Vietnam

My first reaction when my parents announced that we were going to Vietnam for a holiday trip was .....'Huh? Why Vietnam of all places? Why can't we go to Korea or Japan instead?'
I wasn't really looking forward to going to the country, to tell the truth.

The first thing I noticed upon arrival in the country- the traffic. Oh my gosh. More than half of the vehicle population over there are motorbikes. And I always complain about motorbikes swerving right in front of me when I'm driving. Imagine the entire road of motorbikes. Very few traffic lights. Traffic moving freely about, cutting into each others lanes. I am so not driving in Vietnam!

The place we stayed in was a budget hotel, more like rooms rented out to tourists. It has all the basic facilities such as aircon, TV, comfortable beds and ensuite, and it's cheap, so I can't complain. There are plenty of these type of hotels over there.

I realized that there are many tourists in Saigon (Ho Chi Minh City). The city is such a popular tourist destination, you can see tourists everywhere! As a result, you can see bars, souvenir shops, and English books everywhere.

The Vietnamese people, they are very friendly. They have smiles on their faces, and they are a cheerful lot. They can speak conversational English, although it's hard to understand their English at times. I heard they can speak some French too, although I didn't hear the language being spoken among the locals.

We went on a tour around the city on the second day- where we were brought to the War Musuem, The Reunification Palace, and the market. The following day, we followed the Mekong river tour, where we met two nice Vietnamese girls and one Malaysian girl from Batu Pahat.
Actually, most of the stuff we saw in the second day- can be found in Malaysia too. :p

Anyways, it was a memorable trip. I enjoyed bargaining with the locals, walking along the streets of Vietnam and making friends with the local girls. :)

Semester 6

Half a year ago, I was totally dreading it. The start of clinical school. I even went to the extent of saying that it was my 'death sentence'. I imagined pure torture, no life whatsforever.

Now, half a year later, I'm still alive and well, thank you. Clinical school is certainly not as bad as I originally expected. Sure, there might be some busy times, but I can cope with it.
My housemates and I still have the time to go out for neals together and movies during the weekends. Workload....not so bad, we only have on call once a week (not including covering ward for case presentations). Lecturers, most of them are fine, some lecturers are nice even! The most they would say is 'What have you been learning for the past 2.5 years?'

My first posting was Surgery. We were thrown into the wards the very first day itself. So of course we were a bit aimless for the first couple of weeks. Clerking surgery patients, witnessing endoscopy and surgeries....learning about the entire GI system, breasts and thyroid. The only lecturer to watch out for....he's not that bad actually. We learn a lot from him.

Second posting....Internal Medicine. A bit more busy compared to surgery, as we have to make it a point to clerk patient's daily. Case presentations almost every day. But IMO, we learn the most from this posting. The lecturers taughts us every single system, and many common diseases. And we were taught how to perform thorough physical examination of every system in the body.
Most of my friends I know enjoy this posting the most. It is fun to come up with differential diagnoses for a patient, because one single symptom can lead to many different possibilities. Some lecturers in this posting are nice too.

Third posting....Family Medicine. The supposedly most relaxing posting of all. Well, the first four weeks were certainly not that relaxing, we had to follow the lecturers clinics. But this posting is the most planned and structured posting of all 3. I wish I had started with this posting first, because this lecturer made it a point to lead and guide us along the way, so we wouldn't be lost. If only we had this sort of guidance for the other postings....
Anyways, I enjoyed this posting a lot. I loved sitting in the lecturers air-conditioned clinics, I loved observing how the lecturers deal with patients. I love how in the primary healthcare system, the patient is looked as a whole, and not as a disease. I think that prevention is better than cure. Maybe, just maybe, I would become a GP in the future, we'll see. ;) And yes, like I mentioned in my previous post...I recall fondly the Kampung Angkat project, the school health visit, the MCH and MO clinics....
And of course, during this posting, I had the time for other things as well. The trip to Malacca, the eating out, the Gala dinner, the trips down to KL.....

Yes, so now I've officially completed one semester of clinical school. :) 4 more to go, I graduate and real torture begins!

A flurry of activities!

Wow, I've been kept occupied these past couple of weeks! So many things happened..

