"I haven't decided yet..."

I went to the hospital to settle the matters regarding MMC membership registration forms. I was accompanied by two friends when we went to see a child psychiatrist (Dr. 'A') for her signature as our 'witness'. After exchanging a few words, she asked about which specialty that we would like to join. I was stunned. One of my friends answered "O&G" while the other said "child psychiatry" (I wonder whether it is genuine or just to please the lecturer. But that's another story). As she turned to me, I was speechless for a fraction of time before I answered "I haven't decided yet,"

The "O&G" guy (yep, a guy, but please don't get him wrong. His interest is genuinely academic and has nothing to do with perverseness) has already decided the field ever since we were in the first year of med school. The "child psy" girl is actually interested in anything pertaining to children (and obviously Paediatric is her main interest). But me? I never pondered upon it seriously. As I mentioned before in one of my previous posts, I was interested in Psychiatry. But I wasn't really sure about it.

There are a lot of things to be considered before making such an important decision in our career. At first I was planning to undergo the two-year housemanship before I make the decision. But I think it might be too late, because if I were following the plan, I will surely miss the opportunity to embark on an academic training scheme known as SLAB (for Bumiputera) or SLAI (the similar scheme for non-Bumis). [By the way, why should there be any difference between the two?]

What should I do now?

Too bad I didn't attend the "Postgraduate Talk" organized by the college administration. But it is never too late. Fortunately, a friend of mine recommended an e-book entitled "The Ultimate Guide to Choosing a Medical Specialty". I haven't finish reading the book yet. Maybe I should finish reading it first before consulting my seniors regarding the choices. But before that, I should complete the registration form first and submit it by this Monday.

What's next?

As I was packing my stuffs and preparing to transfer them back home, I found a booklet which was distributed to us a few months ago by the Dean's Office. It is entitled "SCHOMOS Guide Book 2009". Basically this booklet is a guideline for those fresh graduates from the med school regarding the steps and procedures to be done once we've graduated and so on. I found it very useful. Thank you MMA and SCHOMOS for preparing such booklet for us.

But for now, I'm planning for a low-budget, short trip around the Peninsular Malaysia beginning next week. Hopefully everything will be fine and work as planned.

The End of the Beginning

Alhamdulillah... I passed my final professional MBBS examination. Many thanks to my teachers, hospital staffs, colleagues, and especially those patients (who "sacrificed" themselves to be interviewed, examined, and being set up procedure upon by the 'noob' like me). Without their support, I don't think I will be able to pass this exam. Thank you very much.

I would also like to express my gratitude towards my parents and my siblings for their relentless support, financially and more importantly, morally. Not forgetting my relatives who really support my effort - particularly my auntie who taught me on proper technique of interview skills when I was going for interview with JPA a few months back. Thank you very much.

Too bad, some of my friends didn't make it. I bet this is how life is. Sometimes you are on the top, the next day you may fall to the bottom. Some of them are much better than me. But God knoweth best. Surely there is hikmah behind all the events that took place.

As for me, I will not take this success for granted. Perhaps a week of relaxation and vacation might do, but soon I will resume my struggle to become more competent than I am today. Medicine is a lifelong learning process. You may know best in certain area, but absolutely not in ALL area. With this, I hereby wish myself luck and all the best for my career path as a medical practitioner / healthcare worker / or just simply, a doctor.

"Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning". - Churchill

Developmental Assessment

Theoretically, it is straight forward & well guided. Practically, it is quite difficult if you are not used to it. So, the keyword is "Practice". Basically, it is divided into four components, namely, "Gross motor", "Fine motor and vision", "Language and Hearing", and "Social". (DA is culture specific. Although there is not much difference, it is better for us to refer to the one in the Paediatric Protocols by KKM in addition to those in the Paediatric textbooks from the Western countries - Nelson, 'Sunflower' etc). Some of them can be assessed by simply observing the child whereas the others may require cooperation from the child. Most of the time, the child would be irritated at most, and shy away at least. Some might even cry and refuse to cooperate. Sigh, this is one of the reasons why I don't like Paediatrics. It's because it is difficult for me to get close to the kids. My lecturer used to tell me once when I was examining a baby, "Why are you being so formal to the child?" (lolz).

Part of the reason is that I didn't have enough experience playing with kids (except during my childhood, of course). I am the youngest sibling, and my cousins live quite far from my home. Furthermore, I was sent to a boarding school for five years. By the time I finished my secondary school, they have all grown up. But the good news is that, my eldest brother is married! Soon, I will become Uncle and I would have all the opportunity to improve my difficulty in dealing with kids. As for the time being, perhaps I should be frequenting the ward to get used to doing DA on a child.

p.s. The exam is over, but I still have to prepare just in case I might be called to sit for special examination (i.e. viva borderline) on Monday. Till then, please wish me luck and pray for me. Thanks~

Short Case - Useful Tips from (a) Friend(s)

1- i know looking at patient face very important, but look at examiner face more important ah!!!.. if cant see, then listen for voices like 'huh? ermmm' and so on.. dun hesitate to change ur answer haha

2- plz identify questions to say yes to!!
eg: when examiner ask u direct question like- dont u think the spleen is enlarged? plz say YES!!!!

- a quote from a friend, taken from the discussion board of a facebook group where we compile all the questions asked during this final exam.

Yes I believe he is right. As far as I remember, one of my lecturers used to say, "For your level (MBBS) , the examiners will always try their best to pass you. Unlike the post graduate exam. " So if they are asking you, say,"Are you sure?", then it is time for you to reconsider your answer immediately.

Calm down, even if you perform quite badly on the first case (there will be three cases within 30 minutes).

Make sure to use "standard" sentences, such as "I would like to complete my examination by doing neurovascular examination,..bla,...bla..." just like what is written in the textbooks as well as those useful reference books.

Always "back to the basics" whenever you are stuck. For example, if a Paediatric patient presented with a syndromic facies that you are not sure of, just describe whatever you see even though you don't know the diagnosis. Some of my friends (or should I call them fellow doctors by now, albeit unofficially) had had a patient diagnosed as osteogenesis imperfecta, but they failed to provide the diagnosis. However, they managed to describe the facies as well as other signs properly and the examiners were satisfied. Of course I am not sure whether the examiners will pass them or not, because the result is not out yet. But that's the least that we can do rather than kept ourselves silent for the next few minutes during the exam.

Last but not least, practice makes perfect. Must start from the very beginning of the clinical years. Then, once you are in the final year just top it up with the management of the diseases. Do as I say (read:write), not as what I did. I was not so serious with the physical examination when I first entered the final year. I never practiced the whole steps every time I did my physical examination (because in a long case, we have the information about the patient prior so that we can focus on looking for the expected findings) .Instead, I just focused on the area where there's possible findings only (except during end of posting examination). The result is, I still have to keep reminding myself not to miss the steps in the physical examination and have to arrange them accordingly.

***This post is written based on my personal experience, as well as from the advices given by my fellow colleagues and lecturers throughout the last two years. You should know yourself better. Hence whatever is best for you just take it, and leave the rest. And if you don't mind, do correct me if I'm wrong. Thank you in advance...

Alright, now it's time for me to continue struggling... Please pray for my success... =)