Mar 12 - 20
1) Finally, after several delays due to extension of the movement control order (MCO), our group (Group B) has completed the family medicine rotation! This means there are two more major rotations to go - the so-called "multispecialty rotation" (consisting of emergency medicine, radiology, ophthalmology, and otorhinolaryngology), and obstetrics and gynecology. After that, we have a week of written papers and a soul-draining 20 station OSCE. For each station, we get 1 minute to read the question, then 6 minutes to perform whatever task needs to be performed. The task could be anything from history taking (asking patients about what brought them here), communication (breaking bad news to patients, or educating patients about certain medications/procedures), physical examination, or practical skills procedures. Bottom line is none of us are really looking forward to it...
2) Reflecting on the current rotation, I have found family medicine to be a unique experience. This is due to a few reasons. Firstly, the opportunity to compare and contrast both the public and private aspects of medical practice. During our time in family medicine, we got a chance to visit a different clinic each day. This meant that some days we were attached to the public community health clinics, and on other days we went to private GP practices. Some of the main differences between the private and public settings include the availability of medications, continuity of care, and cost. For instance, government health clinics would usually have certain types of medication only, while in the private setting, the only limiting factor would be whether the patient could afford the medication. In terms of continuity of care, in a private setting, the patient would see the same doctor/specialist, which means they would develop good rapport over time, while in the government setting, they might not see the same doctor each time for follow up. Finally, the most important factor - cost! While a private GP does have a set consultation fee, this is still many times more expensive than the equivalent government health clinic, where each consultation costs a mere RM1.
3) Another reason I found family medicine to be unique is that we had the opportunity to see a patient managed from start to finish i.e. from the moment they walk in until they leave. Whereas in other settings, such as the medical or surgical wards in hospitals, we only see patients at a particular time, perhaps before their surgery, or after their surgery. In the GP setting, we learnt how to take a history of the patients' complaints, perform necessary physical examinations, order relevant investigations/blood tests, prescribe them the appropriate medications, and follow them up as required. This made me realise how important the primary care consultation is for patients. The primary care physician is the first point of contact for patients, and they see undifferentiated cases (meaning patients which have not been seen by any other healthcare professionals before this). Their duty, among other things, is to ensure that no "warning signs" are missed. As an example, for every 100 patients who come in with the common cold, perhaps 95 of them do indeed have the common cold which will resolve by itself, while another 5 may have more serious underlying medical conditions that require further investigating. By looking for warning signs, the physician avoids misdiagnosing these five patients with a simple common cold.
4) Throughout the rotation, I found all the doctors (in both private and public settings) to be phenomenally nice and helpful. Each of them had their unique style of teaching, for example, by asking us to examine patients in the waiting room before presenting it to them, or by testing our book knowledge about common medical conditions encountered in this department. Generally, we would see a lot of patients with a history of diabetes, hypertension (high blood pressure), and dyslipidemia (high cholesterol). Others would present with more acute conditions, such as diarrhoea, rash, joint pains, or headaches. Regardless, we saw our fair share of cases during our time here.
5) Having finished our exam today, we have two days of "free time" before our next rotation (emergency medicine) starts on Monday. For both emergency medicine and radiology, our clinical attachment will be at Seberang Jaya Hospital (not the usual Penang General Hospital). I look forward to a fruitful and enriching experience in the coming rotations. And on that positive note, I'll end my blog post here. Thanks so much for visiting as always, and have a nice day. Take care and stay safe, cheers!
Look who I bumped into post-exam @ Gurney Plaza - Melvin and Melissa! :D
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