Wednesday, January 30, 2013


Time really flies. One minute, I'm in this posting, and another minute, I'm already submitting my portfolio. Past few weeks was pretty stressful and I did suggest that there should be support groups for students. We're always so busy with portfolios that some of us don't take the time out to relax for awhile because time is too precious to lose.

Time and time again, I keep asking myself, "What is the meaning of life?" and "Why do I want to be a doctor?" In some ways, I guess, I don't really remember why to begin with. But if I were to start again, I suppose, I would choose this again, but I wouldn't know why. For some, it's easy. Family. Ambition. Faith. These drive them to continue. But, I don't have that drive to keep me going. Not yet. And, I guess, that sometimes, we wouldn't know the reason why until we've reached the end.

Tuesday, October 16, 2012


I had that awkward moment today. The one where someone remembers you but you don't seem to be able to recall who he is or where you've seen him. It was not long after when I realized, it was the ortho specialist. He has been an inspiring figure in my learning process, along with 2 other obstetricians. The one thing they all have in common is that they do not scold me even though I'm clearly inadequate in knowledge and skills. They would teach my friends and I patiently.

I don't know about the others but I become more motivated when I'm pulled into the learning process when I least expect it. I feel thankful that I have met doctors like him during this period of time in Batu Pahat. Orthopedics, gynecology, certain topics in surgery and internal medicine are not my strongest "subjects". So, the feeling was like entering a battlefield without any armor. Despite having that feeling, I struggled through the morning orthopedic clinic, trying to examine patients, coming up with the diagnosis, identifying the obvious fractures until I was suddenly called by the specialist to examine a patient in front of him... out of the blue.

I guess I was lucky in some sense. It was a spot diagnosis of rheumatoid arthritis which usually comes out in exams but I just froze when it came to examination of the hands. My commentaries were here and there. It was a total mess. There was also another patient with bilateral frozen shoulders. There it was, another classical presentation, something that came out in my last exam. Once again, it wasn't just the shoulders that were "frozen", I was too. So, there's that. Despite all that, I learnt. I call it "Ortho revisited". I wasn't at my best today but I very much do hope I still have the time to improve.

Sometimes, I wish I did not have portfolios to attend to so that I can solely focus on studying and applying what I have learnt but somehow, I still find it difficult to manage my time. Obs & gyn posting finished in a breeze. I have learnt much but there is much that I haven't learnt too.

Oh yeah, I met a patient who is 102 years old! He was chatty though. =) And, I thought it was pretty cool to meet someone who has lived more than a 100 years.

Wednesday, April 11, 2012


Many who have gone through the gynae posting would have a countdown of their own. 2 more weeks! 1 more week! 3 more days! Last day! Most of the time, it is because they are glad it is over as they won't need to stay in the ward from 8am to 5pm (which is after awhile, nothing, really) and we students would say that we won't be targets waiting for the bullet to hit us.

It's not too bad once you are in the situation. What the lecturers do, they do it for our own good. One side of me is thankful because the lecturers do come to the ward at random times because they would end up teaching us although it was not scheduled on our timetable. But it is also because they come at random times that keeps me up on my toes which is a good thing because that means everyone would have covered the whole ward but also, there would be the constant heightened anxiety.

As for me, my countdown is to finishing another cycle, another SAQ paper, another long case and not needing to face certain people for a long long time to come.

Yesterday, the new grouping for Sem 10 was released and within 2 hours, more than half of the original groupmates I was supposed to have swapped to different groups already. Well, I ended up changing as well. Everyone wants to be in the best group and by best I mean the order of the posting. The reason why it was favourable was because seniors told us that there would be more free time in Pediatrics compared to other postings which was why many wanted to finish with that posting. It would also mean there would be more time to study/finish portfolios etc. That, I chose to be my 3rd which means I end with Internal Medicine of which I didn't think it would be so bad.

Some say that whatever you choose, it is okay, as long as it is not Surgery or O&G. Anyway, I dreaded at the fact that I had to start with O&G in the new sem (hopefully, after I pass Sem 9) because after this experience, I don't quite enjoy it. You are supposed to love what you do so that you have an aim, a motivation, a reason to keep yourself out of bed and doing something for your patients. Someone told me that if you don't have that "calling", then medicine isn't really the thing for you.

And, until now, I still doubt if this is what I want. It seems like most of my friends already know what they want to do... Surgery, Obs & Gyn, Peds... And, I'm still wondering where I'd end up. I was told that by now, I should already know where I want to go. But I was also told that even if I want to go to a certain field, I can't because there may be lack of staff in certain departments or that my interest would die off as it is crushed by the unfriendly environment of the working place.