1) The Kampung Angkat visit last Saturday

We went to an Orang Asli village called Kampung Tekir. We took measurements, and took developmental and diet history from the people there. I learnt to take a proper diet and paediatric history, as well as learn about the culture of the orang Asli people. I also got to go for a home visit. There were two babies, a girl and a boy. The baby girl was actually the baby boy's aunt! No kidding. But the children were so cute. And we got to sit on a tractor! It was such a fulfilling visit :)

2) Tun Dr. Mahathir comes to IMU!

Yes, no kidding. On Tuesday, my batchmates and I took 2 buses down to the Bukit Jalil campus, to attend a dialogue session between us students and our beloved ex-prime minister, Tun Dr. Mahathir. I can still recall clearly when our country was under his rule....our country became a very fast developing country. He was the one who introduced Vision 2020, he was the one who introduced the Multimedia Super Corridor, the PetronasTwin towers, the Sepang Circuit, the KL Tower, were all built during his time as the prime minister. And he was the one who put our country on the map of the world. Because of him, people from other countries know Malaysia.

And so yes, I actually got to see him and listen to him in person! What an experience :)

I didn't really get to talk to him though, because after the session, so many people crowded around him!

3) School Health visit

Today, me and my groupmates followed a group of HTJ nurses to a secondary school in the outskirts of Seremban. The nurses were to give the Form 3 students there Tetanus jabs.

Our jobs were to perform health checks for the students. It was a great experience, and the students reminded me of myself 10 years ago! And it seemed like yesterday when I was in Form 3....

Fam Med

So begins my 3rd posting, Family Medicine posting.


So far, the first week has been lectures, lectures and nothing else. Boring.

But hopefully next week things will pick up when I get attached to the Klinik Kesihatan Seremban.

It's supposedly the easiest posting, so hopefully I can do well in this posting, especially since I haven't been doing well theory wise for the first 2 postings.

I leave you with some recent pictures of mine.

p.s. I have been gaining weight. Yikes!

Lazy me

I'm supposed to be happy....it's the start of a brand new posting tomorrow. And the supposedly easiest and most relaxing posting- Family Medicine.

Well, I'm glad that Surgery and Internal Medicine postings are over, and that all I have left of semester 6 is Family Medicine.

But still, I feel lazy to come back to Seremban. A one week holiday/ break just isn't enough!
I feel like I had not enough rest.

How is lazy me going to be an intern, ermm....I mean houseman like this? :p

One week holiday...a much needed break.

Been resting a home, watching Grey's with mum, doing IM and practising IV injections in mum's shop, etc. And going online, uploading long overdue photos to Facebook (I found my camera cable, yay!). And my newest addiction on Facebook, Pet Society. I love my Ailee :)
Released my pet tortoise, Kelly, yesterday. To symbolize freedom. Am going to get a new pet tortoise today, and going to name it Izzie. (Here's to hoping it doesn't get sick like Izzie).

And I have a brand new haircut!

Who knew that doing good to others can backfire on you? Who knew that a gesture of kindness to some people turns out to be an inconviencence to others? I just want to do good, I just want to be a kind person, but in the end, I made a big mistake by being kind.

lazy.....

I'm getting lazier and lazier to blog. I somehow find Facebook, watching my favourite shows which I download and listening to romantic songs on Youtube more exciting past times compared to blogging. <_< I need some sort of motivation to blog again!

Anyways, if last week we had only one case presentation, which resulted in me waking up not so early almost every morning and feeling lazy, this two weeks will be the busiest weeks I've had so far. Clerking patients, then case presentations , then TBLs, then studying for upcoming exams in 2 weeks time. So much to study, so little time!

I had my 2nd Mini CEX today, which went ok, I was systemic in my physical examination, but I moved the patient too many times. And had to be prompted a little to reach the diagnosis and investigations. But on the whole, the feedback was pretty encouraging :)

That's about it for now.....signing off peeps!

