Showing posts with label M4. Show all posts
Showing posts with label M4. Show all posts

Monday, February 28, 2011

Exciting Times

Electives, truly the best time of medical school. Three weeks into official electives period and it's been a refreshing time. Clinical training has never been so self-directed, flexible and inspiring at the same time. No regrets starting three weeks earlier, and giving myself a week's break in between sometime in March to recuperate and run errands.

My first posting was in General Surgery under Dr C, together with Celeste. I had a terrible Surgical posting in year 3, and desperately needed to get my surgical acumen in order (I had never heard of the Alverado score prior to this year). Subconsciously, I also wanted to give myself a chance to see Surgery from a new perspective, to see a Surgeon beyond the crazy-butcher-with-anger-management-problems. Because Dr C was tied up with some other overseas students in the first week, Celeste and I were given the free reign to join other teams. Celeste had a really good time in the Upper GI team, while I had a nolessthanterrible time in Colorectal (hmmm). Still, we spent our afternoons crashing M3 tutorials, clerking and joining clinics. Celeste even got commended in the Straits Times Forum for helping to translate in the clinic! (: When we finally got to join Dr C and his team, it was more like free teh tarik from the machine in the morning, a light clinic followed by lunch and free drinks. Afternoons are either spent in clinic, or clerking before heading home for a good rest. Three weeks with Dr C gave me some food for thought as well. Anyway, to answer the question, my impression of surgeons had indeed changed for the better. It appears that my earlier description only applied to a certain hospital. :p

My second posting was at SGH Internal medicine with Professor O. I got this contact from Wenyang (senior), since Prof doesn't teach year 3/4s and I had never heard of him before. Turns out that Prof had agreed to take 6 students in total, which was great because it was an automatic CG! It was a strange mishmash of people, and Cel and I were really afraid that it would be very strange and we would totally get owned. But it turned out to be a fun group, from which we learnt much from. Prof O found his khakis to tutor us in other subspecialities as well, so we had a good number of bedside tutorials and lectures so much so that it was totally like a medicine posting altogether. Beyond academia, Prof O and Dr N were inspiring in more ways than one.

Prof O, Dr David and the group (Mok was very excited at touching Prof's shoulder HAHA)
Dr N with the sunflower we gave her for being so cute!

It seems to me that throughout my entire 4 years in medicine, the people who never fail to inspire me have always been internists. It is an unglamorous job, the pay is unrewarding because of the lack of procedures, the hours are long. When we sat in a lecture for the Internal Medicine doctors, I realized that more than half the room was filled with foreign doctors. When I asked why, I was told that no one wanted to do Internal medicine, for the reasons mentioned above. On the last day of my posting, I clerked a lady who had end stage renal failure. I spoke to her for over an hour. I had almost forgotten what it feels like to spend time talking to patients. It felt nice. (:

I had a break today, because my posting at the National Cancer Centre starts tomorrow. Its exciting, since we've never really studied oncology before, and I'm thankful that I can hide behind Yukit in times of brain failure hehe. I spent today going to the Visa office, getting the Flu jab and going to the bank. In the afternoon I had a 3 hour nap (zomg) followed by an evening run.

God is good! Coke is bad!

Wednesday, December 29, 2010

Spot the human


Me: Ok, test you. Describe the pot.

Marcus: Ok...this is a pot showing the lung. There are patchy areas of consolidation. I see...

Yiliang: I see...me! I have that shirt! That's me!

Me: O_O

Moral of the story: Study the pot. Think about the pot. Dream about the pot. Talk about the pot. Become the pot.

Tuesday, December 21, 2010

Destiny

Remember THIS post? That was in M1.

Now I'm M4, studying for the Pathology MBBS 2nd Professionals (Part III can you believe it). Yiliang and Fred are sitting opposite me copying out Robbins and staring blankly at Forensic Pathology notes respectively (ok Fred just fell asleep). Sheila who is beside me just woke up from post-lunch nap and went for a pee break.

At the other end of the library are a couple of M5s. They had revision lectures over the entire weekend, Sunday included, and will continue to do so till the end of time MBBS. There is also one mysterious M3 (???) and a couple of unidentified creatures who are here despite it being school holidays.

Christmas is in 4 days, and the plan is to study through. My destiny indeed.

Friday, October 29, 2010

How the BTC changed my life

Pathology has been a week full of lots and lots of revision. Along with long lunches and sleepy lectures pretending to be tutorials, things have been pretty enjoyable. Been amazed though, at the passion that some people have for their work - "Look at these slides! Aren't they pretty? That's why I became a Pathologist."