On a random note, today's a public holiday and I'm glad it is. =)

Monday, April 09, 2012


Not everyone can be a teacher. And I know that because I learnt it the hard way.

Some people say that sometimes, you've just got to thicken your skin for a while so that whatever morally demeaning words that come your way would not hurt so much and in the end, not affect your day. Someone once said that there is no such thing as a constructive criticism. It all depends on how the criticism is taken by the receiver. I can't be more thankful to have a few inspiring lecturers in the gynae posting. They are the ones who really make us think for ourselves and make us build our own character. And, it is a fact that wherever you go and work, there will always be people who would want to bring you down because that is just how they are.

Well, I try to keep that thought close to myself because for one, I just feel that those who are paid to teach us students aren't doing a very good job. Of course, I don't expect to be highly treated but what I am trying to say is that teachers should teach if they want to teach, not because they have to teach. I don't appreciate the mood swings that my group and I get from the various "external" (because they don't work for the university) doctors. Not only does it ruin the group dynamics but also in the end, we don't get to learn much.

If we don't ask questions, we are said to have poor participation. If we do ask, the feedback would either be: a) you don't have to know because it is not your level, b) well, what do you think?, c) why don't you go find out yourself in the books and tell me another time, d) why don't you focus on something that is more common?, e) I actually get the answer to my question

Today, I've got most of the above but not to the same questions of course. I ask questions because it is my way of reinforcing what I've studied and knowing what I've been lacking. And, I know for a fact that I lack communication skills as well as the knowledge. However, it doesn't mean that just because I can't converse, I don't know anything. But when it comes to writing, I'm alright (I feel) in a way that words actually flow. Perhaps, it is just that sudden blood rush to the brain when I have to answer something out of the blue which leaves me speechless. Give me some time to think and I'd tell but truth is, out there, you're never given time to really think about it.

I was quite eager to find out how things run in the combined clinic because we hardly see pregnant patients with an underlying medical condition. And even if they do, there would be one or two in a long long while. Yet, it is commonly asked in exams. So, I just wonder how am I to learn blindly from books when there are actual patients out there who I can learn from? I gathered a bit more courage, think around the problem and proceed with the plan regardless of the consequences. I'm not proud of what I did. But, I'm glad I did it. =) That would be talking to the patients who are waiting outside the clinic (which is one room out of the 10 I think) instead of staying inside and listening to what plans have been made.

I felt quite disappointed with the professionalism our country's doctors' have. Well, I'm not generalizing the population but it is bound to be a few of those "kind". It's not just in this posting, but I've experienced in the psychiatry as well as A&E. Today, when I tried to ask about it, I got a remark that made me stun for awhile of which I wish I could have said what I wanted to say. How was I to respond to "Instead of following the combined clinic which is a subspecialty that you don't have to know, why don't you tell me the hypertension CPG?" ( =.= *** what? everything? there are like 40 over pages. C'mon, I don't have photographic memory.) So, I kept quiet while thinking where to start. "Since you can't tell me everying in the hypertension CPG, then why follow the combined clinic?"

Birds of the same feathers flock together. Strangely enough, I met quite a few others who possessed certain "similarities". As regards to the professionalism, I don't see the need of going around saying "D*mn it, where is the bl**dy OT book?" and yelling away when there are still patients around. Neither do I see the need in laughing behind someone who just received bad news about their health which is similar to: She asked for it, who asked her to fool around? Now, she's pregnant. Or, what did she expect? Of course she is going to have HIV. What did she expect from using heroine? Just hepatitis?

Humans are only humans. And it's sad to hear that from a fellow human being who was taught to have empathy, who tells others to have empathy. I am not shocked at all if I still see junior doctors getting scoldings in front of patients by a senior doctor who then turns and speak to the patient nicely. I thought times have changed. I guess not. Maybe it might have improved a bit, but then again, this is what it is. If I have learnt anything today, I learnt that I do not want to be someone like that in future. I learnt from an inspiring lecturer that morales matter more than knowledge.

Tuesday, April 03, 2012


We all feel frustrated for various reasons at some point in life. And, I do, very much so, especially for the past couple of months. Be it a person, a subject or with myself, somehow, there would be something lingering in one's mind.

Not too long ago, I was pre-occupied with whether or not I might have gotten TB from the patients I saw in the ward because it wasn't just one patient, but several. Neither me or the patients were wearing masks when I talked to them and boy, oh boy, could you imagine how much anxiety I had. It all started more than 2 months ago when I "clerked" a patient in my ENT posting who had a sore throat and a cold. Ever since then, I had persistent cough but only at night which worsened during the Chinese New Year celebration but eventually became intermittent. My asthma inhaler expired and there was no free time in my schedule to go to the nearest community clinic to change it for a new one. Somewhere along the subsequent postings, I managed to get a chest x-ray taken of which it was said to be normal. Then, another suggested that I get tested for TB of which I was never able to cough out phlegms for samples.

