I've just spent about five hours in front of the television on Christmas eve. I know this sounds sad but I've really enjoyed myself! I sang along with the Christmas music show and watched very interesting movies. The Pirates of the Caribbean: the Curse of the Black Pearl was amazing! I love Jack Sparrow and Will Turner! Such great actors. I have to admit that I haven't actually seen any of the pirates of the Caribbean series before because I was put off by the scary looking creature on the poster (Devy Jones being the most scary)... But it was alright watching it on tele, I could switch to another channel when I couldn't bear it. Also watch Gordon Ramsay's show - which was quite sickening. A chef chopped off the head from a wriggling eel, took its heart out and made a guest swallow the beating heart! And Gordon also took his son out for hunting trip and later cook the animal he killed. I appreciate the need for freshness of the food, yet I don't think there's a need to go that far. His son looked just about primary school age and he's definitely not supposed to be getting excited about watching his father shoot down a bird and later cook it and say it's yummy.
Anyway I've finally come up with revision plan. There is too much to learn, coupled with too little time plus an extremely low motivation to study = the perfect recipe for disaster. Luckily the exam this time isn't really going to affect my academic standing. Hopefully I'll be able to follow my revision plan until exam time. Then I'll be fine. I hope. Merry Christmas!
Tuesday, December 25
Sunday, December 16
Panic
I panic very easily. When I'm asked to do a job that I'm not very familiar with, I would start palpitating, going over instructions over and over and be slow and clumsy in what I do. In my first week, in an endocrine/surgical clinic, a doctor asked me to send a request card for MIBG in gamma camera and get a date for the scan- I was like ?!?!? and why did he send the other two students to take the history and I got picked for the job which I haven't got a clue about? And it must have been my unlucky day - the technician wouldn't accept the card because it wasn't clearly written enough and I spent some time arguing with him. He was mean... saying 'if you are confident that it's MIBG then write it down yourself and countersign it, or else I won't take it', and I had to bring the card back so the doctor can add the few letters into the card. It was for a patient with pheochromocytoma, and when I came back, the doctor talked about the condition. 'Pheochromocytoma is a catecholamine-secreting tumour, and catecholamine is hormones for fight-and-flight response, like just now when I asked you to send the request card the catecholamine level in your body must have shot up.' Nice one doctor, now I will remember what catecholamine is and what MIBG is for a long time.
Whenever a consultant talks to me, I get palpitation anyway. In the renal ward rounds last two months, whenever the consultant (particularly Janet) said something to me, I would jump. It's not just things like 'tell me about myeloma', but also simply stuff like 'tell me about his fluid balance' or 'fetch me his drug chart'. Sometimes I get surprises like 'why don't you type up the clinical notes' or 'order an ecg for this gentleman'. There I was, standing quietly behind the entourage of doctors hoping to be invisible, and statements like these made me feel extremely alarmed. I usually would simply go 'what? can you say that again?', hyperventilating. I recall her saying 'don't panic!' to me for quite a few times already. I don't know why I reacted like that. Maybe its just I have expected to play no role as a lowly student. However Janet was different in that she tried to include everyone and make me feel like part of the team. Anyway I spent most of my ward rounds being on my feet. I got used to it, and it became rather fun after a while.
Presenting history is often a horrible experience. We had a bedside teaching session with Prof Carlson last week and I presented a patient's history. It was my first time presenting in weeks. (My groupmates have managed to turn the clinical debrief meant for us to practise presenting history into spoonfeeding teaching session). I knew it wasn't the most coherant one I've presented, but the professor had just too much to critisised - in front of the patient and my groupmates. I usually take critism in a very positive way. But for the first time, I actually thought that was too much to take and I felt a little embarassed, holding my head down half the time.
'How did you know he had reflux? Did he used the word? What do you mean by bit of weight loss? How much is a bit? How can you tell if you don't ask? You must always ask about any complications with regards to previous surgeries. You can't just say all the symptoms in random orders.' etc etc
But it wasn't his fault. He must have been expecting more from a medical student 11th week into her clinical training. It was just me being stupid.
I do realised that consultants are not always there to bite. Most of them are amusing and have a bit of personality. The first thing surgical firm lead said to us at the introductory session was 'you all look like mugheads'... how eccentric was that? He has been really cool and I like him. And just last week a charming consultant told me 'your english is really good, if you haven't been telling me I would have thought that you were raised in England' Hahahahaaaa!!!!! Though thats not the first time I get compliment like this, I was still extremely overjoyed!
Finally, I am pleased to announce that I have been allocated an A&E SSC to do. (SSC = student selected component. 4 weeks clinical attachment of whatever speciality we want and we can put in 8 choices). I'm really looking forward to the attachment! It will no doubt bring up my catecholamine level but I think that will be what I want. Hope it'll be exciting!
Whenever a consultant talks to me, I get palpitation anyway. In the renal ward rounds last two months, whenever the consultant (particularly Janet) said something to me, I would jump. It's not just things like 'tell me about myeloma', but also simply stuff like 'tell me about his fluid balance' or 'fetch me his drug chart'. Sometimes I get surprises like 'why don't you type up the clinical notes' or 'order an ecg for this gentleman'. There I was, standing quietly behind the entourage of doctors hoping to be invisible, and statements like these made me feel extremely alarmed. I usually would simply go 'what? can you say that again?', hyperventilating. I recall her saying 'don't panic!' to me for quite a few times already. I don't know why I reacted like that. Maybe its just I have expected to play no role as a lowly student. However Janet was different in that she tried to include everyone and make me feel like part of the team. Anyway I spent most of my ward rounds being on my feet. I got used to it, and it became rather fun after a while.
Presenting history is often a horrible experience. We had a bedside teaching session with Prof Carlson last week and I presented a patient's history. It was my first time presenting in weeks. (My groupmates have managed to turn the clinical debrief meant for us to practise presenting history into spoonfeeding teaching session). I knew it wasn't the most coherant one I've presented, but the professor had just too much to critisised - in front of the patient and my groupmates. I usually take critism in a very positive way. But for the first time, I actually thought that was too much to take and I felt a little embarassed, holding my head down half the time.
'How did you know he had reflux? Did he used the word? What do you mean by bit of weight loss? How much is a bit? How can you tell if you don't ask? You must always ask about any complications with regards to previous surgeries. You can't just say all the symptoms in random orders.' etc etc
But it wasn't his fault. He must have been expecting more from a medical student 11th week into her clinical training. It was just me being stupid.
I do realised that consultants are not always there to bite. Most of them are amusing and have a bit of personality. The first thing surgical firm lead said to us at the introductory session was 'you all look like mugheads'... how eccentric was that? He has been really cool and I like him. And just last week a charming consultant told me 'your english is really good, if you haven't been telling me I would have thought that you were raised in England' Hahahahaaaa!!!!! Though thats not the first time I get compliment like this, I was still extremely overjoyed!
Finally, I am pleased to announce that I have been allocated an A&E SSC to do. (SSC = student selected component. 4 weeks clinical attachment of whatever speciality we want and we can put in 8 choices). I'm really looking forward to the attachment! It will no doubt bring up my catecholamine level but I think that will be what I want. Hope it'll be exciting!
Saturday, December 8
Sexual harassment at work
I've never thought that I would ever be harassed... Not that it happened for many times.
The first time was a week for I return to KL for summer holiday this year, worked at a psychiatric ward. This elderly male patient, A, kept smiling at me, and wouldn't it be rude if I just look away? I smiled back every time. And then over one or two hours his smile went funny, more friendly. Later on while I was standing nearby, he suddenly walked towards me and hugged me very tightly and kissed my cheek. Before I could react, another male staff noticed and saved me. Did you know what the staff said to A? "That was very bad you naugthy man." Anyway it didn't mind eventhough the permanent staff insisted that I fill in an incident reporting form.
The next one was a patient that I've met twice after my summer holiday. He suffered from alcoholic liver disease, I suspect with encephalopathy. The first time I met him, he was really agitated, half the time trying to climb out of bed. From breakfast through to lunchtime, he was asking me to have sex with him, with him holding his penis and being naked, crying 'come on, lets get on with it' - o dear - and I was alone with him in a side room doing one-to-one care. But I knew he was not capable of doing any harm as being sick he didn't have the strength. The next time I worked on the ward it was three or four weeks on. He wasn't as confused but I also noticed that he's lost a huge muscle bulk on his legs, which was really sad - but who wouldn't be after being forced to stay in bed for three weeks continuously? Yet the sexual disinhibition was still there in that he still refused to get dressed, kept holding his penis and asking me to have sex with him. Strictly speaking, this doesn't really count as sexual harassment since he was clearly confused, yet he did leave me frightened for a moment.
And today, about patient C, it was almost certainly outright harassment. The ward was really short of staff and I was rushing around like a headless chicken trying finishing my morning washing. So I was quite clumsy, knocking over things, spilling drinks and kept apologizing to patients.
When I went to patient C behind the curtains to help him have a wash, he said 'stop apologizing, you've done nothing wrong'. That was nice of him, I thought. 'OK,' I said.
'Tell me what have you completed today?'. Trying to boast my self confidence? No need for that - no time to waste. 'Not much,' I replied.
'Don't understand what you mean,' he said. And then he started putting his hands around my waist and then rubbing it down my bum. I walked away out of his reach right away. Then got back to business, getting him to sit up and have a wash.
I know I should have been stern in telling him off. But I just can't do that. I can do a lot of things but telling people off and rejecting people are not my strong points. I could have told one of the staff there but I was occupied to the last minute before I finish my shift. So I'll just let it go for this time.
I am legally entitled to complaint since sexual harassment constitutes any unwelcomed behaviour of a sexual nature. Fortunately on these occasions there weren't any harm done and hence I've didn't want any formal complaint. I just need to think if I am confronted with worse situations in the future what can I do.
The first time was a week for I return to KL for summer holiday this year, worked at a psychiatric ward. This elderly male patient, A, kept smiling at me, and wouldn't it be rude if I just look away? I smiled back every time. And then over one or two hours his smile went funny, more friendly. Later on while I was standing nearby, he suddenly walked towards me and hugged me very tightly and kissed my cheek. Before I could react, another male staff noticed and saved me. Did you know what the staff said to A? "That was very bad you naugthy man." Anyway it didn't mind eventhough the permanent staff insisted that I fill in an incident reporting form.
The next one was a patient that I've met twice after my summer holiday. He suffered from alcoholic liver disease, I suspect with encephalopathy. The first time I met him, he was really agitated, half the time trying to climb out of bed. From breakfast through to lunchtime, he was asking me to have sex with him, with him holding his penis and being naked, crying 'come on, lets get on with it' - o dear - and I was alone with him in a side room doing one-to-one care. But I knew he was not capable of doing any harm as being sick he didn't have the strength. The next time I worked on the ward it was three or four weeks on. He wasn't as confused but I also noticed that he's lost a huge muscle bulk on his legs, which was really sad - but who wouldn't be after being forced to stay in bed for three weeks continuously? Yet the sexual disinhibition was still there in that he still refused to get dressed, kept holding his penis and asking me to have sex with him. Strictly speaking, this doesn't really count as sexual harassment since he was clearly confused, yet he did leave me frightened for a moment.
And today, about patient C, it was almost certainly outright harassment. The ward was really short of staff and I was rushing around like a headless chicken trying finishing my morning washing. So I was quite clumsy, knocking over things, spilling drinks and kept apologizing to patients.
When I went to patient C behind the curtains to help him have a wash, he said 'stop apologizing, you've done nothing wrong'. That was nice of him, I thought. 'OK,' I said.
'Tell me what have you completed today?'. Trying to boast my self confidence? No need for that - no time to waste. 'Not much,' I replied.
'Don't understand what you mean,' he said. And then he started putting his hands around my waist and then rubbing it down my bum. I walked away out of his reach right away. Then got back to business, getting him to sit up and have a wash.
I know I should have been stern in telling him off. But I just can't do that. I can do a lot of things but telling people off and rejecting people are not my strong points. I could have told one of the staff there but I was occupied to the last minute before I finish my shift. So I'll just let it go for this time.
I am legally entitled to complaint since sexual harassment constitutes any unwelcomed behaviour of a sexual nature. Fortunately on these occasions there weren't any harm done and hence I've didn't want any formal complaint. I just need to think if I am confronted with worse situations in the future what can I do.
Wednesday, December 5
Chinese school
I would like to comment based on my personal experience regarding the article in The Star http://thestar.com.my/columnists/story.asp?file=/2007/12/4/columnists/vkchin/19629191&sec=VKChin. I went to a chinese primary school in Kuala Lumpur. As the author has rightly said, by the time a girl finishes her education in a chinese primary school, there is no doubt that she would have been caned at least once. I remember I was so glad to be out of the chinese school system after standard six. I used to really hate chinese school because it was dictatic. We were not allowed to keep long hair and we spent a lot of time lining up being lectured. Academic wise, teachers often expected less than perfection, certainly from my class (which is the top class of the year). I was caned because of careless mistakes in maths (eg 7 x 3= 22), selecting the wrong answer in MCQ when we were specifically asked to revise for the topic, getting a C for essay practise and on many other silly occasions. I hated chinese calligraphy and hence have always got either a C or a D for that. Plus chinese school teachers are very harsh in grading, only one or two in the class would get an A in a typical essay writing practise (It was really not us who was stupid - almost the whole class got an A in the end-of-year national standardised exams UPSR). You have no idea how meticulous my teacher was - I spent so much time drawing box-like margins on every pages in my exercise books just because she wanted it that way.