Ailing

Latest updates

Arrghh.....so many things happened over the past week, but I was so lazy to blog :p

1. Watched 2 movies- Slumdog Millionaire(better be good as it won 8 Academy Awards) and Angels and Demons (which was great)

2. Had my first Mini CEX, which fortunately for me was held by my Internal Med tutor who is one of the nicest Internal Med lecturers you can find. But....he held my Mini CEX in front of all my groupmates. So they were all there to witness my humilitation! :p Just kidding. I was actually grateful they were there to support me through my Mini CEX. :) History taking was fine for me, I need to improve on my physical examination techniques though.

3. Had a scary Case Presentation on Wednesday. The lecturer was harsh to all of us who presented that day, but particularly harsh to the first presenter. He was a bit harsh to me to when I presented, but that's ok. Not so bad. Finally at the end of the CP, he said he was strict on us because he wants us to be perfect.

4. Clerked some patients with sad stories. E.g., one patient who has 7 children, but lives in a welfare home. He claimed that all his illness started ever since he started living there one year ago. Another patient, whose whole life turned upside down ever since his wife died many years ago. He never fully recovered from the loss.

5. The health scare! One patient here in HTJ died of Meningitis last week. Some students who were in contact with the patient, senior batches I think, were given prophylaxis. My housemates said they clerked one meningitis patient on Wednesday, don't know whether it was the same patient. Please let it not be!
And of course, the H1N1 influenza virus has finally reached Malaysia. Oh joy. A student took a flight back to Penang from USA recently. Welcome to Malaysia.
It's only a matter of time before the virus reaches Seremban and we all will be wearing masks in the hospital. *shudders*

Hmmm.....what should I tell you about Internal Medicine?

a) Clerking patients in Port Dickson Hospital (who are mostly cooperative and friendly as they are more relaxed over there) ,
b) case presentations with lecturers (especially one lecturer who is nice, and he teaches us in very detail about CNS examination),
c) Task based learning (TBL) sessions- we learnt that we have to prepare our cases in powerpoint presentation

I despise driving, but I still drove down to Port Dickson from Mon-Wed, and even KL on Saturday (my first time driving down to KL, heh)

And now I've got to prepare for my TBL presentation tomorrow and research for my research project proposal due next week.

And prepare for the Mini-CEX exam next Tuesday.

Oh well.....at least I have 'Grey's Anatomy' to cheer me up. (Please don't die, Izzie! You were a beautiful bride. Alex and the rest of them would be devastated if you do. And Meredith and Derek, it's your turn to get hitched......) The only thing, the season finale is next week....and after that no more Grey's until September. :( Wonder whether leading actress Ellen Pompeo would have had her baby by then. If not, I think it's a good idea to write the pregnancy into the show. Great twist to Meredith and Derek's relationship....Hah! :)

p.s. Happy Mother's Day!!!

I love you, mum!!

Why is she better than me in everything?
Why is she so well-liked?
So confident?
Good looking?
So organized?
Why when I'm with her, I'm like her shadow?
She outshines me in everything.

I am fine....I am fine....
Just trying to shake 'the incident' off my mind. It seems to be sticking to my mind like a parasite and draining the energy off me. Usually, I feel just fine, but this past couple of days, I just can't feel like myself.
It's my fault....I have only myself to blame..
Anyways, let's just treat it as a learning experience.

It has nothing to do with Internal Med- which so far is ok, quite relaxing....since we go to Port Dickson to clerk one case and then have case presentation...
Internal Med case presentations are later compared to Surgery ones....
And oh....Internal Med lecturers actually teach in much more detail compared to Surgeons.

Ok, have to do my on call report now....Why Internal Med got on call report ? We didn't need to do On Call Reports in Surgery....

The End of Surgery Posting

Finally....I have successfully completed my very first posting in Clinical School....Surgery posting.
7 long, tiring, but exciting weeks.
I'll have memories of waking up early in order to join the ward rounds....and then ending up not really gaining much from the rounds anyways.....:p
Memories of covering the entire ward among the 6 of us in the subgroup.....the night before case presentations with DK. And the memory of myself 'stumbling' during our final case presentation with him. Well, we all did in some way or another. We made him 'sweat' for not being able to properly describe a swelling, not able to properly describe an ulcer, and not being able to present a proper summary! (in my case).
Memories of the TBL sessions... (in which I admit I slept in some of them:p) which became much more interesting after a 'particular incident' (a near feud).
Memories of the night on call sessions (especially at the A&E).....where we got to witness a variety of cases and procedures.
Memories of the self visits to the venepuncture unit..
Memories of the operation theatre, and all the surgeries I've witnessed.
Memories of the patients I clerked.....all had different personalities, come from different races and backgrounds.... some were more coorperative than others.
Memories of some of the chats I have with the patients, memories of being told off by the family member of a patient...

