Saturday, July 30, 2011

CoMMed: The End Posting



At last.

Finished my postings.

Hell yeah, it was EASY.

I got the dark-bespectacled-short-dark-hair lecture.
I seriously forgot the name.

And so,we begin our end posting.Basically, it is about environment,water,housing and sosial health.




"Did you finish your record?"

"Yes sir."

"What type of family did you study?"

"Nuclear family sir. It consist of 3 member. Saji,Amitha and Sherine. The case sir."

Flipping through the pages.

"Owh i see. Okay, Tell me your observation ."

This is how you present your case.

"Sir, the family is nuclear type family, living in pucca house.The head of house is a bus driver,but the wife doesn't work. Hence the total income is around 8000 rupees( like 700ringgit per month). They spent the money wisely. No debts and had savings in account. They spent most of their money on food,fuel and house maintenance.."

He cut me before i could finish my presentation.

"Okay, tell me  the name of classification we used for assessing social class."

"Sir, its modified Kuppusamy scale sir.(Park:601 , Asma Rahim: 338)"

"Okay, what other classification you can name?"

"Erm...." totally blank.


"Its Pareek scale,Kulshrestha scale,Prasad scale..."

And i continued my presentation on my own.

"Sir, since the family spent wisely on food. There is no correction to be done regarding the menu. There is no deficit in nutrition requirement. They had balanced diet..."

He cut me again.

"Give me the total requirement of Vitamin A "

"Sir, for adult male and female its 600microgram for retinol and 2400 microgram for carotene.For children, it is 400 for retinol mcg  and 1600 for carotene." (Record 1 : 33)

He seemed to disagree.Aaargh, i didn't study the infant part because my case doesn't have an infant.

"How about infant?"

"Around 400mcg and 1600mcg..." totally from book, with slight alteration.

He disagree again.

"Look up for the answer in book okay?"

Waiting for another question, while he finished correcting my record.

"Finished sir?"

"Yes,you can go."


Hence, it is the very end of Community posting. Another term to go, one more community medicine posting to finish.I hope i've done well. Well, i wished i knew the answer for the vitamin part. Anyways, hooray! Finished commed posting already!




Friday, July 29, 2011

CoMMed: Community diagnosis presentation



Today we had a horrible presentation session for community medicine posting. All students were divided into individual topics to be presented using power point. But, we do not know what to do. At least , not about what the exact right thing to do. Basically, all lecturers seemed so agitated and quite furious with our performance. I was watching from the first row in horror as one by one scolded and yelled at presenter.

"Why in the world would you do like this? You think this department are so carefree ,so you can 'jack' us as you like? You people have no attitude! Not even interested in doing your duty. It is such a waste to sit here and watch your presentation. What ever you presented is already taken in theory class. We don't want theory part! We want to know the results from your observation. We want to know either you can deduce an inference from the observation. "

And another lecturer continued,

" Yeah, you people have no common sense. Not even one person came to us and ask what to do, how to do the presentation. You people don't even bother"

I just glanced to my fellow friends,and shared the what-the-hell-we-dont-know-bout-that-you-should-teach-us look. I hate to admit that i simply blur all the time and had no idea what is going on in theoretically. Seriously, i didn't hate Community Medicine, but i am not in love with it too. So, where should i stand?


I should study and finish writing 64 spotters in record book. Then, i shall study the environment,sociology and economy topic for viva tomorrow.

I hope everything goes well.





    

Thursday, July 28, 2011

Endoscopy and C. T scan


For those who had abdomen or git problem, the most common test to be done is endoscopy. Well,basically they shove a tube with camera down your throat.

The procedure took at least 5minit. First, a topical analgesic sprayed at the back of your mouth to prevent gag reflex. They put a mouth guard,and the tube is inserted. During the procedure, the patient tend to make a very loud horrible belching sound. I did. I was actually forced to breath through my nore becaure i kept on gagging. The moment the tube entered my stomach, then to duodenum,i can say that it is pretty painful. I am soo done with it!


CT scan? Nothing much to tell except painful intravenous dye injection. Maybe not really painful,just that the dye is somehow hot. I can actually feel the dye seeping through the vessels,into my chest,perineal region and gall bladder. In the end,they couldn't find what is wrong with me. All they can say, "don't take fatty food especially red meat.". Okay,i will try to fast and 'berpantang' from meat,mutton, and seafood. My consultant physician said that if i have another attack during fasting,they will do MRCP. What is that? Ask Mr Goo.





To kill the pain, i took Drotin. Its working this time. Not like cyclopam or spasmo proxyvon.
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Tuesday, July 26, 2011

A field trip again...