Students would get caning for trivial things like forgetting to bring book or PE shirt. There were several times in which my sisters and I, on separate occasions, forgot to bring a file or book or even a piece of paper that we panicked and phoned mum to bring it for us. And mummy did actually travelled for 30minutes to deliver us our stuff. It seemed so ridiculous when I think back.
Another thing notoriously famous among chinese schools are the heavy bags. In standard six, we had to bring, on top of many textbooks, workbooks and exercise books, two big heavy dictionaries in Malay and Chinese language. My school bag normally weighed 30kg, that's excluding the pile of exercise books on my left hand and an extra small bag of files on my right hand. I actually developed a bit of kyphosis in primary school because of these heavy bags. Hence my bag felt like feather when I went to secondary school.
It was very difficult to shine and develop your full potential while in a chinese school. Only the very best 3-5 people gets the opportunities represent the school for bigger competitions. We hardly get to volunteer to participate in competitions, especially in my class, my teachers would usually just call the same 3-4 people to compete in story telling, public speaking and singing competitions without even asking if anyone else is interested. I was quite pissed off with that on several occasion - although I did not have much hidden talent to reveal, I'd like to be presented the opportunity to prove myself.
It is only fair that I think about the benefits of having a primary education in a chinese school. It gave me a very strong foundation in chinese language - I can tell you for a fact that my proficiency in chinese language was excellent (that was 10 years ago unfortunately). The drilling in mathematics built solid base of arithmancy for secondary and tertiary education - any ex-chinese school students always have an edge over other students when they are compared in later education. And I had fun playing snare drum for the school band in standard 4-6. It was quite enjoyable being one of the school pianists playing the school song in weekly assembly and in singing competitions and performances.
So should caning be allowed in chinese school? No. I think it is time for chinese school to revert to the national recommendation about caning student, which is something like caning is only to be done for serious offense, action to be taken by the disciplinary teacher or the principle with witness present etc. But I know chinese school is changing for the better, in terms of allowing students more freedom to participate in activities, certainly from what my youngest sister said about my former school. We know that operant conditioning works on mice, but there must be better, more civilised ways of making a point to children.
Students would get caning for trivial things like forgetting to bring book or PE shirt. There were several times in which my sisters and I, on separate occasions, forgot to bring a file or book or even a piece of paper that we panicked and phoned mum to bring it for us. And mummy did actually travelled for 30minutes to deliver us our stuff. It seemed so ridiculous when I think back.
Another thing notoriously famous among chinese schools are the heavy bags. In standard six, we had to bring, on top of many textbooks, workbooks and exercise books, two big heavy dictionaries in Malay and Chinese language. My school bag normally weighed 30kg, that's excluding the pile of exercise books on my left hand and an extra small bag of files on my right hand. I actually developed a bit of kyphosis in primary school because of these heavy bags. Hence my bag felt like feather when I went to secondary school.
It was very difficult to shine and develop your full potential while in a chinese school. Only the very best 3-5 people gets the opportunities represent the school for bigger competitions. We hardly get to volunteer to participate in competitions, especially in my class, my teachers would usually just call the same 3-4 people to compete in story telling, public speaking and singing competitions without even asking if anyone else is interested. I was quite pissed off with that on several occasion - although I did not have much hidden talent to reveal, I'd like to be presented the opportunity to prove myself.
It is only fair that I think about the benefits of having a primary education in a chinese school. It gave me a very strong foundation in chinese language - I can tell you for a fact that my proficiency in chinese language was excellent (that was 10 years ago unfortunately). The drilling in mathematics built solid base of arithmancy for secondary and tertiary education - any ex-chinese school students always have an edge over other students when they are compared in later education. And I had fun playing snare drum for the school band in standard 4-6. It was quite enjoyable being one of the school pianists playing the school song in weekly assembly and in singing competitions and performances.
So should caning be allowed in chinese school? No. I think it is time for chinese school to revert to the national recommendation about caning student, which is something like caning is only to be done for serious offense, action to be taken by the disciplinary teacher or the principle with witness present etc. But I know chinese school is changing for the better, in terms of allowing students more freedom to participate in activities, certainly from what my youngest sister said about my former school. We know that operant conditioning works on mice, but there must be better, more civilised ways of making a point to children.
Saturday, December 1
Shock
Shock 1:
Surgical house officer on-call was called to see a 60 year old lady who had profuse PR/PV bleeding and I was following him around for the day. That was quite an experience. I know I have another 3 years before qualifying, but the thought of being expected to do something to prevent the patient in front of me from dying is just scary. 'So what are you going to do when a lady presents like this?' 'umm... find out the cause of the bleeding, or um.. take a history, give some fluids maybe..' WRONG! I must have read about management of hypovolaemic shock for at least 10 times yet I couldn't give confident answer. It's really alarming to recall how badly I hesitated while the lady's BP dropped by the minute. And it was also really impressive to see the house officer managing the situation so calmly. Bags of fluids and bloods going into the lady via three cannulas, blood pressure checked frequently, oxygen mask on, ECG, ABG, urgent bloods test ordered, reviewing results and sending more sample and prescribing more fluids and bloods, calling anaesthetists and seniors, writing clinical notes, assessing patient, talking to relative, asking nurses for help, teaching me, briefing the registrar - how could anyone ever manage so much at a time? Anyway the lady was sent to theatre as an emergency to have an endoscopy and colonoscopy for further management. I hope she is alright now. I have definitely learnt from this experience, and hopefully when I see another one of these shocks, I won't be as hesitant.
Shock 2:
My winning entry for the Shine award 2007 was published in the Student BMA news. Caught me by COMPLETE SURPRISE - can't say that it's a pleasant one though. Why couldn't someone have the courtesy to inform me about it before they actually publish it? I'm not mad or anything... it's just really not funny to suddenly come across my name and my essay on a medical student newspaper circulated countrywide.
Surgical house officer on-call was called to see a 60 year old lady who had profuse PR/PV bleeding and I was following him around for the day. That was quite an experience. I know I have another 3 years before qualifying, but the thought of being expected to do something to prevent the patient in front of me from dying is just scary. 'So what are you going to do when a lady presents like this?' 'umm... find out the cause of the bleeding, or um.. take a history, give some fluids maybe..' WRONG! I must have read about management of hypovolaemic shock for at least 10 times yet I couldn't give confident answer. It's really alarming to recall how badly I hesitated while the lady's BP dropped by the minute. And it was also really impressive to see the house officer managing the situation so calmly. Bags of fluids and bloods going into the lady via three cannulas, blood pressure checked frequently, oxygen mask on, ECG, ABG, urgent bloods test ordered, reviewing results and sending more sample and prescribing more fluids and bloods, calling anaesthetists and seniors, writing clinical notes, assessing patient, talking to relative, asking nurses for help, teaching me, briefing the registrar - how could anyone ever manage so much at a time? Anyway the lady was sent to theatre as an emergency to have an endoscopy and colonoscopy for further management. I hope she is alright now. I have definitely learnt from this experience, and hopefully when I see another one of these shocks, I won't be as hesitant.
Shock 2:
My winning entry for the Shine award 2007 was published in the Student BMA news. Caught me by COMPLETE SURPRISE - can't say that it's a pleasant one though. Why couldn't someone have the courtesy to inform me about it before they actually publish it? I'm not mad or anything... it's just really not funny to suddenly come across my name and my essay on a medical student newspaper circulated countrywide.
Indiscrimately positive
Once a friend told me that I have the tendency to always think that everything is good. Every PBL group has been pleasant. All my tutor have been fine. All the medical specialities are interesting. BBGS, UTP, KMB and Manchester have all been amazing. Where I am living now is not the most expensive accommodation, but it's fine and I have no complaint. My family is the best in the world. All is well.
Unfortunately this doesn't agree with everybody.
Ok, this entry, so contradictory to the title, is a rant about my current PBL group. Since the beginning to the term but more so recently, I always find myself disagreeing with the rest of the group. They always have lots of complaint. Whenever they have just a little bit of free time to chat, they would complain. They talked about how the renal doctors were unapproachable, how the podiatry and hospice placements were boring, how teaching were not held on time etc, and very often I had to disagree with them all. However, I still wanted to be accepted by the group and hence very often I've just kept quiet (especially when they were giving feedback at the end of the renal firm). Also, whenever our clinical teachers were late for teaching, a few in our group would always suggest that we leave or make excuses to delay or cancel the teaching rather than making some effort to make our time worthwhile. To be honest, I have come to a point that I just can't to tolerate this anymore. Before this I would sometimes have gone away with them wasting away two hours sitting in the crush hall. Call me a boring person but I really hate wasting time just sitting around chatting when it could be used for more productive things like sitting in a clinic or clerking patients or practising skills. In the past two years I was involved in so many voluntary work not because I want to enhance my CV, but because I genuinely enjoy keeping myself occupied doing meaningful things. My groupmates are just the exact opposite. My clinical partner actually said to me that she enjoyed standing around doing nothing while we were on-call yesterday rather than taking blood. For the last few weeks she's been complaining that we don't get to practise the skill (which is not true by the way), and now when the opportunity arise she's not bothered, how obscure is that?
In this firm, we get lots of teaching sessions, which are overrated by my groupmates. I have no idea why but my groupmates love to be spoonfed. They were continually saying to the other doctors 'this firm is so much better than the renal firm, we've learn more in a week here than we had for eight weeks in renal', and I sometimes just had to say something to the contrary because I have thoroughly enjoyed and have learnt as much in the renal firm. The people in my group always speaks as though they represented the view of everyone, and my view always happen to be completely the opposite of the supposed majority view. Sigh... this is so difficult isn't it? A few girls in the group had started to avoid talking to me, don't really know why but I assumed it's because I enjoyed the renal and community block while they didn't. Is it my fault that I went to the trouble of learning things and making myself useful? Is it my fault that no one wants to take my offer when I ask them if they want to go to the ward? Is it my fault that I've seen and examined more patients than the rest of them? Is it my fault that they are not positive enough to look at the brighter side and cease learning opportunities?
I know I can be overly keen at times, which is why I have made it a point to not be at hospital after 5pm and I shall be engaged with extra curricular activities. Over the last two weeks I've been thinking that I really want to get along with my groupmates. But, maybe it's my fault or maybe it's their, we just disagree all the time (while I kept quiet most of the time). I have tried to reason with them, yet they just kept making excuses. Most of them are 1-3 years younger than me. I remember doing silly things just two or three years ago, it's amazing how much I grew just over the last few years after leaving home. Maybe it's just part of their process of maturation. I will be bitched behind my back but I don't care. I am not prepared succumb to behaving like them, turning up just to compulsory teaching, clerk the minimum number of patient and engage in discussion just to ensure that the teacher sees it and not mark us down. My ultimate purpose of studying medicine is to learn to become a competent doctor and I will do anything to achieve that.
p/s - Latest venupuncture stats: 7 successes 3 failures. Getting better!
Unfortunately this doesn't agree with everybody.
Ok, this entry, so contradictory to the title, is a rant about my current PBL group. Since the beginning to the term but more so recently, I always find myself disagreeing with the rest of the group. They always have lots of complaint. Whenever they have just a little bit of free time to chat, they would complain. They talked about how the renal doctors were unapproachable, how the podiatry and hospice placements were boring, how teaching were not held on time etc, and very often I had to disagree with them all. However, I still wanted to be accepted by the group and hence very often I've just kept quiet (especially when they were giving feedback at the end of the renal firm). Also, whenever our clinical teachers were late for teaching, a few in our group would always suggest that we leave or make excuses to delay or cancel the teaching rather than making some effort to make our time worthwhile. To be honest, I have come to a point that I just can't to tolerate this anymore. Before this I would sometimes have gone away with them wasting away two hours sitting in the crush hall. Call me a boring person but I really hate wasting time just sitting around chatting when it could be used for more productive things like sitting in a clinic or clerking patients or practising skills. In the past two years I was involved in so many voluntary work not because I want to enhance my CV, but because I genuinely enjoy keeping myself occupied doing meaningful things. My groupmates are just the exact opposite. My clinical partner actually said to me that she enjoyed standing around doing nothing while we were on-call yesterday rather than taking blood. For the last few weeks she's been complaining that we don't get to practise the skill (which is not true by the way), and now when the opportunity arise she's not bothered, how obscure is that?
In this firm, we get lots of teaching sessions, which are overrated by my groupmates. I have no idea why but my groupmates love to be spoonfed. They were continually saying to the other doctors 'this firm is so much better than the renal firm, we've learn more in a week here than we had for eight weeks in renal', and I sometimes just had to say something to the contrary because I have thoroughly enjoyed and have learnt as much in the renal firm. The people in my group always speaks as though they represented the view of everyone, and my view always happen to be completely the opposite of the supposed majority view. Sigh... this is so difficult isn't it? A few girls in the group had started to avoid talking to me, don't really know why but I assumed it's because I enjoyed the renal and community block while they didn't. Is it my fault that I went to the trouble of learning things and making myself useful? Is it my fault that no one wants to take my offer when I ask them if they want to go to the ward? Is it my fault that I've seen and examined more patients than the rest of them? Is it my fault that they are not positive enough to look at the brighter side and cease learning opportunities?
