Almost 3/4 into GS

I was pretty inspired by one senior who did weekly post about her journey through HO-ship and wanted to do the same. But I guess it didn’t happened – I was too busy, too lazy, and too unmotivated. Since I have some free time now, I figured why not?

Almost 2 months have passed since I last blogged, went through 2 different teams as well. I am definitely very honored to be in teams with good seniors and amazing co-HOs.

My 2nd team was HPB (hepatopancreaticobiliary) and there’s two HPB teams. I was in the not-so-shag team. Tbh, when I first found out I was posted to HPB, I was quite excited actually. Since M3-M5, I haven’t been to HPB or CLR (colorectal) team and these are really the bulk content of GS we should know as medical students.

I remembered feeling so incompetent in my first team despite the reassurances from my seniors and other colleagues. And when I transited over to the 2nd team, I felt like I was able to cope much better and managed things much better. Like knowing a little bit more about my patients, knowing how to handle the administrative work well. My bosses from HPB team were amazing as well. I often hear stories from them from their past, their present and also, about the career pathway in surgery. No doubt the 2 of them inspired me to want to pursue a career in surgery.

Which was why I have applied for the MRCS part A examinations this coming September. Honestly, I think I have learned a lot from both my 1st team and HPB team with regards to knowledge and application of what I learned from medical school. I was able to correlate the management of acute pancreatitis, cholecystitis/cholelithiasis, malignancies of the pancreas and liver. I’ve even managed to see 2 patients with intrahepatic cholangiocarcinoma who have underwent stent insertion, with very different outcomes.

Of course, starting a new team isn’t always easy. I remember my first day in HPB, this patient died right in front of me. I have completely zero clue on what to do. I just stood there and texted my seniors and sent a priority message to the palliative team taking care of this patient.

(Off topic, in healthcare here, we have this messaging application called tigertext, and essentially, as long as you have the name of the person, you can drop them a message. There is this feature of “priority message” whereby the person who received it will get an annoying and loud beeping on the phone to let them know this is an emergency. Sometimes people abuse it for the wrong reasons, but ya, people from many many meters away can hear.)

That was my first time sending a priority text over, and I am so glad the palliative medicine doctor didn’t slaughter me for sending the priority text during their rounds. But wow, what a way to start HPB.

Regardless, the team was really amazing and I even gotten the chance to go to lumps and bumps OT, where the MOs will excise out the lump (can be abscess or sebaceous cyst), and we get to close the skin too. This whole experience really affirmed my decision to pursue surgery as a potential career in the future.

But then, as I transited into my new team, CLR, I realised most patients come in for colorectal cancers who have undergo some sort of colectomy with stoma. Most patients would be on total parenteral nutrition (TPN), and what we (HOs) are really doing is mainly coordinating care and settling the administrative work. I understand that this is the job of a HO, but I don’t feel like I am learning a lot either. Most times, we are trying to settle discharge issues, or when a new acute event happen, we will need to attend to them.

Generally, I really don’t enjoy this posting as much as I wanted to. This also spurred me to reconsider my decision to pursue GS in the future. GS can never escape from malignancies and I really have not enjoyed dealing/studying with cancers since medical school. Maybe I do not see myself in this path. Then again, there’s still other surgical specialities like cardiothoracic, neurosurgery, eye, ENT, etc… which are still up for grab. This would depend on my MO posting. Hopefully I can get the relevant postings I want, and get to truly experience life in the subspecialty before applying for anything.

Somehow, I realised specialty training is quite important because there’s always a motivation for you to be a better doctor. You have to advance your knowledge and skills, sit for examinations and show competency as well. Majority of which, would’ve ended by the time medical school ends. Who would want to use their free time to study? I doubt not a lot of people would want that. Especially when free time is so hard to come by. Feels sad that I’m not spending a lot of time meeting and catching up with my old friends, or trying out new things, or doing things I want in general. Feels like I’m just trying to catch up on sleep.

Shag Not sure if this will ever get better, but I just hope that things will be slightly better in the next few months. Anyway, 12 more days before I transit to a different team, and another 1 more month before the end of GS posting.

Hopefully the learning opportunities will continue to present itself, and that I can find a posting I truly enjoy +++

Consecutive mistakes

2nd week has been shag and nerve wrecking.

Honestly my bosses are nice and my workload is more or less manageable.
But despite all these, I seriously can’t help but to feel so trash about myself.
Many mistakes have been made, I am still taking the same 2 hours on 5 patients vs 15 patients.
I’m still unsure about things and feeling the need to ask for help.
Sometimes, I still hesitate to call seniors for help for fear of disturbing them, getting scolded.

I cannot say I have it very badly because there are people out there with worse bosses, with higher patient load, but I really can’t help but to feel that I am not progressing at the pace I want.

I really don’t think it’s a good idea to write about the mistakes made here. But if I every read this many many months or years later, I hope I can still remember these events with just a few words: getting accused/system error INR/SN TT boss. Honestly, the number of mistakes I made over the few consecutive days is really urgh… I feel so embarrassed making such mistakes and I really dreaded heading back to work because I need to face my bosses. If I can’t get such basics right, then how can I aim for bigger things…

Idk, maybe I’m just too hard on myself. But oh well.