Now that we're into the so-called lull period of M4, I've found myself having more time and being more relaxed to just sit around and chat with people. I used to think that I was really averse to doing that, perhaps out of fear of awkward moments/not knowing what to say. But I realized that talking to very unfamiliar people can really be very fascinating and I was surprisingly comfortable at the Dean's Office's invitation to coffee. Well, why pass up on free coffee? :p Things like these open my mind to see the world beyond this little elitist bubble that I live in. A chat with Dr Goh WL on the phone was also a timely reminder that what matters in this world is relationship relationship relationship.

One other thing that I've been thankful for are the BTC rides to and from school with my dear BTC troopers, Ian (carrying a trooper gun) and Raymond. They are fantastic company. (: I was just thinking what I would miss about school life, with graduation looming about 1.5 years from now. I think I would really miss the BTC very much.

Monday, October 18, 2010

10 things I wish I knew on entering Medical School

Remember a post I wrote a long time ago about How to Induce Menstruation? When I checked my blog stats recently, I realized that it had the highest number of independent hits (ie. people who googled the subject and were directed to that entry specifically). I guess people do appreciate useful information! :p So, in light of many recent happening, I was inspired to come up with my own 10 things I wish I knew before entering medical school. Maybe aspiring medics who google the subject before their interview will somehow come across it! :p

Disclaimer: These following comments are my own personal opinions only and do not necessarily reflect the positions or opinions of YLLSoM, her students or affiliates. All comments are based upon my current knowledge and my own personal experiences.

#1 “Not everyone in medical school is a genius” (oops) – a church friend of mine who is now in M1 now recently expressed his concern at the upcoming CA1. When I told him to chillax, he told me that “The seniors say that most people get 80-90% for CA1!” and was very worried. I entered medical school with great trepidation at being amongst little Einsteins. This translated to a lot of unnecessary worry and excessive studying. I later realized that my peers were really just normal human beings (save for the exceptional few) who also actually needed to study hard to get good grades! So really, no need to be too freaked out. (PS: I later corrected my church friend and told him that many people get 100%).

#2 “Play like mad in M1” – One of my greatest regrets (still is) is studying too much in M1. Seriously. I made notes for every single lecture, revised like one million times, camped in the library from 8am to 10pm, but never made it to the Dean’s List -_-. Gave up and slacked off in year 2, which wasn’t the best idea in light of Microbiology :/ So friends, please use your M1 wisely. Join a CCA! Get into organizing committees! Stay in hall! Do fun and stupid and time consuming things that you’ll never get to do again! I guess my saving grace is that I was involved in Freshmen Orientation, which was pretty fun (:

#3 “Being a good student does not necessarily mean full attendance at lectures and tutorials” - Now before the Dean’s Office comes after me, I’d qualify and say that the definition of a good medical student extends beyond that - it means doing everything you can to make sure that you become the best doctor that you ever can. It may include attending all lectures and tutorials, but also time to self-study, rest and relax instead of going to a lecture and falling asleep and/or be disruptive and distracted. Fine line there, admittedly.

#4 "Take cross-faculty modules" – To my utmost disappointment, I only discovered the possibility of this in year 3. While other NUS students fret over credits and bidding just before the start of a new term, we medical students have nothing to worry about, since our curriculum is set in stone for us. But did you know that we actually have the liberty to bid for modules in other faculties that don’t require credits? (we don’t have any credits) Things like foreign languages (ie. Malay, French) and possibly many more exciting modules. Take these up in M1 and M2, when you are still based in NUS and it’s much easier to get to class and fits your schedule much better. A caveat is that you must be amongst the top 50% of the cohort to successfully apply through the Dean’s Office.

#5 “Don’t use school as an excuse not to meet other friends” – People in medicine have this bad habit of using medical school as an excuse for being busy, or having to study. That only bodes the death of your social life. Your friends in other faculties have projects, presentations, midterms, reports, quizzes and final papers. We, on the other hand, have one Professional Examination at the end of the year? And maybe a handful of CAs or the occasional write up. Get rid of the notion that medicine kills your social life!

#6 “Treasure your time in medical school, don’t accelerate it” – At this stage of my medical training, I have seen Housemen/Resident float around like zombies nearing the end of their 36-hour call, and doctors who are cranky because of the crap load of paper work that awaits them. As medical students, we call our own shots. We can self-declare holidays, go home at 10am (O&G FTW!) and hang around in the lounge or go for a Mr Bean break at any time of the day. This freedom is for ours to have, so treasure it! The Student Internship Program (SIP) in M5 truncates this freedom of ours for a few months, where we function like real doctors and do real doctor stuff. Some of my friends choose to structure their M4 electives in the form of the M5 SIP style, which is great if you want to really experience what it is like to function within a particular department as a doctor (Like my friend Fred, who is a workaholic and finds it fun). Otherwise, there is little reason to give up precious student-ship time that exists only now in relation to a lifetime of work!