During community medicine posting, there are either theory class, field trip or seminars . In a week we will brought to the local area to ask question around and get ourselves a complete data of the family.

To be frank, i dunno anything or blurr all the time.

As long as it is in Kannada or Hindi, i can at least understand what they were asking or discussing. I tell ya, it is easy to ask questions in other language, but to understand the answer , took a lot of liberty to process the sound going through  the external ear canal, then into the middle ear cavity which is then processed by cochlea and transmitted to brain. I guess, my impulses always stuck midway, coz i always dont understand what are they saying. It gets tougher when it comes to elderly people, you know..the gummy-not-so-adequate-teeth speech.... Heheh...


My unitmate going into the house. This is a pucca house. 

Ventilation and lighting are inadequate.

Jot down the details...

See if the kitchen is high,medium or low in height.
We were also required to see whether the family used a LP or wood stove. 



They usually waash their clothes out side on the rock.
 Kasik hempas-hempas itu kain achi!!!

Field Trip : Police Quarters



Field trip again.

This time it is in the police quarters area.

Bet all the policemen here had an awesome mustache!!!

Yes, they did.

Like usual, i just stand and watch my friend asking around the details in the form provided.

Decide whether it is a pucca or kutcha house. 

How many rooms?

Gas or wooden stove?

Any family planning?

Income?

Details of family members.

Yeah, this trip is all about community studies.

We were supposed to fill in the form and walk away.

I'm glad there is a nearby store where we can eat ice cream.

And this is suppose to be an individual case.

Yeah, i don't speak their language.

Hence, a local friend is needed.

Like usual, i stood there, nodding and smiling and snapping pictures.










Saturday, July 16, 2011

Cetrizine c'est magnifique!!!

I had a lot to do list in my mind.
One by one, i completed one by one.
Tick the box and move to the next list.
A very long list indeed.



My eyes burning, my throat hurts,my body hot as a hare, and  i have a nasal-hoarse-husky but sexy voice. The flu won't take me down. I will complete my to do list what ever it takes within the targeted time!!!

I'm fighting against the cold breeze, fighting against the pouring rain to class everyday(which explains the fever), the sleeping inducing weather,the long hours or minutes of free time( waiting teachers,waiting bus to move,waiting in bus,waiting for attendance to be taken, etc... ), listening to lectures in class while trying hard not to doze in the first bench ( i sat there because i'm bit deaf,bit blind too, but most of the time i had to process what they say in Indian-English accent).

For the flu, i used cetrizine hydrochloride 10mg. Well, quite effective to treat runny nose,blocked airway and reduces sputum. Cetrizine is the common drug we had in the drawer other than Crochin( paracetamol for antipyretic and analgesic effect), Cyclopam (antispasmodics for period cramps), Prometazine(antimotion sickness,sedation effect for long journeys by bus or car), loperamide( antidiarhea)or chikit teik onn ( ubat herba cina yang bulat-bulat tue) , dentogel (ulcers in mouth), minyak yuu yee cap limau , minyak cap kapak and blah-blah.

 I knew i'm supposed to take antibiotics but since i thought the fever and cold would recede in few days, so i didn't take the precaution measures. However,  i am stuck with the flu  for almost 1 week. Padan muka ! Tomorrow, i have to go and buy some cefadroxil 500mg and take it for 3 days.

If i am not too lazy to walk out that door.


p/s: remembered 1st question in Kimia SPM, " Nyatakan cara-cara merawat batuk menggunaka bahan-bahan yang terdapat di rumah. I answered : Gunakan teh halia untuk melegakan batuk dan selsema. Cengkih juga digunakan untuk melegakan sakit tekak."

Friday, July 15, 2011

I don't like that you do abortions, but if you didn’t...