My boss once told me, “a good HO will make an MO useless”, “a good MO will make a reg useless” etc.. This was similar to what someone told me in M5. A good M5 SIP will have to think like a HO, yadah yadah… But tbh, I think it’s quite tough because we usually don’t have a good grasp of what HO life is like until we are doing it. Maybe not for YLL students since SIPs + studying for exams are lumped together in a posting, unlike LKC/Duke students were their SIPs are after their graduating exams. The LKC/Duke medical students really just follow the HO and do their work as tho they’re the HO, and I guess life is a lot easier once they start working as a HO. Sometimes I wonder if NUS would ever consider this system. Hmmm…

On the slightly brighter side:
– I’m so glad my 2 duke SIPs were there to help me manage like so much of my workload, really gonna miss them after this week. They have made my life much happier in the team.
– Medicine is a calling. Like literally. I have gotten better at calling for scans and arranging them asap so my patient’s can get evaluated for confirming the diagnosis and further management. I truly remember the first day trying to call for scan and getting asked: “so what this pt come in for”, “why you need the scan now”, “what are the vitals/labs” and then fumbling around the system while the radiologist is waiting for me to get the answer. Don’t ever do that man, cause it waste their time too. But I’m damn glad that those I’ve called were very patient with me. Nowadays I guess I already have most things prepped and ready to call.
– The best thing that happened this week was when I managed to arrange scans for all my new admits during the call, such that I didn’t have to call anyone to arrange for the scans the next morning. Tbh, I really hate calling people. lol. Families included. Esp families, Idk why it sounds so awkward to end the conversation LOL.
– I think my documentation for my patients are definitely improving and hopefully it’ll get better as more time passes
– also, many seniors/friends have reached out sharing their experiences as a HO and the mistakes they’ve made, how it helped them to be better. It is really very encouraging and touching to know that you’re not alone in this and that everyone is suffering together. Hopefully all these will make us better and stronger doctors in the future.

This upcoming week is going to be damn shag. On-call on Monday, team is taking new admits on Wednesday. On call on Friday again. Then the following week on the 31st, I’ll be joining a new team with completely new co-HO and new bosses. I hope I can survive through next week’s hellhole.

^{featured image from happycat318 on instagram}

Shock

I’m typing like all these posts in one go, however much my sleep-deprived and stress-filled body can take it. Otherwise, I won’t be able to remember these 2 weeks worth of event to share LOL.

Anyway, this is going to end up in a multipart series so there’s some posts here and there to keep you guys entertained/enlightened and also for me to reflect on things.

During the orientation week, it’s really mainly for us to pick up skills and learn how the team works before we get thrown into oblivion. For my team, I had like 1 house officer (HO), 2 medical officer (MO), 1 associate consultant (AC), 1 consultant (con). This team has been like that for almost a month, and I joined them when the 1 HO + 2 MO are on their last week. With that said, ofc I needed to learn as much as possible before the 3 of them left me and 3 new people joining the team.

I am honestly so glad that my HO is super teachy and guides me through almost everything. He shares many tips and tricks I needed to know, and I guess at some point in time, he realized that he hand held me too much and so, he decide to throw me into situations to make me become a bit more independent LOL. I guess that kind of worked because (1) I become less reliant on him, (2) I get a bit more confidence when facing patients/talking to other people, (3) I get to attempt to problem solve on my own first before asking for help (though it takes 5ever). He has no idea how much I appreciated it, especially after hearing from my friends that the HO/MOs don’t even bother teaching them.

I remembered the nurse from a ward texted my HO, and he was caught up with an angry patient. The nurse told my HO that the patient blood pressure is 190, so he told me to go see first.

Approach to hypertension, not too difficult right? Just make sure not hypertensive emergency (i.e. with end-organ invovlement like heart attack, stroke, renal failure etc)… So I was there by myself, trying to make sure patient is ok and is not in some life threatening condition. Tried to get the nurse to check the vitals (BP, heart rate, respiratory rate, oxygen saturation) while I try to figure things out. I find of figured that the BP spike was due to the abdominal pain he was having and the nurse asked if I could give him something. I wasn’t very sure, and wasn’t confident so I didn’t agree and said I’ll wait for my HO to come over before anything. Throughout my 15 minutes there, I was just stoning and observing my patient.

Slowly, but surely, the patient deterrioriate right in front of me. BP went from 190 > 170 > 130, while the heart rate climbed up from 100 > 110 > 130. Temp also started climbing from 36.8 > 37.1 >37.3 and patient starting shivering damn bad. This is definitiely concerning for shock. Quoting from UptoDate: “Shock is a life-threatening condition of circulatory failure, causing inadequate oxygen delivery to meet cellular metabolic needs and oxygen consumption requirements, producing cellular and tissue hypoxia”… Eventually his temperature went up to 38.9… This whole entire chunk took place in like minutes and I was so shocked how patient can deteriorate so quickly.