I know I can be overly keen at times, which is why I have made it a point to not be at hospital after 5pm and I shall be engaged with extra curricular activities. Over the last two weeks I've been thinking that I really want to get along with my groupmates. But, maybe it's my fault or maybe it's their, we just disagree all the time (while I kept quiet most of the time). I have tried to reason with them, yet they just kept making excuses. Most of them are 1-3 years younger than me. I remember doing silly things just two or three years ago, it's amazing how much I grew just over the last few years after leaving home. Maybe it's just part of their process of maturation. I will be bitched behind my back but I don't care. I am not prepared succumb to behaving like them, turning up just to compulsory teaching, clerk the minimum number of patient and engage in discussion just to ensure that the teacher sees it and not mark us down. My ultimate purpose of studying medicine is to learn to become a competent doctor and I will do anything to achieve that.
p/s - Latest venupuncture stats: 7 successes 3 failures. Getting better!
Tuesday, November 27
Random stuff
Last Saturday was a very tiring day. I worked from 0700-2230. Did home care. It was my first time actually, but did not feel too nervous because I've had a bit of experience in care already. Must admit that although I don't mind doing it again, I don't particularly enjoy it. I like nursing heavily confused people in hospital because they are hilarious!
Finished my attachment with the renal firm and started the surgical firm. Again, must admit that although I've had a great time there, I don't particularly miss it as eight weeks of clerking patients presenting with rather similar symptoms can be a little boring, although having said that I haven't learn everything that I think I should know about renal.
I've been a little naughty today going back to renal outpatient to practise taking blood. (No where else to go - got kicked out from the undergraduate building because of the fourth year exams, not even allowed to get my book from the locker) I'm improving - took blood from 3 patients and all was successful! (Current venupuncture stat: 6 successes 3 failures; Current cannulation stat: 1 success). And now that I'm in the renal firm I'm aiming to be doing at least 1 cannulation, 1 catheterisation and 1 assisting in theatre - don't know how, I need to find out soon.
The surgical firm is definitely a refreshing change. The firm seems better organised in terms of teaching and the wards are more spacious and felt more relaxed. I've not figured out how the medical staff organise themselves in managing the patients hence felt a little lost for the past two days (but this is acceptable since today was only my second day).
I thought I wouldn't enjoy surgery but surprisingly I found it ok. Went to observe a paraumbilical hernia repair this morning. Quite straight forward I suppose but I think I learn better from simple things like this for a start. There was a nice friendly registrar who talked me through what they were doing, taught me a bit on hernia and examined a lady's hernia with me. The consultant was nice as well, although she was in such a moany mood that she kept on talking about how the clinical staff are being undervalued by unintelligent NHS managers. I had to stay until about five yesterday to clerk one of the patient for the operation but it was all worth it. I listened to the anaesthetist taking history and discussing the anaesthesia, pain relief with the patient, then listened to the registrar consenting the patient. Those were well useful because I swear I was probably more clueless about the operation than the patient. Also the anaesthetist was really nice so I've learnt a little bit. It was my first time watching induction for general anaesthetic. Intubation looked scary. And I was quite shocked to see that the patient actually stopped breathing when the muscle relaxant was injected... after which only I remember that I've actually know this for ages from books already. It's just hard to believe. I mean in BLS, when a person is not breathing, you are suppose to give chest compression straight away, implying how close 'not breathing' is to 'death'. Was this what happened to me as well 5 years ago when I had to be given general anaesthetic to remove a lump on my tongue? But don't be put off by my silly thoughts. Obviously not breathing for a few seconds isn't harmful. I just need sometime to get used to this idea.
You guys at home, if you've received my post can you send me a text message just so that I know please? Thanks. I miss all of you and I love you!
Finished my attachment with the renal firm and started the surgical firm. Again, must admit that although I've had a great time there, I don't particularly miss it as eight weeks of clerking patients presenting with rather similar symptoms can be a little boring, although having said that I haven't learn everything that I think I should know about renal.
I've been a little naughty today going back to renal outpatient to practise taking blood. (No where else to go - got kicked out from the undergraduate building because of the fourth year exams, not even allowed to get my book from the locker) I'm improving - took blood from 3 patients and all was successful! (Current venupuncture stat: 6 successes 3 failures; Current cannulation stat: 1 success). And now that I'm in the renal firm I'm aiming to be doing at least 1 cannulation, 1 catheterisation and 1 assisting in theatre - don't know how, I need to find out soon.
The surgical firm is definitely a refreshing change. The firm seems better organised in terms of teaching and the wards are more spacious and felt more relaxed. I've not figured out how the medical staff organise themselves in managing the patients hence felt a little lost for the past two days (but this is acceptable since today was only my second day).
I thought I wouldn't enjoy surgery but surprisingly I found it ok. Went to observe a paraumbilical hernia repair this morning. Quite straight forward I suppose but I think I learn better from simple things like this for a start. There was a nice friendly registrar who talked me through what they were doing, taught me a bit on hernia and examined a lady's hernia with me. The consultant was nice as well, although she was in such a moany mood that she kept on talking about how the clinical staff are being undervalued by unintelligent NHS managers. I had to stay until about five yesterday to clerk one of the patient for the operation but it was all worth it. I listened to the anaesthetist taking history and discussing the anaesthesia, pain relief with the patient, then listened to the registrar consenting the patient. Those were well useful because I swear I was probably more clueless about the operation than the patient. Also the anaesthetist was really nice so I've learnt a little bit. It was my first time watching induction for general anaesthetic. Intubation looked scary. And I was quite shocked to see that the patient actually stopped breathing when the muscle relaxant was injected... after which only I remember that I've actually know this for ages from books already. It's just hard to believe. I mean in BLS, when a person is not breathing, you are suppose to give chest compression straight away, implying how close 'not breathing' is to 'death'. Was this what happened to me as well 5 years ago when I had to be given general anaesthetic to remove a lump on my tongue? But don't be put off by my silly thoughts. Obviously not breathing for a few seconds isn't harmful. I just need sometime to get used to this idea.
You guys at home, if you've received my post can you send me a text message just so that I know please? Thanks. I miss all of you and I love you!
Sunday, November 18
What have I learnt?
I am on a 4-weeks integrated block, meaning that we spend Monday and Friday in the hospital (renal firm) and Tuesday to Thursday in the community (in a GP surgery or the community). I've found out that: Doctors walk fast, read fast and work long hours; and that men cannot multitask.
I've been really lucky to be allocated to this GP. Not only do we get free sandwiches every Thursday, he gets us as involve as possible in whatever he does. Home visits are really interesting. And the relationship between him and his patients is just amazing, he's such an excellent doctor, all his patients say that.
Dealt with death (or rather dying). Our GP when to a nursing home, said that an end-stage dementia patient might have just had a stroke - no point sending her to hospital as she will only die of horrible bed sores, and started her on the care for the dying pathway. A nurse who had cared for her and seen her suffered cried. He also then showed us the all the death certificates he signed for the past 10 years or so. We went to a one day placement on a hospice, observe a doctor managing symptom relief. Talking to patients there were alright actually, doesn't seem as if they were going to die very soon. I just felt that the atmosphere is deliberately made so beautiful and serene that it constantly reminds everyone present of what the patients are there for. On the ward some patients were not getting better despite dialysis and the doctors has decided to just stop treatment. Very harsh when I first thought about it. I mean, a patient has known renal failure, and you are just going to let his creatinine climb, and literally watch him get uraemic and die? But on second thought I figured if I were in that state, I wouldn't want to die while people are inserting and removing lines into and from my body all the time and forcing medications down my throats that is going to make me feel sick and unwell.
On the other hand, I've also learnt about intervention that offers hope. I sat in a renal post-transplant annual review clinic and saw same liver post-transplant patients in a liver clinic. Transplant is not as bad as I thought. I previously thought quality of life post-transplant would not be good because of various medication to take, but patients normally only take 2/3 immunosuppressants - that can't be too bad. And patients are no longer hooked on to dialysis, restricted diet and various existing medications. Things are even better for the liver patients since transplanted liver could potentially last for a life time. The transplant nurse told me that once the blood vessel of the donated kidney is joined to the patient, you can very obviously see the colour of life coming back on the patient's face. Such an amazing description, isn't it? It's not likely that I'll be seeing a transplant surgery but I think I'm going to ask tomorrow.
I've been really lucky to be allocated to this GP. Not only do we get free sandwiches every Thursday, he gets us as involve as possible in whatever he does. Home visits are really interesting. And the relationship between him and his patients is just amazing, he's such an excellent doctor, all his patients say that.
Dealt with death (or rather dying). Our GP when to a nursing home, said that an end-stage dementia patient might have just had a stroke - no point sending her to hospital as she will only die of horrible bed sores, and started her on the care for the dying pathway. A nurse who had cared for her and seen her suffered cried. He also then showed us the all the death certificates he signed for the past 10 years or so. We went to a one day placement on a hospice, observe a doctor managing symptom relief. Talking to patients there were alright actually, doesn't seem as if they were going to die very soon. I just felt that the atmosphere is deliberately made so beautiful and serene that it constantly reminds everyone present of what the patients are there for. On the ward some patients were not getting better despite dialysis and the doctors has decided to just stop treatment. Very harsh when I first thought about it. I mean, a patient has known renal failure, and you are just going to let his creatinine climb, and literally watch him get uraemic and die? But on second thought I figured if I were in that state, I wouldn't want to die while people are inserting and removing lines into and from my body all the time and forcing medications down my throats that is going to make me feel sick and unwell.
On the other hand, I've also learnt about intervention that offers hope. I sat in a renal post-transplant annual review clinic and saw same liver post-transplant patients in a liver clinic. Transplant is not as bad as I thought. I previously thought quality of life post-transplant would not be good because of various medication to take, but patients normally only take 2/3 immunosuppressants - that can't be too bad. And patients are no longer hooked on to dialysis, restricted diet and various existing medications. Things are even better for the liver patients since transplanted liver could potentially last for a life time. The transplant nurse told me that once the blood vessel of the donated kidney is joined to the patient, you can very obviously see the colour of life coming back on the patient's face. Such an amazing description, isn't it? It's not likely that I'll be seeing a transplant surgery but I think I'm going to ask tomorrow.
Friday, November 9
Balance
I feel that I need to get my balance back again. I felt that I haven't learnt much this week. But there's really nothing much to be learnt this week. Patients just happens to have boring, unchanging old problems. Staff in my ward were bit stress due to a C. diff outbreak in the ward. Hence I have made the decision regarding learning - I would keep enthusiasted but I won't hang around earlier than 0900 or later than 1700.
Short term solution to treat my burnt out feeling - Weekend plan: Ride bicycle, Play piano, Shop for winter clothes, Jogging at Platt Field and Watch movie.
I have lost 8-9kg since I came back from summer holiday. All my pants and skirts are annoyingly loose now. (Annoying because my fob watch and name badge shake vigorously when I walk around the hospital).
I miss mummy, papa and all my sisters.
Wednesday, November 7
Bitching
This post is a waste of time. Unless you have too much time to kill, don't bother reading.
Basically I just want to rant about my PBL group. They are alright generally. Just one or two people whom I wonder from time to time why the hell are they doing medicine. One of them is my clinical partner. She is lovely but she is simply not keen to learn medicine. She doesn't bother remembering patients' names and clerk patients only because Dr New said 'we must have 8 clerkings by the end of the firm' - and as soon as Dr new said it's ok to only have 2 or 3 clerkings, she went straight back home for a lay in. She doesn't want to learn anything else other than what we are suppose to know at this point. And she's often with the attitude - we've got to let our tutor see that we are doing work so we don't get marked down, then we'll be ok. Our group sort of got told off yesterday that our PBL discussion isn't up to scratch, and today in the GP surgery, she was actually reading her PBL notes rather than learning from the consultations, seeing interesting signs and symptoms from the patients and paying attention to the doctor's excellent communication skills. I mean, if you are still not mature enough to get out of this schoolchildren attitude towards learning (put on the hardworking act when the teacher sees you, and when the teacher leaves just throw away the mask), then I'm afraid medicine, especially in such self directed learning environment, isn't for you.
I always get very excited after clerking a patient, especially whose diagnosis is yet unknown, reading a lot and trying to work out if I could out what the problem is. My clinical partner and many of my groupmates just never showed any interest to discuss these queries. My clinical partner would rather discuss her cat, her boyfriend, her going home every weekend or her car insurance with our GP than asking him any medical questions. Maybe it's just me the boring medical student with nothing else to talk about other than medical topics. And none of my groupmates wants to hang around the ward to learn stuff no matter how many times I've asked them to join me. Maybe I am just too keen, bit overenthusiastic for them to cope with. I have to say, nevertheless, that having a group with this low level of motivation does hold me back a bit. I actually feel more accepted by the doctors in the ward than my group. I'm constantly reconsidering should I actually be less enthusiast.
