Sunday 27 December 2020

DAY 1564-1578

Dec 14 - 28

1) Back to the blog after two weeks. As my current group (Group B) passes the half way mark of our eight-week rotation, I realise that family medicine is really quite interesting - its focus on the whole patient, its holistic perspective, its continuity of care, and its integrative methodology make this field unique. 

2) Consequently, I am aware of how much more there is to cover, from basic revision of medicine in general, to paediatrics, psychiatry, and some obstetrics and gynaecology thrown in for good measure. Therefore, I have made the difficult decision to not return home for Christmas break this year. In all honesty, as much as I would have loved to be back home, I would not be able to focus on my revision as I would be busy going out and hanging out with friends/ relatives. Secondly, I have already planned to return home for Chinese New Year next year, so at least I have that to look forward to.

3) My time in family medicine has been really enjoyable. We have had experience in three different clinical settings - the health clinics (klinik kesihatan), the maternal and child health clinics (klinik kesihatan ibu dan anak), and private GP clinics. We have had the opportunity to do home visits with a registered nurse, as well as visit an old folks' home. Besides, we also managed to visit the occupational and physiotherapy departments in Penang General Hospital. A mainstay of patient management in these settings, other than return of mobility and function, is chronic pain management. I personally enjoyed the occupational and physiotherapy clinics the most, as there were so many creative approaches used to manage the patient's symptoms and conditions.

4) As the year 2020 comes to an end, I cannot help but look back with a slight sense of pride at how far I've come on this long road of medicine. When 2021 begins, I can finally say that I will (touchwood) graduate in just over a year. Of course, along with that expectation of graduating, there is increasing expectation that I should have some basic medical knowledge. Hopefully, I will have filled up some of those gaps in my knowledge and practical skills when the time comes. Here's hoping everyone had a wonderful Merry Christmas (for those celebrating), and happy holidays to everyone! I'm looking forward to a better and more productive year :)

5) Thanks very much for visiting my blog as always. Too bad I don't have a lot of interesting pictures to share this time around. Have a great week ahead, cheers! 

The price of getting a nice photo XD
(just kidding - my group mate and I were practicing venepuncture (blood taking) and IV cannulation)

An incredible learning experience here at the X-Ray department today :)

From phlebotomist to patient...

Ok lah it was quite well done...

Fish fillet rice at Gurney Plaza Food Hall

Merry Christmas and a Happy New Year!

An opportunity to test out functional electrical stimulation (FES), a treatment that applies small electrical charges to improve mobility, for example in cases of stroke or spinal cord damage

Delighted with my new oversized purple clipboard :D

Our latest addition to the apartment!

It seems as though I'm staring into the dark abyss of space and time...



Sunday 13 December 2020

DAY 1548-1563

Nov 28 - Dec 13

1) A lot has happened since my last blogpost. For starters, I have finished my psychiatry rotation, and have begun family medicine. The scope of family medicine is very broad - it's a complete mix of all rotations, and it's quite impossible to predict what type of complaint the patient might come in with. There are, however, some problems that are more commonly seen in family medicine. These include diabetes, hypertension, and dyslipidemia (collectively known as "the big three"), Nevertheless, it's been really interesting visiting the different health clinics (Klinik Kesihatan) and private GP settings to see what goes on behind the scenes.

2) I am of the opinion that family medicine gives medical students the most exposure in terms of practical skills. We have a clinical logbook to fill, which includes a list of procedures which we should ideally observe, assist, or perform. Some simple procedures include taking blood pressure and pulse, calculating BMI, the different types of injections (e.g. IM, SC, IV, ID), wound dressing, using the ECG machine and interpreting the results, and many more. As the saying goes, practice makes perfect! Hopefully, we'll have practiced enough before sitting for our end-of-rotation exams.

3) Assessment for family medicine consists of two - the OSLER and DoSKE. OSLER stands for "Objective Structured Long Examination Record" - it is basically a 15-minute observed clerking of a patient, followed by a discussion on the differentials, investigations and management plan. The 40-minute DoSKE (which stands for "Documenting Skills Examination") assesses candidates on four tasks - writing a referral, writing a prescription, requesting an appropriate X-Ray, and requesting a blood investigation. At the end of the year - they will be the usual OSCE as well as written examination, consisting of single best answers, extended matching questions, and short answer questions. 

4) Studies aside, I've been quite busy with other events as well. I was an invited panelist for the "Aspiring Doctors Virtual Event", where I talked about my journey through medical school and intercalated masters. Here's the link of the entire video if you're interested - https://www.youtube.com/watch?v=a-ZCEj23vsY. Besides that, I presented a poster for the 31st International Symposium on ALS/MND, which was the culmination of my year long research as a Masters student. It was exciting to hear the progress made in the field of amyotrophic lateral sclerosis (also known as motor neurone disease) research.

