Understanding Challenges Clinicians Face – Divya Baji

Date: August 12, 2014

This month’s blog has been submitted by Divya Baji, a PhD student at the Centre for Doctoral Training in Medical and Biological Engineering based at the University of Leeds.

‘Clinical Immersion’ – a two week hospital placement – has been offered to students and post-doctoral research assistants with an aptitude and preference to work in medical technology innovation. The IKC believe there is valuable learning to be gained by immersing the participants in a clinical environment to gain an appreciation of the day-to-day activities and challenges clinicians face.

My name is Divya Baji and I’m a final year PhD student in Medical and Biological Engineering. I am developing a dynamic in-vitro knee model capable of simulating the kinematics of the joint to predict the biomechanics and biotribology of bone and cartilage substitutions. I always had an aspiration for medicine and my interest in innovation and design brought me to medical engineering. I want to pursue a career where I can bring this to the medical/healthcare industry. I was interested in the placement as I saw its potential to give me a great learning platform which was completely different from what I was used to in academia. This was certainly an excellent and unique opportunity for me.

This placement was an insight into the unification of medicine and engineering. It gave me the opportunity to see the direct impact medial engineers make in the healthcare system. I observed how surgeons make use of the medical devices and tools; and the impact it has on the patients. Healthcare is highly reliant on high-tech equipments and the medical engineered devices constantly pushed the boundaries of surgery and patient care.

The placement was organised David Russell, a vascular surgeon from Leeds General Infirmary who we observed during surgeries, along with many other surgeons for different operations. They were all very helpful at explaining what they were doing during the surgery, some even drew us diagrams to explain the procedure before starting. This helped us understand the medical issue and the treatment allowing us to focus on the procedure and its technical challenges.

Communication and teamwork are key in diagnosis, treatment, and taking action

The placement began in vascular clinics where I observed how well the physicians communicate with the patients and the staff team to obtain relevant information for diagnosis, take actions for treatments and make patients comfortable. The team work and efficiency was the same when I shadowed them in ward rounds. I also watched the Da Vinci surgical robot being used in paediatric operations. The robot had three mechanical arms to hold instruments and another for the camera. They were controlled by the surgeon from a console with the help of the camera that showed highly magnified 3D images of the patients’ interior. It enabled the surgeons to operate with high precision movements which cannot be achieved through bare hands.

We observed several angioplasty cases in the vascular radiography theatres. Although the procedure was the same, each case was unique in the sense that the complications were different in different patients and the surgeons immediately adapted the treatment to its need. I observed several endovascular repairs of abdominal aortic aneurysms using stent grafts. I developed an appreciation towards the role of radiography in minimally invasive surgery. Teamwork between surgeons, nurses, anaesthetists and radiographers were crucial in the surgery and each of them played an important role in the procedure.  We were also fortunate enough to see the removal of an infected graft. This was a challenging open surgery that required a lot more time and effort than the initial graft implant procedures. Although synthetic grafts are successful in most cases there are cases like this which emphasise the need for biological tissue replacements.

Thinking about the future of applied medical engineering

The placement brought an appreciation to multi-disciplinary work in the NHS, the advances in modern medicine and the patients’ trust that allowed the surgeons and physicians to use these technologies. It has not only showed me the application of some great equipments currently used by the NHS but has also helped me understand some of the limitations engineers might have in such environment. This encouraged me to think out of the box to for innovative designs while developing technologies for the medical industry.

This experience made me think about practical applications of engineering and the importance of translating new technologies for healthcare. This was also a great networking opportunity which gave me a chance to speak to some exceptional people in this field. 3D printing of sterile materials to provide medical aid in a crisis; and developing simulations and models to teach medical students and train surgeons are a few examples of things we discussed that are challenges for the future. This placement was a great inspiration and has certainly influenced my perspective of medical innovations.

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