I don't generally bitch about people. Since a few years ago when I discovered my tendency to prejudice, I take extra effort all the time to make sure I keep an open mind about people. But this is just too frustrating.
Basically I just want to rant about my PBL group. They are alright generally. Just one or two people whom I wonder from time to time why the hell are they doing medicine. One of them is my clinical partner. She is lovely but she is simply not keen to learn medicine. She doesn't bother remembering patients' names and clerk patients only because Dr New said 'we must have 8 clerkings by the end of the firm' - and as soon as Dr new said it's ok to only have 2 or 3 clerkings, she went straight back home for a lay in. She doesn't want to learn anything else other than what we are suppose to know at this point. And she's often with the attitude - we've got to let our tutor see that we are doing work so we don't get marked down, then we'll be ok. Our group sort of got told off yesterday that our PBL discussion isn't up to scratch, and today in the GP surgery, she was actually reading her PBL notes rather than learning from the consultations, seeing interesting signs and symptoms from the patients and paying attention to the doctor's excellent communication skills. I mean, if you are still not mature enough to get out of this schoolchildren attitude towards learning (put on the hardworking act when the teacher sees you, and when the teacher leaves just throw away the mask), then I'm afraid medicine, especially in such self directed learning environment, isn't for you.
I always get very excited after clerking a patient, especially whose diagnosis is yet unknown, reading a lot and trying to work out if I could out what the problem is. My clinical partner and many of my groupmates just never showed any interest to discuss these queries. My clinical partner would rather discuss her cat, her boyfriend, her going home every weekend or her car insurance with our GP than asking him any medical questions. Maybe it's just me the boring medical student with nothing else to talk about other than medical topics. And none of my groupmates wants to hang around the ward to learn stuff no matter how many times I've asked them to join me. Maybe I am just too keen, bit overenthusiastic for them to cope with. I have to say, nevertheless, that having a group with this low level of motivation does hold me back a bit. I actually feel more accepted by the doctors in the ward than my group. I'm constantly reconsidering should I actually be less enthusiast.
I don't generally bitch about people. Since a few years ago when I discovered my tendency to prejudice, I take extra effort all the time to make sure I keep an open mind about people. But this is just too frustrating.
Monday, November 5
Disorientation
I'm always disorientated in the ward, but today was particularly bad. After PBL at 4:30pm, I thought I would go on to the ward and practise examining some patients. I examine my first patient's abdomen. After the examination, I thank him and said 'have a nice weekend'.
Then went on to the next patient. This is a chap whom I already know (I've taken a history from him last Friday). He said 'what are you doing here on a sunday?', and I naturally went 'it's not sunday today, it's friday'... 'patient looking confused' ... I added 'no, I'm not trying to wind you up, it's definitely friday today'. So we went to arguing for a while, I even asked somebody else to come and clarify to the patient that today is indeed Friday!
Then, I made my way to the bus to go home. On the bus, I thought about the Crossing Borders meeting which I would be going to, which reminded me that today is a monday, not a friday! Aaaaaaaghhhhhhh!!! So I'm as confused as some of the patients in the ward..
Apart from the disorientation I had a great day. The first patient I examined has spider naevi and probable hepatomegaly, and the second chap has a clear basal crepitation. Ward round was enjoyable. I always feel like part of the team in Janet's ward round. I'm really grateful to be included in the team. I think when I become a consultant I want to be like her. And it's very nice to finally have a role model to look up to after 6 weeks in hospital.
Then went on to the next patient. This is a chap whom I already know (I've taken a history from him last Friday). He said 'what are you doing here on a sunday?', and I naturally went 'it's not sunday today, it's friday'... 'patient looking confused' ... I added 'no, I'm not trying to wind you up, it's definitely friday today'. So we went to arguing for a while, I even asked somebody else to come and clarify to the patient that today is indeed Friday!
Then, I made my way to the bus to go home. On the bus, I thought about the Crossing Borders meeting which I would be going to, which reminded me that today is a monday, not a friday! Aaaaaaaghhhhhhh!!! So I'm as confused as some of the patients in the ward..
Apart from the disorientation I had a great day. The first patient I examined has spider naevi and probable hepatomegaly, and the second chap has a clear basal crepitation. Ward round was enjoyable. I always feel like part of the team in Janet's ward round. I'm really grateful to be included in the team. I think when I become a consultant I want to be like her. And it's very nice to finally have a role model to look up to after 6 weeks in hospital.
Wednesday, October 31
Have I reached my limit?
I would like to think I haven't but I'm not sure. My life definitely need sorting out now. It's just a problem of the balancing act, a vital component of being a medic. Since starting the clinical year, I've been feeling really exhausted everyday. I normally wake up at 5am just to do some reading and get ready, and then go out at 7:15am to catch the bus to reach the hospital at 8:30am. Then I don't leave the hospital until about 4:30-5pm, and usually reach home at about 7:30-8pm. As you can imagine, I'd be totally drained off by then that I would mess around with the computer for a while then go to bed. If I'm not too worn out, I might cook something or shower. If I need to do some any assignment for the next day, I would wake up at 2:30am to do it.
So, for the past few weeks, I haven't been eating or resting well. My standard of hygiene has fallen, and my room is in a big mess.
Plus, I feel bad that I'm not doing enough for medsin as I hold the vice president post. To be honest, I don't really know what the way forward is. My job is to liase with the projects and make sure the projects get the support they need. The thing is no one from the project has contacted me for help, so I assumed that they're all doing ok. I'm not really looking for work to do at the moment. I know I should be communicating more frequently with the projects but I just have no energy or time left to do that. In addition, I have my own Crossing Borders project to coordinate (At the same time, Gemma the co-coordinator is also have a stress-related break down). Also, there seems to be a communication problem within the medsin manchester committee. I have a feeling that people are not too happy with me but they are not saying it. This is really frustrating because everyone may think that I'm a bitch but I don't know what the problem is. Medsin is a constant source of headache I wonder why I took up the position in the first place. And for the past two weekends, I've been away from Manchester to attend national medsin events.
Luckily papa and mummy relationship problem has eased off a bit. It was quite emotionally taxing to be a mediator between the two of them over the summer.
So, as for last week, I was at least still quite motivated to read through stuff I've picked up in the ward and clinics. But now I just don't feel like doing anything. The medical team in the ward is nice. Janet who is a consultant has learnt my name and has started to boss me around to do stuff in the ward, but I like it. The other doctors have been really kind to me as well that now I'm beginnning to feel like part of the team. Maybe that's why I feel that I need to know everything I've learnt in the ward in order to not appear stupid.
I have yet to tear but I'm having a really hard time controlling it. Hopefully I'll be able to get some good rest this weekend and get my balance right again.
So, for the past few weeks, I haven't been eating or resting well. My standard of hygiene has fallen, and my room is in a big mess.
Plus, I feel bad that I'm not doing enough for medsin as I hold the vice president post. To be honest, I don't really know what the way forward is. My job is to liase with the projects and make sure the projects get the support they need. The thing is no one from the project has contacted me for help, so I assumed that they're all doing ok. I'm not really looking for work to do at the moment. I know I should be communicating more frequently with the projects but I just have no energy or time left to do that. In addition, I have my own Crossing Borders project to coordinate (At the same time, Gemma the co-coordinator is also have a stress-related break down). Also, there seems to be a communication problem within the medsin manchester committee. I have a feeling that people are not too happy with me but they are not saying it. This is really frustrating because everyone may think that I'm a bitch but I don't know what the problem is. Medsin is a constant source of headache I wonder why I took up the position in the first place. And for the past two weekends, I've been away from Manchester to attend national medsin events.
Luckily papa and mummy relationship problem has eased off a bit. It was quite emotionally taxing to be a mediator between the two of them over the summer.
So, as for last week, I was at least still quite motivated to read through stuff I've picked up in the ward and clinics. But now I just don't feel like doing anything. The medical team in the ward is nice. Janet who is a consultant has learnt my name and has started to boss me around to do stuff in the ward, but I like it. The other doctors have been really kind to me as well that now I'm beginnning to feel like part of the team. Maybe that's why I feel that I need to know everything I've learnt in the ward in order to not appear stupid.
I have yet to tear but I'm having a really hard time controlling it. Hopefully I'll be able to get some good rest this weekend and get my balance right again.
Friday, October 19
Getting better
These two weeks, particularly this week have been productive eventhough I actually spent less time on the ward compared to the first week. We are getting braver at voicing our concern for lack of quality teaching to registrars. I also found myself communicating a little more to the medical team, which obviously makes life easier even if it only means that one of the consultant has learnt to recognise that I'm a medical student attached to the renal ward.
Just going to summarise what I did this week:
Monday: Teaching for the whole day, learnt catheterisation, otherwise unproductive
Tuesday: Went to contact lens clinical trial in the morning and earned 20pounds. HPN clinic in the afternoon - very very good, learnt loads.
Wedsnesday: Consultant ward round-learnt about CV exam, leg exam, enterocutaneous fistula, read observation chart, anti-anginal drugs, pCO2 etc - very useful, consultant said 'the medical student don't know anything but very enthusiasted', took it as a compliment. Practised venupuncture and cannulation on dummies, getting steady. Clerked two more patients. Watched ST insert a femoral line and the nurse preparring and finishing dialysis.
Thursday: Good clinical teaching on abdo exam. Took a history togather with 3 other people in my group as part of the teaching(... sort of realise that my history taking being more systematic). PBL on renal artery stenosis - especially enjoyable because I've picked up quite a good amount of renal medical knowledge.
Friday: First time in theatre for Permcath insertion, wore oversized scrubs (size S). Dr was nice, cared to explained things to me, nurses was friendly showing me around. Also discussed an SLE patient's management with the doctor and learnt immunosuppressive therapy. Went to ward and took blood from two patients. One failure (stabbed him 3 times still no blood...) and one success (at my first go!) [overall venupuncture stats - 3 successes 2 failures]. Examine a lady's abdomen and took a history from a chap who spoke very little English.
Mummy asked if I'm quite busy nowadays because I'm seldom online. Indeed, I'm really busy. I shouldn't be, there's only 6 hours of scheduled teaching in a week in our timetable. We are expected to fill up the rest of the time ourselves (self-directed learning). I think I've done fairly well in maximising the learning opportunities available. I lack sleep every night because I was trying to do so much reading about conditions or procedures I've learnt during the day. But its been really exciting. I love renal medicine!
Just going to summarise what I did this week:
Monday: Teaching for the whole day, learnt catheterisation, otherwise unproductive
Tuesday: Went to contact lens clinical trial in the morning and earned 20pounds. HPN clinic in the afternoon - very very good, learnt loads.
Wedsnesday: Consultant ward round-learnt about CV exam, leg exam, enterocutaneous fistula, read observation chart, anti-anginal drugs, pCO2 etc - very useful, consultant said 'the medical student don't know anything but very enthusiasted', took it as a compliment. Practised venupuncture and cannulation on dummies, getting steady. Clerked two more patients. Watched ST insert a femoral line and the nurse preparring and finishing dialysis.
Thursday: Good clinical teaching on abdo exam. Took a history togather with 3 other people in my group as part of the teaching(... sort of realise that my history taking being more systematic). PBL on renal artery stenosis - especially enjoyable because I've picked up quite a good amount of renal medical knowledge.
Friday: First time in theatre for Permcath insertion, wore oversized scrubs (size S). Dr was nice, cared to explained things to me, nurses was friendly showing me around. Also discussed an SLE patient's management with the doctor and learnt immunosuppressive therapy. Went to ward and took blood from two patients. One failure (stabbed him 3 times still no blood...) and one success (at my first go!) [overall venupuncture stats - 3 successes 2 failures]. Examine a lady's abdomen and took a history from a chap who spoke very little English.
Mummy asked if I'm quite busy nowadays because I'm seldom online. Indeed, I'm really busy. I shouldn't be, there's only 6 hours of scheduled teaching in a week in our timetable. We are expected to fill up the rest of the time ourselves (self-directed learning). I think I've done fairly well in maximising the learning opportunities available. I lack sleep every night because I was trying to do so much reading about conditions or procedures I've learnt during the day. But its been really exciting. I love renal medicine!
Wednesday, October 3
Disappointing start
So I held high expectations. So I should have been warned. Firm attachment isn't as exciting as I thought it would be. Renal ward is good. I recon I will learn a lot not only about the urinary tract, but also the cardiovascular as well as the respiratory system. But I'm just kind of lost. The consultant just told us to clerk lots and lots of patients, and attend time tabled ward rounds and teaching. Did not bother to introduce us to the medical and nursing team in the wards. So you can imagine the staff seeing us as just 'some medical students' buzzing around the ward. Patients are nice. Only sometimes a little crowded, having eight of us in the ward at one time. Medical staff are not very enthusiasted to teach, just looked busy all the time. No, we don't feel like part of the team at all at the moment. It was just quite pointless being there besides opportunity to clerk patients and browsing through the electronic patient records. Clinical teaching sucks. Two person presented a case each, and the doctor commented on the history taken. No discussion, no teaching and little learning.
