The Department of Internal Medicine at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), Lahore offers Critical Care Service, Endocrinology, Gastroenterology, Cardiology, General Internal Medicine, Infectious Diseases, Nephrology, Neurology, Orofacial Pain and Headache Service, Palliative Medicine, Pulmonary Medicine, Psychiatry services, and a Comprehensive Health Care Clinic.
The Division of Gastroenterology runs daily consultant-led clinics for patients presenting with gastrointestinal disorders.
The hospital houses a purpose-built, state-of-the-art Endoscopy Unit, providing diagnostic and therapeutic endoscopy facilities with the latest video-scopes and recording systems. International standards of cleaning and sterilisation of equipment are followed to ensure patient safety. Our computerised reporting system ensures that a permanent record of all procedures performed is maintained.
Our team of gastroenterologists offer the following endoscopy services:
Diagnostic and therapeutic Oesophago-Gastro-Duodenoscopy (OGD) including dilatation, polypectomy, banding, metallic stent placement, Argon Plasma Coagulation (APC) therapy and Percutaneous Endoscopic Gastrostomy (PEG) placement.
Diagnostic and therapeutic colonoscopy, including polypectomy, dilatation, Argon Plasma Coagulation (APC) and metallic stent placement.
Diagnostic and therapeutic ERCP, including biliary or pancreatic stone removal, as well as, stent placement (plastic and metallic).
Under the supervision of consultant physicians and hospitalists, the Division of Hospital Medicine runs general medicine clinics for patients with a full range of general medical issues, including diabetes, hypertension and other chronic conditions, as well as those needing preoperative medical screening. SKMCH&RC is also recognised by the United Nations for medical examination of its employees, for both pre-employment medical screening, as well as, for the evaluation of general medical conditions. Our clinics are used by various external organisations for pre-employment and annual medical surveillance of their employees, as well.
Our team consists of infectious disease specialists and fellows. Our division offers a College of Physicians and Surgeons, Pakistan (CPSP) accredited fellowship training programme in infectious disease, which eventually leads to FCPS. Residents from the Internal Medicine Department rotate through all our sections. The Hospital also has an active infection control team.
The Division of Neurology conducts two outpatient clinics each week. It provides a comprehensive clinical assessment for various neurological disorders.
Our pulmonology team consists of qualified pulmonologists that provide interventional pulmonology and critical care services. Currently, we conduct bronchoscopies with lavage and biopsy, transbronchial biopsies, laryngoscopies, pleuroscopies, foreign body removals, endoscopic bronchial ultrasound (EBUS) and EBUD guided aspirations, and pulmonary function tests.
The service provides a full range of mental health diagnostic and management services for both adults and children for illnesses such as depression, anxiety, psychosis, dementia, personality disorders, ADHD, drug addiction and similar other disorders. Alongside clinical psychologists, a consultant psychiatrist is dedicated to providing mental health liaison service to assess and manage complex mental health problems for patients admitted to the hospital.
The division of Orofacial Pain and Headache provides a thorough and comprehensive diagnostic and therapeutic care to patients with headache disorders (migraine headache disorders, tension-type headaches, or cluster headaches), musculoskeletal disorders (myalgia, myofascial pain, or temporomandibular disorders (TMD), cervical myalgia), neuropathic pain conditions (trigeminal neuralgia, burning mouth syndrome, or atypical odontalgia), and other painful conditions, which may affect the head, face, jaw, and neck region.
In addition, we provide care to patients with benign oral lesions (lichen planus, fibroma, or pyogenic granulomas), Sjogren syndrome, and lesions associated with Graft-Versus-Host-Disease, as well as, post-cancer therapy-related illnesses such as oral or oropharyngeal mucositis, nerve damage, and trismus.
This division offers the following intervention services:
SKMCH&RC is dedicated to training the next generation of medical leaders. In the Internal Medicine Department, we offer the following postgraduate training programmes:
The four-year FCPS in Internal Medicine is recognised by the College of Physicians and Surgeons Pakistan (CPSP). Teaching within the department is a mix of classroom-style lectures and hands-on teaching at the bedsides of patients or in clinics. The classroom lectures consist of case-based discussions, journal clubs and exam-oriented multiple-choice question-based teaching.
The Internal Medicine Department also provides training geared towards the MRCP (UK) examination. Trainees preparing for the examination have the opportunity to attend the in-house PACES preparatory course and a course in the UK. Trainees in the past have been helped in securing observer positions in the UK before their PACES exam.
The two-year Fellowship in Infectious Diseases, a CPSP-accredited programme, imparts training to fellows regarding clinical infectious diseases in both inpatient and outpatient settings as well as through rotations in microbiology. SKMCH&RC caters to an extensive range of infections, both in otherwise healthy and in immunity compromised patients. Elective rotations in other quality institutions are a mandatory part of the programme.
A three-year Fellowship in Gastroenterology and Hepatology is a CPSP-accredited programme that provides fellows with rigorous training in the various aspects of gastrointestinal, pancreaticobiliary, and liver diseases, including extensive experience in endoscopy.
