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...

DAY 1544-1547

Nov 24 - 27

1) Quite unlike the last blogpost where nothing much was happening, there have been a few exciting things happening these past few days. Obviously, the main reason I'm writing this post is because our psychiatry exams are over! Exams are never not stressful, so I was really glad to be the first batch of students to be called for examination. There were six stations, each with an examiner and a real patient. We had 15 minutes to clerk, followed by 20 minutes of presentation and discussion. Before I knew it, the bell had rung, indicating that time was up, and that I had to leave immediately. And just like that, Group B is done with psychiatry. That means we can look forward to starting our new rotation (family medicine) next Monday. 

2) Since coming back from the UK, I have been steadily gaining weight and developing really bad eating habits. It doesn't help that Malaysia has good food, and that my mum cooks really delicious food. On top of that, I have been neglecting my exercise, especially in light of the lockdown restrictions. It was my dad who encouraged me to change all this. I made a promise to myself that I would start exercising more frequently and being more active when I was in Penang. And of course, what better way to motivate myself than by enrolling in a virtual run. I enrolled in two - the Vitality London 10,000 and the Greater Manchester Marathon 2020. Both of these runs were held virtually due to the pandemic, so I could run it from home.

3) Using my fitness app that tracks distances via GPS, I began the arduous task of slowly regaining some of that stamina. Of course, it was a delicate task to balance my study time and my recreational time, especially as I could not afford to exert too much or risk being tired for the rest of the day. So baby steps it was. A huge advantage of the virtual run was that I could submit multiple runs and they would take the total mileage covered. This was especially important for the Manchester Marathon, as there was little chance I would be able to actually cover the full 42.2km in one go! So I split the distance into four runs - 10.5km each; I found this much more manageable. 

4) Long story short, I managed to complete both virtual races and submitted my runs online. Coincidentally, I received both finisher packs yesterday. Essentially, they represent the fruits of my hard-won labour - the race medal, finisher's tee, and some trinkets. Spurred on by my achievements, I went out for a longer than usual jog today. Most of my "baby-step" evening runs have been 15-20 min at a slow pace, so as not to tire myself. Today, I pushed really hard and completed a 5km in under 30 min. It was my first decent 5km run in at least two years. In London, during the Great King's Run, I had previously tried and failed to achieve this milestone, managing 5km in 31.5 min instead. 

5) Suffice to say, I was feeling pretty chuffed with myself after this run. Hence this blogpost today.  It is an incredible experience to feel fit again after so long, and I intend to maintain this level of fitness even as my study load increases. Anyway, that is it for this edition of my blog. Thanks very much for tuning in, and have a great day. Cheers!

Finally received my Vitality London 10,000 finisher pack! :D

Huge medal to commemorate this achievement!

The Greater Manchester Marathon has a special place in my heart - in 2018, I ran the full marathon (yes, all 42.2km of it) in aid of the Children Adventure Farm Trust (CAFT, UK). Now, I have taken part and completed the Greater Manchester Marathon 2020

Manchester Marathon medals are well-known for their enormous size and weight

Post-run snack, just a few weeks too late XD

My 5 km run today - it is not a particularly fast time, but symbolically, being able to run 5 km in under half an hour represents a good milestone for me :)

DAY 1529-1543

Nov 9 - 23

1) Not much has transpired since my last blog post. The partial lockdown is still in place, and if we're lucky, is expected to end by Dec 6. Until then, we've received confirmation that clinicals will continue as usual, which should mean no delay from my current rotation (psychiatry) to the next one (family medicine). Speaking of which, we have our clinical and communication skills (CASC) exam for psychiatry in just three days.

2) Essentially, we have one station with a real patient and an examiner. We are given one minute to read a scenario, and then we have fifteen minutes to clerk the patient. After that, we have twenty minutes to present the case summary, formulation, and management to our examiner. Believe me when I say that is a lot to get through in such a short amount of time. Nevertheless, it is an important skill to have as working doctors do not have the luxury of time; most consultations (especially the follow-up sessions) last at most 5-10 minutes! 

3) On a side note, it's already December - and so the year 2020 is coming to an end. And what a crazy year it has been! From mask-wearing to social distancing and distance learning, we've had to adapt so much to the coronavirus pandemic. Fortunately, there are many ongoing independent vaccine trials, many of which are showing really good promise. Hopefully, if the vaccines pass large Phase III Clinical Trials and are approved for public use, then mass vaccination can begin, and we may yet see a post-COVID world.