Not that patient is having hemorrhagic shock, but this is just to show the physiology and severity – usually when the BP drops, the heart rate goes up to compensate since BP = HR x cardiac output, and BP is maintained by increasing HR. However, after a certain point, increases in the HR is unable to support the BP, and therefore, the BP dips.

Yeap, so anyway, I was quite stumbled and I wasn’t exactly sure what to do. I mean theoretically, I will “call for senior, stabilize ABCs, start O2 supplementation if needed, set 2 large bore IVs, run bolus IV fluids, draw bloods and start medications”. This is what we usually say during exams.

But irl, everything is different. Trying to call for senior takes damn long – if you have the phone number of your senior, great, can call. If you don’t, that’s another 5 mins of trying to search for the number. Then again, the seniors may be busy getting caught with something else, so must find another senior. Just before the senior picks up, you also need to know what you’re going to say, otherwise it is a waste of everyone’s time. All these things will take way more than the time you need to say “I will like to escalate this to a senior” during exams.

Thankfully, when the patient deteriorated, I was able to get hold of my HO, who then came over and called my seniors. None of them picked up but I was so freaking thankful the APN (Advanced Practice Nurse) came over to help too. Eventually things kind of settled and we managed to help the patient before he deteriorates further.

That whole CTSP (call to see patient) really gave me a lot of confidence to see patients whenever they have problems, like (1) hypotension, (2) desaturation, (3) abdominal/chest pain, etc… At least today, I have seen a few CTSP and manage to handle them ok. Could’ve been better but I guess it wasn’t too bad.

The problem about CTSP is that, I am broken away from the changes I needed to do after rounds, and then having absolutely 0 clue on what the rest of the team has done. And eventually, me falling way behind everyone. This is a really shitty feeling man… I’ve been trying to work out some system so I can be efficient and see the bigger picture, but nothing is truly working. Fml. I really hope to figure this out soon man. I don’t want to be a burden or go back home at 8-9pm because I am freaking slow and am not up to speed and up to date with things.

Sigh,

I guess that’s all for this post.

Burned rolls D:

So I’m back with a sad piece of news that my cinnamon rolls got burnt. And the taste wasn’t that great either. So probably if I’m able to find the time again, I’ll re-bake it and maybe not throw away the current batch.

Expectation on the left, and some poor guinea pig had to try my burnt rolls LOL.

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Anyway, a few days has passed since the last time I sat down to write 4 posts at one go. Then I realized there were other things I would like to share too. Especially clinical stories. I feel those are the type of stories people don’t share about, and would be quite interesting to read/hear.

Just to clarify, I’m sure there’s this misconception somewhere that if your symptoms are XXX then you have XXX disease, and that’s one aspect of what the doctors do. Tbh, this isn’t what medicine really is, and a lot of symptoms are very non-specific and sometimes you won’t know what you’re dealing with. That’s why we have approaches and differential diagnoses.

Someone coming in with abdominal pain can present with so many possibilities of what the problem is and what doctors really do is to (1) make sure it’s not life-threatening, (2) develop a list of possible diagnosis based on your symptoms/physical examination findings and (3) investigations to support/reject the possible diagnosis. And then, depending on how the condition affects the patient/scoring systems etc, management may be different for 2 people with the same presentation.

I think back when I was younger, usually you tell the doctors that you have XX, XX, and XX then they just need to give you the drug and you’ll get better. But there’s so much more to it.

The thinking processes for medicine is also very different in general. Like you need to know your conditions and also how to approach symptoms. No point in me knowing a lot about pancreatic cancer when I’m not sure how to make sense of your abdominal pain for 1 year duration. This is why I also admire doctors who have been long enough in the field to be able to do that. Hahah.

Now that those are out of the way, I’ll share 2 experiences I had when I was in internal med (IM) posting and looking back, I felt like I could do a lot better.

So this lady, prob 30-40s came in to A&E for an episode for blackout (or fainted). What I tried to do was to take a history from her to see what was the cause of her blackout. Back then, I only knew a few conditions (E.g. cardiac causes of syncope, vasogenic syncope, hypoglycemia), so my history was targeted to ask those questions and see if any of her symptoms fit any. Tbh, none of them fit and my presentation of information to the resident was honestly quite a mess. When she took the history from the patient again, I realized I missed out so many things lol. And now after my 3rd year finals, I realized that I could’ve confirmed she had an episode of syncope rather than a seizure, asked for pre-syncope, syncope, and post-syncope events and then ask the relevant questions to rule out conditions and narrow my diagnosis. It was embarrassing to think of it now, but wow, never knew so much things goes on right? Hahaha

Ok, so then the other patient I saw (i think) came in with right iliac fossa pain and other symptoms of appendicitis. Even the physical examination was quite supportive of this diagnosis. Lmao, that was my only diagnosis and I know I need to have more differentials because, same as the above, I only asked questions to confirm this diagnosis but not rule out the rest. Before I presented the information, I went to look at his CT scans and realized he had some colonic inflammation, which then adds diverticulitis, colitis as 2 differentials. Of course, I presented the case with my new findings, and I was quite interested to see what was the actual issue since he was going for colonoscopy. Guess what, COVID hit and we were banned from the wards before he even went for colonoscopy. Oh well, I guess I’ll never find out. But that’s something interesting to think about.

