIATED HOSPITALS FOR INTERNSHIP-------------------------8
 Duration of internship------------------------------------------------------9
 Time that can be spent at the hospitals in KSA and abroad---------9
 Leaves during internship--------------------------------------------------10
 Assessment------------------------------------------------------------------10
 Changes in schedule-------------------------------------------------------11
 Penalties----------------------------------------------------------------------11
 ROTATIONS--------------------------------------------------12
 EAMPLES OF SELECTIVE CHOICES--------------------- 14
 SKILLS AND PROCEDURES EXPECTED FROM
INTERNS------------------------------------------------------ 15
 APPENDIX---------------------------------------------------- 18

Dr AbdulKarim S. AlMakadma College of Medicine Internship Manual

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Dean’s Message

Dear Alfaisal College of Medicine’s Graduate

Congratulations on completion of your academic years. As a

bridge to formal practice, the internship year prove its value. İ
would like you all to take this year serious, attend, learn, practice
so you can complete your succsess story.

Remember that you are drawing your first image as a doctor,

punctuality, respicting time and excellent communication skills
with patients and colleagues will print the fist impression as Alfaisal
graduate, the bar is high but i have pull trust that you all will make
Alfaisal proud of you.

Professor Khalid Al-Kattan

Dean of College of Medicine

Dr AbdulKarim S. AlMakadma College of Medicine Internship Manual

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InternshIp DIrector’s Message

Dear Alfaisal College of Medicine Graduates:

Sincere and well-deserved congratulations for the successful completion

of the first phase of your medical career. Now you will be stepping
towards an intermediate phase between the undergraduate and graduate
ones, this phase is called the “Internship Year”

Although a vague and often confusing title to those outside of the medical
field, the position of medical intern is a vital bridge from those just
completing medical school to becoming well on one’s way to
independently practicing medicine

No medical textbook can prepare an intern to care for an acutely ill

patient with an uncertain diagnosis. No live simulation can train an intern
how to inform an entire extended family that their loved one will not
survive the hospitalization. No humanities course can coach an intern to
respect and appropriately navigate through a diverse array of cultural
beliefs on disease and dying in order to deliver the best medical care
possible.

Experiencing and then re-experiencing these incredibly difficult and life-

changing events is the only way to leave a medical internship with enough
mental conditioning to embark on the next steep curve in medical
training.

Dr AbdulKarim S. AlMakadma College of Medicine Internship Manual

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It is to be very well understood that the main objective of your

internship (in conjunction to the long years of medical school before)
is to produce a graduate who will be able to practice as a general
practitioner, even if he is planning to go for one of the specialized
residency training programs

If you manage your time appropriately, you will learn a lot, become more
confident when dealing with patients and their families. You will witness
tragedies, grief and note the joy and gratitude of people that will impart
while in hospitals. You will build and expand your professional network
with clinicians, mentors, experts, professors, nurses, researchers and
others

We expect you to keep, preserve and improve the reputation of AU

graduates as role models for the medical graduates among the national
peers. You are our ambassadors.

Finally, remember that the Alfaisal Internship Program Office, always is

there for you to help and support as long as you adhere to the guidance
and rules present in this booklet

Sincerely, yours

AbdulKarim S. AlMakadma
Director, Internship Program
Director, National Affiliated Hospitals’ Affairs office

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OBJECTIVES OF INTERNSHIP

The main objective of the internship period is to train interns to practice

independently for patient care. By the end of the internship period the
graduate should independently and reliably be able to:
 Take general and focused history from patients, families and/or
parents
 Perform general and focused physical examination
 List and priorotize his/her hypotheses
 Plan necessary investigations
 Discuss differential diagnosis and final diagnosis
 Consult with colleagues for the diagnosis and management of
patients
 Plan patient management/treatment
 Write clearly understandable consultation notes, giving appropriate
information and advice
 Present patients giving detailed information and provde answers to
questions
 Perform the procedures listed in Appendix
 Take part in decision making process forpatients
 Provide evidence-based information and suggestions

