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.

Positive!

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" 

:)

Another Random Post

Masa sekolah dulu aku suka tulis surat untuk diri sendiri. Selalunya surat tu pasal hal-hal yang berkaitan dengan future plan, do's & don't, motivational thoughts lagi-lagi bila aku down dekat nak exam ataupun rasa insecure dengan something. Entah mana tah semua surat tu pergi. Aku pun bukannya jenis orang yang pandai simpan barang. Tau-tau je dah hilang. Tau-tau je dah takde. Tak reti jaga barang orang kata. Memang. Handphone baru setahun dah berlekuk sana-sini. Orang punyalah jaga siap bumper siap tampered glass bagai.

Aah ek kadang aku rasa aku ni lagi banyak cerita pasal aku punya weakness daripada strength. Pasni kena gali cari balik ah strength aku apa. Nanti habis medschool nak interview untuk houseman kang taktahu nak cakap apa pasal weakness lagi banyak daripada strength. Tak. Sama je kot sebenarnya. Cuma aku lagi nampak kekurangan aku daripada kelebihan aku. Aku lagi nampak kelebihan orang daripada kelebihan aku. Sebab tulah insecure tak sudah. Entah ada orang lain yang nampak aku cantik, aku pandai, aku baik, aku bersinar-sinar bak bulan di malam hari yang kelam malap tanpa cahaya. Ada ke? Hahahahaha. Kbai. Tengok tu tak confident dengan diri sendiri!  Mesti ada punya. Sorang dua jadilahkan daripada takde langsung. 

Nak masuk posting paeds lagi seminggu. Cuaks gila namateyyy. Group whatsapp aku, Doctor, ada pesakit kemain rancak lagi. Pagi buta dah aktif. Aku jadi makin cuak tengok depa ni kemain rancak je discuss itu ini. Aku cakap dalam hati, kena belajar betul-betul ni. Bukannya sikit yang kau taktahu. Sikit je yang kau tahu. Nanti dah masuk posting pergilah mengedeng dekat senior dengan houseman. Cari depa! Minta tolong ajar mana yang taktahu. Sekarang bukan zaman kena suap lagi dah. Zaman kalau kau tak suap sendiri kau mati kebulur. Nak ke? Jangan nanti lepas habis medschool menyesal sebab tak competence nak jadi dokter. Nak ke macam tu? Patient datang taktahu nak diagnose sakit apa taktau nak bagi ubat apa.

Salah sekarang takpe. Susah sekarang takpe. Kena marah sekarang takpe. Menangis sekarang takpe. Jangan nanti-nanti dah jadi dokter jadi stress taknak pergi keje sebab tak reti buat itu ini. Pulunlah sekarang puas-puas. Untuk masa depan sendiri juga nanti. Okay? 

Sampai sekarang aku still dengan orang yang sama sejak 4 tahun lepas. Harapnya sampai bila-bila. Dah tak payah nak fikir negatiflah apa. Kalau memang betul dialah orangnya busy macam mana pun nanti, sama-sama juga akhirnya. Boleh nak curiga nak insecure tapi biarlah ada tempatnya. Eii focus on your studylah! Nak habiskan mbbs on time kan? Nak kawin by 25/26/27. Mana boleh repeat even a single year pun. Tak boleh! Sekarang ni belajar bebetul habiskan mbbs dalam masa 3 tahun lagi, pass interview, jadi dokter dan kawin. Minta pada Tuhan lancarkan semuanya. Tuhan tu dengar cuma diri sendiri jelah malas nak minta. Sombong benor.

Sebab sekarang dah malas nak tulis surat untuk diri sendiri. Tulis blog jelah yang termampu. Nak tengok esok-esok apa perasaan bila baca post harini. Malas nak enable comments sebab taknak orang comment pape nak orang baca je. Hahahaha kbai.

Nanti-nanti :)

Clinical Posting

Welcome to clinical years dear self.
Semalam name list for clinical posting keluar. Aku dapat posting paediatric dulu. Third year ni ada 4 posting; internal medicine, surgery, O &G dengan paeds. Kitorang semua ni dibahagikan pada 4 group besar ikut posting yang ada. Pastu daripada tiap group ni pecah lagi kepada 3 subgroup. Aku taktahu lagi subgroup aku dengan siapa. Heharap semuanya senang nak bekerja sesama.

After paeds ni aku akan proceed ke O&G, surgery last sekali internal medicine. Sekarang tengah elementary class sampai next week. 7 Sept ni nanti baru start clinical posting. Cuaks gila namateyy. Heharap semuanya berjalan dengan lancar. Positip!