2nd story probably wasn’t as bad as the first one, but I really learned a lot despite such short 2 weeks posting in IM. Really missed my clinicals, but also damn insecure about how I’ll perform in school and clinicals once M4 starts.

I’mma gonna dump some photos (which happened while I was an M3) here which I wanted to upload on insta but like didn’t so now it’s such an awkward time to post. Just to safe keep my memories you know (getting older and more forgetful already).

1st photo was when we had some microsurgery class on suturing the lens of pigs eyeballs. I spent the entire few hours trying to hold the needle with the forceps. Like no joke, I didn’t even get to suture. The needle is really damn tiny, and the tools are not suitable for lefties D: Much frustrations. I guess microsurgery is something I don’t think I’ll be doing HHA

2nd photo was a rare house 3 gathering for CNY buffet. Glad to see so many of them again. Tho I really feel like everyone’s moving along with the life and the cohesion we all once had is like drifting already. It’s sad but I hope everything is going well for everyone.

3rd photo was during our CHP posting where the 3 of us had to stay in school to rush through the statistical analysis because we were running out of time. Thankfully I got an A for that despite failing my pre-CHP posting quiz (which was like 20% i think, or maybe 10%). I guess all the hardwork was worth it. I think we could’ve published that paper at some journal, but damn, I didn’t follow up with that. Still think this is a wasted opportunity.

4th photo was us back pre-COVID19 at chomp chomp. TBH chomp chomp reminded me of the time I was in OT when the surgeons were doing below knee amputation. The burning flesh smelled like the BBQ wings from chomp chomp. NO JOKE HAHA. Don’t judge me for this. Always nice to see them bros when everyone is in different phases of their life now.

5th photo: this was the surprise celebration for one for my counsellees. I was so worried this got exposed (and it almost did because the waiters dropped the bomb, but thankfully my junior didn’t hear it LOL). Good to have a photo with them finally.

Graduation ceremony was cancelled this year, so I guess the mushrooms had no choice but to hold an informal one while we wait for them to grad next year officially. HAHA, was good meet up with me getting fatter because unhealthy diet and also a surprise when we decided to drop by one of their houses.

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So I guess that’s all haha. Stay safe and be socially responsible!

*Clickbait title* Just click la. haha

Okay, so I’m just sitting here writing my 4th post (you’ve seen the first of this post almost a week ago haha), I realized how much I miss writing even though I been procrastinating and not write haha. It definitely feels every different to engage with a larger group of people whom I don’t know (tho some of y’all are classmates/army friends/or new friends whom I’ve made here). I would like to remain anonymous but then it didn’t work, and people eventually found out. Hahaha, so I kept this open in the end. Don’t think you’ll find anything other than cringe worthy topics hahah. I need to stop hahah-ing, this is too much. LOL

Anyway, I’ve decided to change my style of writing a bit more informative and also, with some inspiration from Nino’s home (https://www.youtube.com/watch?v=Bqvnf787PJA) go check his videos out. I hope this works out nonetheless, ya it better be.

His videos are mainly cooking videos and it does seem like some ASMR baking video. Once you look at his English captions, you’ll realized he is just flaming you HAHA, Damn funny and damn entertaining. Besides, his cat is so cute. Just look at that caption hahaha.

Anyway, back to this COVID19 thing (again LOL). Now that circuit breaker measures are transiting towards the pre-COVID19 stage, I must say I’m so used to staying home right now I just want to rot at home and not socialize. Or maybe it’s the everyday wake up 9am to study until 12am then and repeat for 1 month plus that made me so shagged out and just want to rot. And I think I honestly should, before I got no opportunity to hahah.

Also, I got an addiction for bubbletea thanks to circuit breaker LOL. I guess when you’re studying too hard, and need something to motivate yourself, bubbletea is the answer (just kidding, good news, you can go get your bubbleteas now). It’s damn expensive to waste $$ on bubbletea, but this is really quite comforting… Until you realized it doesn’t work anymore (thankfully this happened a few days before exam so I can still survive haha).

Okay, thinking back now, I really miss going out and hanging out with friends. I think I might have lost some friends here and there cause too busy with studying to actually reply, but I’m thankful for all those who stuck with me :’) It’s really sad how you think friendships that started out together can take such a drastic turn and then that friendship doesn’t exist. But regardless, I’m still thankful for everything that happened. There’s this quote about dont be sad it was over, be happy that it did or something like that.

I think to lighten up the mood, and also to beautify here, I’ll just post some nice photos here haha. Used to be quite a photo person but I don’t think I am as photo as before. But I’m still photogenic, jk

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Ok damn, I hope this didn’t end in a sad mood haha. Alright, so I guess it’s time for new plans (2 weeks) before M4 start. Can’t wait for M4 to start! Before that, I’mma try to bake a cinnamon cake/roll/bun/whatever that is haha.

Enjoy yourself ya!

dIsCoId GrOuP fOr MeD?