#7 “Pace yourself” – People come into medical school in hope of completing it, without realizing that school is not the end. It is not about getting 100% in CA1 or finding a place in the Dean’s List. There is a destination to reach, one that goes far beyond M5, or Housemanship. Medicine is a lifelong journey. And with all journeys, there is a need to pace yourself, at a speed that you are comfortable at - not one that makes you burn out too early, or lag behind too far. Be sensitive to yourself - the moment you feel like you’re burning out, take a break and eat some kinder bueno. Life is much happier this way. (:

#8 “Remember your M1 self” – Even before getting into medical school, I sought advice from many people. What I remember the most was the many taunts and prophecies that I would always just be a part of the system, that change is difficult and that the ideals that I hold to will always remain as ideals. I think after 5 years of being at the bearing brunt of angsty doctors who serve to tear apart your ideals of how medicine should be practiced, it’s not difficult to become just another one. That is why I appreciate that along the way, I’ve met doctors who have been on the interview panel, and remind us to hold on dearly to the ideals that we proclaimed before our interviewers. Want to save the world? Go ahead!

#9 “Consider all aspects of medicine” – As I look back on the way I studied medicine over the past 3.5 years, I can’t help but feel a sense of narrow mindedness. All this while, studying medicine to me was…just studying medicine! Nothing more. In retrospect, I wish I had considered the multi-faceted nature of the subject. In studying the cell at the biochemical level, I could have considered issues surrounding the origins of life. In going through my Medicine and Geriatric posting, end of life issues would have been an interesting topic for discussion. Obstetrics and Gynaecology had me tangled up in abortion and antenatal testing. Psychiatry? How should we, and do we treat the “mad, bad and sad”? Is pharmacology the only means to an end? What about alternative medicines? In 3.5 years, I have studied the medical aspect of medicine, nothing more.

#10 “Love medicine, but love people more” - Confusius said, “Choose a job you love, and you will never have to work a day in your life”. Certainly no greater joy to love medicine, and a privilege to dedicate your whole life to its cause. But having said that, danger lies in loving the subject, but not the heart of the profession. Every patient has a name. We must always remember to love the person behind each drug dosage and each X-ray film. After all, we are called to cure sometimes, relieve often and to comfort always. (:

Saturday, September 18, 2010

Leadership

The best thing I remembered about the Medical Society in year 1 was that at every single school event I attended, the P and VP were there. They knew their seniors and juniors by their names, took effort to say hi in the corridors and ask how dreadful biochemistry was. I always wondered how Quan Yao seemed to be everywhere, at every possible time. It made school nice, because there is always great assurance with great leaders. Leaders like that are hard to come by, people who take position with a vision and a mission. Too many leaders today are in it for the name, the accolades and experience. No wonder Chew Lip is making the waves now with his LHL award and the recent lauch of Abe the Tummy Dummy (Quan Yao was on the team also, btw).

Some people you meet give you this feeling of excellence. You know that these people are made for bigger things, in a league of their own. Then there are those who try to reach that realm , but unfortunately never do. Most end up somewhere in between. But I guess leaders should not be judged by their capabilities alone, but also by the passion that they have for a particular cause. Passion inspires, and gets people going. Putting a capable leader who does not have a heart for the cause only does a great injustice to the mission - things become a duty, and a half hearted attempt.

It's obvious, you know.

Wednesday, September 15, 2010

Assessments

I had my Paediatrics mini-cex (mid-posting clinical examination) today and it was a relatively simple case of gastroenteritis in a 15 month old boy. I'm so glad its over, like a great burden lifted off my shoulders. I wonder when I'll ever grow out of this exam-burden syndrome. How much more can I be reminded that exams are but exams, that they come and they go? After 3.5 years in medical school, have I not grown used to the barrage of assessments and exams? Still, they never fail to impose this sense of dread and basal worry that keeps you from sleeping, studying and playing in peace. Over the long weekend, I spent a night over at Pulau Ubin for a youth group retreat. I had half a mind to excuse myself from it previously, in view of the exam today. Eventually I decided that it was not worth sacrificing an annual affair for, and headed for Ubin despite it. Over the course of the retreat, the thought of cex lingered, and ironically, I'd say that it occupied a significant proportion of my mind for a large part of the retreat. How do these things so plague me? It's so irrational and bewildering.

I wonder how this will play out when I finally graduate and become a real doctor. Every new patient I see will be an assessment in itself, just that this time there is no case file to cheat and refer to. Am I going to face each day with fear and trepidation? I'd most certainly develop an anxiety disorder.

I can't wait to travel Europe again!

