Saturday, September 5, 2015

For D

2 weeks of elementary classes before the clinical posting starts had just ended yesterday. The first week we learnt about how to take the history, some introduction to the postings; internal medicine, surgery, paediatrics and o&g, introduction to the operation theatre, how to build rapport (therapeutic relationship between doctor & patient), universal precaution that have to be taken seriously before examining the patients and so and so. The second week was all about the physical examination. How to perform cardiovascular, respiratory, abdominal and neurological examination.

History taking is the most important part as 70 percent of diagnosis rise from it. So it should be done correctly, precisely, accurately and so and so, followed by the physical examination and then the laboratory investigation. History taking looks like it is easy to be done. First, build the rapport. Then ask the patient what brings s/he comes to the hospital (the chief complaint). Based on the complaint we proceed to the history of presenting illness, past medical history, family history, drugs history, and social history plus menstrual and gynae history (for women). Looks easy, just talking-asking and listening to the patients. But actually for a beginner like me it is way difficult. Cause the time you heard the chief complaint, you must already have some differential diagnosis in your head so that you can ask the patients questions related to the diseases that you expect the patient have. One chief complaint leads to many possible diagnosis. 

Then look for positive findings and important negative findings to exclude some differential diagnosis. My basic medical sciences is suck. I think last two years I learnt only for the sake of passing the block exams & professional exam. And I used to study last minutes, a week before the exams. So that is why during the physical examination classes when the lecturers asked why this patient has this and this, if the abnormal finding is this what is the possible diagnosis, what is the pathophysiology of the symptoms, why? how? can you explain further? I CANNOT ANSWER IT and it is so frustrating. Yes, there's certain questions that i can answer but still it pissed me off. 

Now you see, this is the result for studying just for the sake of exam. As the exam ends, the knowledge starts to disappear as well. 

I will starts my paediatric posting this coming Monday (7th Sept). So now I needdd to clear my mind. Buka buku baru. All the things I am going to learn in paeds are what I will be encountering during my practice as a doctor. Learn by heart. Read, understand, remember and apply. Learn with all my heartttt. I am going to be a doctor. I am needed by the people to treat them. I need to be excellent in my study. I need to be persistent in my study. I need to. 

"If you want to be a doctor, be a good one"

Clerk patients at least 5 patients per day. Practice physical examination on them. Study the common cases in Malaysia first followed by uncommon one. Be positive. Always. If the lecturers get angry with me (obviously there is something wrong I have done) dont be disappointed. It means that there are many things that I have to learn, dont be depressed. Do not. Always be positive. Make a study group. Study! I am going to become a doctor and I have to be a good one. Let's work hard and smart for D (distinction)! 

I can do it.

Sure things will become more challenging in clinical years. No more spoon feed. I have to be more independent. It is not easy to become a doctor. But it is not that difficult to be the one. Many have succeeded. And now it is my turn to be one of them.

I can do this.
I will become a doctor in 3 years time!

"Have courage & be kind"