Pre-registration house officer (PRHO), often known as a houseman or house officer, is a former official term for a grade of junior doctor that was, until 2005, the only job open to medical graduates in the United Kingdom who had just passed their final examinations at medical school and had received their medical degrees. The term "house officer" is still used to refer to FY1s and FY2s.

1. By Dr. Muhammad Saifullah
House Surgeon
Surgical Unit V, DHQ Hospital
Faisalabad

2. 1. OBTAINING
INFORMATION
from the patients,
2. COMMUNICATING
such information to the
appropriate person

3. SMOKING
 Doctors should set an EXAMPLE by not
smoking.
 NEVER SMOKE especially in front of the
patients.

5. QUIT SMOKING
 Any patient who is
going to have a
general anesthesia
should be encouraged
to stop smoking
completely.

6. TIME KEEPING
 Check your duty
roaster.
 Be punctual……
…means being in
the ward at least 30
min before the
consultant is
expected and
assess the patient’s
recent condition.

7. RESPONSIBILITY AND
CONSULTATION
 Important LINK-MAN in the team.
 SEEK ADVICE from senior member of the staff.
 Informing about THE UNUSUAL
HAPPENING e.g., sudden death, unexpected
complication or threatening relatives.

8. RELATIONSHIPS
 With FAMILY DOCTORS ………..can provide
valuable information about the patient’s disease
and his calls must be answered promptly. It is good
practice to call the family doctor at the time of
operation and if he visits the patient afterwards, he
should be provided all the valuable information.
When the patient is discharged, he should be given
a note which provides all the information like
Diagnosis, Treatment, Drug dosage and Follow-
up/After-care.

9.  With NURSING STAFF ……….should be
good because they can provide valuable
information regarding patient’s diet and
current condition.
 With RELATIVES ………..is important and
they should be given a short, simple account
of the medical condition and prognosis. Any
close relative should be informed about any
sudden deterioration in condition.

10. AUTOPSY
 Breaking bad news
 If the cause is unknown then consent should
be taken for autopsy.
 If the consent is not given then the house
surgeon should refuse to issue a death
certificate and should notify the consultant at
once.

11. NOTE TAKING
 DETAILED HISTORY
 COMPLETE PHYSICAL EXAMINATION
 DAILY PROGRESS REPORTS
 INVESTIGATIONS
 DIFFERENTIAL DIAGNOSIS
 PROVISIONAL DIAGNOSIS

12. LABORATORIES
 Avoidance of any unnecessary
investigations.
 Ordering a Radiograph with necessary
information
1. Provisional Diagnosis
2. Relevant clinical findings
3. Details of operation on the relevant
part
4. Dates of previous Radiological
studies
5. Name of relevant investigation
required

13. RADIOLOGY
PLAIN RADIOGRAPH: Fractures and Acute abdomen
CONTRAST STUDIES: Esophageal stricture and GI obstruction
USG SCANNING: Fetal anomalies, masses, cysts and biliary
or pancreatic disease
CT SCAN: Intracranial lesions, abdominal masses and
retro-peritoneal lesions
MRI SCAN: Hepatic tumors and Posterior cranial fossa
tumors
ISOTOPE IMAGING: Thyroid uptake, bone mets, pulmonary
emboli, MI and Intra-cardiac shunts
INTERVENTIONAL
RADIOLOGY:
Aspirating renal cysts, embolizing bleeding
vessels and percutaneous biopsies

14. PRESCRIBING DRUGS
 On the drug prescription
card commence with;
1. Date
2. Pharmaceutical name
3. Dosage
4. Route
5. Times of administration
6. Sign the entry

15. PRESCRIBING DRUGS
 When a drug is discontinued, date
should be written down and signed.
 Any unusual reaction to drug is noted
and mentioned.

16. WARD ROUNDS
 Noting the NUMBER OF EMPTY BEDS
especially if the ward is to receive emergency
cases that day.
 When the consultant goes round, the house
surgeon should have case notes and latest
results available for inspection and discussion.

17. DISCHARGING A PATIENT
 Anticepating a patient to be discharged
when he is medically safe to go.
 If a patient wants to go early then he/she
should sign a form and then he/she is
allowed to go.
 If he refuses to sign then doctor and a
witness should sign, noting down the
refusal.

18. OPERATING LIST
Requirements include
1. Consent
2. Marking
3. Timing

19. CONSENT
 Informed consent
 Patient must know that which part is
diseased and what is to be removed.
 Options available
 Possible risks of not being operated
 Operation complications

20. MARKING
In paired structures, side should be
marked which ever is to be operated
upon.

21. TIMING
 Time available
 Facilities available
 Ensure that the list could be completed
in the given time.

22. DEATH CERTIFICATES
 PART I
o 1ST line shows immediate cause of
death e.g, septicemia
o 2ND line shows the reason of
immediate cause e.g, peritonitis
o 3RD line represents the reason for line
# 2 e.g, DU perforation

23.  PART II
Represents the generalized diseases
e.g, Chronic bronchitis, HTN and DM.
The death certificate must be issued
as early as possible.