Wednesday, September 8, 2010

Questions of Life

What should I be when I grow up?
Which Residency will accept me?
Does it mean I have to plan my electives stragetically?
Should I have as much fun as I can while I still can?
Will I pass my MBBS?
Will I have a family?
How many children will I have?
How am I to work and look after them at the same time?
Will I be a good wife?
Will I be a good mother?
Will I be a filial daughter?
Will I be a good doctor?
Can I survive doing shift work till I'm 50?
Can I survive being called back to deliver babies at 3am when I'm 50?
Can I justify processing administration for an abortion?
Do I like gynaecology enough for it to retire into it when I'm older?
Will surgical training suck away my life?
Do I have enough strength to face dying people?
Will I have time for church ministry?
Will I be content becoming a general practitioner?
How much am I willing to give up for the sake of work-life balance?
How much money do I need to make?
Will I be able to do humanitarian work?
Did I make the right decision in choosing Medicine as a career?

Where does God want me?

Friday, August 6, 2010

First pass

Today Prof was talking about using HRT patches to minimize first pass effect...then I thought of Shanhaiguan's 天下第一关 (First Pass under Heaven)! So random. Miss being on holiday.


Thursday, August 5, 2010

Here, take my cloak as well

I was rather taken aback by a conversation I had today with a friend (henceforth known as X). It was after the lectures, and a couple of us were just hanging around and I casually went up to X to say hi. I knew that X had an interest in a particular elective posting. This was roughly how the conversation went...

G: hey X! so did you apply for the ABC elective?
X: Ehhh no I didn't.
G: Oh? How come?
X: Oh because I'm not really keen on that particular elective.
G: Oh...then will you be doing that posting under another elective?
X: Yup, at PRQ hospital.
G: Oh! Ok that's cool...with which doctor?
X: Errr...can you not ask so many questions? Everyone is very secretive about it you know...
G: Oh right, sorry then.

X's reply took me by surprise. Obviously I had assumed that asking someone else about their elective plans wasn't something that could come across as offensive. I should have been more sensitive.

Still, I wondered if it was just me, or the curriculum, the new residency program, or the fact that we are one and a half years to graduation, that people around me were becoming increasingly competitive. I entered medical school three years ago thinking how fortunate I was to have been admitted, not just for the course, but also for the fact that in a faculty like this, competition would be something rather secondary. I hadmany reasons to think so- firstly, that the basic requirement for us is to pass the exam. A first class honours comes by once every 5 years, and other than that, the rest of us fall into a generic category of "pass", with nothing to differentiate one from another. Secondly, I assumed that all of us were admitted on the premise of having some sort of altruism. Surely, we are all working together to become good doctors, not "better-than-you" doctors, I thought. Thirdly, upon graduation, we are guaranteed jobs! Unlike other faculties where students need to compete for internships, pupillage and others, we are by default entered into a system in which we are rotated through hospitals, all under the same House Officer umbrella.

I guess point 3 no longer holds, in light of the residency program. The hot question in recent times has been "So, which residency program are you interested in?" Not surprisingly, most people have something that they've set their eyes on. There is most certainly nothing wrong with that, and everyone is entitled to their own aspirations. Still, as I look at the statistics, only 30% of all our great aspirations will come to fufilment in 1.5 years time. The other 70% of us will well, remain as House Officers, an apparent one notch lower in rank. Shouldn't most of us be ready to accept that role then?

Even before we've realised it, the rat race has long begun, and we are all just filthy rats in this filthy race. Harsh words, but not without a slither of truth. Troubled by it, I spoke with B on the way home, asking him what he thought was an appropriate Christian response to such competition.

...And if someone wants to sue you and take your tunic, let him have your cloak as well. If someone forces you to go one mile, go with him two miles. Give to the one who asks you, and do not turn away from the one who wants to borrow from you. (Matthew 5:38-42)

Give him my cloak too? Surely not if I'm freezing too?! I thought. I came home after a long day to find myself reading three separate articles that came up on my newsfeed, all unrelated to each other. The first was Why be a rat in the rat race... and the second was How will you measure your life? The third was from Kitesong. In several ways, God was teaching me something about developing the right work ethic, in understanding the purpose of my life, and to have an eternal perspective. What matters most? What is my definition of success?

Perhaps one day I will learn to say, "Here, take my cloak as well."

Tuesday, June 22, 2010

Slimy babies

On the first day of O&G posting the department pwned me with a night call, that same night.

In the middle of the night, someone's water bag burst too early, another's fetal heart rate went into a precarious situation, scrubbed in for my first emergency caesarian section, assisted the midwife in encouraging labour, saw my first vaginal delivery, delivered the placenta and assisted in the episiotomy.

The conclusion? Babies are really slimy.

PS: Officially M4!