Just realize my last post here is about 8 years ago. (not sure if anyone still read blogs nowadays)
How time passes and how much changes has occurred..
I remembered I created this blog while I was in secondary school as a channel to express my thoughts (before facebook, instagram, whatsapp and the only other social channel was friendster).
Looking back at my old posts, there are mixed feelings. Most of the posts represent the most vulnerable time of me when I was still helpless, freshly coming out from home and looking for ways succeed. I was indeed thankful that I had help along the way- my families and various friends that I met along the way. I am gonna summarize what had happen to me in this 8 years. Hopefully my experience will provide some insights/idea to high schooler out there who are trying to seek this path.
I am currently a medical officer at Sarawak, serving in a state hospital and my homestate.
After I left Matriculation Labuan, I went to Sunway College for MUFY (Monash University Foundation Year)
I secured a scholarship to get into Monash University Malaysia, studying Bachelor of Medicine and graduated in 2016.
My 5 year life as a medical student is indeed quite challenging. After 2 years of intense theory learning and exams (pretty boring, good old lectures and classroom teachings), you are thrown to the clinical environment to survive and learn. As a Monash Student, our teaching hospital is Hospital Sultanah Aminah at Johor Bahru. Your daily routine usually consist of trying to clerk patient +/- clinical activities assigned by the school with a few teachings sessions and lectures in universities.
Here are a few examples of the teaching sessions:
(i) Bedside teaching : you will present cases to your lecturer based on patients that you have clerked and examined at which you will be grilled and corrected on your history taking and physical examination. You will be criticized on your shortfalls: Failure to pick up even the most obvious sign from the patient, getting an entire different history from what is really happen. Of course through all of this, hopefully you will feel "motivated" and read about it afterward.
(ii) Problem based teaching: each week there will be an assigned topic/clinical condition at which each of your team members will prepare presentation/topics around it. Discussion will be done with assigned lecturers. Most of the knowledge gain here are based on personal/team effort with occasional input from the lecturer. Also you get to brush up on your presentation skills.
(iii) Clinical skills session: various skills are taught that are deemed basic/essential to your future clinical practice, blood taking, IV cannula insertion, urine catheter insertion etc. Of course doing it on a mannequin is much different from doing it on a real patient (A.K.A they won't scream in pain). Having said that, I felt that these sessions only give me an idea of the method of doing those procedures. The real training starts during housemanship when you are "force" to do it by hook or by crook,
(iv) Other sessions: community visits, attachments to NGO etc. One of most memorable session will be my attachment to NASCSOM(National Council of Senior Citizens Organisations Malaysia) at which I went to an old folks home near Klang Valley every week for a few month to observe how this NGO works. by the end of the visits, I have to submit a report/presentation to the university. Although most of the time we end up going for makan sessions (Opps). it really opened my views of age care system in our countries that needs a lot of improvements compared to developed countries.
Lectures are keep minimal to avoid spoon feeding and will gets lesser at lesser as you progress to year 4 and 5. Every few month, you will be thrown to a different posting (medical, surgery, peadiatrics, psychiatric, family medicine, obstetric and gynaecology) at which you have different hurdle/requirement to pass. The whole process can be stressful and challenging at times as every now and then you are thrown into a world that you knew almost nothing about and had to relearn everything again, Moreover, before you are used to it, you will be rotated out again.
After graduating from Medical School, there was a 5 month period wait before I got my housemanship post at Kedah (pre-introduction of contract houseman). I was posted to Hospital Sultan Abdul Halim (Sungai Petani) for 2 years there. Before I continue, I would like to say that what you have heard from the internet/news are partially true (varies from person to person). Housemanship can be deemed busiest time of my life until now. Sometimes I felt like I have totally disconnected from the world for 2 years although in the end, all of these is to prepare us to face the responsibility we bear as a registered doctor. You are mostly sleep deprived and your sole motivation is to "get things done as ordered". your working hour is around 70-75 hours/week officially with one off day entitled for every 6 working days but to be honest, you often need to work more than that to cover the heavy workload. you will need to go through 6 posting, 5 compulsory (medicine, surgery, orthopedic, obstetric and gynaecology, peadiatrics and an elective posting: emergency, psychiatry, anesthesiology, family medicine). various posting have different requirement at which you will need to complete your logbook (contains various requirement and procedure) to pass the posting. I wouldn't elaborate much on the requirement as the system has slightly changed now after the introduction of contract system.
Basic summary of what you are expected to do as a houseofficer for one shift would be:
1) morning reviews - depend on postings, can be as few as 2-3 reviews or up to 10-12 reviews.
Intermittently when you are unlucky enough to pick up unstable sign from the patient, you had to delay your reviews for other patient to attend him or inform your superior officer. you are expected to complete your reviews prior to medical officer rounds (about 8am). when I first started, one patient review can take up to 30-60 min as everything looks important to me and I had no idea where to start!! As time passes, you will learn what to look for/monitor at the patient with a particular condition and go through other things quickly to avoid missing stuff.
2) medical officer/specialist rounds: it usually starts after 8am (varies from department) at which you need to present the case/update condition to the medical officer/specialist. occasionally, you will be bombarded with clinical questions about the patient (which you have no idea about. Dey ,where got time for last minute read up?) the worse scenario will be forgetting the case entirely or patient telling a completing different story (aka di-sabotage).
3) ward work: this is when the ward havoc starts. ward round sometime can be finished late ( as late as 12 noon) and MO/specialist are off to perform other duties. You will mostly have no time for break - You will have a joblists full of job from ward round to settle before new cases got admitted (or already there, waiting for you to attned) Now you have to try to complete new case clerking, take blood, request radiology examination, completing discharge/getting appointment, make referral, perform procedure, call up other places to dig more on patient's history before the next round (certain department have up to twice a day/three time a day round). you have sometimes as little as 2-3 hours to complete all those (of course with your other colleague). If some of your colleague decided to take emergency leave or curi tulang, that's it la your hope to finish your work on time, Missing on ward work is not tolerated as it involves patient's care. Occasionally you get patient who collapse/unstable and you end up having to attend to them first. you will also need to attend to new admission to the ward and clerk/examine them prior to be seen by your medical officer/specialist.
4)Clinic/Operation theatre: certain posting requires you to help out in clinics, reviewing patient, getting appointments, referring to another department based on department policies. Operation theatre wise you will need to assist in surgeries (orthopedic, O&G, surgery) at which long hours of standing/retracting is expected regardless of how tired you are. The abnormal posture, retracting, not understanding what is actually happening (look like a bloody mess at times) can be frustrating and difficult at times. Honestly, this is the least favourite part for me.
5) Other thing would include attending to talks/presentation/ department meeting etc - Self explanatory.
I glad that I managed to finish 2 years of housemanship smoothly with help from my colleague. There are times that are hard and I only had 1 meal/day and extension of working hour up to 3-4 hours due to unsettled ward work/issues. Couldn't say I never thought about changing of profession/quiting but I'm glad I manage to endure and completed it. The whole process has definitely trained me to be better (dealing of different people, prioritizing task, observation) and hopefully will continue to guide me on my future.
Hopefully this post can provide some idea on what is the life of a medical doctor in Malaysia (based on my experience of course, not guaranteed the same XD) and help those who are still choosing their career path to make their own choice.
Good luck!