Okay, so I have a few DMs on instagram for the past few months about my blog and med school journey. Probably I’ll just share a bit more here.

So this blog was originally started because I wanted to improve on my English and write essays here (For BMAT, major throwback) and also to vent out frustrations on what was going on with me and my first guy ex.

Then along the way, I found these 2 medical blogs which I found fascinating and entertaining (Dr Og – https://sgdr.blogspot.com/) and also important information on med sch as a student (sg404medic – https://sg404medic.wordpress.com/). Both were damn inspiring, and since then I decided to share my experiences so you kind of have an idea on what to expect and also learn about things people usually don’t talk about/share (unless you ask).

I really loved reading their stories and felt like maybe I should do the same too. So hearing from y’all is quite surprising haha.

Okay, so there’s like some recurring theme to the questions that has been asked a few times so I figured out why not post them here then you can take a look too.

1. Application for transfers starts on Feb (I know NUS website said no transferring allowed, I thought so too until someone told me that people transferred before [really damn bless to know this news otherwise I wouldn’t have applied for transfer and waste this chance to study locally], so regardless, just apply and see if they allow k! Don’t waste this chance)
2. Previously NUS have this thing called EIS (Exceptional individual scheme) where you can post your achievements under certain categories, but now it’s called something else and there’s not much limitation.
3. Another piece of advice is that if you got any research experience, put it down k! I think the school is valuing research more (Esp poly kids with your FYP – if you’re doing research as FYP)
4. Personal statement wise, please start early and go read up on the online resources k! There’s plenty of things like these out there! If you’re not sure how to start, just write down pointers down feel is important then work on the drafts later. Get all the ideas out first.
5. You can join forums/discord channels where you can find applicants and all to go through this journey together (shoutout to the person who showed me this discord channel XD and also those who are in that channel and reading this – Hello haahh)
6. Always remember things will work out in the end even though they might not seem like it (esp back to those 4 years where I gave up some opportunities thinking I can go for med interviews but didn’t, or those nights thinking about my future. Then again, I would go through those 4 years than to get into med school at 1st try. I think the 4 years (poly, army, NUS nursing) has really changed me a lot as a person and I really appreciate how things ended up)

I hope these are important notes/advices and all the best for your applications ya! Also right, my application to med school was almost 4 years ago too, so what you read in the older posts might not be that relevant anymore (and tbh, i don’t remember what i write either, and too paiseh to read through what I wrote last time (sure damn cringe hahaha)

Okay, so I’ll end this here! I hope this post would be useful for you guys!

Otherwise you can check out the other 2 blogs if you want haha.

Before COIVD19

Haha, damn… It’s really been a long while… Had a lot of ideas on what to post (when I was lying down at night, trying not to think of exams) and now everything just left my head…

It’s ok, I guess I can start with my internal med (IM) posting. Before IM started, I had family medicine, orthopedics and general surgery (GS) postings. I loved GS postings (even tho some of the surgeons are fierce) because they’re quite straight forward and logical. Also, I get to go to the OT.

Been thinking of awhile if it was aept to put this here, but I guess here it goes.

So me and my clinical partner wanted to watch this low anterior resectioning of the rectum + colostomy creation (basically take out some large intestines and then pull out a stoma). We went to the OT, introduced ourselves and then just stood in one corner and watch (thankfully it was laparoscopic so we can watch the surgery on the television rather than to scrub in, crowd around to try and see then be burdens). We were in the OT since 2pm, and we had a tutorial on breast conditions at 6pm.

Both of us were just there trying to watch the surgeons freeing the bowels from the posterior abdominal wall and by 6.30pm+ they were done (from freeing the bowels, nothing has been cut yet). So the resident who was there told us the surgery was only 1/4 done (this surgery was supposed to be done by 4 hours). There were times in between both of us were wondering if we should leave for tutorial, but then since we stayed so long already, might as well finish it right. I dieded right there when I heard that. So we decide to go for tutorial instead. LOL.

The next day, we had this tutorial with this same surgeon. I was curious why the surgery took so long (i.e. was there any anatomical complications or what not that made the surgery harder) so I decided to asked her.

I mean my English phrasing didn’t came out right, so when I asked: (somewhere along the lines of) “Dr, why your surgery so long). The whole class became quiet and the surgeon passive aggressive me D:

Then I realized shit, I fucked up LOL.

I apologized for the english and clarified what I meant. And I thought it ended there. It didn’t.

Lmao I had to go back my old posts and check if I said this story before, but ok, I guess regardless you gonna hear it again if I did

Moving on…

A few days later, I decided to watch this surgeon do her colonoscopies on her patients (thankfully another friend went with me LOL) AND I GOT FLAMED HAHAHAHAHAA (can tell she upset with it, but damn). Long story short, I think I made an impression on her (she’s one of the in charge for GS residency) and I think quite a lot of people from her team knows LOL. I meant she said it as a joke (I was so embarrassed ok HAHAH) and she was cool with it (in a way HAHA, like before we left she said she was just surprised la). But all is cool, we took a photo together :,)

Tbh, she’s quite a good surgeon and a super cool one and I admired her from the start already. I guess if I ever apply for residency in GS, I hope she’ll still remember me HAHAH.