Maybe it's me. I should make some readjust my own expectations.
Maybe it's me. I should make some readjust my own expectations.
Friday, September 21
Unfortunate fate with bicycle - I NEARLY DIE!
I am back at Manchester for the third year of my medical course. The course now is based at Hope Hospital, which is about 7 miles away from where I live. Since I was informed that I will be placed at Hope, I have planned to cycle to the hospital everyday. Cyclist friends have been telling me how refreshing and amazing cycling is and I am of course absolutely convinced, being such a natural cyclist - I have never fall off my bicycle before - until this week.
Before buying the bicycle, I did think long and hard about the distance, the traffic, the maintenance etc. While I had those potential worries, I am sorely tempted by the prospect of burning off 800+ calories per day and saving money on transportation. So I bought a bicycle - Trek T10 for ladies which costs 276 pounds including helmet, light and puncture resistance tyres. I actually wanted a second hand one but they didn't have them on the store, so I chose the cheapest one available. This was last Saturday.
Excitedly, I thought I would try out the route to Hope on Sunday morning. I went out at around 7:30 as that was not a peak hour for traffic. Cycling was great, I enjoyed the breeze and the sense of freedom. The bits uphill was quite a bit of hard work, but it was not too bad for me. It took me about 50 minutes to an hour to reach my destination. Good job! After a quick rest, I started to make my way back home. Then I arrived at an roundabout tunnel. It was a downhill slope and I thought I could control the bicycle. I took the risk and I fell, abrasing my knee. But that was no big deal. The disaster came next. I was just at Chorlton Road when the paddle wouldn't go forward anymore. I pulled over and inspect the bike. An portion of the inflated bit of the front tyre was butting out of the wheel... what a scary sight! I tried in vain to force the it in. After a few minutes, there was a loud bang on the tyre, followed by another explosive bang. At that point, I was at least 5 miles away from home and I need rescuing... So I called Lauren to pick me and my bicycle up with her car, and luckily she was really kind enough to spend her Sunday morning helping me. And on Tuesday, I spent 2 hours dragging the bicycle with the punctured tyre to the shop for repair.
As I would not judge a person by first encounter, I was determined to count my fate with this bicycle because of this incident. Yesterday, again, I cycled first along Rusholme and Oxford Road to the student union for the freshers fayre. That was fine. Later on I made my way to Hope - another smooth journey. I managed to arrive in 40 minutes! After our venupuncture and cannulation session, I followed Tess to cycle back home. She cycled really quickly... About a mile away from the hospital, I tried to change lane by hand signal and the tyre sort of got trapped into the tram railing and I fell off my bike. This time was much scarier. I fell on the road and if the car at the back had not brake in time, I would have been run over. Disorientated for a while, I quickly regain my height, pull the bicycle to the pavement. A lady was asking me if I was all right, said loads of things to me but I just remembered that she said the tram line is known to be dead slippery.
I sat on the pavement for a half a minute to get my bearing. I stood up again, looked at the bike - the steering was twisted and locked to one side, the brake line and the chain came off. A fellow cyclist helped me put my steering facing forward again and put the brake line back. I fixed the steering alignment and the chain. But I decided that the bike was not safe to be ridden, and I was not safe to be riding, so I push the bicycle back to Hope's bicycle shed and went to A&E and get my wound on my knee and my hips sorted - don't worry, they only involve the skin. I was more worried of head injuries as the helmet did hit the road (having learnt about the effects of subdural hemorrhages etc). But I thought I was ok, still being able to push the bike all the way back and play sudoku in the waiting area. In A&E, the nurse gave me paracetamol while the doctor covered my knee with a dressing and gave me a tetanus jab. Then I left my bicycle locked at the hospital shed and took the tram back.
Now it's time for the pertinent question again: to cycle or not to cycle? I was first really put off by the punctured tyre on my first ride and now this accident seems to be an obvious indication for me not to continue cycling. True, I may be on my way making a nearly 300 pounds loss and daily deficit in 800+ calories burnt; but still, I can't risk my own life. When not at the verge of death, I always feel that death is nothing to be feared of. But at situation such as this accident, I was making a completely different stand. I don't want to die yet. I still have plenty of things to learn. I have yet to take a complete history from a patient. I have not tried abdo and respiratory examination on real patients. My effort in bringing my family together is still very much needed. I just have so much things to do. So, I've made up my mind. I will not take the risk of cycling anymore. I will no longer be cycling to Hope.
Before buying the bicycle, I did think long and hard about the distance, the traffic, the maintenance etc. While I had those potential worries, I am sorely tempted by the prospect of burning off 800+ calories per day and saving money on transportation. So I bought a bicycle - Trek T10 for ladies which costs 276 pounds including helmet, light and puncture resistance tyres. I actually wanted a second hand one but they didn't have them on the store, so I chose the cheapest one available. This was last Saturday.
Excitedly, I thought I would try out the route to Hope on Sunday morning. I went out at around 7:30 as that was not a peak hour for traffic. Cycling was great, I enjoyed the breeze and the sense of freedom. The bits uphill was quite a bit of hard work, but it was not too bad for me. It took me about 50 minutes to an hour to reach my destination. Good job! After a quick rest, I started to make my way back home. Then I arrived at an roundabout tunnel. It was a downhill slope and I thought I could control the bicycle. I took the risk and I fell, abrasing my knee. But that was no big deal. The disaster came next. I was just at Chorlton Road when the paddle wouldn't go forward anymore. I pulled over and inspect the bike. An portion of the inflated bit of the front tyre was butting out of the wheel... what a scary sight! I tried in vain to force the it in. After a few minutes, there was a loud bang on the tyre, followed by another explosive bang. At that point, I was at least 5 miles away from home and I need rescuing... So I called Lauren to pick me and my bicycle up with her car, and luckily she was really kind enough to spend her Sunday morning helping me. And on Tuesday, I spent 2 hours dragging the bicycle with the punctured tyre to the shop for repair.
As I would not judge a person by first encounter, I was determined to count my fate with this bicycle because of this incident. Yesterday, again, I cycled first along Rusholme and Oxford Road to the student union for the freshers fayre. That was fine. Later on I made my way to Hope - another smooth journey. I managed to arrive in 40 minutes! After our venupuncture and cannulation session, I followed Tess to cycle back home. She cycled really quickly... About a mile away from the hospital, I tried to change lane by hand signal and the tyre sort of got trapped into the tram railing and I fell off my bike. This time was much scarier. I fell on the road and if the car at the back had not brake in time, I would have been run over. Disorientated for a while, I quickly regain my height, pull the bicycle to the pavement. A lady was asking me if I was all right, said loads of things to me but I just remembered that she said the tram line is known to be dead slippery.
I sat on the pavement for a half a minute to get my bearing. I stood up again, looked at the bike - the steering was twisted and locked to one side, the brake line and the chain came off. A fellow cyclist helped me put my steering facing forward again and put the brake line back. I fixed the steering alignment and the chain. But I decided that the bike was not safe to be ridden, and I was not safe to be riding, so I push the bicycle back to Hope's bicycle shed and went to A&E and get my wound on my knee and my hips sorted - don't worry, they only involve the skin. I was more worried of head injuries as the helmet did hit the road (having learnt about the effects of subdural hemorrhages etc). But I thought I was ok, still being able to push the bike all the way back and play sudoku in the waiting area. In A&E, the nurse gave me paracetamol while the doctor covered my knee with a dressing and gave me a tetanus jab. Then I left my bicycle locked at the hospital shed and took the tram back.
Now it's time for the pertinent question again: to cycle or not to cycle? I was first really put off by the punctured tyre on my first ride and now this accident seems to be an obvious indication for me not to continue cycling. True, I may be on my way making a nearly 300 pounds loss and daily deficit in 800+ calories burnt; but still, I can't risk my own life. When not at the verge of death, I always feel that death is nothing to be feared of. But at situation such as this accident, I was making a completely different stand. I don't want to die yet. I still have plenty of things to learn. I have yet to take a complete history from a patient. I have not tried abdo and respiratory examination on real patients. My effort in bringing my family together is still very much needed. I just have so much things to do. So, I've made up my mind. I will not take the risk of cycling anymore. I will no longer be cycling to Hope.
Wednesday, June 27
Year 2 results
At last, the results of year 2 medical exams are out.
Semester 3 test: Honours
Semester 4 test: Honours
Progress test (Sem 3): Honours
Progress test (Sem 4): Distinction
OSCE (Sem 3): Satisfactory
SSC (Sem 4): Satisfactory
Overall: 2 Honour points
I'm really delighted about my first distinction ever in medical school. Way to go for me!
Semester 3 test: Honours
Semester 4 test: Honours
Progress test (Sem 3): Honours
Progress test (Sem 4): Distinction
OSCE (Sem 3): Satisfactory
SSC (Sem 4): Satisfactory
Overall: 2 Honour points
I'm really delighted about my first distinction ever in medical school. Way to go for me!
Saturday, June 9
My sisters
I've long wanted to write about my four younger sisters.This first photo is taken in 2005 I think in Langkawi before I flew to England for the first time. Clockwise from left: Wan Lee, Yee Leng, Yee Yen (me), Wan Cheng and Wan Teng.
Yee Leng is two years younger than me and is currently working as a Kindergarten teacher and a part time tuition teacher. I think she's the only one out of the five of us who thinks success in life = earning lots of money and be a strong businesswoman that sort of thing. In everything she does, she does her best. Very talented in creative stuff, she's not particularly as academically gifted as some of us in the family are. I can imagine that this has been quite hard for her because mummy (especially) tend to compare her results with my results, eventhough I think her results is always already quite good. Mummy expects almost perfect results (like straight As equivalent) and this often upsets herself and Yee Leng. Yet, Yee Leng shines in the world outside the academia. She was a national level drama champion in secondary school. She often impressed her boss when she did part time sales job after SPM, and seems to excel in dealing with people. She is also the only one the family who has several boyfriends and break ups already. Always seen quarrelling with papa, her opinions are sometimes brushed off because papa thinks that 'she's not mature enough', and Yee Leng has learnt avoiding talking to papa. She plans to study Mass Communication and find a job related to public relation earn lots of money in the future.
Wan Cheng is two years younger than Yee Leng. She's a bit like me, always work hard and often lucky enough to be rewarded with good results in exams (up to mummy's expectation at least). But she doesn't seem to be as lucky as I am. For example, I got into BBGS/Seri Bintang Utara at my first attempt while she didn't manage that after several attempts. (She nevertheless made full use of her time at Seri Bintang Selatan.) She also didn't manage to get a scholarship to study medicine even with her starling results. I feel guilty at times because it feels to me as if I have stolen all her luck. Wan Cheng basically gets along well with everyone in the family, I think because of her ability to listen well and adapt in situations. She also learn Taekwondo and Piano like me - and she's now at higher grades than me in both things! I tell her lots of stuff about my course and she gets really fascinated by physiology, pharmacology, neuroscience stuff. She's potentially a deep thinker and has a great ambition of establishing herself as a scientific researcher. She has just started Biomedical Sciences in UTAR. And I should also say that she's obviously lucky enough to have a high metabolic rate - no matter how much she eats she would not go fat!
Wan Lee is three years younger than Wan Cheng. She's still in form 3 in SMK Cheras. She used to be very shy, timid and have low self esteem back in primary school. It could be due to the competitive chinese primary school environment where if you are not exceptionally good in your studies, you would not be valued. I pointed that out to her at the start of her secondary school and encourage her to voice out her opinion. Now radical changes has happened to this young lady. Wan Lee holds important position in her school's librarian board and is among the top students in her class. I'm so proud of her. She's now not afraid to say what she thinks and would argue with me at times though she's ultimately a peace lover- it's still actually quite hard to get her aggressively fired up about something. She's clearly a good singer, having won numerous prizes for singing and choir competition. She's also progressing well in violin. She's not yet reveal her real talent in life and she's not sure what she'd like to be in the future. But she did tell me that the learnt violin because she wants to join some philharmonic orchestra... I assumed that that's a back up plan? Anyway bright future for this young lady who has transformed into a well opinionated person who has a sense of purpose in her life.
Wan Teng, as also known as Miss Manja, is three years younger than Wan Lee, and 10 years younger than me. Everyone in the family would describe her as intelligent but lazy. I would even say that she's more intelligent than I am. But she doesn't really care whether she gets into the top class or not and things like that. And I think that's perfectly fine as she should be enjoying childhood while in primary school. Just have to be careful not to let her make the lackadaisical attitude a habit. Eventhough she usually gets what she wants as the youngest in the family, she's quite sensible in knowing what to do and what not to do. For example, as a prefect in standard five, she's told me once that she stood up against a standard six prefect because the older prefect was abusing her power to punish students. She loves playing badminton with me, but I hate playing with her because she's so lousy. (But I will still play with her because other people in the family are too lazy to get out of the house). She's very active in her school choir and has won a few competitions. I bought a diary for her a few years ago and she writes very cute and interesting entries, and I notice her English vocabulary expanding. She's asked me not to fly back home on the 14th of June because it's her birthday - to avoid me getting all the attention -how childish!
