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....
Wednesday, April 29, 2009
Thursday, April 23, 2009
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.
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.
Friday, April 17, 2009
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?
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?
Friday, April 10, 2009
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!
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!
Monday, April 6, 2009
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!
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!
Thursday, April 2, 2009
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
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
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