I don't like that you do abortions, but if you didn’t, I would probably be dead


I was paged by labor and delivery three times during the 10 minute drive from my house. I headed straight from the parking lot to the labor ward expecting a patient of mine to be close to delivery. I was wrong.
The chief resident and attending obstetrician were waiting. They looked tired and worried.
A woman had arrived on Friday with ruptured membranes. She was 21 weeks along in her pregnancy and now there was no amniotic fluid left at all. She and her husband wanted everything done. Despite the dismal prognosis for her baby, in respect for the patient’s autonomy, antibiotics were started. Within 24 hours it was clear she had an infection.
Delivery was recommended as these infections are potentially deadly. The parents refused. “The antibiotics might work,” they said. And no amount of discussion about the overwhelming medical evidence that supported delivery could sway their decision. Inducing labor at 21 weeks while their baby was still alive was abortion.
The infection worsened despite the antibiotics. The patient, who was rapidly deteriorating, and her husband reluctantly consented to an induction of labor.
And now it was clear why I was needed. Infected uteruses don’t contract very well. Prostaglandins and oxytocin both failed to produce even a cramp.
“They are very pro-life,” the resident warned. “It took several hours of convincing just to get them to agree to talk with you.” Considering I practiced in the bible belt this was not an unfamiliar scenario. I shrugged and walked into the room.
My patient was clearly very ill. Flushed, sweating, and drifting in and out of consciousness. The smell of anaerobes unmistakeable.
I reviewed what had transpired to date. The infection. The prognosis. And what I could offer. A dilation and evacuation.
They had two concerns. The first, their baby was still alive in spite of the infection. The second problem was that I was an abortionist. Couldn’t a doctor who didn’t perform abortions do the procedure?
“I understand your baby is still alive, but he or she cannot live. It is sad and it is unfair, but the pregnancy is now killing you. It is not a matter of if you die, but when.” I paused. “You have other children at home and they will be without a mother. If it is any consolation, at 21 weeks babies do not feel pain.”
The husband’s body language said it all. “How did you learn to do these procedures,” he asked.
“By doing abortions. Lots of them. I have done more late term abortions than most doctors of my generation. That makes me very skilled. But the privilege of helping women end their pregnancies safely also gave me the skill to help women like your wife. There is no other way. You have to do a lot of these procedures to become proficient. Even more to do them safely for a women at 21 weeks who has an infection.”
There was no response, so I continued. “This is a very precarious situation. An infected uterus is easy to damage. I could make a hole and injure other organs. Even if the procedure goes well, the bleeding might not stop. A hysterectomy could still be needed. The infection in the blood stream might still get worse. But without the procedure, your wife will die.”
My patient spoke. “I don’t want to die.”
Within the hour we were in the operating room. The procedure went well. The bleeding, though profuse, was controlled without a blood transfusion. Within 24 hours she looked like a completely different woman.
Several months later I was surprised to find her name on my schedule. Especially given the reason was a first prenatal visit. After the appointment was over, I expressed my pleasure to have her in my practice, but also my surprise.
She looked at me and said, “I don’t like that you do abortions, but if you didn’t, I would probably be dead and not celebrating this new life. My husband isn’t thrilled that I am seeing you. He just can’t wrap his head around the fact that women sometimes really need someone who can do what you do. But I don’t see how I could go to anyone else. You saved my life.”
I think of the many times I have been in this exact situation over the years and it makes me wonder what happens now to the women who rupture their membranes at 21 weeks in Idaho, Nebraska, North Carolina, and Ohio. These women can’t choose to have a dilation and evacuation or even an induction of labor. They must wait until their baby succumbs in utero or for a spontaneous delivery, almost always a grim prognosis for their baby. Unless of course an infection develops and her life and health are in danger. Only then, when it is more dangerous, can a woman terminate her pregnancy at 21 weeks with ruptured membranes.
And if the induction of labor fails, as they often do, will these women be able to find a provider in one of those states skilled enough to safely perform a dilation and evacuation at 21 weeks in the presence of an infection?

Thursday, July 14, 2011

Elder's shelter.

Today,we had a trip to an elderly shelter house. There are two unit houses separately each for men and women.

I wished i had something to give. They each needed basic daily things like slippers, toothbrush ( aik..ade gigi lagi ke?), toothpaste, machine washer,good thick blanket, and maybe some good rice too.

Well, one of the granma's there asked me to come front. I hugged her and embrace her hand.I knew they needed a hug more than money or materialistic things in this world. Yeah, most of them either left to die there, left by their own children, had no family at all, or came there for treatment. Some of them, still manage to communicate well. But, some had gone senile.

This is the third time we went here.We went there  last time during our 5th and 6th term postings. 



This amma is very friendly and sings alot. She even welcome us with her joyful singing. I am really gratefull for she can speak English.Go amma!!! We promise you we come again next time!
I aske her, what she do all day in the shelter. They do nothing. They had to hand wash their clothes  all by themselves.
Just have a look at her! Very charming granny rite! Siap ada bunga lagi kat sanggul tu...
This is one of the three dorms in the shelter for women section.
The entrance.
The weather is very cold and nice. The shelter is surrounded by green field.
Another scenery.
I guess this is the toilet.


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Monday, July 11, 2011

A Field Trip


I am lucky and grateful. Wanna know why?