Finally, my sisters and I would not be who we are today without mummy and papa. Don't be deceived by their apparently happy faces in the picture. They have somewhat similar yet clashing opinions resulting in them having cold and outright war in the house through the years. I sometimes disagree with them but now am having more and more 'adult chat' with them. I'm hoping to be able to apply those Cognitive Behavioural Therapy/Counselling/Psychotherapy skills I've learnt to resolve their problems. It's going to be hard, but I really want my parents to be happy after all they've done for the all of us. Wish me luck and I shall look forward to a perfect happy family by the end of my summer vacation. (Too idealistic...)
Monday, June 4
Examining life
Bearing in mind that I will be super free and relaxed for the next two weeks before I head back to KL, I went to the Manchester central library today to borrow a few books. The book I am reading at the moment is called Philosophy for Dummies.
I have actually done bits of philosophy in MARA College Banting as part of the Theory of Knowledge (TOK) subject in the International Baccalaureate programme. Fascinating subject, never had enough of it. I remember enjoying myself thinking hard to come up with coherent arguments in TOK. We debated lots of random topics on dream, sources of knowledge, abortion, the hudud law, pornography, languages, perception, ethics, first human landing on the moon etc. I only wish that we were allocated as much time to study TOK as math or chemistry.
I took this book today after having an interesting conversation with Lizz yesterday on metaphysics. Lizz is a medical student in Bristol who has just finished her intercalated degree on Medical Humanities and English Literature. I know in college many of my friends simply don't see the point of having such 'time-wasting' subject like TOK, and I can see why. Sometimes you can just go on and on arguing for ages without coming to any conclusion, or worse find yourself back to square one.
Personally I wouldn't spend years studying a degree on philosophy but it can be something very nice to think and write about in my free time. I recall when I was four or five years old, I was playing with a neighbour kid (HanHan) at the front yard, and soon her mother called his name and ask him to go back home. Then it suddenly occured to me the questions: Why am I me? Why am I not born as HanHan? What if I have my body but a mind of HanHan or vice versa? Why do I only call my own parents papa and mummy ever since I was born and not respond to other parents? I don't remember the moment I was born: Could there be someone else sitting in my body then? Why is it that I can control what I want to think and I can control my own body, but I can't control what HanHan thinks and does, or that of my sisters? And again, why am I myself, not HanHan or my other sisters? I ran into the house and asked papa these questions. He said "I don't know, you'll have to ask God". Well, he didn't mean it because our family don't believe in God. I didn't think much about it until college time when we study TOK. I've also been examining these things since my late teens by reading religious books (mainly on Buddhism).
Am I still the same person as I was at four years of age? Yes, because I've still not resolved those questions and no, because I'm different now in that I have opinions, skills, knowledge, life principle and more questions. Sometimes when I reflect upon what I've achieved in life, I couldn't believe that I am actually myself. Looking at my own reflection on the mirror, this person actually looks fairly pretty, confident, perfect almost, and she has proven to be rather intelligent, hardworking and ambitious. She simply couldn't be me! She is someone I've envisioned myself to be back in school. I want to be like her but... am I her now? Obviously yes, I have achieved my vision and I am her. But what now? Mmmm good question Yee Yen, what now? Maybe I should keep on refusing to believe that the person in the mirror and Yee Yen that everyone knows at this moment is in fact not myself.
I have actually done bits of philosophy in MARA College Banting as part of the Theory of Knowledge (TOK) subject in the International Baccalaureate programme. Fascinating subject, never had enough of it. I remember enjoying myself thinking hard to come up with coherent arguments in TOK. We debated lots of random topics on dream, sources of knowledge, abortion, the hudud law, pornography, languages, perception, ethics, first human landing on the moon etc. I only wish that we were allocated as much time to study TOK as math or chemistry.I took this book today after having an interesting conversation with Lizz yesterday on metaphysics. Lizz is a medical student in Bristol who has just finished her intercalated degree on Medical Humanities and English Literature. I know in college many of my friends simply don't see the point of having such 'time-wasting' subject like TOK, and I can see why. Sometimes you can just go on and on arguing for ages without coming to any conclusion, or worse find yourself back to square one.
Personally I wouldn't spend years studying a degree on philosophy but it can be something very nice to think and write about in my free time. I recall when I was four or five years old, I was playing with a neighbour kid (HanHan) at the front yard, and soon her mother called his name and ask him to go back home. Then it suddenly occured to me the questions: Why am I me? Why am I not born as HanHan? What if I have my body but a mind of HanHan or vice versa? Why do I only call my own parents papa and mummy ever since I was born and not respond to other parents? I don't remember the moment I was born: Could there be someone else sitting in my body then? Why is it that I can control what I want to think and I can control my own body, but I can't control what HanHan thinks and does, or that of my sisters? And again, why am I myself, not HanHan or my other sisters? I ran into the house and asked papa these questions. He said "I don't know, you'll have to ask God". Well, he didn't mean it because our family don't believe in God. I didn't think much about it until college time when we study TOK. I've also been examining these things since my late teens by reading religious books (mainly on Buddhism).
Am I still the same person as I was at four years of age? Yes, because I've still not resolved those questions and no, because I'm different now in that I have opinions, skills, knowledge, life principle and more questions. Sometimes when I reflect upon what I've achieved in life, I couldn't believe that I am actually myself. Looking at my own reflection on the mirror, this person actually looks fairly pretty, confident, perfect almost, and she has proven to be rather intelligent, hardworking and ambitious. She simply couldn't be me! She is someone I've envisioned myself to be back in school. I want to be like her but... am I her now? Obviously yes, I have achieved my vision and I am her. But what now? Mmmm good question Yee Yen, what now? Maybe I should keep on refusing to believe that the person in the mirror and Yee Yen that everyone knows at this moment is in fact not myself.
Stress over
Exams are over and I'm feeling much more relaxed now. Don't ask me how exams went.
I've just came back from the Medsin South West Training Day with Joel and Tolani. Trainers from Manchester (Tolani, Joel and I), Peninsula (Sarah and Jen) and Bristol (Lizzy) joined forces to conduct a training for medical schools in the South West of England. It was held at Exeter on Saturday. Both the trainers and the trainees had an amazing time. I ran a workshop on Leadership with Tolani and another workshop on Teambuilding and Communication with Sarah. I am so glad that people enjoyed the games I created and was really pleased meeting and working togather with people I met in TNT. Here are some pictures taken on the training day.
I've just came back from the Medsin South West Training Day with Joel and Tolani. Trainers from Manchester (Tolani, Joel and I), Peninsula (Sarah and Jen) and Bristol (Lizzy) joined forces to conduct a training for medical schools in the South West of England. It was held at Exeter on Saturday. Both the trainers and the trainees had an amazing time. I ran a workshop on Leadership with Tolani and another workshop on Teambuilding and Communication with Sarah. I am so glad that people enjoyed the games I created and was really pleased meeting and working togather with people I met in TNT. Here are some pictures taken on the training day.
Sunday, May 27
Qualifying exams for doctors
MALACCA: Medical graduates who studied overseas may have to sit for a unified medical examination and, whether their university is recognised or not, a pass in the examination would allow them to practise in Malaysia.
Health Minister Datuk Seri Dr Chua Soi Lek said this would ensure these graduates had the required standard and quality to practise medicine in the country.
He said the ministry was discussing the matter with the Malaysian Medical Council (MMC), adding that Malaysia recognises 344 universities for medical studies.
“We cannot continue giving recognition to more and more universities because we have to evaluate and monitor their standards from time to time.
“We are also not capable of doing so as there are more than 300 universities,” he told reporters after opening the 17th annual general meeting of the Federation of Alumni Associations of Taiwan Universities here yesterday.
Dr Chua said the local unified medical examination had to be introduced as a long-term solution.
“We want to maintain the quality and standard of our doctors.
“It would be disappointing if, one day, Malaysians lose confidence in their own doctors.
“So we should not focus on quantity. The standard is more important,” he said, adding that there had lately been a drop in the quality of doctors.
Among the causes was the medical students' lack of commitment. Many took up the course not because they were interested in medicine, he said.
Dr Chua said these students only believed they had to be doctors because of their excellent results in the SPM and STPM examinations.
“We have implemented a programme where we try to get them accustomed to a hospital environment for five days.
“At the end of it, we see about 10% of them pulling out of the course.
“What we want is commitment and passion which is lacking,” said Dr Chua, adding that the ministry would increase the number of course days to between seven and 10 next year.
He said that so far, the Government recognised eight Taiwanese universities and 250 of the graduates had registered to become doctors, 120 as dentists and 57 as pharmacists.
The Malaysian Medical Association said that although a unified medical examination for overseas graduates was good, it had to be well thought out.
Association president Datuk Dr Teoh Siang Chin said the examination could be conducted in three parts, comprising practical, written and viva voce.
“The plan will not work with the candidate sitting for just one paper. It could take between two and three days,” he said when contacted yesterday.
MMC president Tan Sri Dr Ismail Merican said the examination would remove the problem of varying standards as a result of graduates coming from different universities.
The move would also see the MMC not being taxed with issues such as paperwork and conducting inspections on medical schools, which are time-consuming.
Mmmm..... Though I probably have nothing to fear (except communicating in Malay with patients after not speaking the language for a while...), after 1001 exams in medical school, we still have to prove our worth when we come back home? Stress!!! Have I just landed myself in a profession with most exams ever? Some of my friends might just not come back home and continue working in the UK... Will write more when after my last paper on Tuesday, my brain's not right at the moment...
Health Minister Datuk Seri Dr Chua Soi Lek said this would ensure these graduates had the required standard and quality to practise medicine in the country.
He said the ministry was discussing the matter with the Malaysian Medical Council (MMC), adding that Malaysia recognises 344 universities for medical studies.
“We cannot continue giving recognition to more and more universities because we have to evaluate and monitor their standards from time to time.
“We are also not capable of doing so as there are more than 300 universities,” he told reporters after opening the 17th annual general meeting of the Federation of Alumni Associations of Taiwan Universities here yesterday.
Dr Chua said the local unified medical examination had to be introduced as a long-term solution.
“We want to maintain the quality and standard of our doctors.
“It would be disappointing if, one day, Malaysians lose confidence in their own doctors.
“So we should not focus on quantity. The standard is more important,” he said, adding that there had lately been a drop in the quality of doctors.
Among the causes was the medical students' lack of commitment. Many took up the course not because they were interested in medicine, he said.
Dr Chua said these students only believed they had to be doctors because of their excellent results in the SPM and STPM examinations.
“We have implemented a programme where we try to get them accustomed to a hospital environment for five days.
“At the end of it, we see about 10% of them pulling out of the course.
“What we want is commitment and passion which is lacking,” said Dr Chua, adding that the ministry would increase the number of course days to between seven and 10 next year.
He said that so far, the Government recognised eight Taiwanese universities and 250 of the graduates had registered to become doctors, 120 as dentists and 57 as pharmacists.
The Malaysian Medical Association said that although a unified medical examination for overseas graduates was good, it had to be well thought out.
Association president Datuk Dr Teoh Siang Chin said the examination could be conducted in three parts, comprising practical, written and viva voce.
“The plan will not work with the candidate sitting for just one paper. It could take between two and three days,” he said when contacted yesterday.
MMC president Tan Sri Dr Ismail Merican said the examination would remove the problem of varying standards as a result of graduates coming from different universities.
The move would also see the MMC not being taxed with issues such as paperwork and conducting inspections on medical schools, which are time-consuming.
Mmmm..... Though I probably have nothing to fear (except communicating in Malay with patients after not speaking the language for a while...), after 1001 exams in medical school, we still have to prove our worth when we come back home? Stress!!! Have I just landed myself in a profession with most exams ever? Some of my friends might just not come back home and continue working in the UK... Will write more when after my last paper on Tuesday, my brain's not right at the moment...
Friday, May 18
Monday, May 14
CAGE questionnaire
CAGE questionnaire is a set of questions used by medics as a quick screen for alcoholic. I am applying these set of questions to screen for my addiction towards the internet.
1. Have you ever felt you should CUT down on going online?
YES
2. Have people ANNOYED you by criticising you going online?
NO
3. Have you ever felt bad or GUILTY about going online?
YES
4. Have you ever go online first thing in the morning to steady your nerves or get rid of a hangover (EYE- opener)?
YES
I am indeed an internet addict.
1. Have you ever felt you should CUT down on going online?
YES
2. Have people ANNOYED you by criticising you going online?
NO
3. Have you ever felt bad or GUILTY about going online?
YES
4. Have you ever go online first thing in the morning to steady your nerves or get rid of a hangover (EYE- opener)?
YES
I am indeed an internet addict.
Saturday, May 5
Ridiculous!
How come I can still find time blogging? hehe... trying to make myself feel guilty - I SHOULD BE STUDYING FOR THE EXAMS NEXT WEEK!!! ok... after this. Promise myself - Will definitely definitely definitely finish the case on the liver before I go to bed tonight, even if it means no sleeping for me.
What is so ridiculous? Three things I read from online Malaysian newspapers.