Ok, I hope this (…words…) thing doesn’t annoy y’all or make it any harder to read but I figured out it was easier to share more stuff and make y’all feel more connected haha.

Moving back to IM posting.

Tbh, I was quite down for GS already until IM started. IM was quite interesting because the thought processes are so much more different than GS. We had rotated to 2 teams (2 weeks) before COVID19 hit us and we had no more IM postings.

My first team was endocrine, and it wasn’t a very teachy team so I didn’t learn a lot from it (and the cons scolded us for contacting him because students should never contact a consultant… and we only had his number…) but I was super glad the HO and MO were nice and they tried to teach us some stuff (so thankful for these people).

Right, before I move on to team 2, we had a lot of front loading lectures before we start so we don’t get so lost (but we still do), and there was this cardio doctor who was damn inspiring and damn good. Hahha, I was walking past this walkway and we saw each other. Can tell from the body posture he wanted to say hi, but didn’t cause he ain’t sure if I recognized him (like that gesture where ou moved your body already then held back?)… Damn, I should’ve said hi tho (think he must’ve remembered me for something stupid i said in his lecture) ! He’s quite teachy and I was hoping to be able to go to his team (AND I HAD CARDIO AS MY LAST TEAM :,( so when COVID19 hit, I didn’t get the chance). Fml. Oh well, I hope I can see more of these inspiring doctors/surgeons who are willing to teach students. Really makes your clinical experience so much better.

Okay, so for team 2, it was damn amazing! Even tho we were in team gastrology, it felt like GS all over again. The team is super chill, and the con was quite teachy! Everyone else on the team was quite encouraging and will be there for us if we need/got questions etc. Really damn amazing. It was sad that it lasted for 1 week, but regardless, I’ll cherish the good times we had haha.

Tbh NUH is a good teaching hospital, and I regret not taking enough photos/meeting/talking to the super inspiring doctors. But I’m glad I have at least these two photos to safekeep haha.

M4 is going to be another long academic year and I hope it’s gonna be a good one before M5 starts. Very excited to be one step closer to being a doctor!!

See y’all soon!

hElLo M4

Hey everybody! How y’all doing HAHAH

It’s been really a long while since I last blogged, and so many things had happened along the way. I’m surprised half of 2020 had gone past already.

First thing first, my M3 professional examinations (PROS) are over!! Result will be out next week, but safe to say I’ll be moving to M4 (ok, i’m quite confident I’ll pass, but +/- about doing well [which i hope i do, but im not so sure]).

Our exams were supposed to be way earlier in Apr/May (sorry, my short term [actually the entire] memory is bad), and thanks to COVID19, it got delayed.

Studying for PROS was one hell of a journey… like seriously… I have no idea what resources to use to study IM (internal medicine) and seniors notes/textbooks aren’t working great for me. For some odd reason, I decide to go to reddit and look for decks to study.

I must say there are plenty of decks out there, and they’re really good (like AnKing for example). I wish I can screen record and show y’all how the decks look like, but I’m honestly too lazy for that… so y’all can check it out!

Just to contextualize,

1. Reddit is like a social media (i guess in a way) platform, where you can see cute cat photos, children falling down, recipes, etc… according to what you like/follow
2. https://www.reddit.com/r/medicalschoolanki/ (I think is this), has a compilation of decks that people make
3. Anki is this super cool flash card app (free on computer, you should try) that helps with forced repetition of content (and repeats based on certain duration) to aid recall
4. What Anking and other decks from Reddit does is that, they utilize resources from all online platforms (onlinemeded, first aid for USMLE, sketchy, AMBOSS, etc) to supplement the content that flash card cover…

So anyway, as I was trying to mug the cards from AnKing (and also other M3 decks), and saw them having these super short and easy to remember and understand screenshots/photos from First Aid.

I thought to myself, “woah, this is damn easy to remmeber, and the relevant stuff I need to know are all there”.

Before I know it, I was googling which resource this was (I was blind back then and I didn’t see this was from First Aid for USMLE).

I ended up stumbling on AMBOSS and that was a life-changing event for me.

Shit, I sound like someone trying to sell AMBOSS now

But to be very honest, AMBOSS provides both content (e.g. epidemiology, etiology, pathophysiology, clinical features, investigations and findings, management, complications etc) and MCQ for testing. It cost about $365USD per year (i think USD?) and it’s quite expensive.

I signed up for their 5 day free trial and tried.

HOLY COW, it was freaking amazing. Their information is up-to-date (at least that’s what they said, and based on update logs), and you can choose what kind of information you want to see (“high-yield”, “highlight important points”).

Since then, I decided to mug the whole AMBOSS for exams. I’ve actually learned quite a lot of reasoning why things are done certain way, but I was also afraid the content (especially the management parts are not applicable to Singapore context).

Bless.

I had no choice, but to mug AMBOSS and test out how it goes for my PROS (because I got no other better resources). Exams went by (like 2 days ago, omg so happy), and I must say AMBOSS really helped me out a lot with my IM stuff. Bless the MCQ hahha.

