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 Cardiology offers both Trans-thoracic and Trans-Esophageal Echocardiograms. In addition, this division conducts Exercise Tolerance Tests, interprets Holter monitoring, Ambulatory BP monitoring, performs Pericardiocentesis procedures and Cardiology Clinics.
The Internal Medicine Department runs the Comprehensive Health Care Clinic, which provides screening services for common medical conditions. Qualified consultant physicians conduct this clinic.
The hospital Critical Care team consists of qualified critical care physicians, respiratory technicians, and nursing staff. Together, they supervise and manage the Intensive Care Unit (ICU) and the High Dependency Unit (HDU) of the hospital. These units are equipped to provide services of mechanical ventilation and invasive monitoring.
The Division of Endocrinology provides comprehensive management of diabetes mellitus and evaluates patients for complications associated with the disease. It also manages patients with thyroid and parathyroid disorders, pituitary disease including pituitary tumors and hypopituitarism, adrenal disorders and hypogonadism, as well as osteoporosis.
The Division of Gastroenterology conducts consultant-led clinics for patients presenting with gastrointestinal disorders.
SKMCH&RC is a tertiary referral center for cirrhosis, in particular for patients with primary liver cancer or hepatocellular carcinoma. Our consultants are well-versed in innovative and comprehensive therapies, including complications of cirrhosis as well as relatively uncommon hepatobiliary procedures such as detailed below (in Endoscopy section). The multidisciplinary team of medical, surgical, and radiological specialists at SKMCH&RC work closely together to diagnose and treat all types of liver disease and 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 sterilization of equipment are followed to ensure patient safety. Our computerized 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 Esophago-Gastro-Duodenoscopy (EGD) 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.
Under the supervision of consultant physicians and hospitalists, the Division of Hospital Medicine runs general medicine clinics for patients with the 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 recognized 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 organizations for pre-employment and annual medical surveillance of their employees as well.
The Division of Infectious Diseases offers inpatient and outpatient consultations for diagnosis and treatment of a wide range of infections caused by bacteria, viruses, fungi, and parasites.
Our team is equipped to manage meningitis, pneumonia, bloodstream infections, heart valve infections, device infections, joint/bone infections, complicated wound infections, urinary tract infections, enteric infections such as typhoid and infectious diarrhea, tuberculosis, ophthalmic and Ear, Nose, and Throat (ENT) infections. At SKMCH&RC, we are also able to cater to infections in immune-compromised patients as well as those with malaria, dengue, and other topical infections. Aside from these, we also investigate and provide treatment services for fever of an unknown origin, transplant or surgery-related infections, HIV, and sexually transmitted diseases. Our division also administers travel medicine and immunizations, and hospital-based antibiotic infusions.
Our team consists of infectious disease specialists and fellows. Our division offers a College of Physicians and Surgeons, Pakistan (CPSP) accredited fellowship training program 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 Nephrology provides comprehensive assessment and management of both inpatients and outpatients presenting with kidney issues. Our Nephrologists offer quality care to patients with acute kidney injury, including tumor lysis syndrome, and chronic kidney disease receiving cancer treatment. We also provide preoperative assessments and counselling for renal replacement therapy (RRT) in patients undergoing radical Nephrectomies or extensive urological surgeries. The Intensive Care Unit at SKMCH&RC is equipped to provide acute dialysis and Continuous Renal replacement therapy(CRRT) facilities as well as plasma exchange, or plasmapheresis services. Similarly, outpatient services cater to a wide variety of patients who present with renal and metabolic issues.
The Division of Neurology conducts outpatient clinics. It provides a comprehensive clinical assessment for various neurological disorders. They also interpret EEGs done in the ICU.
Our Pulmonology team consists of qualified Pulmonologists that provide Interventional Pulmonology. Currently, we conduct bronchoscopies with lavage and biopsy, Trans bronchial biopsies, laryngoscopies, pleuroscopy, foreign body removals, and pulmonary function tests.
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:
An in-house two year residency program in Orofacial pain is also available to those candidates who are interested in the field.
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.
SKMCH&RC is dedicated to training the next generation of medical leaders. In the Internal Medicine Department, we offer the following postgraduate training programs:
The four-year FCPS in Internal Medicine is recognized by the College of Physicians and Surgeons Pakistan (CPSP). During the four years, the residents have to under-take three mandatory rotations in medical oncology, intensive care, and gastroenterology within the Hospital. Teaching within the department is a mix of classroom-style lectures and hands-on teaching at the patients’ bedsides or in clinics. The classroom lectures consist of case-based discussions, journal clubs and exam-oriented multiple-choice question-based teaching.
The two-year Fellowship in Infectious Diseases, a CPSP-accredited program, 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 immunocompromised patients. Elective rotations to other quality institutions are a mandatory part of the program.
The three-year Fellowship in Gastroenterology and Hepatology is a CPSP-accredited program that provides fellows with rigorous training in the various aspects of gastrointestinal, pancreatico-biliary, and liver diseases, including extensive experience in endoscopy.
After completing their residency in Internal Medicine, fellows are enrolled in the program 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 program in Pulmonary/ Chest Medicine, recognized by the College of Physicians and Surgeons Pakistan (CPSP), which will lead to FCPS in Pulmonary/Chest Medicine.
We have a state of the art endocrine service available at SKMCH&RH 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 program is approved by the College of Physicians and Surgeons Pakistan (CPSP).
The internal medicine department 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 the only hospital which has recently been approved for second fellowship of two years in Palliative medicine by 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.
Palliative medicine clinics are multidisciplinary with specialist nurses, psychologist, nutritionist and physiotherapists working in tandem with the physicians to provide holistic patient care.
In addition to bedside teaching of physical exam skills, a special mock TOACS exam is held twice a year, in-line with the pattern of the CPSP examination to help trainees.
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 to provide insight into the day-to-day responsibilities of physicians in their respective specialties. 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-specialty outpatient 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 attached with. 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.
