Crossroads in Life

2 more Days and It is end of 2011

2011-12-28T08:57:00.000-08:00

This is a big year for me. Where many things accomplished and destroyed...

First of all, I'd finished my Housemanship and went into another chapter in the Healthcare System. In Malaysia, we call it "Medical Officer", sounds a bit high class compared to Houseman / Trainee doctors, responsibility is higher, workload is actually more, requires more brain juices (have to squeeze them like squeezing lime into teh "o" to get the flavour), requires more time and dedication. However, same thing happened, pay is not appropriate. I will analyze and breakdown this way:

A Houseman in Malaysia now are working on shifts. Hooray, less working hours... Yes, it is very nice / luxury for the big hospitals, but kindly think of the smaller district hospital PLEASE. Because of the numbers, it turned out to be an imbalance act between the 2 type hospitals Housemen.

Houseman pay is ok and appropriate for now. Work lesser hours, supposed to be less stressful. But in the hospital i am working in. I see they are much pitiful like a worker working for 900 bucks per month. What they do now since the shift system now are

1) Taking Bloods - does most of the time they know why the blood investigations are needed for? indications? or just follow orders via passing over... Remember to take that tonight, drug level etc... Best is, Dr A, can you please take this blood gas STAT...

2) Do rounds - Doing own rounds are the most important thing for houseman, as they will learn the most, nowadays due to the punch card system, some housemen come late and without knowing how many cases they have in their workplace to review, which means they cannot afford to review each and anyone. And mostly they have to do together with the Medical Officers. Once the medical officers take over the management part, the housemen will never get to learn, as they are just following what the medical officers say.

3) Trace results, folders - A useless job which can be easily done by a trained operator / PPK...

4) Carry out orders - Same thing, take blood, do procedures etc...

5) For surgical field, maybe some documentations, holding retractors, suction etc...

Looks simple, but takes a lot of time, until no time for oral feed. Most of the Housemen in my hospital do not have time for lunch, they work continuously from maybe 6am to 6 - 7 pm... NO SOCIAL LIFE in hospital at all... Not much time to talk, all wear masks and quietly do their procedures

Well, thankfully i am no longer a Houseman, and i escaped from the system earlier, but i foresee later on, we will have our own shift system on medical officers as well.

It is no joke being a doctor. Kindly don't force anyone to study medicine for glamour and monetary rewards. It is wrong, and you might end up opposite. Working in such harsh situation. One can easily get depressed. But another way to look around is, you will be the toughest person if you able to get out of it.

If you want to go for monetary rewards, kindly spend less money and less time on the educations and do business, usually can earn a few folds than being a doctor.

It is late here, good night and hope for a better day tomorrow.

Nowadays...

2010-08-30T17:46:00.000-07:00

What had happened to the community nowadays?

We should cherish what we have right, and stop whining about it.The reason why we keep whining, whining and whining like a old lady is our quality of life improved, and we had best of our life mostly before we start to work. Of course, we get most freedom, leeching from our parents outside, and that was a very good feeling, there is no pressure around, not-so influenced by financial status and so on.

When we grow up, responsibility is even more. We start to work and earn a living, the financial support from our parents is still there if we need it.We still having not much trouble YET.

I am 25, and I just starting to work. At first I thought, OMG, this will be the worst part of my life working as a Houseman / Intern, and this will last at least 2 years. I work almost everyday last time without privilege of PM-off, Weekend-off etc. I even work for 3 days when I am having 38.5 degrees of fever, I have chills and rigors when i work and still i survive. What do we want actually in life? You want to be rich in a flash? then stop working as doctors, go for drug trafficking etc... new fellas, please chance, your workload has significantly reduced, like discount during mega-sale. Appreciate that there are many of us, try to learn more when we are doing less. Stop comparing, stop whining.

Imagine the worst condition that you will be into, and you will not feel shitty in the end. I imagine the worst possibility, I imagine what if it was last time during my senior time, will i survive? Trying to catch up to be as competent as them is a good way to learn. You feel tired after working, but everyday try to learn something out them, you will feel a bit fruitful.

Our job is sort of "noble", we carry title of "Dr" with a degree but we are treated as "servant, dogs" initially, in the end we will climb up the ladder. However, I will still be nice and teaching people. We do learn in the process anyway.