The day before my MCQ paper, I was doing this question on lower GI bleeding patient who was on dialysis – what is the cause of bleed. Answer was angiodysplasia. Anyway, I got this same question before (and this idiot here got this question wrong on both attempts LOL).

And guess what, this question came out for MCQ LOL.

So surprised, but I must say AMBOSS helped me a lot with my internal med. I think general surgery (GS) and ortho is +/-. Orthobullets is much better compared to AMBOSS. GS depends tho, I like some but not all.

Okay, I think that’s enough AMBOSS for today HAHAHA.

But seriously, I’m so thankful for the finding AMBOSS, and also COVID19 for delaying my exams. If the stars (think swiss cheese effect) didn’t align, then things might not work out so well.

I hope to be able to get 80% for my M3 tbh, if not it’s just disappointing.

And honestly, I admire all the seniors who went through M3 with one additional postings (paediatrics, we had this shifted to M4) and so much lesser time to study. They’re amazing.

Ok, I guess I’ll end this here. But don’t worry, I’ve a few more posts down the line, so stay tune yah!

CHP posting

Finally some time and motivation to write up this post.

Community Health Project (CHP) posting is a 4 week posting with 6-week long ortho posting. CHP is basically like a research posting where we had to address one question and conduct door to door surveys to obtain data before analysis and interpretation. Prerty much like writing a normal scientific paper, just that there’s much more manpower and standard wise, it’s quite chill.

Before the start of M3, the CHP team had to meet up to decide on the leader of the big 27 people group to lead this project. As I was the class rep in M1, I had no choice but to get volunteered. I was quite apprehensive back then because I do not want to over-commit myself to handling too many projects. Thankfully, another guy, S, took on the role with me.

That sets the stage up for this project.

From time to time, S will message me about the project and we will have some short random discussion. My impression of S was that he’s quite an enthusiastic guy and a very people person. Given that he’s taking the lead for most work before the actual CHP posting, I was quite chill.

However, when the actual CHP arrived, things wasn’t that great for me. My clinical group (CG) was in-charged of planning the fieldwork. Though generally speaking my CG is quite a quiet one, I’m glad that everyone was very helpful.

Subsequently, after the door to door, the analysis done by another CG over a few days turned up unexpectedly not up to standard. So I had to ”abandon” my team for awhile to let them settle the discussion while I pluck 2 people out from the other CG to redo most of the data analysis.

There were many sleepless (actually late nights) trying to settle the analysis so the rest of the team can work on the report and presentation. And after 2-3 days of those intense hard work, I “joined” back my CG to lead the discussion. Throughout these almost 2 weeks of intense (..) :

1. Trying to guide both teams on how to settle the presentation and format
2. Looking through the work of both team and trying to reconcile
3. Editing the whole paper to be in a more academic tone
4. Help craft out the bulk of the discussion

(…) I realized I learned a few things.

1. I take on the lead so much that people start relying on me. Not to say its a good or bad thing but having to make decision with limited knowledge is quite stressful. For instance, “how to write this?”, “is this interpretation ok?”, “should we exclude this” etc… I was making so much decision that it becomes so stressful I feel like just giving up and not do it. I rather let them crack their brains and decide. Was that micromanagement? Maybe… How did I get myself into that? Probably I realized I should’ve set the standards a little higher at the start so this wouldn’t happen
2. Surprisingly, I enjoyed coordinating so much people to do work. Seeing so many people working on one report together late at night is quite satisfying for me. LOL. I don’t know why, but I really enjoyed that. That’s probably the best part of this project (and also really appreciate all those who helped out).
3. Being the project leader and also leading the second half of the project made me realized how important it is to pave the journey to your intended goal. For example, deciding on what to write in the discussion or how to do the analysis is damn bloody important than to look into the small details. In my experience, I did both, but without that huge framework, things is going to be difficult. Most of the time, halfway through the project, I realized I was stuck with deciding on the next step. I guess, things eventually work out.
4. Any med juniors/students here who will be doing CHP. I suggest you to get your data analysis group to run a trial of analysis on SPSS/R commander and see what kind of data you want while you’re doing door to door. Because this is the best time for you to see what’s their level of understanding and also decide how you want to proceed. Otherwise, if you decide to do them until everything is completed, life is gonna be so much harder like mine.

Overall, CHP was quite an interesting posting. But I doubt I’ll get good grades cause I screwed up my EOPT quite badly. Oh well. This posting is gonna pass and Internal Med (IM) is going to start next week.

Til now, I have no idea what’s my GS and ortho grades. Hopefully, they’ll come out soon. Gen Surgery has passed for almost 22 weeks with no news of the grades lmao.

Anyway, IM seems to be fun since the hospital expect us to join the rounds and take charge of patients! I think that’ll be super amazing to finally be useful!!

But I also can foresee the sleepless nights trying to digest content for IM and also trying to prepare for PROS 2 weeks after the 10-week IM posting block.

Should get my air ticket for my 4 weeks electives soon too.

Anyway, take care readers! The news on Wuhan virus sounds like it’s gonna get worse from here.