4) And on that positive note, I'll end my blog post here. I should really get back to preparing for my exams haha. Anyway, thanks very much for visiting as always, and have a great week ahead. Stay healthy and stay safe. Cheers! 

Completely unplanned meet-up with my buddy Sim!

@Granny's Cottage, Gurney Plaza

So there's this shop that sells Thai food in Gurney Food Hall

(this is their "red curry rendang set with rice")

This is their green curry set

And this is their basic chicken and egg rice set

(I really enjoy the curry as it rich and creamy)

My first Starbucks in a year :)

Random picture of a cat sleeping soundly

(@ Berjaya Court)

DAY 1517-1528

Oct 27 - Nov 8

1) What a difference another two weeks makes! As Malaysia expands its partial lockdown (called the Conditional Movement Control Order or CMCO) to include most states, both my hometown (Ipoh, Perak) as well as where I'm currently studying (Penang) are soon to be affected. This one-month partial lockdown is in response to the resurgence of COVID-19 cases in the community, with yesterday recording 1,755 new cases - the highest number of daily cases thus far. As a medical student, what this means (according to the e-mail sent to us from the college) is that all classes will revert to online mode. However, they are hopeful that clinical teaching should continue as before, which means we do not lose out on the all-important practical skills.

2) As it is, my group (Group B) is nearing the end of our psychiatry rotation, with just a week and half left before our end-of-rotation clinical assessment. In the past two weeks, we visited the psychiatric wards, the Health Clinics (at Perak Road & Macalister Road), the psychogeriatric clinics, and the private clinics (at Adventist Hospital). I have had the opportunity of engaging with a variety of patients suffering from mental illness, and I have found the experience to be invaluable. It is really interesting to see how the mental illness develops in a patient, and to explore the bio-psychosocial stressors that predisposed and precipitated the illness. Unfortunately, there also seems to be a lot of stigma and misconceptions regarding mental illness, the result of which is that patients often present late or not at all. Therefore, the onus falls on us to educate the patients and their family (as well as the wider community) about the myths and misconceptions that people generally may have regarding mental issues.

3) An interesting incident happened to me yesterday. After a long day, I was heading to sleep after using the bathroom, when I found myself locked out of my bathroom door. Somehow the door had become locked and the door knob would not turn. I spent a good hour or so trying everything I could, including the old "credit card" method, as well as by using scissors to hold the latch and try to push it inwards. Nothing worked, and I began to panic at the thought of having to call a locksmith. In a last-ditch effort, I searched online and found a method involving a coin placed into the indent of the doorknob. Lo and behold - that saved the day! Few things have given me more joy and euphoria than successfully unlocking my bathroom door. Now I am extra careful in making sure I do not close the bathroom door completely, just in case it gets jammed again. 

4) The next two weeks will be busy for me, as I will probably be preparing for the end-of-rotation assessment for psychiatry. Until then, take care and look out for yourself and each other during this most trying of times. Thanks for visiting my blog as always, and have a great week ahead. Cheers! 

Meet-up after a year! @ Nando's Gurney Plaza

(l-r: Melvin, Melissa, Kuhan, Esther, Myself)

Lunch at Sepoy Cafe with long-time friends :)

(l-r: Myself, Amir, Mad Noor, Alvin)

With my ever supportive sub-group mates (Group B3)

l-r: Myself, Sharifah, Angel, Ain

Psychiatry has been a blast thanks to them ft. myself as moderator for problem-based learning

l-r: Myself, Aida, Fadhli, Ainin, Jia Min, Jit Hong

Very big fish head curry for lunch today XD

The other day I hurt my left knee when I fell while jogging. It had healed quite well until I was forced to wear long pants to clerk patients in hospital. As my wound was still not completely dry, it stuck to my pant leg and when I tugged a little too hard at it, the whole scab came off! So for the rest of the week, I had to apply some antiseptic (betadine), a cotton gauze, and basically wrap my left knee using a crepe bandage. I'm happy to report that the scar is all dry and well now :)

Green curry rice set @ Food Hall, Gurney Plaza

Salmon teriyaki for dinner today :)

Ayam penyet (lit. flattened chicken) set rice

(Lunch menu at Sepoy Cafe)

Night life at campus XD

(Jokes - there is no life at campus)

Beautiful rangoli art in our college (for the upcoming Diwali celebrations)

The door that would not open (a.k.a. my bathroom door)

After over an hour of fiddling around, this was literally my last attempt

Lo and behold - the knob turned!

