DAY 2218-2239

Sept 28 - Oct 19

1) Finally some time off to manage my blog - it's been a while since I last updated this. Anyway, I've been busy these past few weeks, starting with my first set of night shifts (from 21:00-09:00), then switching back to regular day shifts, then back again to nights. Night shifts are quite interesting in that generally, the management is less curative than it is supportive. For one, the management plans have already been laid out by the consultants on the day team. As the night team, our aim is to ensure these plans are actioned throughout the night. We'll also adjust any medications / intervene according to the patients' condition, and basically keep them going until the morning handover.

2) Conversely, patients also tend to do poorly at night. Whether this is sundowning in patients with dementia, or diurnal variation in patients with asthma, patients tend to deteriorate easily overnight. Given that there are less staff in each ward, the burden then falls on the night team to prioritise patients who are the most unwell first. During my short stint in the AMU (Acute Medical Unit), we would clerk and examine all newly-admitted patients that had not been seen in the ED. Over the course of the night, some patients would desaturate, some would spike temperatures, yet some others would self-discharge against medical advice, and some would unfortunately pass on. Come morning, we would post-take (i.e. see) the new patients with the consultant, before handing over any outstanding jobs to the day team.

3) In addition to ward work, doctors on any training pathway are required to maintain a portfolio. At the end of each year, this portfolio is reviewed by a committee that decides if the doctor is allowed to progress to the next stage of training. To fulfill the criteria set out in the portfolio, we are required to engage in a variety of supervised learning events, including case-based discussions (CBDs), direct observed procedural skills (DOPS), and mini clinical evaluation exercises (mini-CEXs). In addition, we need to log in a minimum of 60 hours of learning, write some reflections, and get involved in an audit / quality improvement project. In short, there is always something to do throughout the year. 

4) All in all, while it is indeed challenging, there are many good learning opportunities working as a junior doctor in the NHS. And with that, I'll end my blog post here. Thanks very much for visiting as always, and have a great week ahead. Cheers!

An apple a day might keep the doctor away, but a cup of coffee keeps the doctor awake

(My first set of night shifts was brutal if I'm honest)

Privileges of being a member of the doctors' mess

Stocked up on some white boards - very helpful in penning my thoughts or for doodling...

Doodle exhibit A: One can dream XD

View from home

Hearty breakfast after a long night

Still happy as always :)

Full moon tonight

DAY 936-948

Mar 26 - Apr 7

1) And yet in another blink of an eye (for me, at least - I've lost all concept of time) another two weeks have flashed by. Our medicine rotation is finally over (for Group B), and the upcoming public health rotation promises to be more "relaxed". I am delighted to have survived both surgery and medicine rotations, and to have public health as the last rotation before our end-of-semester exams in May.

2) As it is, I cannot believe that four months have passed by so fast! I still remember coming to Penang in January, and moving in to Sri York with my housemate, and saying goodbye to my family once again :'( Heck, it was just yesterday that I touched down in KLIA, after spending my last days in rainy Dublin. Everything seems to have whizzed by so fast - a little too fast if I'm honest. I sometimes like to take a breather and to think back about all the adventures and memories that I've made - it's so easy to forget in the midst of everyday life!

3) Back to reality then. The other day, as part of our portfolio review for medicine (consisting of 10 case write-ups and some other stuff), we had to print out the feedback of those write-ups. Uproar ensued as the library printers (and if I'm honest, all printers in the college) stopped functioning in accordance to Murphy's Law - whatever can go wrong, will go wrong. It was at the last opportune moment that the librarian managed to fix the printer, and I was first in line to print the remaining feedback (for those wondering, I couldn't print it out any earlier as I needed to get the feedback from the examiners first). What a RELIEF!

4) The medicine portfolio was a cinch compared to the surgery one. Just 10 case write-ups, as opposed to 23 cases, and we could type it out as well! The only downside is there was no added time after our medicine end-of-rotation assessment (EORA) to compete the portfolio (in surgery we had around 5 or 6 days to finish our surgical portfolio after EORA). For public health, continuous assessment (similar to EORA) is via a 10% report regarding a health-related topic (mine is entitled "Effect of Monsoons on Health in Nepal"). At the end of the semester, we have our end-of-semester exams, consisting of an MCQ (multiple-choice questions) paper for Medicine, and an MCQ paper and OSPA (Objective Structured Practical Assessment) paper for Public Health. There is, thankfully, no MCQ paper for surgery, yet. (Please don't get any ideas)

5) For public health, we are split up to three groups - one for each District Health Office (DHO) location, namely Seberang Perai, Barat Daya, and Timur Laut. I've been assigned (without much choice actually) to Seberang Perai - the furthest location. The upside is my entire Seberang Jaya Hospital "crew" (namely Ray, Mahitha, and Ruth) have been posted here too, which is great! We only travel to the DHO thrice a week; the other two days are spent in the lecture theatre at RUMC.

6) That is basically our rotations in a nutshell, hopefully it provided some insight/ was at least mildly entertaining to read haha. Thanks very much for tuning in, and have a nice week ahead. Cheers!

On the road back home (just the first left and voila - Sri York!)

Spotted this during MPU (General Studies) Presentation (our "Ethnic Relations" module is in 

Malay Language)

Close-up of the white text from above - showcasing the diversity of our language (or serving to confuse just about everyone else)

So the other day Denise introduced me to this cafe called Harvest Times Cafe - a 10 minute drive away from accommodation...

Their soup of the day - creamy mushroom soup with bread basket

Garlic butter chicken kiev - served on a bed of mashed potatoes and salad

Grilled tilapia in basic white sauce

Our set menu came with dessert - cake and ice cream! :)

So another one of Denise's recommendations - chicken shawarma @ Gurney Paragon!

