DAY 1548-1563

Nov 28 - Dec 13

1) A lot has happened since my last blogpost. For starters, I have finished my psychiatry rotation, and have begun family medicine. The scope of family medicine is very broad - it's a complete mix of all rotations, and it's quite impossible to predict what type of complaint the patient might come in with. There are, however, some problems that are more commonly seen in family medicine. These include diabetes, hypertension, and dyslipidemia (collectively known as "the big three"), Nevertheless, it's been really interesting visiting the different health clinics (Klinik Kesihatan) and private GP settings to see what goes on behind the scenes.

2) I am of the opinion that family medicine gives medical students the most exposure in terms of practical skills. We have a clinical logbook to fill, which includes a list of procedures which we should ideally observe, assist, or perform. Some simple procedures include taking blood pressure and pulse, calculating BMI, the different types of injections (e.g. IM, SC, IV, ID), wound dressing, using the ECG machine and interpreting the results, and many more. As the saying goes, practice makes perfect! Hopefully, we'll have practiced enough before sitting for our end-of-rotation exams.

3) Assessment for family medicine consists of two - the OSLER and DoSKE. OSLER stands for "Objective Structured Long Examination Record" - it is basically a 15-minute observed clerking of a patient, followed by a discussion on the differentials, investigations and management plan. The 40-minute DoSKE (which stands for "Documenting Skills Examination") assesses candidates on four tasks - writing a referral, writing a prescription, requesting an appropriate X-Ray, and requesting a blood investigation. At the end of the year - they will be the usual OSCE as well as written examination, consisting of single best answers, extended matching questions, and short answer questions. 

4) Studies aside, I've been quite busy with other events as well. I was an invited panelist for the "Aspiring Doctors Virtual Event", where I talked about my journey through medical school and intercalated masters. Here's the link of the entire video if you're interested - https://www.youtube.com/watch?v=a-ZCEj23vsY. Besides that, I presented a poster for the 31st International Symposium on ALS/MND, which was the culmination of my year long research as a Masters student. It was exciting to hear the progress made in the field of amyotrophic lateral sclerosis (also known as motor neurone disease) research.

5) Yesterday, I again went hiking up Penang Hill (Bukit Bendera) with my good friend Mad Noor. This time, we went up earlier, and I felt great going up the first half (to the lower station). A third way up the second half, however, I had a really bad stomachache. Knowing that I would not be able to reach the top in time, I had no choice but to descend back to the lower station where toilets were available. The worst thing is when I tried to resume hiking later, my muscles had cooled down and become a bit stiff. That made the second leg of the hike very arduous. Nevertheless, I made it to the top - eventually. We had a nice drink to cool off, before taking the tram down (that has become our routine).

6) All in all, it has been a productive two weeks for me. I anticipate that the days leading up to our Xmas break will be very busy, as I have a lot of catching up to do with my studies. That's all for today's blogpost - thanks very much for visiting, and have a great week ahead. Cheers! 

Dinner @ Lagenda House & Cafe, as recommended by Kuhan

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

Dinner with Afifah and Sharifah - after a very long (but productive) day at Bayan Baru Health Clinic

Lunch at Tesco Food Court with my group mate Sharifah and our other two 

"group mates" Rachel and Afifah :)

Meet up with my buddy Zi Yan at the unlikeliest of places - college!

Chilling with a drink after reaching the summit of Penang Hill - with Mad Noor :)

Now that the highlight reels are finished, here are all the pictures in chronological order:

I ordered the fish meal - which came with butterfly pea rice, soup, and a "congkak" set of appetizers! :)

A close up of the "congkak set" - which consists of omelettes, crackers, tomatoes and onions, cucumbers, and dipping sauces

The same dish, but after removing the pandan leaf which covered the butterfly pea rice

Here are all our meals!

For dessert, a beautiful panna cotta with strawberry sauce

Some sago pudding with coconut milk

Caramelised bananas with ice cream - yum!

Today, Sharifah recommended that we try this popular franchise called "3 Budak Gemok" (lit: Three Fat Guys") - after our morning clinic session

Their specialty is "ayam kicap sambal power" (or sweet soy sauce chicken with sambal chilli)

I really liked the sambal, as it had a nice kick to it!

We're in Pusat Sejahtera USM today, specifically the lab department. Here are some interesting charts on urine microscopy (and what to look out for).

This is a Roche Urisys 1100 urine analyser

(you can see the test strip - which is dipped in the patient's urine before being placed in the slot for automated analysis)

Guidelines for the measurement of HbA1c - an important diagnostic and screening tool for diabetes

This is the A1care Analyser

Sysmex KX21N haematology analyser - basically where all the full blood count reports are handled

The tubes with lavender tops are called "vacutainers" - they contain EDTA as an anticoagulant, and are used for collecting blood samples for analysis (using the haematology analyser above)

The name of the restaurant is Bangkok Tomyam

We ordered "tom kha" (Thai coconut soup), "ayam gajus" (cashew nut chicken), and "kangkung belacan" (stir-fry water spinach)

The "tom kha" was very rich in flavour, but could have done with a bit more spice :)

Getting ready to celebrate the most wonderful time of the year!

This was just the beginning - they've now added photo booths and other shops surrounding the Christmas tree!

Tried the sizzling mee at Gurney Plaza - extremely filling!

Lunch with friends

Sharifah swears by these - the Swiss Roll from Bread History

(upon her recommendation, I decided to try one myself)

I must say, presentation wise, incredibly beautiful and delicious-looking Swiss rolls

Blueberry and chocolate combo!

Originally planned to use the gym - ended up in the Mezzanine instead XD

Getting ready to present my poster to the world!

A fruitful and rewarding experience indeed! Next year's symposium will be in Basel, Switzerland

My apartment is getting a makeover

In case it wasn't already clear, the newly painted side is on the left (the grey tone colour scheme)

At the lower station again

The view from the lower station was amazing! Too bad it was also a lot hotter than usual

Not sure how anyone would bring their bicycles up here in the first place XD

Map of Penang Hill

Just 200m more to go (the summit is basically just Cliff Cafe)

There are at least ten stores just like these on the lower deck - ready to capitalise on the tired hikers (myself included!)

Oreo milkshake

That's the face of someone who doesn't care about the calories soon to be consumed

Another spot recommended by Mad Noor - Ali Nasi Lemak Daun Pisang (translated loosely as Ali's banana leaf-wrapped nasi lemak). They come in different flavours - cili bilis, udang, and sotong (chilli anchovies, prawns, or squid)

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