Ahh....so many memories.... :)

And as for today's end of posting exam.....my very first clinical school exam.....well, it went ok.
The lecturer (I got Dr. IA), would chose a patient, and give you about 40 minutes to an hour to clerk the patient- take a complete history, and do physical examination on the patient. Then after the time is up, you'll have to present the case individually to the lecturer, and he'll ask you some questions.
I went off to quite a rocky start, having left my marking scheme at home, so had to go back home to take it. When I arrived, the lecturer was already there. He immediately led me to the back of Ward 3B and pointed at a patient. For a moment, I looked at the patient and he looked back at me. I was still sweating from all the running I did earlier on. When I started to talk....I found out....the patient could speak English! That is really rare here in Malaysia! Patient was a Malay male....who presented with incisional hernia. I did tell him that I was sitting for an exam.
He made me at ease....and we even talked a little about my background first....before I officially clerked him. For me, I think that was a blessing.
After Dr. IA returned to the ward, I was the first to present my case to him. He is a nice lecturer, and he guided me in some parts....and he told me which parts I missed out on. I made the mistake of treating the incisional hernia as more of a swelling compared to a hernia itself. As a result, I missed out on asking questions such as whether it could be reduced, whether it reduced when patient was lying down....etc. And I didn't ask the patient to stand up! And didn't really do a thorough examination on the entire abdomen. Oh well. This is my first exam after all, I can improve on it.
But the most important thing is that I passed! I have officially passed Surgery- my first clinical school posting! :)

Now, I have to prepare my heart for Internal Medicine. I am certainly NOT looking forward to that posting. From what I heard, it is even harder compared to Surgery. Because in Surgery, Surgeons are more focused and precise, just focusing on the presenting complaint and the system or organ involved. E.g. when a patient presents with appendicitis, you focus on the abdomen, and not so much on the hearts or lungs. But in Internal Med, I heard you have to cover all your systems. And certain Internal Med lecturers are strict, I heard. Oh well, I'll fully enjoy this weekend first! And will deal with Internal Med when it comes.

One more week....

One more week of surgery to go! Just handed in 3 case summaries and 1 case report today. Next week is my end of posting exam (on Thursday). My first clinical school exam! Nervous. I am going to get Dr. IA as my examiner, he seems ok so far, had presented a case to him on Wednesday. Hopefully it would go on smoothly.

This week, I discovered that:
a) I still cannot feel for invisible veins when performing venepuncture
b) I still cannot side park, in fact, I am horrible in side parking and reversing.

The only unusal thing that happened this week.....I clerked one patient who is an ex-IVDU(intravenous drug user) and a patient who is a prisoner. With handcuffs on and all.
Well, learning not to be judgemental is also part of our training right?

Weekend is here!

I'm just so glad that the academic week is finally over. It seemed like a never ending sequence of covering wards at night (clerking patients for next day's case presentation), case presentations in the morning, clerking more patients, and then outpatient department attachment, or to the operation teatre, then task based learning (TBL) sessions in the afternoon. And not to mention on call on Tuesday nights for me. And I have to visit my CFCS patient at his home this weekend.
But it's all in good fun...We still can afford to go out and enjoy meals with friends, and we watch movies every weekend without fail!
I realised today that learning is not about focusing on passing exams, but actually taking the time to think....why was this particular patient not discharged yet, whether the patient has been advised on what to eat, not eat, not allowed to do after surgery, etc. Only then can we become more compassionate and caring doctors!

Things that I've learnt today....