I love my samsung galaxy and internet pocket worth 98rupee per 2Gb.

With that, i blogged,twittered and facebook-ed.




Today, we are visiting a local house. It took 10minutes from hospital by bus.

Damn,this suppose to be a group job.

 But,obviously, memang blurr aje.

I could catch few words during conversation.

 Grandma asked me, "...uru(place)... magu(child)?"

"Malaysia. Kannada gottila, swalpa-swalpa amma, Hindi thoda-thoda amma..."



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Sunday, July 10, 2011

Kanak-kanak...

HOD Obg says : the more worried parents are, the sicker the child gets!
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Tips for medical students entering intern year


by Elizabeth Breuer, MD

As intern year winds down and all of the giddy 4th year medical students are shelling out 200 dollars to rent that a robe for one day of pomp and circumstance, all of us interns are impatiently waiting for the fresh meat to arrive.

Having just experienced every single emotion under the psychological rainbow this year, I am going to give a few pointers (or not really pointers but just some anecdotal evidence that it’s ok to feel the way you’re feeling). I am stupid enough to admit to all of the silly things that I did. This is not to prove that I’m an idiot, but to allay the fears of anybody who finds themselves in my shoes starting July 1.



1. You might have been a good medical student but you now know essentially nothing. You also have much more power and ability to screw things up than you ever had. This, however, is ok because you are being very closely watched by every single nurse, medical assistant, older resident, attending, even the lady who empties the trash, and you will not really do anything so stupid that you could actually hurt somebody (hopefully). You will do really dumb things though, for example, a wet prep is called a WET prep for a reason…you need to put a few drops of water on it. Somebody, not to name names, did a DRY prep. The whole point of residency is to do dumb things. The dumber the thing you did, the more likely, if you’re smart, is to not repeat the dumb thing.

2. Accept the fact that you will dumb things and you might hear about it. It might be a change from being a protected doe-eyed medical student to be paged by an older resident or attending to ask you to explain why you did such a thing. Don’t argue. Just say, I’m sorry, cry in the corner for one second and get over it. The whole point of residency is to do dumb things. You are not a bad person or incompetent because you made a mistake.

3. Having a pager sucks. The only profession ever that still uses an outdated contraption invented in the 1970s for drug dealers, residents and all doctors for the rest of eternity are given pagers which need to be worn and answered at all times. This cannot be turned off and have the potential to bring bad news at any time. However, I must add that having a pager is also something that becomes normal very quickly and grows more annoying than scary as time goes on. You might start to feel naked without the two pounds of buzzing plastic with two lines missing from the screen.

4. It’s ok to be absolutely terrified. I was so nervous when I did my first speculum exam as a resident that it took me five minutes to realize that the speculum was actually broken and that I wasn’t just a complete idiot that didn’t know how to use it. Being nervous reminds us that we are taking care of people who are sick and we shouldn’t be nonchalant about it. When I did my first delivery, I think I almost vomited. Being scared is totally normal.

5. If you are completely over your head, ask for help. Seriously, even if it might seem dumb to somebody older than you. Because, back to point 1, you are stupid and everybody knows that. Don’t pretend to be smart because that is dumb.

6. Things that seem scary will become second nature. The most awesome thing about being an intern is that while I almost vomited during my first delivery, I now am comfortable in the delivery room and can handle many different situations. Lots of bleeding, ok! Bad laceration, ok! (to a point, then same thing, ask for help). I’ve done enough deliveries now that I have fun with them. You will develop your own style and you will learn. Everybody does it. Something that helped me get through all the nerves is reminding myself that almost everybody that graduates from medical school survives residency and graduates to be a competent physician. So, if they can do it, why can’t I? You can do it too.

7. It’s ok to complain. Residency is full of sacrifice. You will miss holidays with families, weddings, birthdays, weekends off, dates with boyfriends. You will be grumpy. You will be exhausted. My advice though is to complain to your co-workers. Complaining at home and to your family doesn’t really work as well because they are also suffering your hours and your holiday-missing and they really don’t understand how much your job sucks. I have completely failed to follow this advice. Fortunately I have an understanding family and a wonderful, exceptionally tolerant husband. (And on a completely personal tangent, avoid getting married as an intern. The wedding was great but planning ruined my life.)

8. Step back and realize how totally amazing your job is. You get to help people at their most vulnerable moments. I get to use needles and knives, scissors and suture as everyday tools. I bring life into the world. Wade through all of the crap, the hurt feelings, and just appreciate how great it is to be a physician. Even though the field of medicine is changing probably to the disadvantage of all of us, there is a reason people are willing to sacrifice so much to do what we do. Medicine is rewarding, stimulating, complex and most of all, really fun. Residency is a great community and an awesome bonding experience. Enjoy it.

