Everyday I wish I could turn back time or at least extend more hours to the limited 24 we have each day. It is busy. Even taking time to blog this instead of reading up pancreatic cancer is a ‘gross violation’ that induce enough guilt to last me for the day.
Suddenly, we have lost the comfort zone of being just a 3rd or 4th year student. Our seniors have left the school as fresh graduates, leaving us behind as fifth-year students (or ‘final-year’ for those who are darn sure they will pass), the frontline of facing high expectations from lecturers and nurses about our knowledge and skills. It is definitely no fun to disappoint them on a daily basis.
“Mr. Foo, this is your Waterloo…” So said my surgery tutor after my case presentation. This is a wake-up call indeed, but then I ponder, “Have I been taking things lightly in Klang and for the past few weeks in surgery?”
'Haaa..? Apa you kata? Patient collapse?!! Takda pulse? Takda breathing? Case apa?' 'Alamak.. Ambik resus troli. Pasang cardiac monitor. Sedia adrenaline. Start CPR. Saya datang sekarang!' Somewhere deep in the endoplasmic reticulum of my gastrocs, some secret calcium reserve pours out onto them actin-myosin bridges. Muscle fibrils miraculously jump into action, cardiac chambers leap to life, previously unfired neurons blaze with renewed energy, all to propel this house officer down the ward aisles to yet another hapless patient.
I feel like taking back my words from the previous entry. I realise if we dare open our mouths and ask, the doctors and lecturers would turn their head and give an answer. And they are willing to teach and provide practice opportunities like clerking and blood works.
And unfortunately, this is where I disappoint them. Instead of helping them, I keep fumbling with notes, and the needles keep producing haematomas.
This caused me to question what in the world did we do in Klang, that we are still so ill-prepared for this 5th year.
Being the MS on-call last night, I was in Trauma poking needles at veins, causing pain to anyone that was unlucky enough to come my way. And then I realised this, after years of studying medical sciences, what could be most important to finish the job of the day is doing the blood works and procedures on time. The MAs and nurses are superior in this compared to us. Which made me think that maybe I should have trained instead to be a staff nurse, and my contribution at the age of 24 to the patients could have been so much more.
Being a final-year medical student: a 2/52 weeks review (*warning: bitching lamentations below....)
It may sound ridiculous but I have yet to do bedside clerking after 2 weeks in surgery. I am in the theatre in scrubs almost everyday, but I have yet to take history and examine any patients. Thanks to the peculiar school calendar that mandates us to clash with seniors' final exams for more than 2 weeks.
If you are sound in the principles of medical education, this is totally ridiculous.
Adult students, we all are I agree with the no-spoon feeding policy. We are all adults, it makes sense. However, it is rather frustrating if lecturers tend to avoid teaching opportunities instead of jumping at them when chased upon by hungry, enthusiastic medical students. The heart-sinking feeling is there when taking students for rounds look more like a chore than good fun.
What happenned to the good old tradition of giving first priority to teaching medical undergraduates?
Now, we are merely amoebas in the hospital hierarchy of importance. Hence, it was so touching, I almost 'cried' when the paediatric surgeon actually thanked me for joining him in an operation on Monday. I have never heard such a thing before.
More often than not, doctors prefer it when amoebas are not around. It is almost laughable that our logbook require us to assist in simple operations like appendicectomy and herniorrhaphy. Of course, it is no-brains work to retract and cut, but there are just too many post-grad doctors around to take the spots.
But then again, we are all adults, right? So, we should know about thickening our face, and be desperate enough to fight for opportunities.
Malulah...final year already.... Probably I am not being fair to the enthusiastic lecturers and doctors, but that is the general feeling that I get.
I always hear depressing reviews from lecturers about the poor performance of our seniors in their exams, yet our surgical rotation are being virtually cut short to a mere 4-weeks just for the exams of some seniors who either did too well or too badly. If the school expect us to improve on our standards, we need to go practise our skills. We need to see patients. And it certainly does not help the situation by cutting off our ward experience just for the sake of avoiding the possibility of soalan bocor to candidates.
This is a case of conflict between the aspirations and expectations of the curriculum and the teachers and the actual learning environment that is prepared for us.
Yes, it is true that spoon-feeding is no good for us. Yes, we are adults. But we can only do so much if obstacles are here and there, and we only learn to be street-smart in getting more learning opportunities by tips from seniors who are not so experienced themselves.
I cannot agree much with the priorities of my educators. We are given 2 months for public health, much of which the days are spent only in the mornings leaving free time for students. Yet, we are given only 2 weeks in emergency medicine, the place where it matters most. There are hours of parasitology lectures in second year, but nobody bothered to teach us suturing, to teach us simple Hokkien, Cantonese, Tamil terms to help us in our clerking, to teach us about anti-psychotic drugs, et cetera.