1. Make aliens pay medical bills
http://thestar.com.my/news/story.asp?file=/2007/5/5/nation/17641968&sec=nation
Has The Star caught up with the recent rampant use of indecent of words by the many fame-seeking politicians? The government has a point of not subsidising cost of medical care for foreigners, but why do we have to call them alien? It is not as if these people are filthy rich folks exploiting our national resources, these are poverty stricken Indonesians and Filipinos who probably have no where else to turn to. If they have no mercy at all for these sick people, at least show some sign of civilization in speech and writing.
2. Zainuddin proposes classifications of bloggers
http://www.nst.com.my/Current_News/NST/Saturday/NewsBreak/20070505190240/Article/index_html
I am personally against any sort of regulation on the world of blogging. It's simply stupid. I am a Petronas scholar and I am actually not supposed to criticize the government or say anything that is sensitive - and I have not. But I firmly believe that Malaysian are mature enough to be given some space and freedom to discuss about issues affecting us. It pains me to read reports nearly on a daily basis on government trying to impose views on us. I visit many Malaysian blogs regularly, and I have just realised that our country is just full of people who are actually great thinkers and can argue eloquently. And these blogs are making readers think, debate problems and find solutions. Malaysians are actually using our brains for good!!! I see this as a sign of progress of our people and our nation from 'just accept everything decided by our leaders' to 'we all have a role to play, and I want my voice heard'. Malaysia as a country, had a history of people reacting disproportionately aggressively to stupid remarks sensitive to religion, race, political ideology etc. But I think we have come a long way, and are grown up now. Leaders are still treating us like little babies, that everything we do needs to be scrutinized. I am telling you, at this rate, Malaysia will never grow up.
3. Siren chasers to be fined on the spot
http://thestar.com.my/news/story.asp?file=/2007/5/5/nation/20070505071106&sec=nation
OK, I agree that Malaysians have a bad habit of trailing siren-ed vehicles to beat the traffic. That is not fair. I also agree that drivers who obstruct emergency vehicles like ambulance and fire engine should be fined (not that our ambulances have that kind of lifesaving sense of urgency). I only have a problem with this statement being released after two policemen died after they rammed into a car that came to a sudden halt at a junction while escorting a VVIP. I don't know the whole situation but seems to me that this is a mere unfortunate accident. I always think VVIP should not have the privilege to light-speed on the roads, but I suppose they have earned it being born/elected/appointed to the position. While escorts are trained to speed, they should also have been trained to look out for own and the public safety since their job of speeding and intimidating/bullying other motorists to give way does involve some risks. To put the blame on ordinary motorist, I think, is not very fair.
OK. Enough of ranting for now. I also want to show you myself in the news. Check out these websites:
http://www.manchester.ac.uk/aboutus/news/display/index.htm?id=114474
http://www.nst.com.my/Current_News/NST/Friday/National/20070427080225/Article
Now I shall immerse myself into the world of the hepatobiliary system. Err... dark green yucky bile juice... taste bitter. I know because I had to clean up a patient who made a big mess vomiting and pooing bile before.
What is so ridiculous? Three things I read from online Malaysian newspapers.
1. Make aliens pay medical bills
http://thestar.com.my/news/story.asp?file=/2007/5/5/nation/17641968&sec=nation
Has The Star caught up with the recent rampant use of indecent of words by the many fame-seeking politicians? The government has a point of not subsidising cost of medical care for foreigners, but why do we have to call them alien? It is not as if these people are filthy rich folks exploiting our national resources, these are poverty stricken Indonesians and Filipinos who probably have no where else to turn to. If they have no mercy at all for these sick people, at least show some sign of civilization in speech and writing.
2. Zainuddin proposes classifications of bloggers
http://www.nst.com.my/Current_News/NST/Saturday/NewsBreak/20070505190240/Article/index_html
I am personally against any sort of regulation on the world of blogging. It's simply stupid. I am a Petronas scholar and I am actually not supposed to criticize the government or say anything that is sensitive - and I have not. But I firmly believe that Malaysian are mature enough to be given some space and freedom to discuss about issues affecting us. It pains me to read reports nearly on a daily basis on government trying to impose views on us. I visit many Malaysian blogs regularly, and I have just realised that our country is just full of people who are actually great thinkers and can argue eloquently. And these blogs are making readers think, debate problems and find solutions. Malaysians are actually using our brains for good!!! I see this as a sign of progress of our people and our nation from 'just accept everything decided by our leaders' to 'we all have a role to play, and I want my voice heard'. Malaysia as a country, had a history of people reacting disproportionately aggressively to stupid remarks sensitive to religion, race, political ideology etc. But I think we have come a long way, and are grown up now. Leaders are still treating us like little babies, that everything we do needs to be scrutinized. I am telling you, at this rate, Malaysia will never grow up.
3. Siren chasers to be fined on the spot
http://thestar.com.my/news/story.asp?file=/2007/5/5/nation/20070505071106&sec=nation
OK, I agree that Malaysians have a bad habit of trailing siren-ed vehicles to beat the traffic. That is not fair. I also agree that drivers who obstruct emergency vehicles like ambulance and fire engine should be fined (not that our ambulances have that kind of lifesaving sense of urgency). I only have a problem with this statement being released after two policemen died after they rammed into a car that came to a sudden halt at a junction while escorting a VVIP. I don't know the whole situation but seems to me that this is a mere unfortunate accident. I always think VVIP should not have the privilege to light-speed on the roads, but I suppose they have earned it being born/elected/appointed to the position. While escorts are trained to speed, they should also have been trained to look out for own and the public safety since their job of speeding and intimidating/bullying other motorists to give way does involve some risks. To put the blame on ordinary motorist, I think, is not very fair.
OK. Enough of ranting for now. I also want to show you myself in the news. Check out these websites:
http://www.manchester.ac.uk/aboutus/news/display/index.htm?id=114474
http://www.nst.com.my/Current_News/NST/Friday/National/20070427080225/Article
Now I shall immerse myself into the world of the hepatobiliary system. Err... dark green yucky bile juice... taste bitter. I know because I had to clean up a patient who made a big mess vomiting and pooing bile before.
Tuesday, May 1
I am stupid
I slept when I shouldn't have. So many things in my mind. Shouldn't have taken up so many things that I cannot handle. Stupid me. Now I cannot do anything right. Nothing is going right. I am the stupidest person in the world.
Monday, April 30
Down
Today is a sad day. Things were not done to perfection. Just depresses me. And have been feeling useless. I am useless. What can I do? Nothing. I am useless. Just like rubbish. I only live to pretend. So now I am going to continue burying myself in books.
Tuesday, April 24
Thursday, April 12
Long day, tiring but sweet
I broke my personal record of working for the longest hour. Yesterday, I went out at 6:15am and did not come back home until 10:30pm. It was bloody tiring, but unusually satisfying. This was how I spent my day yesterday:
0730 - 1330 Stroke Rehabilitation Ward
1400 - 2130 Medical Assessment Unit (MAU)
Part 1: Seeing patients with neurological problems
I am big big fan neuro stuff. In the stroke unit, I cared for many patients having the symptoms exactly the described in books: flexed upper limb, extended lower limb, general weakness on one side, expressive aphasia etc. I also saw how remarkable physiotherapy, occupational therapy and speech and language therapy were in helping these patients regain their day-to-day function. The ward was one of the most multidisciplinary ward I have ever seen. In MAU, I saw quite a few patients with Parkinson's disease (I have actually seen quite a few Parkinson's patients with varying severity since I started working). I witnessed the classical triads of resting tremor, rigidity and bradykinesia and was surprised by how drugs can change a patient's quality of life for the better.
Part 2: Emotional drain
I suppose the one disadvantage of working in acute units like A&E, MAU or SAU is that I will be the first one to introduce patient to the feeling of lossing your dignity for being sick and being under my care in hospital. In hospital, we are often so concerned with safety and preventing falls that we make patient use commodes, bedpans and pads, or that every steps that patients make all the way to the loo (and yes, including taking off your pants and sitting on the toilet) needs to be supervised. All these must be quite a shock to many patients. Yesterday, I actually saw tears from three patients because of all these nightmares that they were subjected to (and perhaps also because of their illness). I was sorry but I had no choice. All I can do was to try my best to comfort them.
Part 3: My sweet experience
Firstly, it was especially sweet because, out of no reason, everyone that I met yesterday, staff and patient alike, made an effort to remember my name. That was such a rare thing because usually people would give up remembering my name as it is quite hard to pronounce. One patient did give up and ended up calling me 'Yeeeeha', and I did not mind since he was a stroke patient (who had not completely regain his speech function). Such a fun group of people to work with. And I had been called 'a nice nurse' and 'a nice girl' by patients so many times yesterday, got a kiss and a pad on my shoulder. Words simply cannot describe I proud I was with myself. I am inexperienced but in every shifts I work, I take extra care to satisfy the patients' needs and preserve their dignity. Hearing comments like that just made me feel on top of the world.
0730 - 1330 Stroke Rehabilitation Ward
1400 - 2130 Medical Assessment Unit (MAU)
Part 1: Seeing patients with neurological problems
I am big big fan neuro stuff. In the stroke unit, I cared for many patients having the symptoms exactly the described in books: flexed upper limb, extended lower limb, general weakness on one side, expressive aphasia etc. I also saw how remarkable physiotherapy, occupational therapy and speech and language therapy were in helping these patients regain their day-to-day function. The ward was one of the most multidisciplinary ward I have ever seen. In MAU, I saw quite a few patients with Parkinson's disease (I have actually seen quite a few Parkinson's patients with varying severity since I started working). I witnessed the classical triads of resting tremor, rigidity and bradykinesia and was surprised by how drugs can change a patient's quality of life for the better.
Part 2: Emotional drain
I suppose the one disadvantage of working in acute units like A&E, MAU or SAU is that I will be the first one to introduce patient to the feeling of lossing your dignity for being sick and being under my care in hospital. In hospital, we are often so concerned with safety and preventing falls that we make patient use commodes, bedpans and pads, or that every steps that patients make all the way to the loo (and yes, including taking off your pants and sitting on the toilet) needs to be supervised. All these must be quite a shock to many patients. Yesterday, I actually saw tears from three patients because of all these nightmares that they were subjected to (and perhaps also because of their illness). I was sorry but I had no choice. All I can do was to try my best to comfort them.
Part 3: My sweet experience
Firstly, it was especially sweet because, out of no reason, everyone that I met yesterday, staff and patient alike, made an effort to remember my name. That was such a rare thing because usually people would give up remembering my name as it is quite hard to pronounce. One patient did give up and ended up calling me 'Yeeeeha', and I did not mind since he was a stroke patient (who had not completely regain his speech function). Such a fun group of people to work with. And I had been called 'a nice nurse' and 'a nice girl' by patients so many times yesterday, got a kiss and a pad on my shoulder. Words simply cannot describe I proud I was with myself. I am inexperienced but in every shifts I work, I take extra care to satisfy the patients' needs and preserve their dignity. Hearing comments like that just made me feel on top of the world.
Monday, April 9
Fire Alarm
Why am I blogging at 9am? Because I just triggered the fire alarm in my flat. Luckily it's holiday and only five of us are in the flat. I left the grill turned on to toast bread for about 5 minutes and when I get down to the kitchen, there were clouds of smoke already. Just when I started panic, the fire alarm went off. O dear.... I turned off the grill, opened the window and went out to look for the security guard to turn the alarm off. I told the guard that I left the grill on and he was really nice, said that accident happens. Here I am, without my toast this morning, still having shivers from the accident just now. I will never leave the kitchen with appliances on again.
Thursday, April 5
Update
Life has been boring. It's Easter break now. Thought I want to work for a bit more over holiday. But Apex didn't call me. Maybe they are confused with my availability. Anyway it doesn't really matter. I'm enjoying myself having a relaxing time. Have the usual frustrated-with-myself thing about promising to do work but too lazy to get going. I'll be alright. I must finish portfolio by this weekend and get going with the PBL cases next week.
Mummy and pa is fighting again. Mummy said she wants to live separately with pa. I kind of see this coming. Mummy asked me to tell pa about it but I can't bear myself saying it because I just don't think it's right. I know I am not likely to be able to sort out their problem but I really ought to get back home asap. It's stressing out my younger sisters who have to listening to them quarrel (or not talk to each other) everyday. Family is the only thing I've got and I'm not going to let it go just like that. Cheng and YeeLeng are both stressed due to decisions about higher education.
I have been shortlisted as one of the 12 finalist for the International Student Award organised by the British Council. That means I will be £1000 richer! Brilliant! Also, I am also one of the 8 in the UK to be trained as a trainer for Medsin. That means I'll be able to conduct workshops in medical student conferences and learn interesting ways to run meetings etc. I'm so excited!
Mummy and pa is fighting again. Mummy said she wants to live separately with pa. I kind of see this coming. Mummy asked me to tell pa about it but I can't bear myself saying it because I just don't think it's right. I know I am not likely to be able to sort out their problem but I really ought to get back home asap. It's stressing out my younger sisters who have to listening to them quarrel (or not talk to each other) everyday. Family is the only thing I've got and I'm not going to let it go just like that. Cheng and YeeLeng are both stressed due to decisions about higher education.
