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!

Working in this field has taught me alot about life. One of it is life is very fragile and unpredictable.

Almost everyday or not every other day, I see life seeping out of patients from predictable to unpredictable ones. After pronouncing more than 30+ deaths to family members, I thought this would have made me a tad bit heartless.

Last week, I received a phone call from my sister in the middle of the day while I was busy working. Thinking it was odd for her to call me, I picked up the call. In a very sad tone, she informed me that our paternal grandmother has left us. At that moment itself, I actually felt numb. It felt like another death being pronounced. As I was unable to attend the funeral due to work schedules, I felt guilty but I prayed for her to have a safe journey to the other side.

That night itself, I offered my last respects to my grandmother via videocall. The moment I saw her face, I burst into tears. (Nopes, this job has not made me anymore resilient to all these emotions.) I might not be very close to my grandmother but seeing her for the last time really tugged on my heartstrings. She was very fit and well the last time I saw her (maybe around a year ago?). I wished for her to be at a better place now, away from all the negativity that she was facing in these recent months. 

So people always say that doctors are heartless which I do not think its true. We might pronounced deaths with a pokerface but that is just to maintain our professionalism. A little bit of us still dies inside everytime we face a death especially if its someone dear to us.

Therefore, take care of all your friends that are having a hard time (whether they are doctors or not). Mental health is still a taboo in society nowadays. But it is up to us, to change this perspective :) 

Lastly, always appreciate those around you while they are still beside you so you would not have any regrets when they are gone someday! 

"Take pride in how far you have come and have faith in how far you can go."

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!

After 5 long years in medical school, I finally graduate with a title in front of my name. As cool and impressive as it sounds, the title weighs as much as the responsibility that sits upon my shoulders.

My grandparents love going 'round the morning market and gleefully boast to their grey-haired friends about the existence of a doctor in the family. Like finally. None of their children ended up in the medical field, so I guess it is perfectly understandable that they take pride in the two letters in front of my name. I never really gave it much thought since it does not bother me as I am not there when they do it.

"Sorry, but I am still a medical student"

Soon, family gatherings end up becoming small consultations; asking about this small nagging headache that they have; telling me about how frequent they visit the toilet; showing me this patch of dry, itchy skin on the shin; or even asking me if their children are developing like how the other kids are. Making small conversations about simple health matters are one thing, but asking for medical advice definitely brings it to another level. I would usually use the excuse "Sorry but I am still a medical student" as I fear that I would give a wrong opinion and lead them down the wrong way. Those round the dinner table would just laugh it off and I do get off pretty easily with that.

Now, with a medical certificate in hand, my go-to excuse has clearly passed its expiry date. The words coming out from my mouth are now believed to be somewhat "more reliable" although I still doubt it most of the time. I now have to be responsible for the things I say and do. This is part of adulting that I have to face.

Do I love the title? Hell yeah! I've worked my ass off for this. But I definitely miss the carefree grey-zone during my clinical years where I could go around giving small tiny weeny medical advices without worrying much about the consequences when I start of the conversations with "Well....I could offer you some advice as a medical student."

Every junior doctor (houseman) in Malaysia were required to undergo a 5-days course known as Program Transformasi Minda (PTM) carried out at a hotel before officially reporting to your respective hospitals. Mostly every hospital in a certain state will conduct the course together except certain bigger hospitals which conduct it individually due to their huge intake of junior doctors.

What is this Program Transformasi Minda (PTM)?
Well, a direct English translation of it is Mind Transformation Programme. Sounds rather interesting, right?

So, I went through this course for the pass week. I was quite reluctant to go for it at first because it felt like boring school camp all over again. The course started on 22nd April and we were required to reach the venue at 2pm. We handed in all the required documents and checked into the hotel. We were required to get 2 other roommates to share a room. I heard certain states had actually allocated roommates for you but for Johor, you can find your own roommates if you want.

I felt like my post will bore you guys out if I go on in detail regarding the content of the course. So here is a summary, you will listen to loads and loads of talk about Malaysian healthcare from clinical to management, get put into groups (not by choice) to do some group works and lastly, eat 6 meals a day. And this is all done from 6am to 12am everyday.

Time did started passing faster from the 2nd day onwards and without realising it, it was the last day. I was glad to be put into a group with 14 other brilliant doctors from different backgrounds and universities. I enjoyed my time there with all the fun and laughter we shared. I did not think that I would be able to find such good friends at such a short span of time. But we somehow bonded over due to similar thought wavelengths i guess.

Here is a photo of the awesome G6 *poppin' bottles in the ice, like a blizzard*:


Overall, the course itself was not too bad so for those that will be going for it in the future, go with an open mind. You might able to encounter something unexpected.

For now, I am still going through orientation for the week at my chosen hospital and will start tagging from this coming Sunday onwards.

Bonus: Photo of all the NUMedians who decides to stay in this state down under~

What would you picture in your mind if I were to ask you to imagine the life of a medical student?


WELL......IT IS. Trust me.

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.

1) Why it's ok to be wrong?

Better be wrong now as a student than when you are a doctor

Answering wrongly in teaching session does not cause much disadvantages unless your school has a system for penalising wrong answerers (not sure whether this word exists) then you shouldn't do it. Benefits of answering questions during teaching sessions: 

• Increases learning motivation if you managed to get the right answer.
• Give your lecturers an opportunity to assess you and your peers' current understanding. Asking around your peers that did not understand the lesson is like the blind leading the blind and you will actually waste more time. 
• Makes the teaching session more engaging as it creates a two-way learning. It often helps for those who have minds that often drift off after 15 minutes into a monotonous teaching.
• Always keep in mind that you would want to be wrong now as you have your lecturers or clinical staffs to correct you and no life will be harm in the process of it. When you officially work as a doctor, keeping mistakes in minimal is the best as our patient's faith and trust are in our hands.
• Best of all, you get around 5 minutes of fame with all the attention on you while you're answering. 

You are on the path to success just by trying as W. Clement Stone once said,"Success is achieved and maintained by those who try and keep trying."



At the end of the day, we are all humans. Therefore, it's ok to be wrong as long as we learn from it.