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Tuesday, February 16, 2010

Cases That I've Clerked, but...

I was away to my hometown for the last few days during the Chinese New Year break. It's not that I can't go online in my hometown, it's just that I decided to spend quality time with my family members, away from all my routine. So that I can kick-start my revision fresh and free from all the mess that I faced before.

Upon returning from the holiday, I took the initiative to flip through all the notes that I have been jotting down throughout the years. Then I realized that I have clerked quit a number of cases before. Unfortunately most of them are lost because they were written on a piece of paper without proper filing system. Sometimes lost at the 'mercy' of the washing machine. T_T

However, I managed to recover some of them and decided to do something about it. Perhaps compiling them and trying to improve them by identifying all the salient points not to be missed in the history, proper physical examination techniques and interpretation of the lab investigations etc. My lecturers and seniors used to remind me about the habit of jotting down on pieces of paper, but the habit seemed to be difficult to be changed. Yet, it is not too late for me. In fact, by tracing back all the cases and 'refurbishing' them, I would somehow be able to revise as well as prepare for the upcoming exam and my future in the medical career.

I just noticed that I have clerked quite a number of patients with chronic illnesses such as DM, hypertension, ischaemic heart disease etc - be it as comorbidity or the main problem secondary to the complications of such diseases. Perhaps I can just do it in a single go, by tackling from primary care setting (prevention, follow up, education etc), until the management of its complications as well as the complications secondary to the medication etc. I should have mastered the skill that required for these diseases as well as their management up to date.

By the way, my advice to the junior medical students who are about to start their clinical years:
Please, never ever abandon those knowledge that you have obtained during your pre-clinical year. They are definitely useful particularly in order to understand the pathophysiology and the natural history of diseases. Otherwise the faculty won't waste two precious years for them. And if you are aspiring to become a surgeon, please keep your Anatomy textbook (be it Snell or Grey's) handy. Biochemistry may not be of much use for the undergraduate clinical years, (in my humble opinion) but that doesn't mean that we should 'format' those 'folders' for the subject in our brain.

I think that's about it for now. Need to work on 'unfinished businesses' before the end of next week (i.e. before the beginning of study weeks.

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