Life as a Junior Doctor

Around 2 years ago, I was writing the post: 1 down, 5 more to go and without realising it, I'm in my last posting now. Left with the posting that I dreaded the most: Paediatrics. Everyone has this one particular posting that they dislike the most and for me, Paediatrics is that posting because I'm not really a fan of little humans. 

The Paediatrics posting itself is separated to 2 major subpostings: NICU and General Paediatrics. As I'm currently relocated for the second time due to COVID, but this time in a tertiary hospital. Thus, there are multiple subpostings within general paediatrics such as Oncology, Nephrology and Neuromedical. 

Not sure whether its good luck or not, I started off with General Paediatrics. Everyday is a battle with those little humans. How I miss procedural works on adults (At least they don't shout into my ears). It is a dilemma everyday as you know you can't get mad at them because they are afraid but you are secretly annoyed/tired and just want to get your job done. The few voices that you can hear from outside the procedural room everyday are screams, cries and "Baby Shark Doo doo doo". I have played so much baby shark that its currently no. 1 on my suggested list on Youtube. Other than screams and shouts, we do get some pretty funny stories from the procedure rooms. I have colleagues that were bitten by toddlers (We just wanted to get a little blood :'(), toddlers that fake cry and when you tease them, they become flustered and also children who were not knocked out by 5mg of IV Midazolam prior to lumbar punctures (Adults would have passed out with that dose).

Done my neuromedical sub-subposting last week. It was quite an eye opening experience as I was able to witness all sorts of seizure patterns. I was even able to see a few rare genetic disorders which lead to recurrent seizures. Looking at different kinds of EEG patterns nearly made me cross-eyed (EEG is way beyond my brain capacity to understand). I'm thankful to my specialist who was kind enough to try to explain them to me although I just stared at her blankly the whole time (I was not having absent seizure I think, maybe I need EEG too). Thanks for your patience.

Currently, I am 1 month into this posting and hope I am able to come out of it in 1 piece 😐

Cheers!

1. Screening for patients - I spend a fair share of time rotating among a few community health clinics every week to screen for patients whom fit the criteria of the study. As easy as it may seem, the task could be overwhelming at times due to the huge amount of patients in each clinic. These numbers go up all the way till the thousands.
2. Gaining consent - This is something emphasized and taught since Day 1 of medical school. Before signing up a patient for a study/research, it is important that he/she understands the risks and procedure of the whole shebang. Legally, you could be sued for malpractice and negligence if something unfortunate happens to the patient during the entire study duration for issues pertaining to the study. This is especially important if your research involves the testing of new drugs in the market. SO.....I'm PREEETYYY sure you want to get that part right. 

   Source: claudiajb

3. Data entry and encoding - As the RA, you basically play the role of a secretary because the investigators (usually doctors and specialists) are too busy to be bothered by secretarial work . Data collected has to be keyed into the system for safekeeping. You would not want a fire to wipe out all your study files.
4. Scheduling appointments and follow-ups - Yes. You get be a phone operator too. 
5. Tracing blood reports - More often than not, the nurses in the department would be more than willing to get this done for you. However, as they can get quite busy carrying out orders from other doctors, it is usually faster if you pick up this task yourself.

So what is tagging as a Houseman?
For sure, it is not the game that we used to play as children.


I'm currently in my 5th week of work and the first 2 weeks were compulsory to start as taggers.As a tagger, you are supposed to tag along your senior HO and see how they get things done. Mostly, you are expected to start doing things as a HO with zero knowledge on the work while asking your seniors on how to do this and that.Well, I was glad that I've met some really good and patient seniors to guide me through those 2 weeks and still continues to check up on me now.

The official working hours for a tagger is 7am to 10pm everyday. Yes, you saw it right. Its EVERYDAY. Certain hospitals gives a day off in a week during tagging but some don't. I'm glad mine do because that offday feels like jackpot.

At the end of tagging, there will be an assessment which varies with departments and hospitals. For me, I was only needed to sit in the outpatient clinic to see patients independently to pass it. I've heard some of them needed to reach a quota of certain procedures to pass and some even has written exams.

Overall, tagging is a tough process for both mentally and physically but it is a necessity to learn as much as possible in the shortest amount of time.

My personal experience on tagging was not too bad other than lack of sleep. As I'm in surgical, I am needed in the ward around 5.30am. Thus, I woke up around 4-4.30am everyday. The lack of sleep was taking quite a toll on my body but luckily the 2 weeks passed in a flash. As there is really alot of work to do in a day, the long working hours doesn't really felt that long. But I was really glad to start on normal shift hours to start feeling that I have a life outside of hospital grounds.

For those who are starting on HO anytime soon, you can endure through it! And maybe shed some pounds on the way. Tagging could really involve some serious cardio and intermittent fasting at times.

All the best!

Confidence is something that varies among people. Some are born with it, some work hard to gain it and some believe it is something unobtainable. To me, confidence is something that can be acquired through continuous practice. Like the saying, "Fake it till you make it."

Is it important to have confidence as a medical student or doctor? 
I would answer "yes" to this question and below are a few reasons why I believe so. 
(Below content may contain some personal experiences and made up scenarios)

 

i) Only when you believe in yourself, your patients will believe in you

 

ii) Confidence can improve communication skills

Most important of all, strike a balance between low confidence and overconfidence. Be confident enough to bring you good and not too much until it causes hate. Moderation is the key.