I suppose it was only a month later when I came in contact with another patient who had TB. Before that, I depended on my new inhaler. Anyway, it was during my long case of which I came to talk face to face with the patient. I have always thought that patients with infectious diseases would not be arranged for us, which was somewhat true. Unfortunately for me, I took that for granted and I definitely freaked out after seeing the x-ray. Well, a few days later when I presented the case to a different lecturer for one of the teachings, I was once again given another scare. That night, I had a pretty bad cough with outcomes I've never faced before.

But having to go through this, though it may mean nothing to some, it brought me to various places in terms of experience. It was my first to go through the healthcare system and see how efficient things are done. To be part of this experience was definitely scary for me because I felt like I did not know who to turn to. To be constantly worried and thinking about the what ifs as well as the worst outcome possible. All that is experienced by a patient, I somehow feel thankful for it because now, it made me a better person. It taught me how to be compassionate.

Now, every patient that I meet and learn from, I'd ask about how they felt, about their worries and concerns. I would ask if they understood what was going on and if they had any questions for the doctors who took care of them. Back in Phase 1 of our studies, we never knew why we had to ask if the patient had any worries. All I knew was that marks were allocated for asking. But now, I realised that it is one way of approaching the patient holistically in a sense that, it is not just the medical but also the social. The care does not end at when the patient discharges from the hospital. It also extends beyond to what will happen when the patient goes home.

Well, at least, this was what I also grasp most in the current Gynecology posting. There is always something ethical to discuss about. And in the ward, there will be women who tries their best to protect a life, be it theirs (in those with a malignancy, or a mass and want to do something about it) or a lifeform of several weeks old.

Monday, March 26, 2012


It's the first day of Gynae posting today. After an inspiring talk by the posting coordinator, it makes me want to really give it my all. But that effect would last probably for a few days. The cycle repeats itself -

1. Feeling lost because you don't know where to start
2. Feeling stressed out because you realise there are too many things to read and learn in a day
3. Continuous stress because you realise that exams are coming soon and you wish you knew some things earlier
4. "Do or die" when it's long case & SAQ
5. Enjoy for 2 days (weekends)
6. Back to step 1 in the new posting

Still, I hope I can make the best out of it after going through the many postings in Sem 8. =) Just thought of sharing something I came across a long while ago which I feel should be a constant reminder to me.

"may i see the things in front of me as they are, not as i think them to be.
may i walk the steps ahead of me one at a time, not wondering if there's a map.
may i say the things that fix things, not break them further apart.
may i do what i need to do, not be distracted by what i can't.
may i dream of what i hope for, not of what i fear.
may i love you like i love you, not as any other, me."

Monday, January 02, 2012


Since I came back from Selective/Elective, I was in Family Med posting for 4 weeks followed by 2 weeks of Ortho and 2 weeks of Psych. Ortho was fun! Previously, I disliked everything about it because I could not understand the concept behind it and the scope of learning was so wide that I had no idea what to focus on because in EOS 7 back then, anything could come out. Anyway, that was the past. In short, exams were horribly tough. With only 10 minutes per SAQ question, I pretty much stared at my paper. Only Ortho SAQ paper was do-able because what we learned actually came out unlike the other postings, questions asked were cases we hardly see in the clinic.

Just entering Dermatology posting. It's a two week posting and 1 week has passed. I haven't gotten the hang of it yet. As usual, I don't get many things. I mean, yeah, it takes experience to tell what the person has but it's all so SIMILAR. =.= And, really, it does get me frustrated when everyone goes like, "Yeah, it's scaly, there are plaques.. It's *fill in the blanks*" And I don't see scales. Maybe because the scales I had in mind were like animal scales but I'm just trying really hard but still, I don't see it. Maybe I'm too far away from the lesion or I just need a magnifying glass. Then, differentials would come out - psoriasis, seborrheic dermatitis, atopic eczema etc etc. Then, I get all stressed out.

Just the other day, my group came across one condition called keratosis pilaris. It's a common condition but the name itself gives me that awkward feeling like how I'm learning a whole new set of language in Dermato.

Oh, in 5 weeks time, there's an ACLS theory and practical to sit for. We are on our own. Minor postings, to me is packed and somehow, I've got to fit time to memorize the algorithms like how seniors did. It's just the 1st out of the 8 weeks in minor postings and I'm already stressed. =.= I hope ENT, Ophthalmo and A&E wouldn't be too bad.