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INTERNSHIP ACTIVITIES
 Interns will be required to perform the listed tasks, procedures in this
manual, either under supervision or independently, depending on the
procedure. The main idea of internship is to actually perform the
required tasks and procedures-a real hand-on practice, not
observership.
 Interns will be considered part of the team and will participate in case
presentations and discussions
 Each intern should present at least 2 cases during a one-month rotation
 Each intern should present a seminar during a rotation
 Training activities for interns will include case presentations/discussions,
practical workshop sessions (to be defined by every department
separately)
 Interns will have patients assigned for them. The patient follow-up will
be supervised by residents and/or other senior members of the team.
 The number of patients to be followed by one intern at a time will neithr
be less than 2, nor more than 4.
 Teaching activities during internship will include 2-3 hours formal
sessions per week. This can be organized as lectures, case
presentations-discussions, journal clubs or similar activities. The
planning will be made by the departments’ faculty members but the main
effort put for these presentations should be from the interns, in
consultation with the faculty members. Usually these activities will be
conducted on an afternoons decided by the individual department
according to the departmental timetable. The teaching activities will be
prepared and duties will be assigned for each intern at the beginning of
the rotation.

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General Rules For Internshıp Perıod:

1- Starting date :
 Internship programme will start on 1st July from each
internship year , e.g. 20202.
 For students who will have to join after the usual starting date
due to various reasons (such as finishing clerkships late, returning
from a rotation abroad after the 1st day of a month), the
starting date will be the 1st day of each month.
 Please notice that the internship can not be started before
finishing all the courses needed to be medical school graduate

2- Affiliated hospitals for Internship:

 The primary internship sites for Alfaisal University College of
Medicine interns, with which the University has agreements, are:
1. King Faisal Specialist Hospital and Research Centre
2. King Saud Medical City (KSMC)
3. King Fahad Medical City (KFMC)
4. Prince Mohammad Ben AbdulAziz Hospital (PMAH)
5. Prince Sultan Military Medical City (PSMMC)
6. Specializes Medical Center (SMC)
7. Al Habib Medical Group Hospitals (HMG)
8. Riyadh National Hospital (RNH)
9. Riyadh Care Hospital (RCH)
10. Other hospitals may be added as primary sites, based on
agreements
 The interns will be assigned to different hospitals as per their
interest and according to the availability
 No more than six months can be spent in private hospital, not more
than 4 months out of them can be done in the same hospital

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3- Duration of internship:
The Duration of the internship is 12 months, it needs to be finished
within 12 months.
Internship has to be finished within 12 months. Only and only in special
cases and on individual bases this duration can be extended.

4- Time that can be spent at the hospitals in KSA and abroad

 Saudi Interns can do up to 6 months of their internship abroad.
 For non-Saudi interns, there is no limit for the time that can be
spent abroad (i.e., the whole duration can be done abroad)
 Any internship rotation (obligatory, elective, selective) can be done
outside the affiliated hospitals and /or outside Saudi Arabia in line
with the above rules.
 The hospital for that purpose (either in Saudi Arabia or abroad) has
to be a teaching or a university hospital and has to be approved by
the Internship Committee.
 Each request from the interns to have some of their internship
period in Saudi Arabia but outside the afiliated hospitals will be
reviewed for approval by the Internship committee.
 The Intern him self will be responsible for the payment of any
needed fees for the non affiliated hospitals
 Such requests have to sent to the internship director at least 3
months in advance, with all required documents.
 For the evaluations from hospitals outside KSA it should be on
AU evaluation form or on official papers showing the name of
the supervisor and his/her contacts for the purpose of
verification

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5- Leaves during internship:

 Interns will be allowed to have up to 30 working days of leave.
However not more than 5 days will be allowed for one rotation (2
months).
 Emergency/Conference/Sick leaves will be discussed and
approved by the Internship Committee.
 Interns will be allowed to attend one conference during the whole
internship period. Additional congress/conference leave requests will
be considered by the internship comittee based on the intern’s
performance.
 Interns are entitled to 5 working days of leave during one eid holiday
(Ramadan or Hajj holiday).
 Interns may take up to one month off for valid reasons; however
these requests should be received by the internship committee at
least 3 months in advance.