5) Yesterday, I again went hiking up Penang Hill (Bukit Bendera) with my good friend Mad Noor. This time, we went up earlier, and I felt great going up the first half (to the lower station). A third way up the second half, however, I had a really bad stomachache. Knowing that I would not be able to reach the top in time, I had no choice but to descend back to the lower station where toilets were available. The worst thing is when I tried to resume hiking later, my muscles had cooled down and become a bit stiff. That made the second leg of the hike very arduous. Nevertheless, I made it to the top - eventually. We had a nice drink to cool off, before taking the tram down (that has become our routine).

6) All in all, it has been a productive two weeks for me. I anticipate that the days leading up to our Xmas break will be very busy, as I have a lot of catching up to do with my studies. That's all for today's blogpost - thanks very much for visiting, and have a great week ahead. Cheers! 

Dinner @ Lagenda House & Cafe, as recommended by Kuhan
(l-r: Melvin, Myself, Esther, Kuhan, and Melissa)

Dinner with Afifah and Sharifah - after a very long (but productive) day at Bayan Baru Health Clinic

Lunch at Tesco Food Court with my group mate Sharifah and our other two 
"group mates" Rachel and Afifah :)

Meet up with my buddy Zi Yan at the unlikeliest of places - college!

Chilling with a drink after reaching the summit of Penang Hill - with Mad Noor :)

Now that the highlight reels are finished, here are all the pictures in chronological order:

I ordered the fish meal - which came with butterfly pea rice, soup, and a "congkak" set of appetizers! :)

A close up of the "congkak set" - which consists of omelettes, crackers, tomatoes and onions, cucumbers, and dipping sauces

The same dish, but after removing the pandan leaf which covered the butterfly pea rice

Here are all our meals!

For dessert, a beautiful panna cotta with strawberry sauce

Some sago pudding with coconut milk

Caramelised bananas with ice cream - yum!


Today, Sharifah recommended that we try this popular franchise called "3 Budak Gemok" (lit: Three Fat Guys") - after our morning clinic session

Their specialty is "ayam kicap sambal power" (or sweet soy sauce chicken with sambal chilli)
I really liked the sambal, as it had a nice kick to it!

We're in Pusat Sejahtera USM today, specifically the lab department. Here are some interesting charts on urine microscopy (and what to look out for).

This is a Roche Urisys 1100 urine analyser
(you can see the test strip - which is dipped in the patient's urine before being placed in the slot for automated analysis)

Guidelines for the measurement of HbA1c - an important diagnostic and screening tool for diabetes

This is the A1care Analyser

Sysmex KX21N haematology analyser - basically where all the full blood count reports are handled

The tubes with lavender tops are called "vacutainers" - they contain EDTA as an anticoagulant, and are used for collecting blood samples for analysis (using the haematology analyser above)

The name of the restaurant is Bangkok Tomyam

We ordered "tom kha" (Thai coconut soup), "ayam gajus" (cashew nut chicken), and "kangkung belacan" (stir-fry water spinach)

The "tom kha" was very rich in flavour, but could have done with a bit more spice :)

Getting ready to celebrate the most wonderful time of the year!

This was just the beginning - they've now added photo booths and other shops surrounding the Christmas tree!

Tried the sizzling mee at Gurney Plaza - extremely filling!

Lunch with friends

Sharifah swears by these - the Swiss Roll from Bread History
(upon her recommendation, I decided to try one myself)

I must say, presentation wise, incredibly beautiful and delicious-looking Swiss rolls

Blueberry and chocolate combo!

Originally planned to use the gym - ended up in the Mezzanine instead XD

Getting ready to present my poster to the world!

A fruitful and rewarding experience indeed! Next year's symposium will be in Basel, Switzerland

My apartment is getting a makeover

In case it wasn't already clear, the newly painted side is on the left (the grey tone colour scheme)

At the lower station again

The view from the lower station was amazing! Too bad it was also a lot hotter than usual


Not sure how anyone would bring their bicycles up here in the first place XD

Map of Penang Hill

Just 200m more to go (the summit is basically just Cliff Cafe)

There are at least ten stores just like these on the lower deck - ready to capitalise on the tired hikers (myself included!)

Oreo milkshake

That's the face of someone who doesn't care about the calories soon to be consumed

Another spot recommended by Mad Noor - Ali Nasi Lemak Daun Pisang (translated loosely as Ali's banana leaf-wrapped nasi lemak). They come in different flavours - cili bilis, udang, and sotong (chilli anchovies, prawns, or squid)