DAY 2267-2288

Nov 16 - Dec 7

1) Four months have passed since I started working here in the UK. And just like that, my first rotation (in gastroenterology) is over. As I walked through the double doors one last time, I couldn't help but reflect on my journey so far. From our first week of shadowing and induction, and not knowing where the antibiotics section was on the drug chart, to gaining confidence in performing my own ascitic drains / taps - it has been a very rewarding journey indeed. 

2) I had previously assumed that being in gastroenterology meant that I would spend most (if not all) my working hours here. Interestingly, that has not been the case. In fact, I have often been called to work in other medical departments including the Acute Medical Unit (AMU), Emergency Department (A&E), and Frail & Elderly Assessment Unit (FEAU). While I definitely appreciate the exposure to other wards, I feel that this has somewhat disrupted the continuity of care towards my patients in the gastroenterology ward. On the plus side, I have now become a bit more confident working in other departments.

3) Now on to my next rotation - trauma and orthopaedic (T&O) surgery. I have recently been attending their Monday teaching sessions, which I have found very useful. Of course, the excellent free lunches may also be part of the incentive to attend. Regardless, I start my first "official" working day in T&O today. Having previously shadowed a fellow colleague, I hope that I have developed enough basic skills to survive the next four months. I'll share my thoughts working here in the next blog post.

4) This brings me to my last update - the formal assessment for the "Research Methods in Health" module, which is a pre-requisite for doctors on the Specialised Foundation Programme (SFP). We have two exams coming up - an online exam (MCQs and SAQs), as well as a 2,000 word essay to write. Fortunately, I have already submitted my essay, so it's just the online exam which I need to worry about. If I'm honest, I had not expected how challenging it might be to juggle between studying for exams and working at the same time.

5) And that's about it for this edition of my blog. As always, thank you for visiting and have a great week ahead. Cheers! 

This is ascitic fluid for analysis - patients with liver cirrhosis tend to present with fluid in the tummy (ascites) which can be really uncomfortable. If it's large enough, the ascites can be drained, and we can do this manually in the ward itself. Whenever we do an ascitic drain, we also send some ascitic fluid to the lab to rule out an infection.

This is blood for blood culture - patients who appear septic / spiking temperatures would require a septic screen, which includes (among other tests) a blood culture. We send a sample of blood to the lab for analysis, to find out if any microorganisms have invaded the bloodstream, and if so, what antibiotics they are susceptible to. This guides our choice of antibiotics.

A very useful 2-in-1 clipboard / file

So you can store notes and use it as a clipboard

Bought myself a sturdy umbrella after my old one broke

Hits a little too close to home XD

Meet Anas - RCSI Bahrain graduate, fellow F1 doctor, and lunch buddy for today :)

Before it was cold, it was foggy

This is the foggiest night I have ever encountered anywhere

Literally can't see 50m ahead

Chylous ascites?

Literally my last ascitic drain for the rotation

Ward 230 - Missed but not forgotten

What I walk into pretty much every morning

DAY 2204-2217

Sept 14 - 27

1) It's been two months now, and the F1 doctors are halfway through their first rotation. For the past week, I've been assigned to the acute medical unit (AMU), and specifically to see patients in the Emergency Department. I thoroughly enjoyed my brief time here, as it gave me the opportunity to see undifferentiated patients and develop an approach to examining and managing common presentations. 

2) An update from my previous blog post regarding the Prescribing Safety Assessment (PSA) - I passed! This means that I have fulfilled one of the mandatory requirements for progression to the next year (F2). It also means that I have one less item to worry about, as if working and learning on the job weren't stressful enough... 

3) Recently, we've had Keele medical students (usually in their final year) shadow us throughout our shifts. They would clerk and examine patients, and present them for discussion before getting signed off. They were also allowed to prescribe medications using their "purple pen" - an excellent initiative by the university to expose medical students to prescribing before actually starting work. Of course, each prescription would need to be checked and countersigned to ensure patient safety. I've relished the opportunity to assist and guide these medical students, as i) I've only recently graduated and so can relate very much to their challenges, and ii) because I hope they will learn from my mistakes and become better doctors. 

4) With the PSA out of the way, I can focus on doing my job, and also look through the requirements for progression into F2. Essentially, every junior doctor keeps an online portfolio which records any procedures, skills, teaching, and reflection done. Certain assessments (such as the PSA and ALS training) are mandatory for progression. At the end of the year, a review is carried out by senior consultants to decide if the doctors are allowed to progress into F2. I have only just started skimming through the requirements for my e-Portfolio, and hopefully I'll be able to get started soon.

5) Other events that have transpired in the past few weeks include the temperature dropping quite significantly (especially in the past week), and me getting a haircut. I also got some proper winter clothing to keep me nice and warm for the coming winter. So far so good - I'm happy to be working here and looking forward to learning more on the job. That's it for this blog post, wishing everyone a great week ahead, take care and stay safe. Cheers!

