Chan Weng Kit's Blogspot: DAY 1670-1674

Mar 30 - Apr 3

1) X-rays were first discovered by Wilhelm Roentgen in 1895, when he discovered that the cathode radiation he was experimenting on passed through human tissue, leaving bones and metal visible. Fast forward to today, and X-ray radiography remains one of the cheapest and fastest non-invasive imaging techniques available. We use X-rays for a variety of diagnostic purposes, as a screening tool to exclude fractures or foreign objects, and to visualise the proper placement of various lines and tubes. The reason for this brief history of the origin of X-rays is because, for the past week, we have been posted in the department of radiology, at Seberang Jaya Hospital.

2) There are four commonly used imaging modalities in the current hospital i.e. radiography (X-rays), ultrasound (US), magnetic resonance imaging (MRI), and computed tomography (CT). Each imaging technique serves a different purpose. For example, X-rays are really cheap, fast, and convenient, and can easily detect most bone abnormalities e.g. deformities, fractures, and some tumours. Ultrasound and MRI are more useful at detecting soft tissue abnormalities e.g. specific organ damage, tears, and ligament injuries. They also do not expose the patient to any radiation, compared to X-rays. Regardless of their strengths and weaknesses, each imaging modality has a role to play, and the expert radiologist only selects the test(s) based on what is absolutely necessary to answer the clinical question.

3) In radiology, each one of us was assigned a different station each day, such that by the end of the week, we had covered all the imaging modalities in the department of radiology. In addition, we had afternoon lectures/tutorials to consolidate all that we had seen in our practicals. I was indeed fortunate as all the doctors and technicians that I observed were very happy to teach, and as a result I was able to learn a lot. Fun fact: when I was quite a bit younger, I had somewhat of an aspiration of becoming a radiologist - as that would mean secluding myself from everyone, interpreting scans and just writing up radiology reports. Having been through the rotation, however, I realise that radiology, much like other departments, is very much a team-based effort, in the same vein as emergency medicine.

4) For the past week, I observed as medical officers, radiographers, and technicians worked together to coordinate the entire process of preparing patients for imaging. For example, someone has to set up the X-ray machine and place the patient in the correct orientation (e.g. standing or lying down) and at the appropriate distance away. Someone else has to key in the patient's details, select the correct body part to be analysed (e.g. chest), the view and orientation, as well as ensure the appropriate level of radiation exposure, including any precautions (especially for children). Next, someone has to interpret the test results, and write a radiology report with the impression of what the scan shows. This would sometimes involve discussion with the specialists if the case was more complex. As you can see, a lot of people are involved in the wellbeing of just one patient. And there would be a long line of patients from morning till lunch time.

5) Having finished yet another rotation, we have a one-week break for "self-directed learning" before continuing with the next two rotations in this multi-specialty block - ENT and ophthalmology. That would lead to the final rotation of fourth year which is obstetrics and gynaecology. For now, however, we get a break. And it couldn't have come any sooner. Thanks very much for visiting my blog as always, and have a great weekend. Cheers! :D