1) Don't mention the age/race of the patient when presenting the case (it is a sensitive issue). Instead, mention the name of the patient. (this is based on lecturer's preference, I think)
2) Look for the underlying reason for the patient's illness.....think of the chief/presenting complaint of the patient and not just report the entire case
3) Don't ever say that patients are uncooperative- they might be confused, depressed, in distress, in pain, etc.
4) Don't ever mention that you cannot communicate with your patients due to language barrier, etc. Eye contact sufficient for communication! You can tell a lot by looking at a patient's eyes , and by just looking at the patient

Of course, this is just the point of view of one lecturer, but it can be helpful for us in the future.
We still have lots to learn!

What I have accomplished halfway (3.5 weeks) through surgery posting:
a) clerked 30+ patients
b) talked to 50+ patients
c) took 3 blood samples
d) assisted in 5 ECGs
e) observed 10 branula insertions (I want to do one myself, damnit!)
f) witnessed 3 surgeries
g) become translator for doctors
h) learnt to stand for long hours
i) learnt to sleep little
j) learnt to tolerate certain people

Clinical school

2nd week of surgery posting...

Not as bad as I initially expected it to be.
The lecturers are not as fierce as what I expected, except for one particular lecturer ;)
Clerking patients daily, case presentations, Task based learning sessions, clinical skills unit sessions, endosccopy and outpatient department sessions, the night on call sessions.....so far so good....

The only worry I have is....I don't know much! Everyone else seems to know so much, I feel a bit inadequate...not being able to answer questions and explain stuff.... And I can't bring myself to be as enthusiastic as some colleagues of mine. Some people are just so enthusiastic about clinical years!

Latest update

I'm in the middle of orientation week. Never knew that sitting the entire day in a lecture theatre can be that tiring!
From next week onwards, it would be totally different. We are now expected to be 'hospital furniture', not 'library furniture'. We will be making the transition from mugging books to mugging patients, from medical students to student doctors.

I'm currently in William's house using his computer. Li Cin is outside watching TV....she just logged off and then I logged on. We're stranded in William's place, as our 2 other housemates Fang Han and Yee Wei went to play Futsal, but we're just too tired to go support :p

I'm still trying to adapt to life in Seremban and life in clinical school. This week is still orientation week, so we're still trying to have as much fun as possible, going out 'makan' as a batch, visiting others houses, etc. before the actual thing starts next week.

I'm still trying to master the skill of driving in Seremban. Not confident enough yet.

We still do not have internet connection at our place!

Ailing

Is it wrong....

Is it wrong that I'm totally dreading the start of the clinical phase of med school?
Is it wrong that there is this sinking and heavy feeling in my heart whenever I am reminded that I have to go to Seremban in a few days time?
Is it wrong that I am not looking forward to the fact that I have to spend the entire day in uni/hospital- wake up very early in the morning and come home very late at night?
Is it wrong that I am not looking forward to suffering?
Is it wrong that I look to that day, the first day back in uni with trepidation?
Is there anything wrong with me?

25 Random things about myself...

1. I love...and I mean love...titbits and chocolate and icecream
2. I like vegetables, but I don't really like fruits (except grapes and apples)
3. I'm allergic to seafood
4. I get fat very easily
5. I love going online- it's my favourite pasttime
6. I love watching 'Lost','Grey's Anatomy',and 'American Idol.'
7. I just started watching 'House' this holidays
8. I don't enjoy driving
9. I just learnt to sew buttons these couple of days
10. I love spoilers- e.g. checking out a website or message board to see the outcome of an episode of a favourite programme which hasn't been aired
11. I love to flip to the end of a story book, just to know the ending before I start reading the book!
12. I am humble and kind :P
13. I have low self-esteem
14. My mother is my hero and the number one person in my life (after Jesus)
15. I am very grateful to have the Lord Jesus as my saviour
16. Recently, I discovered my love for snapping photos and camwhoring
17. I love beautiful scenery
18. I am still waiting for Mr.Right to come....I dream of meeting him during my housemanship years. Me and housewoman, him an attending (what do you call it over here?) And would give me a kidney in a jar...which glows in the dark...
19. I hate offending people and hurting others
20. I hate quarrels and fights and wars...why can't everyone live in peace with each other?
21. I just had a haircut...my hair grows very fast and thick
22. My personal ambition is to publish a book of my own in the future
23. I have very poor hand skills and coordination
24. I do things very slowly and steadily
25. I love all of you!!

p.s.. I'm not tagging any particular person...just make a list of your own if you feel like it :) This is just so people can know me better.

