Farewell

So four months have passed and I have finished O&G. I have enjoyed this posting and really would not mind doing it again. The following two points summarises my feeling towards O&G.

Dislike: Treated like slave, too many oncalls (max for me 12 in a month), calling the whole of Peninsular Malaysia hospitals to find ventilator for our prem babies, TDS round, medico-legal issues, having to refer ridiculously simple problems to our registrar (eg: can I give Paracemtamol?), treating doctors I know (most doctors and nurses are at their reproductive age)

Like: My HO friends (Amy and Sha), my specialists (all of them!), my registrars (most of them), daily grand round, presenting cases and getting feedback and teaching, having time of eat, O&G night, labour room calls, caesarean sections, gynae-onco attachment

When I started things were pretty challenging. Including me there were three HOs, but one left a week after I started (he finished) and another one was down and out with depression (and never came back after the long sick leave). So, soon after I started, I was the only HO in the ward. (Déjà vu: I was also the lone HO in the ward when I started in medical, replacing another HO who quitted because he couldn’t cope with the workload). Luckily, the registrars were helpful and specialists were not too fussy. Still, I nearly died on one day, when all the ladies in Cheras decided to fall ill or go into labour at the same time. I clerked in all 9 patients who came rolling in non stop all by myself, whilst having to think about the review VE due, taking baby’s blood, pm round which I haven’t even started (and the ward was full), and with discharges not done yet by 3pm, and nurses and relatives kept asking if I have finished this and that. I was so ready to just drop everything and run out of the damm ward to bury myself under the blanket. But the registrars were ever so understanding and encouraging, so I hang on. With the arrival of another HO came on my second month, the workload was much more bearable and life became a super-relaxing with the arrival of our third HO in my third month.

The nicest thing about O&G is that we save lives, literally, on a daily basis. Babies quite often come out requiring some sort of resuscitation. We do a hell of a lot of caesarean sections to prevent life-threatening complications of pregnancy. But we also deal with death. It is interesting managing cases of intra-uterine death and miscarriages when psychological issues come in.

The hands-on part of O&G is addictive. I found labour room was so enjoyable that that I have requested extra calls (LR rather than ward calls, and it’s easy to get because other HOs generally prefer ward call so they can sleep for more hours at night).

With practice, skills can only get better, and the better I get, the more I want to do it. For example, I started off really dreading suturing the perineum after delivery because I take so long that midwives keep coming into the room to hurry me along, and I almost always had to let someone else take over. There was once the patient whose vaginal wall tear I repaired ended up with a haematoma and I was really scared. What have I done? From then onwards, I really paid attention to how I suture for the wound to heal up nicely. After a while, I was surprised to find that even a clumpsy and slow learner like myself can actually suture. From the second months of the posting, I was confident enough to manage all the perineum repair, easy or difficult, on my own and was proud to not need to call my registrar. Registrars are normally supposed to do the suturing after instrumental deliveries, but I have been asked to do it a few times, and the patients recovered without complication. I started timing myself, learnt to use the forceps rather than my finger to grasp the needle (more difficult, but better to prevent needle stick injury), think how I can improve the cosmetic etc.

I respect doctors who choose to take up O&G. It is certainly not a specialty for the faint-hearted. Trainees are oncall as often as the house officers. Their training can be extended too if they do not perform up to standard. They get bashing from the specialists more often than us. They need to live up the constant pressure. But I can see the attraction. Life is quite good as a specialist with plenty of opportunity for private practice. It is not too difficult and one can really make a difference to people’s lives.

I have really enjoyed O&G and am so sorry I am leaving this fantastic place.

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