Unplanned lunch and catch up with Ivan - fellow F1 and proud Trinity graduate :)

Back at the Health Library - very conducive place to revise or relax

This overhead bridge connects the Health Library to the Lyme building of the hospital

View from the overhead bridge

Different venue today for our fortnightly academic training sessions

The hospital cafeteria does really good Sunday roasts

Post haircut smile - on my way to Newcastle today

Our Lady of the Angels and St. Peter in Chains - a Roman Catholic Parish church built in 1857

Costa Coffee for a light lunch after walking the better part of 4 km

This is the largest cappuccino I've ever had

On the way back home from Newcastle

Got some new threads for the cold :)

DAY 789-793

Oct 30 - Nov 3

1) This is turning out to be one hectic month. We have yet another quiz on Monday (Nov 5), this time on the "REGUB" module (Renal Endocrine, Genitourinary and Breast). Amidst all the studying and stressing about, I've found some time off to attend a session with the other PMC scholars at RCSI. This is the first meeting we have had as a group, and we aim to expand on this to facilitate better transitioning from each year to the next, especially the transition back to Penang, Malaysia.

2) It was a short and informal meeting we had with Mr. Philip Curtis, Director of Student Recruitment, Admissions & Student Services. He informed us that he would have a meeting with the UCD correspondent, to see if we could form a group comprising PMC Scholars over the years. The main goal would be from an academic point of view, including feedback on how to improve the programme as a whole.

3) The rest of the week has been pretty much the same, but one thing I've come to appreciate more is the drastic change in colour as autumn comes. The fallen leaves turn the ground many shades of red, brown and orange. I'm not sure why I haven't noticed it before, but it looks very beautiful! I won't be seeing much of that back home, that's for sure. So best to make the most of my time here. Sadly, most of it will be spent burying myself in my books. Anyway, that's all for today's blog update, and stay tuned for more. Have a good one, cheers!

PMC Scholars from across three years!

Back row l-r: Melissa, Me, Talal, Mr. Philip Curtis

Front row l-r: Engracia, Aisha, Sarah, Shu Chen, Jamie

Empty library is the best library ^^

Halloween food!

Roast chicken with carrots and colcannon mash

(mashed potatoes with chopped cooked kale, green onions, milk or cream, and lots of butter)

DAY 781-788

Oct 23-29

1) So this Sunday I took part in the 2018 SSE Dublin Marathon. It was meant to be my final swan song before returning to Malaysia, but it didn't go according to plan. If there's one thing I've made clear that I wasn't a big fan of here in Dublin, it's the weather. Particularly the perishingly cold weather that we were subjected to today.

2) Anyway, things kicked off relatively well - we took a nice group photo in front of the college, and then got ready to run in our own waves. I thought that I had accounted for the weather by suiting up with thermal wear underneath the singlet and shorts, but evidently I was wrong. I started off happy, running on the spirit and atmosphere of a fantastic crowd.

3) We had a couple of tough slopes to overcome, but in the end - that wasn't the deciding factor in my unimpressive DNF today. Yes, I did not finish the marathon today. Everything was going fine for the first 10km. I met a couple of doctors and we had a lovely chat. The Sun was out for some time, and my prospects were looking quite good at the moment.

4) Then, after the halfway mark (which is 21km by the way), my calves started cramping. Common sense dictates that you stop and rest, but at the same time, I'm well aware that stopping completely only makes things worse. So onwards till mile 16 it was, when the temptation to have a little rest by the pavement got the better of me. Depending on how you look at it, it was either the best or worse decision I made.

5) For the next fifteen minutes my calves and ankles spasmed uncontrollably, and any sort of movement (flexing, extending, adducting or abducting) would trigger a spasm of some sort. I was literally hunched over, a mixture of disappointment and anger as I knew a) the race was practically over for me, b) I might have averted this if I had layered up more and rehydrated a lot more. Ankle spasms are completely new to me, and they felt a lot worse than the usual ones I get in my calves.

6) An EMT (Emergency Medical Technician) came to assist me, and when I first tried, I couldn't stand up. After some time, I could stand up and hobbled my way to the medical tent - which was thankfully only 20 paces away. The sight of rain and a gloomy sky seemed to be giving me all the signs to stop and call it a day. So they called a van to pick me (and some other runners) up and bring us back to Merrion Square - the starting point.

7) Along the way, I had plenty of time to reminisce about the situation. On one hand, bitterly disappointed that it had to end this way, considering I wouldn't be returning for the next iteration of the marathon. But on the other - perhaps it had all been for the better that I did listen to my body. If I had successfully finished the marathon but at the expense of my health, would it have been worth it? But it's easy to think clearly when it's all over, not so when you see waves of runners finishing up and start thinking "why did I stop?"