Nowadays, people show no respects to senior colleagues at ALL. They ask them to do work in a rude way. Mind you, they will become your senior next time, and we know revenge is sweet. I'm a calm person, and yet i cannot stand with this matter. New fellas should show some respect, you need guidance and where you get them from? Your seniors of course....

Rule of Houseman:
1) You are as hard as steel, thou sleep less, do more, eat less...
2) You are absorbing like a oil paper, thou learn once, remember next.
3) You should respect people around you. Think what if you are in their "shoe", e.g. PPK mostly have things to do, i realized they are damn kesian sometimes, that's why i dont rely on them, they got a lot of works + being bullied by the SN.
4) You should not thinking about how much you earn and compare to other people. Now, you invest in your career with your money and Soul. Karma effect, you will earn them back in the future.
5) Do no Harm to you, your colleagues, MO, Specialist, Consultant, and most importantly, your patients. Think of them, what you need to do the keep them off from law suit, best of the health service.
6) You need tonnes of patience

Sometimes, I felt i am secluded with my friends who are non-medical related, they speaking about financial stuffs and i was like ??? Same to us, when we speak regarding medical stuffs, they ???? But i still love them, i try my best every week to hang out with them, learn what they learn in their life, understanding the outside world etc.

Most of Us, WE HAD OUR BEST TIME in our LIFE. We know BEST time will not last forever, let it be sweet memories and GO FORWARD to make Tomorrow as eventful as it is, to create another BEST time in our life, to make our actions into reality. Stop Whining please.

Lastly, some link to inspire most of us. And I am glad that i am alive, with everything I have. I love my family, my wife and my job. Everyday, when i see them i am relieved, thank god I see them. I love them, but i don't know how to express myself to them that how much i love them.

http://www.youtube.com/watch?v=dTdTCubhWV0

Lim M.

Most of the First Procedures

2010-07-27T05:30:00.000-07:00

Chest Tube 2

Chest Tube!

Usual Setting for Adult in Ancient Portable Ventilator

Femoral Cath!

This is consider as negative still!

Virgin Pleural Tap! This is really Scary... KIV Chest Tube!

Old School "Baro"meter....

Virgin Lumbar Puncture!

My Virgin Peritoneal Dialysis ;D

Who's Trop T is Positive? If you leave long enough, even a negative one will become positive ;D

1st CVP Attempt

Some of the Pictures that I had time to take ;D

My First Posting

2010-01-29T03:33:00.000-08:00

Long time didnt blog already.
Time flies, just a blink, I am finishing my very FIRST Rotation in Housemanship - THE Paeds Dept.
First rotation is one of the most memorable posting. Because almost everything is the 1st.
1st time trace results, 1st time take appointments, 1st clerking, 1st patient, 1st virgin call, 1st exam, 1st viva etc.

During the 1st day as HO in the dept, I have no idea what to do. The First HO who i tagged, Dr F, was cool, learnt a bunch procedures from him. Then i also learnt a lot from my Super Senior, Dr T. Eventhough he always sounds "pek chek", but he is a nice man. Everyday clerk, take blood, labelling, do summary, do discharge... but then i always feel i got more to learn everyday.

My Virgin Call was in Paeds Ward, slept 15 - 30 minutes, the patients keep coming in after one and another, met some poor historians etc. But not too bad, I didn't kill anyone, and everyone "survived".

After so many months i'd made some Survival Notes as Paeds HO in my Hosp. I will like to share them. Will Upload them when ready.

Radiology Department Intro

2009-10-13T06:30:00.000-07:00

Rumours said Medical, Surgical is Full. Paeds + A+E doesnt take 1st poster. So Left O+G n Ortho... Pray for ortho first then =/ then next O+G also can... Need to get more familiar with the system, environment and PEOPLE first.

Tmrw is the day of truth, if O+G, i'll be almost dead like zombie. Ortho, i'll be still ok. my knowledge is draining out, i need to buckle up. All the best to myself.

Today, what we did was filling up forms, buying car stickers (for car park, but we wont be able to use it anyways, it is almost always full, and also i think it is more for MOs, Specialists, Consultants etc), and then we headed to radio department.

The radio people sounds nice. And I hope they are really nice when i rushing for case's result ;D

Today still chill. But ppl in other hospitals already got their postings.

