Of Surgery and Medicine

Abstract from my 3 hour story with my juniors in Cafe Wahid

For Surgery
Staying at ward for long period of time and going for "walk-around" instead of ward round is foolish. So, minimise ward visit(maybe 2 case clerking in ward per week?). Visit clinics and read more instead.

For Internal Medicine
Stay at ward, clerk at least 1 full long case per weekday. Clerk different cases. If possible, have at least 2 Observed long case per week.

For both posting, everyone must not worry about not being able to clerk properly because everybody start from zero. WIth time and practice i am sure you will be competent.
Do not panic. Relax and study smart.
Wish you all the best~^^

The essence of medical life

Complete each other, not compete with each other. Remember this always, whatever you do, wherever you are...

Of SPM and JPA

Currently the government is trying to put a limit to the number of subjects a student takes, and to try to rectify the thousand-year-old problem of JPA scholarship awards.

All I can say is, please walk the talk. It seems that in our country, the month between May to July will be the Complain and Appeal period, where hundreds(if not thousands) of deserving students are set aside while even more not-so-deserving students rejoice.

Among the silliest reason given is : Not only academic prowess is assessed, co-curicular activity is also assessed, which is why some students with 6A(1and 2) triumph over a student with 14A1s. This is absolute nonsense. Unless I am mistaken, they are giving out SCHOLARship, not LEADERship or COCURICULARship. Scholarship priority should therefore be given to students with the makings of a Scholar. Not prioritised to those who join 10 co-curicular activities!

Of course, if the student can only study and don't have co-curicular activities, then padan muka la. But to choose a mediocre student to receive scholarship just because they're have more co-curicular activities will produce mediocre scholar as well. Worst, it will produce no scholar at all!

Being good in studies doesn't mean you are good in leadership and other qualities, likewise, being good in co-curicular activities does not make you good in studies. SInce the main purpose of giving scholarship is for the scholar to study, it should be given to the obvious choice!

To add salt to the injury, even if the students hold many post in co-curicular activities, they are not necessarily good leaders! They have a post in the society, but how they work and bring up the society is a totally different thing! We cannot say they are good just because they hold a post in the society!

Some students take 21 subject and excell in them all! COngratulations! But for me, it only shows that you don't have a plan yet for your future, what you want to be. In form 4 students should actually have a rough idea the life they want, and focus on it. If you take 20 subject (The silliest is taking Science when you have already taken Physics,Chemistry and Biology) it show that you have a very good hippocampus but an underdeveloped cerebral cortex :). You quietly tell me that you fail to recognise that sometimes, quality is important, not quantity.

I was in this JPA dilema in 2003 after my SPM. My application for JPA is rejected despite my 9A1s(I am not silly enough to take 20 subject back then) and excellent co-curicular activities,not forgetting that I gave the most(but not very valid i think,looking back) opinion during the silly "globalisation" JPA interview. MCA couldn't help me. So, no choice la, go form 6. 2 years later, I graduated with a 4.00 pointer in Biology, and the dilemma start again. WHat if the public Uni reject me again? Thankfully, luck is by my side, I am inducted into medical school:)This time it is my turn to reject JPA and took PTPTN instead:D

When will this JPA and string-of-As issue will ever end, i don't know, for as long as i remember, every year more and more young brilliant people resents the government. Soon, it will not be hard to find a successful Malaysian in foreign countries...but hard to find one back at home.

Starters for Internal Medicine

Endocrinology

Thyroid
What are the signs to look for when examining a patient with a thyroid problem?
What is the best way to visualise a mass in the neck?
Are there any non pathological cause of hyperthyroidism? If yes, how do we manage?
What is meant by thyroid storm?
a patient's blood test show that she have subclinical hypothyroidism. Explain what is meant by this and plan your management.
a 71 year old lady presented with anorexia, depression, weight loss and muscle weakness for 2 years duration. There is no history of heat intolerance or tremor. ECG showed changes consistent with atrial fibrillation. On examination, the only finding is eyelid ptosis. Neck examination show a mildly enlarged thyroid gland. What is your differentials? What investigation would you do?

So sorry for the controversial post yesterday

That is just my reflection on the changes that i've made in life. SOmetimes we need to reflect on the root of the problem and rectify all mistakes. I am NOT saying that all my friends don't deserve good treatment from me. I am talking about myself, how overzealous passion and unwise behavior can lead to disaster. What the changes i've made throughout my life!

I don't mean to make anyone sad. Its probably the strong words that i use make some people feel uncomfortable.