6- Assessment:
 The interns will be assessed at the end of the rotation (on Monthly
bases) by the internship coordinator of the department/section in
consultation with the staff involved in the internship programme, as
per Alfaisal University-coleege of medicine assesment form. (see
Appendix)
 All the componants of the evaluation from will be considered
 Interns who are found “unsatisfactory” will repeat the rotation.
 Interns who complete all required rotations, and provide 12
evaluations will be issued an Internship certificate showing that they
have successfully completed their internship year. (see appendix)

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7- Changes in schedule:
 There may be some changes in the initial schedule, due to
changes in plans for rotations abroad. In that case, the intern
should apply to the University (NOT to the hospital where he is
rotating), at least 2 months in advance, with the letters of
acceptance and /or other documents.
 This is an absolute necessity both for the University and for the
host institution (hospital) to change plans.
 Requests for any change should pass through the internship office
of COM and the internship coordinator of the relevant hospital.
 Thus, interns should contact and notify the internship director
and the internship office of the College of Medicine for any
requests for changes in their schedule.
 The interns should not contact the Departments or the hospitals
for such requests.

8- Penalties:
Those who will fail to comply with the university and the hospitals ’rule
and regulations, and especially those who fail to join their rotations or
absent themselves without valid reason, will be subjected to the following:
 He /she will be blacklisted in that hospital
 He/she will be asked to repay the money paid to the hospital for
that rotation (2000 SR)
 His/her certificate will show the rotations he/she failed to pass
 Responsible to secure a suitable seat

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ROTATIONS

 The following bare the departments that each interm should rotate in
the following specialities
o INTERNAL MEDICINE: 2 months
o Selective (IM Sub Specialty) 1 month
o SURGERY: 2 months
o Selective (Surgical Subspecilaity) 1 month
o PEDIATRICS: 2 months
o OBSTETRICS-GYNECOLOGY: 2 months
o Emergency: 1 month
o Elective : 1 month

 Rotations within the above mentioned departments will be arranged

by the hospitals’internship supervisors and to be spent in 2 different
sections of those departments.
 Once assigned to a rotation, no changes to be allowed
 Electives can be chosen from any of the electives or selectives list.
Clinical attachments not listed but found suitable for internship can
also be chosen.

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Notes:
Please notice the following important points:
 As the main objective of internship is to prepare the interns for
clinical practice, basic science and /or research attachments should
not be the priority. However, students who wish to spend some
time in research activities can be given an approval for one month
as research elective; a longer research elective will not be
considered part of the 12-month internship.
 Proposed research should definitely be a hands-on activity, either
working actively in a clinical setting or in a research lab.
 The details of the research that the intern will be involved in should
be sent for approval.
 Students who want to have their electives outside affeliated
hospitals with AU or abroad should apply at least 3 months prior to
their intended period at the host institution with the following
documents:
▪ Letter of acceptance from the host institution
▪ Training programme to be provided
 The host institution should be a university or teaching hospital with
experience and/or training program for interns.
 Following acacceptance of the student’s request, the University
(College of Medicine) will send an official letter to the host
institution to initiate the formal procedures.
 No more than 6 months are to be spent in private sector, and no
more 4 months to be spent in one private institute.

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EXAMPLES of SELECTIVE CHOICES

(1month for medical speciality and one month for surgical speciality)

Selective surgeries Selective medicine

 Cardiac surgery  Neurology

 Neurosurgery  Psychiatry

 Dermatology
 ENT
 Gastroenterology
 Ophthalmology
 Pulmonology
 Urology
 Nephrology
 Paediatrics Surgery
 Rheumatology
 Thoracic surgery
 Cardiology
 Emergency (Trauma)
 General Internal Medicine
 Plastic surgery
 ICU (Medical)
 Vascular surgery
 Haematology/Oncology
 Transplant surgery
 Allergy/immunology
 Orthopaedicsics  Infectious Diseases
 Bariatric Surgery  Family Medicine

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SKILLS AND PROCEDURES EXPECTED FROM INTERNS:

A. Communication and Interpersonal Skills:

o Taking Proper full history in different specialities patients
o Doing proper full physical examinations in different specialities
o Taking informed consent
o Organizing and recording patient files
o Prescribing drugs under supervision
o Communicating with families
o Communicating with colleagues and other health
professionals
o Learn how to breaking bad news
B. Examples for Examination Skills:
o Measuring vital signs appropriately
o Measuring height, weight, head circumference, using the growth chart
properly
o Performing complete physical examination:
 Heart and circulatory system examination
 Lung examination
 Abdominal examination
 Rectal examination
 Prostate examination
 Examination of lymphatic system
 Neurological examination
 Mental evaluation
 Breast examination
 Upper and lower extremities examination
 Neck examination
 Head examination
 Ophthalmoscopy examination
 Otoscope examination
 Gynaecologic examination

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C. Examples for Procedural Skills:

o Drawing venous blood, venous access
o IV injection and administering IV therapy
o IM injection, Intradermal injection, Subcutaneous injection
o Arterial puncture for blood gas
o Nasogastric tube insertion
o Gastric lavage
o Capillary blood sampling
o Performing blood transfusion
o Basic restraint for extremities, elastic bandage
o Bleeding control by pressure and tourniquet
o Stabilizing and restraining neck and spine
o Airway care
o Heimlich manoeuvre
o Cardiopulmonary resuscitation
o Administering oxygen
o Basic suturing and Wound care
o Lumbar puncture
o Bladder catheterization
o Normal vaginal Delivery
o Others

D. Laboratory Tests and Related Skills:

o Preparing unstained/fresh samples (blood, urine, CSF, etc) for
microscopic examination
o Preparing blood film for peripheral blood smear
o Measuring bleeding time
o Urinalysis (by dipstick) and microscopic
examination
o Measuring blood sugar by glucometer
o Performing basic respiratory function tests
o Taking ECG
o Taking samples for cultures (throat, urine, blood, cervix, etc)

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E. Examples for Intellectual Skills:

o Assessing the emergency situations
o Assessing vital signs and physical examination findings
o Differentiating normal and abnormal ECG
o Identifying the area and technique of radiographs
o Assessing chest, skeletal, plain abdominal radiographs
o Selecting appropriate laboratory and other diagnostic tests
o Assessing laboratory results, and planning further tests or
treatment
o Following growth and development in children (percentile curves,
Tanner staging, etc)
o Assessing the need for treatment
o Planning the management
o Rational prescribing
o Planning non-drug treatment
o Identifying the cause of death correctly
o Providing guidance for and follow-up of contraception practices
o Identifying high risk pregnancies and referring the patient
appropriately
o Following antenatal care
o Performing and assess CTG
o Providing postnatal care
o Guidance for breastfeeding
o Assessing neonatal APGAR score
o Planning nutrition according to age
o Immunization
o Communicable diseases prevention in the community and Health
promotions programs

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APPENDIX 1: Assessment form

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APPENDIX 2: Internship Certificate

Certificate of Internship Completion

‫شهادة اتمام سنة االمتياز التدريبية‬
College of Medicine at Alfaisal ‫تشهد كلية الطب بجامعة الفيصل بالرياض‬
University testifies that Dr. ------ ---------------‫أن الدكتور‬

completed his internship in the

‫قد أنهى فترة اإلمتياز بالمستشفيات المعتمدة‬
hospitals accredited by the College of
Medicine for a duration of 12 months,
‫من قبل الكلية لمدة إثنى عشر شهرا وكانت‬
as shown below: :‫على النحو التالي‬
Specialty Duration (Months)
‫التخصص‬ ‫المده بالشهور‬

General Internal Medicine 2

‫الطب الباطني‬

Specialty Internal Medicine 1

‫اختصاص‬- ‫الطب الباطني‬

Pediatric Medicine 2
‫طب األطفال‬

General Surgery 2
‫الجراحة العامة‬

Specialty General Surgery 1

‫اختصاص‬- ‫الجراحة‬

Obstetrics & Gynecology 2

‫أمراض النساء والوالدة‬

Emergency 1
‫طوارئ‬

Elective 1
‫إختياري‬

Note: …………………………………………………………………………………

Official Stamp

Dr. AbdulKarim S. AlMakadma Prof. Khaled M. Al-Kattan

Director of Internship Program DeanCollege of Medicine

Dr AbdulKarim S. AlMakadma College of Medicine Internship Manual