To M206

The common sentence spoken by almost everyone from the M206 batch is.....'How fast time flies'.
Indeed, I cannot disagree with that statement. It seemed like only yesterday when I first set foot into the building which was actually an abandoned shopping complex. And now....we have already completed our 1st phase of medical studies....and are about to embark on another new journey, another chapter, another phase of our lives. The clinical phase of medical school. Some of us will be flying overseas , while others would be staying in Seremban.
But wherever the next phase of our lives takes us....we will always recall the fond memories we had together in the Bukit Jalil campus. The random outings, the late night birthday surprises, the night mamak sessions, camping in the library, IMU Cup and various other activities....and of course the one that tops it all....our IMU Cup victory!! These memories, we will carry them with us forever, nothing can take that away from us.

I shall now proclaim this.......I am proud to be part of M206...the batch that totally rocks...the batch that manages to conquer every single thing thrown in our way. Remember, we were the 'guinea pigs'...the first batch to have EOS2 instead of EoS1....the first batch to have a few systems crammed into one single summative.....but every time, we managed to get through.
To each and every person in M206, thank you for being a part of my life. :)
Life goes on.....people weave in and out of our lives, some stay longer than others.....but in the end...we will all carry inside our hearts forever the memories of this campus and the friendships forged here.

Good luck to all of you in your future undertakings....may we all emerge as successful doctors in the future!! And remember, it's not how smart you are that matters. As a doctor, what matters the most is being kind, compassionate, caring and
understanding and empathetic towards our patients.

God bless!!

Trip to Sabah

Me and 6 friends went on a trip around Sabah right after our EoS5 exams. We were there for about a week, returning the night before the exam results were released!

It was such a memorable trip..... the first time that I have actually gone travelling with friends!

I really pushed myself to the limit those few days....

Our guide is a civil engineer doing his PhD, who is a friend of a friend of housemate Rachel. He is such a kind person who brought us to many places, explaining everything to us and telling us lots of stories and facts.

The first day, we went shopping around Kota Kinabalu.

Second day, we sat on a speed boat to Manukan Island, where we went snorkelling.

The third day, a driver drove us up to Kundasang. We went jungle trekking and mountain climbing. (twice in a day!)

We actually trekked up Mount Kinabalu for a certain distance before trekking down again. The second time round, we were at the Hot Springs, and wanted to try out the canopy walk. We ended up going a second jungle trek just to reach the canopy walk. And on the way down, we got drenched in the rain. By the time we reached the Hot Springs, we were so exhausted, that we just wanted to soak our feet in the warm water.

The fourth day, we went to the tip of Borneo and Kudat town. Almost the entire day was spent in the van as it had been raining for the whole night, and there were flash floods everywhere, making it difficult to navigate the roads.

The fifth day, back in Kota Kinabalu, we went river rafting. I was a bit apprehensive at first, knowing that navigating a rough river with a small rafting boat could be dangerous. But I went for it anyways, reminding myself that this is a one in a lifetime experience. It was fun at first, as we splashed each others boats. But things got a little dangerous when one of my friends almost floated too far away while body rafting, and one of the river guides had to come to her rescue. And our boat capsized when being hit by a current! I surfaced up soon after going under, and casually swam back to my boat. Well, it is not so scary after all :p Another of my friends almost got pinned under our boat, one of the guides saved her.

The following day, we took a ferry to Labuan. Our guide drove us around Labuan.

The final day, we drove around Labuan some more, and bought plenty of chocolates and a bottle of wine each ( I didn't buy wine though) as a souvenir.

We returned back late that night with plesant memories of the trip which would stay with us forever.

p.s. Photos to be included as soon as I managed to upload them all on Facebook!

p.p.s 5 photos uploaded, to see more, check Facebook!! ;)

2 down, 3 more to go!! 3 more days to go....until temporary freedom.
3 more days to go until I complete (if all goes well) phase 1 of my medical studies...

Ok, now back to slides and Webpath....