To my friends, you are all my friends and any problem actually arises from myself, which is why i need to reflect and rectify for your hapiness and mine too.

To Kuan Yew and Magicarp, thank you for your concern! Dun worry, its not that i'm unhappy with you all, its just a KPI(Key performance index) for myself:)

Being a Human ain't easy~~

so let us spend a moment to reflect on our Human side.
1) Being compassionate and selfless leads you nowhere
2) Being hard-hearted leads you to your enemies
3) being cold hearted makes you soulless

I had always believed that happiness is when you are surrounded by my family. Because i assume my friends to be part of the family, I subconciously deceived myself that i am happy.

However, I learnt that friends can never be part of your family. You will never know when your friends are going to hurt you. And they will hurt you real bad, especially if you think they are the family you built yourself.

A friend of mine, whom i used to treat as a member of my family, even told me, "We will never be like brothers". So when we treat someone nicely they may not treat you the same. They may even be wary of you as if you have something up your sleeves.

Therefore, a new policy this year is, I will be happy as long as my true family members are with me. Friends, are just your colleagues, the people you see everyday. If we are too good, it will be unfair for our family members and our good friends~

My family members, thank you for being there for me all this while.
To my 3 best friends: Desmond, Frankie and Guan Rhung, Thanx for the support!
To my other friends : sorry if i offend you, but friends are friends! So lets remain that way :)

3rd years

Since all my colleagues are already in 4th year, i doubt they will visit this site to revise Internal Medicine till next year.

So, most of the message and questions i put on here is for the 3rd years. Please make good use of it.

For starters, I will just summarise the long long advice i gave during the MTK.
> For JKM posting people, please start reading Tallys on the 4 main system
>For Internal medicine, please start practicing your long case, especially presentation latest by the 3rd day of the 1st week. Read Endocrine first, as the first workshop is on Endocrinology
>For Surgery, I dunno what to say. Go clinic and practice, read more.
> For O&G, please adapt as soon as possible. Ask for help from your seniors, don't be shy. Its better to be wrong in front of your seniors than in front of the Lecturers.(Especially the Gengar)

All questions are welcomed here(especially Internal Medicine). All the best :)

Jokers

I am quite concerned over the "spoonfeeding syndrome" we Malaysians are having, to the extent that personal hygiene must be educated to the public!

Personal hygiene, body odour etc used to be learned at home, taught by parents. Now must make roadshows to educate on body odour.

Students learn about overcoming body odour.

Truth be told, many Malaysians either don't notice, don't care or maybe love their body odour. Try taking the LRT at 2pm when the LRT is full of school kids. If you have asthma you would probably be suffocated to death

Not only students, adults too. People say, the more the merrier. I say, The more the smellier. It reflects bad upbringing.

Thank you Rexona for teaching the kids.

2 weeks of Orthopaedics

and i am enjoying every bit of it!

And I think that the reason is I got a super nice team.

Team headed by a ultra nice prof, Prof Amara assisted by equally nice Dr Rashidah

This make us more motivated to learn, and i actually learn more in 2 weeks of orthopaedics than 8 weeks in other postings

So hopefully my next team, Paediatric Orthopaedic will be equally nice......

What I did in 2 month

What I did during the longest 2 month of my life

1) Did an elective posting at an orphanage, playing Ultraman
2)Attempt to write a book on PE for miscellaneous conditions in short cases, somehow discouraged today after looking at UM's very own Orthopaedics PE book, which is about the same structure as mine but written by a person with the prefix "DR" :( maybe i'll publish a better one when i get the prefix, hopefully in 2 or 3 years time.
3)Learn cooking and finally succeed in stirring up my favourite "pai ku wang", where the only mistake i made in the ingredients is using the wrong brand of tomato sauce.
4) Complete my "housewiving" posting at my house. I didn't do much, but its tiring,mind you.
5) Attempt to catch up with my friends, some whom i have not met for almost a year. learn some unpleasant surprise regarding some of my classmates backstabbing ways :-(
6)Help in supervising my ex-alma mater's Wesak day float, which I think is the most beautiful i have seen over many years.
7)Travelling, from penang to ipoh to melaka to muar to JB and to singapore in search of food.(which we fail to find during our singapore trip)
8) Went to singapore again and finally managed to dig out the food treasures from the island.
9) Resolution : Be a better person, do not get pissed off so easily, be wise and strong in face of adversity. Reduce the amount of dirty jokes and polishing my skill of "delayed-effect" laser mouth.