A little more about the system:
General X-ray Can just send without any appointment, unless at night, ask the SN to call them. Paeds (Call before send)
Ultrasound might need to speak to Radio MO oncall.
Things that need to get Radiologist to sign MRI, CT, Mammo, Contrast Studies. If urgent - within 1 week (Depends how well you persuade them)
CT / MRI / Contrast Studies req Consent, RFT, Allergy Form (diff btwn contrast n CT/MRI), X-ray form signed by Specialist.
Mammo got its own form.
For Appointments, rmbr to get ptt contact no.

1st Working Day in Penang

2009-10-12T06:37:00.000-07:00

It's a different feeling today. I woked up extra early today to go to the HQ. Why? Report la.

I always thought that Komtar is a piece of junk. And I just realized that it is actually full of government's departments. And wow, the lifts are always full! I have to wait 3 times, in order to go up to my respective floor. REALLY A LOT OF PEOPLE at 750am

We wait, wait, wait and wait... and wait... then the orientation begins. Ms V, who are a very strict person came it, and test the "Penangites" knowledge about penang, only 1 of us know about a particular questions. LOL.

What we really need in Komtar is just a peanut of stuffs. 1 Surat Penempatan, 1 Sijil Pendaftaran Sementara, 1 Passport Photo and that's it. However, PLEASE BE ON TIME, they record your time... so be there at 8am (Cause it is our 1st working day)

I'm cool with the state health HQ, and also 8 ringgit Parking. I never thought that I hafta stuck there for some time. =/

Now, here's the bomb. I reached my respective hospital. My familiar hospital and there're tonnes of form to write, it took me hours to fill up, and some of them i dont even know how to fill up. So many details, minute minute details, microscopic details needed. Something for you guys to prepare, the amount varies from hospital to hospital.

My hosp requires extras of:
9 X Passport photos
5 X Photocopied IC
2 X Photocopied Bank Account (1st page) - They said Any Bank will do.. to be save (CIMB, Maybank)
2 X Photocopied (PC) EPF Status Letter
6 X PC Med Degree Cert
6 X PC Sijil Pendaftaran Sementara
5 X PC Surat Perlantikan SPA
2 X PC Surat Perlantikan KKM
3 X PC Surat Setuju Pelantikan
3 X PC Surat Akuan Sumpah
3 X PC Medical Check Up Results

So prepare yourself... and train your hand muscles at the mean time.... you need loads of them.... hahaha

Enjoyed my first day, stressless.

oh ya, my friend, Dr Little Richard asked me to advertise Hosp Klang, He said really need a lot of HOs there... Most prob if you appeal, you'll get it ;D

Out of The Course + Camp

2009-10-11T07:46:00.000-07:00

i'm back from the course. Last 2 days, din get to sing the Patriotic Songs. Boss kinda indulge in singing Sedia Membantu. ;D Fun Song.

BTN lecturers were quite kind and sporting, well take it as an opinion, eventhough you don't like it, just take it la. in the end, there's an exam with 60 mcqs. That exam cannot be studied, just go and do. After that, we are allowed to go back.

Once again, good times end eventually. So as everyone has to leave to their own path, some here some there. Boss going to KK already. And i'm heading back north.

Also lucky Boss fetch me to Pudu Station, if not i have to wait for another 3 hours to reach back home. Well 3 hours of extra sleep definately worth more than 35 ringgit. ;D

Tmrw, I have to report to JKN, the "HQ" in Penang at 8am. Cheers. Good Night.

BTN Starts TODAY!

2009-10-09T19:56:00.000-07:00

This is my 5th day under government service. Just finished Induction, now BTN. Well, there's an assessment for Induction. +/- Gotong Royong project with Boss and K. Here's some tips passed around during my time and it did come helpful. I've compiled some of the tips and also some group projects' answers as link below: (DONT WORRY, no virus)
http://www.filebox.com/388hqitt4sz9

Accomodation a bit lousy. (GVR) ;D but we cant choose the location.

Well, induction camp is a bit crappy, but certain things are quite useful, e.g. about salary, holidays, there are many types of holidays (it is also being compiled in the file above). The schedule is really packed 8.15am - 11pm... all lectures. Bored to near death. Well things are going real fast, as doomsday is coming real soon. Now 1 night left.

My Seniors are very kind, try to clam me before entering the service. But i know it might not turn out how i think it is. ;D Well, we see how it goes.

