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Internship Guidlines

Internship Guidlines


The Mount St. John’s Medical Center (MSJMC) Internship Program is a rigorous 1-year training experience designed to give you a solid foundation in clinical medicine that will prepare you for full licensure and independent general practice.

Rotations include Medicine, Pediatrics, Obstetrics/Gynecology and Surgery with sub rotations in other sub specialties. The curriculum for each rotation emphasizes the six competencies of: Patient Care, Medical Knowledge, Practice Based Learning and Improvement, Professionalism, Interpersonal and Communication Skills and System based Practice. Our program emphases frequent feedback and evaluation so that you are ensured to have a solid training experience.

The Consultant Faculty is dedicated to house staff training and professional development. Your training experience will be enhanced by problem based learning, bedside teaching and case presentation. To succeed and ultimately fulfill the objectives of the program you will need to demonstrate personal accountability, professionalism and an intense desire to learn. Self directed learning will be required in addition to the above.

Without the successful completion and graduation of the Internship Program, you potentially cannot be fully registered as a doctor in Antigua and Barbuda. This structured training is very important for another reason – it helps to ensure you’re trained properly for your medical career. In medicine, nothing is black and white – your opinions are what ultimately determine a patient’s course of action. If you are wrong, you could seriously injure a patient, sometimes even causing death. As an Intern, you can complete many medical tasks, but you’ll be helped by Senior Staff and Consultants who will supervise you directly in your work at the hospital, so to reduce the risk of injury to patients and improve outcomes.

As an Intern you will be obligated full-time and the program will require maximum personal and professional commitment on your part. As an Intern, you’ll be required to stay at the hospital when on call. Call can be as often as every other day or over an entire weekend and holiday period. When you’re on call, you will have access to a room for sleeping, but you’ll have to respond to any and all calls to your assigned service and you cannot leave the hospital when on call.




Guidance on Internship training

Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and you must:

  • Make the care of your patient your first concern
  • Protect and promote the health of patients and the public
  • Provide a good standard of practice and care
    • Keep your professional knowledge and skills up to date
    • Recognize and work with the limits of your competence
    • Work with colleagues in the ways that best serve patients’ interest
  • Treat patients as individuals and respect their dignity
  • Treat patients politely and considerately
  • Respect patients’ rights to confidentiality
  • Work in partnership with patients:
    • Listen to patients and respond to their concerns and preferences
    • Give patients’ right to reach decisions with you about their treatment and care
    • Support patients in caring for themselves to improve and maintain their health
  • Be honest and open and act with integrity:
    • Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk
    • Never discriminate unfairly against patients or colleagues
    • Never abuse your patients’ trust in you or the public’s trust in the profession

You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions.

Good Medical Practice 
Good clinical care 
Doctors must:


  1. Demonstrate that they recognize personal and professional limits, and ask for help from senior colleagues and other health and social care professionals when necessary.
  2. Know about and follow our guidance on the principles of Good Medical Practice and the standards of competence, care and conduct expected of doctors at MSJMC.
  3. Demonstrate that they are taking increasing responsibility, under supervision and with appropriate discussion with colleagues, for patient care, putting the patient at the Center of their practice by:
    1. Obtaining an appropriate and relevant history and identifying the main findings.
    2. Carrying out an appropriate physical and mental health examination.
    3. Using their knowledge and taking account of relevant factors including physical, psychological and social factors to identify a possible differential diagnosis.
    4. Asking for and interpreting the results of appropriate investigations to confirm clinical findings in a timely manner.
    5. Establishing a differential diagnosis where possible and considering what might change this.
    6. Demonstrating knowledge of treatment options and the limits of evidence supporting them.
    7. Learning to ask for patients’ informed consent (under supervision) in accordance with MSJMC protocol and forms
    8. Helping patients to make decisions on their immediate and longer-term care (including self care) taking into account the way the patient wants to make decisions (through shared decision making, or by the doctor explaining the options and the patient asking the doctor to decide, or by the doctor explaining the options and the patient deciding).
    9. Using medicines safely and effectively (under supervision) including giving a clear explanation to drugs.
    10. Demonstrating an understanding of the safety procedures involved in prescribing controlled drugs.
    11. Keeping (or arranging for the keeping of) accurate and clear clinical records that can be understood by colleagues.
    12. Demonstrating that they can perform core clinical and procedural skills safely. These core clinical and procedural skills are set out in the xxx and by each department (Appendix 1).
    13. Demonstrating knowledge and application of the principles and practice of infection control to reduce the risk of cross-infection.
  4. Demonstrate that they are recognizing and managing acutely ill patients under supervision. This includes showing that they are able to manage a variety of situations where a patient requires resuscitation.
  5. Demonstrate that they promote, monitor and maintain health and safety in the clinical setting
  6. Demonstrate knowledge of systems of quality assurance, including clinical governance. They must be able to demonstrate an application of the principles of risk management to their medical practice. This includes knowledge and explanation of the procedure for reporting adverse incidents and the procedures for avoiding them. This also includes following safe practices relating to dangers in the workplace.
  7. Manage their own time under supervision, and develop strategies with other healthcare workers to maximize efficient use of time.
  8. Demonstrate that they are able to take appropriate action if their own health, performance or conduct, or that of a colleague (including a more senior colleague), puts patients, colleagues or the public at risk.
  9. Demonstrate that they can recognize and use opportunities to promote health and prevent disease and show that they are aware of worldwide health priorities and concerns about health inequalities.

Maintaining Good Medical Practice 
Doctors must:


  1. Develop a portfolio that includes a variety of evidence (including workplace-based assessments, involvement in educational and clinical teaching sessions, and reflections on experiences with patients and colleagues) to demonstrate:
    1. Identify, document and meet their educational needs.
    2. Learn through reflection on their practice.
    3. Show knowledge of the theory of audit, including change management.
  2. Be able to explain how to contribute to audit and how the results of audit can improve their practice and that of others.
  3. Internalize the importance of continuing professional development and self-directed learning and demonstrate this through the assessment process. This will include the need to respond constructively to appraisals and performance reviews.

Teaching and training, appraising and assessing 
Doctors must:


  1. Teach their peers and medical and other health and social care students under guidance, if required to do so, using appropriate skills and methods.
  2. Contribute to the appraisal, assessment or review of students and other colleagues they work with.

Relationships with patients 
Doctors must:


  1. Demonstrate knowledge of the theory and demonstrate the ability to ensure that effective relationships with patients are established and maintained. This includes creating an environment where the doctor can encourage and support the patient to share all information relevant to the consultation.
  2. Introduce themselves to patients and colleagues with appropriate confidence and authority ensuring that patients and colleagues understand their role, remit and limitations.
  3. Demonstrate that they recognize that patients are knowledgeable about themselves and the effect their health has on their daily life. They should use this expertise to encourage and support patients to be involved in their own care. Relatives, or other caring for those with long-term health conditions, are often knowledgeable in this area too.