Thumbs up and all smiles XD

Gula melaka (brown sugar) ice cream - as you can see I am a desserts kinda guy XD

Finally got round to trying this - a huge bowl of tom yam (sour and spicy) seafood noodles

- at Sri York Cafeteria! 

Absolutely wonderful and spicy too haha

DAY 912-914

Mar 2-4

1) Back at it again with the blogs - it's the weekend and I'm desperately trying to finish my portfolio for surgery. In between all that hullabaloo, there's of course time for some enjoyment.

2) Saturday night - our surgical end-of-rotation assessment done, the SpaceX Falcon 9 rocket launched into space to dock at the space station, and my friends and I went to Gurney Plaza to have dinner. I had just finished dance practice with my other batch mates for the final dry run before our dance performance on Sunday morning. Anyway, we went to GO Noodle House for dinner, and I tried their house specialty triple dark sauce "pan mee" - very fancy name, but very delicious indeed.

3) It has become somewhat of a routine for me to go out with Denise, Aden, and Aly at least once a week (especially the weekends). I've never found the time to do anything else during the weekdays but collapse onto my bed after coming home from college. That being said, we've definitely come a long way in our clinical experience, even if it has been nary a month or so since we started back here in Malaysia.

4) Sunday morning - all dance groups met at the stage for our final practice. Self praise is no praise, but today I finally felt our group (the Dikir Barat dance) click together - we memorised our moveset AND lyrics, and it all seemed to work out perfectly. Of course, this was during final rehearsal, and we still had the actual performance to worry about. The order of dances was as follows:
Malay Dance --> Sabah/Sarawak dance --> Chinese Dance --> Silat --> Dikir Barat --> Bollywood Dance. There was a 10-minute break in between each performance, which meant we only started at 10.40am. That gave us plenty of time to explore the carnivals.

5) In the end, it was showtime. Time to dance for our marks (as opposed to singing for our supper XD). I honestly think we put up the best version of our dance ever, as all the moves, the timing, the lyrics, and the cohesiveness of the team as a whole --> everything worked out perfectly! (perhaps the thought that we were being filmed, and therefore probably assessed for marks later on contributed to the exponential increase in dance quality).

6) With our part over, we stayed on for the last dance to cheer our friends on. I then waltzed over to get a RM20 coupon book - to be used for the many stalls at the carnival. I saw a stall offering haircuts for RM10 - a steal anywhere in Malaysia. As my last haircut was almost 2 months ago, now would be the perfect time to go get one. And luckily I went early - when I was done, there was a whole line of people waiting to get their haircut. I was thoroughly impressed with my new look - to be honest I didn't expect as much for RM10 at a charity carnival.

7) With my remaining coupons, I bought some snacks and lunch (pomme aligot - cheesy whipped potatoes with German sausage, strawberry and plum popsicle, and homemade chicken pie) in order to finish off all the coupons. It was blisteringly hot by this time (noon), but I felt like a million bucks (probably a lot cooler without the extra layer of insulation over my head XD). The rest of my day has been spent at home, preparing for our next rotation (Medicine) that begins tomorrow. That's it for this edition of my blog, thanks for tuning in, and as always, have a great week ahead. Cheers! :D

The Dikir Barat ensemble - phenomenal job guys!

(sorry I couldn't record as my phone data is as near as dammit full)

All smiles for my new look - I honestly had NO idea how I looked at this point - as there were no mirrors around! XD

Saturday night dinner with friends @ Gurney Plaza

Triple dark sauce "pan mee" with onsen egg - very authentic, very filling :)

GO Noodle House

Sunday morning- last minute practice before the event began!

Each white tent is a separate stall offering various services/food items/snacks

Everyone crowded over to watch our performances

RUMC Student Services set up shop at the entrance - providing advice and counselling to future prospective medical students

The Sarawak/Sabahan dance - really sorry I missed the first dance!

Dance #3 - Chinese fan dance

Dance #4 - Silat exhibition!

Dance #5 - Dikir Barat - our starting pose

I'm in the middle row second from left (obscured completely in this pic haha)

Pommes aligot (cheesy whipped potatoes) with German sausage (LHS)

Strawberry and plum popsicle (RHS)

That's me AFTER the haircut - I honestly think it's really good haha

DAY 216

Apr 5

1) Today has been a typical day for me in the library. Having struck the Histology Quiz off the list, I'm now left with the submission of two individual assignments, after which it will be the finals that I'm preparing for. I drafted out a simple schedule to follow for the next month or so, which (fingers crossed) will allow me to finish revision by the time exams come about.

2) I spent the better part of the morning working on one of the individual assignments (ICP1). We still have two more patient contact sessions - one at the next Healthcare Symposia, and the other at the Expert Patient Session tomorrow. After that, we'll have all the material to finish our ICP portfolio. Over the course of the afternoon, it was back to revising the usual cycle of GIHEP, FUN2, REGUB, and some anatomy.

3) Tomorrow represents a bit of a crisis for me. I agreed to volunteer for the REACH RCSI Sports Day 2017, but at the same time that means I'll have to forgo both Anatomy Practicals and possibly, the Expert Patient Session. It was a TOUGH choice, but finally I decided that I'd skip lessons tomorrow. Anyway, I'll worry about that another time. I still have all these lessons to sift through, and not a lot of time at all. Our first final exam starts barely three weeks from now, so it's best to start ASAP. That's been my day today, and thanks as always for reading. Have a great day, cheers!

Throwback to a coin

(Vote RSU - yep, just trying to throw in some subtle hints here ^^)