Hopefully CNY day 1 has been great for y’all!

2019 in pictures (II)

When 2nd half of 2019 started, life wasn’t as carefree anymore. New clinical postings meant that there was a need to balance between work and play, especially when work itself is quite intense. I’m really thankful for all my friends who’ve stood by beside me, and also whatever relationships or dates that had happened. I’m sure I’ve learned a lot from them and I hope 2020 would be a much much greater year.

Throwback Tuesday;

July 2019

July was the start of my first clinical posting in famil medicine, went to GP and polyclinic and saw patients with a variety of conditions. I think I might have met one hypochrondriac when I was in the GP because (1) he came for frothy urine which he was worried for proteinuria. He is completely asymptomatic and results all came back normal. (2) He turned up in the polyclinic a few weeks later for another condition. Not too sure why he was there, but he was quite worried. I guess that would be me when I’m sick and suspecting I got things like these.

Friends also started graduating around this period, and got to know someone who made me grow in ways I’ve never thought possible. But I guess things went down in flames as quickly as things peaked.

Also, made my 1st carrot cake! Looking back, I realized I baked and cooked a lot in huge proportions, which is not very ideal because I end up wasting most of them. *sigh*

August 2019

The most exciting part of this month was Taylor Swift releasing her Lover MV! OMG, I totally love this song man!

Continued with baking custard tarts, which the custard got burnt quite quickly when I was away for 5 seconds. I guess I was at that point of transition when I decided to charge my phone and the burnt smell filled up the kitchen. I also did crepe cake with my mushroom friends! Definitely not something I want to do again because of how tedious things were.

Restarted my game in Brave Frontier, and I stopped cause it got a bit boring. Just like IdleHeroes. And guess who’s playing maplestory now LOL.

School also started sponsoring the iPad minis, and I also managed to get my Silver for IPPT on the dot.

September 2020

Around this time I was in my GS posting. Not too bad of a posting, quite enjoyed myself there. However, the fear when starting out at a hospital for the first time was terrible. I’m glad things are improving along the way.

Did my first night call alone and got my bags locked out from the student lounge. Had to grab back in the end and go to KTPH the next day to retrieve my bag. 1st and 2nd night calls were the best night calls cause I got to see quite a few cases like draining of an abscess, umbilical hernia, postobstructive jaundice, intestinal obstruction.

Moving forward in my baking experiences, I did 3 different flavors of cupcakes. Honestly, this was one of the more successful baking experiences. My cheesetart was great (but took a lot of money in terms of ingredients). I guess 2020 is a year where I will improve those shitty baking skills.

October 2019

October was also the last time I kind of stepped into the OT proper. Was quite uneventful cause I was trying to mug and keep my knowledge for GS intact. At the same time, had a few practice sessions with the Ortho research group (UROS team) for the conference up in November.

November 2019

Early November was my birthday, and this year was quite a unique year. I guess as one grows older, you’ll rather hangout with the selected few people rather than have 200 well-wishes. I guess that was great since I enjoyed myself thoroughly, catching up with my friends. And honestly, the biggest surprise came from my army friends – who I thought had completely no clue. Faith in humanity restored hahaha.

I also started on my burger journey this month cause of the free 1-for-1, and I’m really enjoying myself a lot. At the same time, getting fatter and unhealthier. Need to work on those legs, abs and arms. Went gymming a few times, and met a couple of new friends! November has been prety great!

December 2019

Last but not least, and also finally, December! Expenditure for this month definitely shot up the roof because of (1) burgers and (2) bubble tea hahaha. But I guess I’ll start scrimping and saving up, especially when I’m flying next year to Sydney. Wrote cards for my friends too and finally picked up my fitbit after so many months.

 

Looking back at all the photos and videos I took, I’m definitely surprised I took quite a lot of photos here. Memory has also gotten a lot worse over this year and hopefully it’ll be better. As I’m uploading and reviewing my older photos and videos, I realized things have changed a lot and some of these have become my new new-year resolutions. So, here they go!

Looking forward with 2020 vision

Looking back, I wished I had written my resolutions for 2019, that way I can reflect and see what has been done/not done. Oh well. I guess here’s the 2020 ones:

1. Enjoy myself in IM posting and be braver than I was in ortho and GS posting.
2. Have a work life balance when preparing for PROS, tho 2 weeks to prepare and striving for that might be a little hard. Okay, maybe just not to over-stress myself too much I suppose.
3. Rent a car in Sydney and just explore
4. Learn and if possible, participate as much as possible in the neurosurgery posting
5. Learn to make a burger including the bun
6. Bake more and bake better, especially the cheesecakes.
7. Go gym or exercise at least once a week
8. Complete and submit at least 2 papers for publishing (1 has been reviewed and resubmitted)
9. Get more involved in AcaD’s event
10. Don’t always find comfort in my own room
11. Have more solo photos
12. Forge better and stronger friendships
13. Rebound faster from bad hospital experiences and learn to be a better student
14. Be more confident and less fearful

Happy New Year readers! Hope you had as much fun reading as I did writing these!

May 2020 be a good year for you guys 🙂