Never have I been so indebted to a 50 sen coin :')

Signature chilli pan mee @ Food Hall, Gurney Plaza

Even more beautiful Diwali decorations at Gurney Plaza today

DAY 1503-1516

Oct 13 -26

1) Since my eventful trek up Penang Hill two weeks ago, life has returned to its normal, slightly monotonous self. I wake up early, get dressed, take a Grab taxi to school, attend lessons (either on campus or in the wards, depending on the schedule), and then return home, usually quite tired, in the evening. In the blink of an eye, I've survived three weeks of psychiatry rotation, with another three weeks to go before our end-of-rotation clinical examinations. 

2) Coming back to medicine, I realise the difference between conducting research and being a medical student. With the former, one has to be really knowledgeable in a relatively small field of research topics. Critical thinking, including interpreting results, modifying hypotheses, and re-testing hypotheses, as well as presenting one's findings and the significance of those findings - these are the core skills tested in conducting research. Medicine is much more hands-on in that it requires a basic/foundational knowledge in a relatively large and diverse field of health sciences. Good communication skills, patient interaction, and clinical skills, as well as the ability to remain calm and collected in emergency situations is key to being a good medical student.

3) Compared to the other rotations that I have experienced so far, psychiatry is unique in that it is very well structured. We have different "themes" each week, and our course book (we use the same book from RCSI) very helpfully details the chapters that are covered for each particular week. For example, in week 1, we tackled bipolar and other mood disorders (depression and mania). This week, we will look at child psychiatry and psychiatric conditions in pregnancy. The other rotations, while well-organised, are too broad in scope to allow for such categorisations; the student has to just absorb as much as they can before the rotation ends.

4) Moving away from my studies, I've also forced myself to get out and exercise in the evening, no matter how tired I may be after lessons. I usually go for a very short jog around the park just outside my apartment. The main idea is to keep myself in shape and not constantly out of breath (medical school can be very physically demanding too!) Last Saturday, I went out for my evening jog. It had just stopped raining, so the pavement was quite slippery. Unbeknownst to me, a stretch of pavement was littered with small berries that had fallen from a tree. These berries had been squashed by people walking past, making it all the more slippery. 

5) Long story short, I slipped and hit my left knee - hard. At first, I brushed off the dirt from my knee and continued jogging. After I finished, I noticed my knee was now bleeding, and the blood had trickled down my socks. Luckily, it was not a very large wound. I quickly bought dinner and went back to wash the wound thoroughly. The problem with the wound is that it is right where I would bend my knee, which means as the wound heals and forms a scar, I have to be careful not to extend too much or the scar would reopen. 

6) That is basically it for my blog. Unfortunately, no more interesting activities or events for a good while, as I imagine things will get a lot busier in the coming weeks. Thanks for tuning in as always, and have a nice week ahead. Cheers!

With Malik and Ice, whom are now no longer my batchmates *cries*

Fragrant yam rice with pork belly soup

Today, as I was studying in the library, I suddenly heard a loud "CRASH!" Turns out a falling branch had destroyed a small section of our campus compound. They've since repaired it and trimmed the remaining branches off

Nasi goreng pattaya, or "omelette fried rice", topped with sweet chilli and fried shallots

Reuniting with more friends over lunch, @ Sepoy Cafe

My running garb (my shorts don't have pockets so I need a sling bag to store my phone)

Tried salmon fried rice today - very filling, especially after a long run!

Such good fish for less than RM10 (£2)!

Today's special was rice with black pepper chicken (I think XD)

I was at Gurney over the weekend, and this is one of the Thai cuisine restaurants that I frequent

(I think this is called "nasi paprik")

Spring rolls (first time I've seem them served with a soup base to dip!)

Gurney Food Hall, my go-to place for the weekends :)

Inside Gurney Plaza (the Food Hall is on the 4th floor)

Sitting with the chef himself - a nice way to enforce social distancing

These buzzers are really cool - they go off when the food is ready

Some snapshots inside the Food Hall (it usually gets really crowded by noon)

Today I tried their chicken rendang with red curry - was not disappointed!

They call this "nasi hujan panas" - which literally means "hot rain rice" - I've no clue how they came up with such a name, but it goes really well with the fried cabbage and curry

When I first returned from Dublin two years ago, I went jogging in First Garden and fell on my right knee. Now karma dictates that I need to damage my left knee to even it out...