8) Finally, some of you (or let's be honest, maybe none of you XD) may have been wondering why on earth I would take part in this gruelling event in the first place? With little training, a lesion in my lung, absolutely nothing to gain as I've done the marathon before and finished in time, why would I even bother? To be honest, the main reason is much more personal than all that. I'll leave it at that. But after more than a half marathon, what gave way was my legs, not my lungs.

Thus, the moral victory is mine...

That's basically it from my blog, thanks very much for visiting. Have a nice week ahead, cheers! :)

The RCSI Running Team for the SSE Airtricity Dublin Marathon 2018

The night before the run :))

From l-r: Shwe, Areen, Myself, Jane

(just before the starting gun went off)

DAY 758-767

Sept 30 - Oct 9

1) And just like that, another week has passed. A week which has seen me try my best to prepare for our "quiz" - worth only 20% for each module, but at this stage in our course, every single percentage counts. Tropical Medicine and GIHEP (Gastrointestinal Hepatology) were the two modules we were tested on, one after the other with no break in between.

2) Although it was only MCQs in this particular quiz, that didn't make it any easier, at least not for me. Sometimes it feels like no amount of studying would have prepared me for the type of questions asked. Anyway, as they say, that's a thing of the past. Now it's onwards to the next couple of tests in the coming month - REGUB (Renal, Endocrine, Genito-Urinary and Breast), and CNSLF (Central Nervous System, Locomotor, Forensics) - not to mention a pass/fail OSCE in between.

3) You'd expect a brief respite after racking our brains over those two exams in the morning - but as this is RCSI, nothing can be further from the truth. We had four hours worth of study after our exams, compounding to my misery of not having slept enough these couple of days. Plus as they've long started the other modules and I haven't really looked through any of them since I was too busy revising for this exam, I now have to play catch up for the rest of the week. As if I didn't have enough already haha.

4) Anyway, in a sort of ironic way, this is preparing us for reality. When it comes to patient wellbeing (and indeed, their lives), there is simply no excuse. The plus side is the semester seems to be flying by. It's hard to believe that we're deep into our second month, and about a third of the semester gone. Here's to more knowledge acquisition in the coming weeks/months, and to achieving our desired grades in our exams. That's it for this edition of my blog, and thanks as usual for checking in. Have a lovely week ahead, cheers! :D

Post exam "celebration" - lovely Beaumont staff cafeteria food :')

(l-r: Sarita, Joshua, Aliyah, Yours truly, Zi Yan)

Curry lamb with rice and carrots :)

Chicken and mushroom pie - this tasted really awesome :)

Vegetarian something with stuffing and carrots XD

My host mom Emma bought me this really fancy luxury chocolates after coming back from holiday!!<3<3<3

Fish and chips - a staple here in Ireland. Really fresh fish too ^^

And one more for the record :)

DAY 489-493

Jan 2 - 6

1) If you've been following my blog recently, I'm sure you would have noticed the increasingly sporadic blog posts. I suppose it was unavoidable; as medical school progressed, so too did the workload, and on top of all that, I have other responsibilities to shoulder as well. Most recently, after coming back from my "Winter Wonderland" trip, I was faced with another challenge - to pack my stuff and shift to Beaumont - where I'll be spending the rest of this year.

2) So I've spent the past couple of days packing. It's amazing how much more stuff I have compared to last year (when I moved out of Leeson to Dundrum). Finished stowing away all my belongings and cleaning my room, and bade goodbye to my wonderful host Suzanne, before calling a taxi all the way to Beaumont - from one end of the city to the other.

3) Me new host - Emma, greeted me with open arms at the doorstep of her house. After an evening of just relaxing and taking some much needed rest, I've been exploring the vicinity the following morning. There's a medium-sized shopping centre (Northside Shopping Centre) just 10 minutes away. Also, Beaumont Hospital is right behind my house - literally. However, the Education Centre (where RCSI students are based and attend lectures) is located at the opposite end of Beaumont, right beside the main entrance. That means I will have to circumvent the perimeter of the hospital, which is a piece of cake compared to having to travel by bus all the way from the city centre.

4) I'm currently in the library typing away. No one else is here except for two other students. It is a quiet Saturday, just two weeks before school officially reopens. I might as well savour the free time I have now before things become hectic again haha. Anyway, that's all in this blog update, and I hope you enjoyed reading. Thanks for visiting, and have a great day. Cheers!

Last pic with Suzanne and Muireann,

in front of my accommodation for the past half year

My room after my Herculean effort in packing up and cleaning up

My new room :))

(Just after I unloaded my belongings...)

The laceration marks after lugging REALLY heavy luggage that cut into my skin XD

St Luke the Evangelist,

Kilbarron Rd

Northside Shopping Centre

(a slightly smaller St. Stephen's Green Shopping Centre)

Small and comfy interior

Lunch at Sbarro just now

This is literally behind my house

In the virtually empty RCSI Beaumont Library ^^