There are more stuffs to prepare before reporting to JKN (Jabatan Kesihatan Negeri), So best prep those things before entering induction. Cuz we are ought to report the next day after the camp. Here are some of the things that u shd prep: 2 copies which disahkan of:
1) Surat Akuan Sumpah
2) Medical checkup, including drug screening, CXR (the letter will come to you)
3) Surat Setuju Pelantikan
4) Surat Tawaran
5) Surat SPM, and Medical Degree Cert
6) Salinan Sijil Pendaftaran Sementara / Penuh with MMC

Oh and also: 1) Open a Maybank account, and KWSP account (If you not thinking of pencen scheme)

Sigh, i dont even have time to photocopy when i get back.

- Lim M

0 day left

2009-10-05T09:20:00.000-07:00

i've spoke to one of my friend, Dr LCP. Gave me some fruitful advices, and i will like to share his kindness and knowledge. 3 basic principles: 1) Be prepared of scoldings, but try to minimize it by certain ways 2) Keep profile low 3) Documentations

HO is placed at the most bottom of the food chain. Where everyone gets a bite from you, even the nurses... No matter what, how good you are, even if you did nothing, you will get scoldings from a lot of people. There is no excuses. In short, do more make up, make your face thicker, and get all the bombardments. Be mentally strong, life just not fair "usually". Think of it, your MO suffered before too.

During on-call, before calling your MO, we need to prepare and know the case well,try to rule out possible causes, most probably they will ask u, vital signs, what you done etc. (Be prepared to answer those questions)

Keep your profile low, as in dont try to be extra hardworking, as it sets your colleagues under pressure. follow the culture of your ward. learn and adapt. Hardwork doesnt pay much. But be helpful.

Documentations is utmost important to back your ass up. Eventho you called MO help, you need to write down the time and date what you'd asked his/her help, in case he/she doesnt come down to help you. this can reduce the blaming from the MO. However, write correctly. Even the mx that the specialist ordered if u din hear clearly, ask again, let the MO or specialist scold, it is better to get scolded first, as long as you keep the patient alive. If the patient unfortunately passed away, you have more things to face, and the scoldings will be un-imaginable.

Additional advice, as a "tagger", set goals, what you want to achieve day by day. Know the common and emergency cases, common cases aid you in the clinic, emergency cases that you know aid you during on-call period. Whatever need to ask, ask these 2.

So my ultimate goal will be learning to taking blood and setting up lines efficiently first 1 - 2 days of tagging. Slowly learn. Time will change a person, no matter how bad they are, it is just the attittude.

Lim M (Damn Sleepy D)

35hrs left to enter the "hell"-hole

2009-10-04T06:31:00.000-07:00

This is not what i am expecting. i got a letter from KKM and it is a 1 week notice. To me, it is not a Hoo-Haa to get a letter so early. The early u get, the earlier u end your lovely life. No doubt that we will face it soon, but months, weeks and days still counts. See, now i even count by hours. i'm expecting it to come at end of october, but it came now. And Now my life is ruined, being so depressed.

Once i got the letter, multiple random stuffs run in my mind, which i can't stop thinking, influenced by friends and evidenced by my eyes during medical student's life. The ugly life of HOship in Malaysia. i don't know how far that it is true, but i will face it. It is a sad sad job. I've tried to enquire some tips from my fellow friends, most of them replied, enjoy first, when start posting, only start to worry. One of my senior said the emergency part in the OHCM is important. Some said resus.

First of all, i'm going for an induction in Genting View Resort. Lucky that, "boss" is going there as well, at least a company, an ex-housemate to share the time with, at least not so-boring. i need to consider that i'm still quite lucky that i will be still meet the remnants of the PMC colleagues.

Once i'm in the induction, i'm considered paid by the government. This course last 6 days. It's sort of like shaping a person to be loyal to the country programme. Well, you know, i know...

After that start to report to the hosp, and tag to a department. Where all the countless day and night job, scoldings, blamings, framings, history takings, blood takings, phone talkings, no-time to eat, or sleep.... banging in front of my door. Sooner or later, hypertension atks me. Then put me at risk of hypertensive retinopathy, nephropathy, haemorrhagic stroke, heart failure etc.

i expect a lot of things in my mind and i don't know how far if that is true. i am writing in this blog, so that i can remind myself to be a better person, a better teacher, and showing my future child that how tough / easy is the life as a doc.

i know some enjoy being a houseman, some adapt to it, some forced to overcome it.

Before i start, i will like to thank my friends, my coursins and my family for always being there for me (listen to my nagging, pulling string for me, etc). I love you people.

- Lim M (34.5hrs left to the "hell"hole)