Attendance for parasitology (the only parasite case I remeber seeing in Klang GH were only an unconfirmed malaria case and hookworm infection) was compulsory but no one actually persuade you to go to A&E at night to help the nurses and MAs to take blood samples, set IV lines, perform CPR, and make POPs.
Hence, it was not surprising that there are final year students who have never heard of PROZAC, who did not know that Vioxx was taken off the shelves. Some still do not know that Vioxx is a type of COX-2 inhibitors.
Macha sir...we got a problem here.... The general performance of our seniors in the final exams leaves much to be desired, according to some of my critical lecturers. The reason is always the fault of students not being hardworking enough. Agreeable, but have they ever consider that the lack of learning opportunities and inspiring teaching and misplaced priorities could also contribute to the poor standards of medical undergraduates in recent years ?
Closing one eye and passing 90% of us despite poor knowledge and skills does not help as well.
Macha friend...this is a 7-year course lah, dude... Now, if we look at it that our fifth year is actually a preparatory for housemanship with the pseudo title of Dr, it may not look so bad. Probably, only in our 1 1/2 year as housemen will we finally learn the real applicable tricks in the trade to be doctors.
"As for working conditions, I would say the situation is not going to improve significantly in the future. Each year we produce close to a thousand doctors through the public universities excluding those from private colleges and foreign universities.
The number is increasing each year and in the future, there will be a shortage of places to train them as HOs. This is already happening in many developed countries. There will come a time when the MOH will not really need to improve job conditions because there will be a glut of new doctors all wanting to do their housemanship. Market force comes into effect.
In conclusion, my opinion is that you need to have a certain degree of passion in this profession. Difficult working conditions are to expected but our patients’ welfare must be our top priority. We should still fight for our welfare and this can be done through the Malaysian Medical Association, the Malaysian Medical Council and other relevant bodies.
For the youngsters out there who want easy working conditions and good money, my advice to them is this - don't become doctors. A good doctor is one who has passion the job and that's why there are still many left in our public hospitals despite the poor terms offered by our MOH. " (Doctors should quit griping and get on with job - Letters, Malaysiakini.com, 8 March)
Khairy Jamaluddin: "...What irritates me is when disaffected and sceptical young professionals bitch about government, but don't want to come forward and present their own ideas. If you just want to sit at the sidelines and bitch, then I don't have time for that. This is a time for people to come forward and do things. That's what I 'm asking them to do, and that's the big sell as far as I'm concerned. If you [join Umno], then you get proximity to decision-making, to policymaking. Come and tell us what you think. And we'll try to make something happen. The PM has always said that he doesn't care where the ideas come from, as long as it's the best idea, and the best idea should carry the day. Yes, be cynical, because it's always good not to be gullible. But also give this government, give this new image of the party a chance to try to make a difference." Off The Edge, Jan 2005 - Issue 01
Mr. Khairy, the tauke agrees with what you said. But if we bitch aloud, will the University Act and ISA bite back? Some got bitten hard.
I have exactly one more year before I face my final professional exams. The final year started on Monday with posting to the surgery department.
This final phase is a departure from any tiny element of spoon-feeding left in our curriculum. All they give us is a department and student timetable, and the posting objectives and a logbook. We will plan our wardrounds, plan our seminars, and plan our own battleplan (how many clinics to attend, what day to go theatre, when and how often to go to Trauma) so that we can make the most out of the mere 6 weeks allocated for this major posting.
This kind of self-directed learning probably means that the department treat us as mature students, able to fulfill the learning objectives independently and come out as housemen with decent surgical knowledge and skills.
This kind of loose arrangement probably will also create chances for some to do less, and some to do more than what is required.
There will be those who are relaxed and use the time of cancelled tutorials and ward closure for sleep and TV.
There will be those who will hunt down the OT list each day, visit the clinics when the wards are closed for exams, clerk as many patients, and get their logbooks filled as much as possible.
The question is - how do we describe this form of enthusiasm?
Hardworking or Kiasu?
At this present time when we are supposedly to have inherit a rich learning culture from our 'august' institution, the way some of us interpret such enthusiasm is sadly too shallow for tertiary level.
Kiasu is definitely not the right word of description. How can a student who just want to learn more to be a better doctor next time be branded as Kiasu?
Kiasu, meaning 'afraid to lose' should be reserved for those who hesitate to share what they know, to share lecture notes, to share patients, to book the front row all the time, and always fearful of benefitting others with their deeds intended for their selfish gains.
As for me, I envy my colleagues who manage to remain disciplined, focussed and hardworking despite the distractions of festivals, good TV, internet and friends. For the past few years in medical school, I have sometimes wrongly judged them as Kiasu myself.
Now, I want to emulate such people for there is definitely only good in wanting to do the best in what you do, to do it whole-heartedly and leaving no stones unturned in our pursuit of a satisfying and rewarding medical career.