After completing their residency in Internal Medicine, fellows are enrolled in the programme for Fellowship in Gastroenterology and Hepatology. Fellows have a dedicated session each week for research-related activities and are expected to publish at least two research papers during their time with us. In the second and third years, in addition to upper and lower gastrointestinal endoscopy, fellows are trained in advanced gastrointestinal procedures including diagnostic and therapeutic endoscopic retrograde cholangiopancreatography, endoluminal stenting, and other such techniques.
The Division of Pulmonary / Chest Medicine at SKMCH&RC, Lahore is a part of the Department of Internal Medicine and sees a wide variety of patients with cancerous as well as non-cancerous conditions including tuberculosis, Interstitial Lung diseases, Asthma, COPD, Bronchiectasis, pleural and infective lung diseases in immunocompetent as well as immunocompromised individuals. SKMCH&RC, Lahore offers a three-year dedicated fellowship training programme in Pulmonary/ Chest Medicine, recognised by the College of Physicians and Surgeons Pakistan (CPSP), which will lead to FCPS in Pulmonary/Chest Medicine.
At the end of the programme, fellows are expected to perform interventional procedures independently including flexible bronchoscopies with bronchial washings, endobronchial and transbronchial biopsies, endobronchial ultrasound examinations with fine-needle aspiration (EBUS -FNA), medical thoracoscopies with pleural biopsies, chest drain insertion (Seldinger and Trocar technique), thoracocentesis, and indwelling pleural catheter insertion. In addition, they will get the experience to perform rigid bronchoscopies, tumour debulking using APC (Argon Plasma Coagulation), and tracheal/bronchial stent insertion under direct supervision.
We have a state-of-the-art endocrine service available at SKMCH&RC consisting of both US and UK trained and experienced endocrine consultants. The service runs on average, eleven endocrine clinics per week, and it is involved in the care of a variety of endocrine-related diseases, including but not limited to diabetes, thyroid disorders, thyroid cancer, pituitary diseases, adrenal disorders, osteoporosis and hormone replacement therapy in both cancer and non-cancer patients. The endocrinology fellowship training programme is approved by the College of Physicians and Surgeons Pakistan (CPSP).
The SKMCH&RC, Lahore has a fifteen bed Intensive Care Unit, which includes four High Dependency Unit (HDU) beds. All of the ICU beds are equipped with ventilators which are run by experienced Critical Care Consultants. A three-year critical care fellowship programme is being offered at SKMCH&RC, recognised by the College of Physicians and Surgeons of Pakistan (CPSP). It includes comprehensive training in all aspects related to critical care.
The Department of Internal Medicine runs specialist palliative medicine clinics. SKMCH&RC is a pioneer in the development of physician-led services in palliative medicine in the country and also has the distinction of being the only hospital which has been approved for second fellowship of two years in palliative medicine by the college of physicians and surgeons of Pakistan (CPSP).
Patients needing symptom management for terminal as well as chronic conditions are seen in the palliative medicine clinic and appropriately managed as inpatients or outpatients as necessary.
Patients needing symptom management for terminal as well as chronic conditions are seen in the palliative medicine clinic and appropriately managed as inpatients or outpatients as necessary.
On alternate Fridays, our fellows teach internal medicine trainees practical clinical and physical examination skills to help them prepare for the TOACS exam. Special mock TOACS exams are held quarterly, in-line with the pattern of the CPSP examination to help trainees prepare for the exams.
The Department of Internal Medicine offers a PACES preparatory course to prepare the candidates for the PACES component of the MRCP (UK) exam. The salient features of the PACES preparatory course include essential history taking and communication skills. Critical ethical issues are discussed in accordance with current UK laws. On the second day of the course, a full mock exam is held to simulate the actual clinical PACES clinical stations, with actual patients.
Training in both Basic Life Support (BLS) and Adult Cardiac Life Support (ACLS) is arranged monthly, in accordance with the guidelines of the British Heart Association.
Clinical observer positions or electives are offered at the Department of Internal Medicine at SKMCH&RC, Lahore to provide insight into the day-to-day responsibilities of physicians in their respective specialities. This is an excellent opportunity for medical students or fresh graduates to observe patient care practices under the direct supervision and guidance of consultants.
Observer positions are offered for four weeks. During these four weeks, students get the opportunity to rotate through general Internal Medicine and sub-speciality out-patient clinics (Pulmonology, Gastroenterology, Palliative Care, Infectious Diseases, Endocrinology, Psychiatry, and Cardiology) and to participate in inpatient rounds and to observe consultations. They also rotate through the Emergency Assessment Room (EAR) and the Intensive Care Unit (ICU).
As a part of medical / specialty teams, students participate in all clinical and teaching activities of the respective team that they are assigned. A schedule of daily activities, as well as orientation to relevant policies, is provided to all the students at the time of commencement of their attachment to the Department.