I have been shortlisted as one of the 12 finalist for the International Student Award organised by the British Council. That means I will be £1000 richer! Brilliant! Also, I am also one of the 8 in the UK to be trained as a trainer for Medsin. That means I'll be able to conduct workshops in medical student conferences and learn interesting ways to run meetings etc. I'm so excited!
Monday, March 12
A record number of As?
This country is developing obsessive compulsive disorder towards the number of As. Guess how many As the best student in SPM got? 19! Well, I would like to say well done to the girl. She deserves it. It's the people's reactions that really bother me. The MP (or whoever) in her area made a big banner (with her face across) to congratulate her, students in her ex-school lined up 2km to welcome her. Is that necessary? Tomorrow the newspapers will be filled with her 'story of success'. Honestly, they are so pathetic!
Every year, all these will be on the news right after public exams results are announced. My question is: why take so many subjects in the first place? The thing is if people are taking so many subjects for the sack of getting the As and making the front page, then something is wrong somewhere. There could be other possibilities: student life is hard - only the very best gets the scholarship.
No matter how you see it, most teenagers are not yet that rational in their thinking, and this applies to the very intelligent ones as well. If I can blame someone for this, I would put the blame on the media for making these top scorers such celebrities. I also blame policy makers in scholarship provisions and universities admissions for there overemphasis on academic results. OK, yes they do take into account co-curriculum, but there is no way, for example my sister YeeLeng who was a national level drama champion and who stayed back everyday in school for various activities (until mummy got so angry with her)with 7As would beat the 19As candidate regardless of her co-co status. Won't you agree? If you ask me, I think if you throw both my sister and the 19As girl into the world, my sister would actually be the one who survives and thrives at the end*.
*But actually this is a bit biased because this sister of mine is a bit more gifted than normal people, so it'll be unfair to compare with normal people - I'll dedicate another entry about her.
OK, enough sourgrapes now. I would like to extent my congratulations to my second sister WanCheng for achieving 12 As in her SPM! Wualawei... Bloody hell that's really amazing! Didn't know she can actually beat me! (Please, no sourgrape again) Hope she is lucky enough to get a scholarship to study medicine. I have come to know a lot people who decided to take up medicine just because they get straight As, but cross my heart I'd say that it's not the case for Cheng. She has a genuine genuine interest and curiousity towards human physiology and would get so excited and fascinated whenever I tell her how things work in our body. Good luck sis!
Every year, all these will be on the news right after public exams results are announced. My question is: why take so many subjects in the first place? The thing is if people are taking so many subjects for the sack of getting the As and making the front page, then something is wrong somewhere. There could be other possibilities: student life is hard - only the very best gets the scholarship.
No matter how you see it, most teenagers are not yet that rational in their thinking, and this applies to the very intelligent ones as well. If I can blame someone for this, I would put the blame on the media for making these top scorers such celebrities. I also blame policy makers in scholarship provisions and universities admissions for there overemphasis on academic results. OK, yes they do take into account co-curriculum, but there is no way, for example my sister YeeLeng who was a national level drama champion and who stayed back everyday in school for various activities (until mummy got so angry with her)with 7As would beat the 19As candidate regardless of her co-co status. Won't you agree? If you ask me, I think if you throw both my sister and the 19As girl into the world, my sister would actually be the one who survives and thrives at the end*.
*But actually this is a bit biased because this sister of mine is a bit more gifted than normal people, so it'll be unfair to compare with normal people - I'll dedicate another entry about her.
OK, enough sourgrapes now. I would like to extent my congratulations to my second sister WanCheng for achieving 12 As in her SPM! Wualawei... Bloody hell that's really amazing! Didn't know she can actually beat me! (Please, no sourgrape again) Hope she is lucky enough to get a scholarship to study medicine. I have come to know a lot people who decided to take up medicine just because they get straight As, but cross my heart I'd say that it's not the case for Cheng. She has a genuine genuine interest and curiousity towards human physiology and would get so excited and fascinated whenever I tell her how things work in our body. Good luck sis!
Saturday, March 10
Aging
Ever since I started seeing patients and working as a health care assistant, I kept telling myself that I would not want to get any older than retirement age. I seem to have equated an old age with being dependent, mentally sluggish, slow and unproductive. Patients tell me that even having a catheter hanging is like a nightmare to one's dignity already, imagine having to be fed, washed and moved around using hoist everyday. I have also realised that I have taken the fact that we are able to move around and express our wishes freely for granted. It's really stressful enough for me to deal with immobile and mute patients in the wards, imagine what is it like for relatives and how frustrated it is for the patient themselves - 1. not being able to speak their mind 2. being a burden to other, feel guilty. So I have decided that I don't want to be old.
Then recently, I have begin to change my mind. I met some individuals in their 70s and 80s are still able to maintain an active life. They don't need people to help them wash or go to the toilet. They are still able to enjoy life with their families and friends. My grandma at the age of 70ish before she passed away was able to walk two miles a day to and from the market and keep the house in perfect order. So I was thinking, should I just get old anyway and see which way I would end up? I think I will actually review this when I'm at my 40s or 50s.
This is such a rubbish post...
And I have to say that you can be sluggish at any age. For example, I bang my forehead on the wall just when I was about to go to sleep. Hurts.
Then recently, I have begin to change my mind. I met some individuals in their 70s and 80s are still able to maintain an active life. They don't need people to help them wash or go to the toilet. They are still able to enjoy life with their families and friends. My grandma at the age of 70ish before she passed away was able to walk two miles a day to and from the market and keep the house in perfect order. So I was thinking, should I just get old anyway and see which way I would end up? I think I will actually review this when I'm at my 40s or 50s.
This is such a rubbish post...
And I have to say that you can be sluggish at any age. For example, I bang my forehead on the wall just when I was about to go to sleep. Hurts.
Thursday, March 1
Exam results
Hello all
Just got my exam results. Relieve to have passed everything but not too excited because the grades are not up to my (and important others') expectations. I received honours grade for two papers (Semester and progress tests) and satisfactory grade for OSCE.
Semester test was really good (two more marks to distinction in fact), perhaps because I really really enjoyed studying the brain and its accesories and told myself I HAVE TO NAIL IT - It's now or never.
Progress test - eventhough it's an honour, I got 48 this time compared to 50 last time, which is a BIG WARNING for me to BE SERIOUS about bucking up and NOT BE COMPLACENT.
OSCE - Just got satisfactory grade. I received 81% (quite impressive actually) which is unfortunately just two marks away from the honours grade. I could have gotten the honours grade - I'm not in denial here but dead serious. I swear I did everything right and deserve full marks (100) in the Cranial nerves testing station but only got 58 marks - What The Hell?! O Well.. at least the results would do me some good - I.e. forcing myself to work harder next time.
I just can't believe how kiasu I am now. Perhaps it's because I'm really feeling the competitiveness among my peers now. Everyone is really serious about their studies now. Back in the first year, I would have been the only one in the group who have completed the anatomy worksheet before dissection. But now I can hardly find anyone who haven't read up before a session. Also I am allocated into a really bright group this semester. Kind of starting to feel a bit insecure about myself...
I also feel a bit of pressure from my parents as well. When I was having my exams, mummy and pa said it's ok not to get honours grade, as long as I have tried my best. But now, it's been almost 24 hours since I sent each of them a text messege regarding my results and I still haven't heard from them... They must be a bit unhappy or disappointed that I haven't manage all honours this time. Lots of internal conflicts and external pressure right now. Can't really talk to anyone about it. Feel sick.
Just got my exam results. Relieve to have passed everything but not too excited because the grades are not up to my (and important others') expectations. I received honours grade for two papers (Semester and progress tests) and satisfactory grade for OSCE.
Semester test was really good (two more marks to distinction in fact), perhaps because I really really enjoyed studying the brain and its accesories and told myself I HAVE TO NAIL IT - It's now or never.
Progress test - eventhough it's an honour, I got 48 this time compared to 50 last time, which is a BIG WARNING for me to BE SERIOUS about bucking up and NOT BE COMPLACENT.
OSCE - Just got satisfactory grade. I received 81% (quite impressive actually) which is unfortunately just two marks away from the honours grade. I could have gotten the honours grade - I'm not in denial here but dead serious. I swear I did everything right and deserve full marks (100) in the Cranial nerves testing station but only got 58 marks - What The Hell?! O Well.. at least the results would do me some good - I.e. forcing myself to work harder next time.
I just can't believe how kiasu I am now. Perhaps it's because I'm really feeling the competitiveness among my peers now. Everyone is really serious about their studies now. Back in the first year, I would have been the only one in the group who have completed the anatomy worksheet before dissection. But now I can hardly find anyone who haven't read up before a session. Also I am allocated into a really bright group this semester. Kind of starting to feel a bit insecure about myself...
I also feel a bit of pressure from my parents as well. When I was having my exams, mummy and pa said it's ok not to get honours grade, as long as I have tried my best. But now, it's been almost 24 hours since I sent each of them a text messege regarding my results and I still haven't heard from them... They must be a bit unhappy or disappointed that I haven't manage all honours this time. Lots of internal conflicts and external pressure right now. Can't really talk to anyone about it. Feel sick.
Wednesday, February 21
Accident
Sorry for being a little jakun but today for the first time in my life I witness a collision accident. I had quite a busy day and was rushing off and waiting at the Piccadilly Garden platform for my volunteering at Reache. The tram to Altrinham started moving while I was still at the platform waiting for the next tram to Eccles. Then about 2 seconds later, I heard a long honk and the tram came to a complete stop. A few people were running across the rail and I asked a girl who was covering her mouth in shock what happened. She told me a guy was ran over and trapped under the tram. 'Goodness!', I thought. By that time there were a swarm of people surrounding the tram and I can see the poor guy's legs under the head of the tram, with the body and head facing the tram. I was not sure if he was alive them - to be honest I was dead scared for him as the way he was trapped looked pretty hopeless. The first thing I thought was - Have anyone rang 999? I saw the tram driver making calls, so I presumed he did. Then I contemplated on going forward and say 'I'm a second year medical student'. But he was still stuck underneath there and I guess the only thing I know, which is basic life support would not be much help then as I can't possibly get underneath. The emergency response was really good. Barely a few minutes after the collision, the police van came, followed by a paramedic in bicycle (as it is very difficult for ambulance to moving around quickly in the city centre). A minute later two police on horses came to control the crowd, and finally the fire engine arrived. By that time, the guy had already been safely pulled out of the underneath. I think he was alright. I saw him sitting up leaning against the tram before I headed off to the next tram platform. No blood, and he was conscious. He might have sustained some head injury and internal bleeding, but no immediate resuscitation was needed.
Witnessing accident really got me thinking. I have considered A&E as a speciality that I want to work in after I graduate, but would I be able to cope well with the patient assaulted by high impact, blunt penetrating injuries, bleeding and being in pain, dealing with uncertainty at the same time staying calm and make the decisions like cutting off a limb to preserve life? I think I would have gone forward and do CPR on him today if necessary but the real test comes when I am really faced with the situation. I thought about road safety as well. I am one of those who always run across the road or tram railing when I am not supposed to. Obviously we think we can beat the car or the tram, but sometimes we just can't judge them. Better to be safe than sorry. The tram involved in the accident was actually going really slow, yet still caused such a trauma. I will never run in front of a moving tram ever again. I also saw some ugly characters: Can you believe that some people were actually taking pictures of the guy trapped underneath the tram using digital cameras and mobile phones? That's just despicable!
And now, I need to finish my PBL work on bowel cancer and preparation for dissection for tomorrow. Too bad that I can't use the excuse of being a bit traumatised.
Witnessing accident really got me thinking. I have considered A&E as a speciality that I want to work in after I graduate, but would I be able to cope well with the patient assaulted by high impact, blunt penetrating injuries, bleeding and being in pain, dealing with uncertainty at the same time staying calm and make the decisions like cutting off a limb to preserve life? I think I would have gone forward and do CPR on him today if necessary but the real test comes when I am really faced with the situation. I thought about road safety as well. I am one of those who always run across the road or tram railing when I am not supposed to. Obviously we think we can beat the car or the tram, but sometimes we just can't judge them. Better to be safe than sorry. The tram involved in the accident was actually going really slow, yet still caused such a trauma. I will never run in front of a moving tram ever again. I also saw some ugly characters: Can you believe that some people were actually taking pictures of the guy trapped underneath the tram using digital cameras and mobile phones? That's just despicable!
And now, I need to finish my PBL work on bowel cancer and preparation for dissection for tomorrow. Too bad that I can't use the excuse of being a bit traumatised.
Sunday, January 21
I HATE EXAMS
I have never felt so pessimistic for a while. I think I might as well just give up and play computer for the next two days. I'll be having OSCE (Objective Structured Clinical Exams) on Tuesday, Thursday and Friday. I can see that I'll be screwing up the anatomy station, possibly all other stations as well. I have no energy whatsoever to look at printed material related to medicine at this point. Please let this week be over quickly. I can't bear trying again and again looking through the books, then lose concentration, then start all over again then lose concentration again. Zero confident for everything at the moment. Hope I'll pass. Not even asking for honours. Just a pass... Exam sucks. And I hate medicine.
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