9. Most importantly, work hard, keep your head down, take care of your patients and take responsibility for your actions.This is by far what will get you through and all that people really expect of you. Just keep going and you’ll be fine!

Summary of the points she brings up:
1. You might have been a good medical student but you now know essentially nothing.
2. Accept the fact that you will (do) dumb things and you might hear about it.
3. Having a pager sucks.
4. It’s ok to be absolutely terrified
5. If you are completely over your head, ask for help.
6. Things that seem scary will become second nature.
7. It’s ok to complain.
8. Step back and realize how totally amazing your job is.
9. Most importantly, work hard, keep your head down, take care of your patients and take responsibility for your actions.
The last point is the most important. The worse species on earth are HOs who will shirk their duties, abandon their colleagues and patients, be dishonest in their clerking and work.
Source: here.

Saturday, July 9, 2011

A healthy soup for doctors to be...


I met a doctor who is also a dean.
He was famous and had a great white-neck-length-hair.



That day my class was cancelled and instead of going home i greeted him and asked wether we could talk.

I sat on the couch facing face to face with the legendary doctor who happened to have no personal life,4 huge white dogs and finished his MBBS for more than 5 years just because examiners hated his hair. But, he was a proud and 'rock' old man.

I gulped...but it is harder to speak when i tried really hard not to shed a tear.

"Tell me" , he said.

" Its been a very long time since we talked sir. We kinda miss to chat with you, sir."

"Yeah, me too. How was your stay in city? Was the food, the room,friends alright? " a very common question among doctors and staffs.

"Well,of course it is great. I've been really gratefull for that. How's yours sir?",smiling with pearly eyes.

"Great! Tell me how i can help you? "



"I've been wondering if i'm not fit to be a doctor."

He beamed.

"Don't worry! You will get through this! You may say that i'm not good enough or others know better than me. You must realize that everyone is different. You think that you came from a different culture but at least we are asians. We can at least adapt to the food,weather or culture."

But, sir i felt soo lagging behind.

I don't think that should be a problem. I had a lot of Malaysian friends you know. They succeeded and passed MBBS. They too had language problem but they never make it as a huge thing to accomplish. All you need is, to pass all exams and with a blink of eyes you'll be in final year. I bet you are a bit relieved that you are now in third year. 
*nodded* 
Okay, let me ask you something.

How does doctors working with animals talk to their patient? 
(I was too dumbstrucked to agree.)

But sir, i could only learn if  i made a mistake. I have no idea which is which, what is what...
Relax,you'll be fine. This is the time to make mistakes. Mistakes by doctors could cost someones life but you have plenty of time to prevent that from now on.This is a learning process. To become a good doctor requires time and experience in which you will get along the way. Don't worry much ! You'll be there. You just need to pass the basic subjects and continue your journey.
First year is the toughest among all years in MBBS. Once you passed, you should be proud of yourself ! Not everyone can pass, and not just anyone could survive medical field. Either distinction or not is another point. An ordinary student could become a legend just by doing extraordinary things and become a great doctor. A doctor is a profession where hard work counts and results are seen in front of our eyes. Medicine is also a repetitious knowledge that you need to by heart everyday.

All you need to do now is to become an intern who makes excellent differential diagnosis. A good doctor however, comes with experience in which you will be, if you stay in medicine and learn from your mistakes. An excellent student will be able to give different possibilities of diseases and makes an attempt to diagnose patient with the right tests upon symptoms and signs presented. For example, fever as a symptom. An excellent student will be able to say , "Sir, i would like to check for the temperature of the patient and see the pattern of fever. If it is step ladder pattern it could be typhoid fever, if it is rising every third day, it could malaria, and if it is continuous fever spike i might say that it is brucellosis." Again, don't worry bout anything. Just focus on your studies. I am sure that you will do well and become a good doctor.

Anything else?  
No sir. Thank you very much!!!

But just after he stood up, he whispers " Don't you have boyfriend problems?" gleefully.

The easiest way to answer to that question is " No sir, i came from girl school, not much admirers sir." I end our talk with a grin and walked out of his office with a light shoulder and wide spaced paces.



I am very much relieved that i solved 'that matter' before and if another 'that matter' happens again, i will say to him " bring me a ring to my  parents house. " I came here to study. Study medicine. Study how to survive. Study how to mingle with people. Study to become a better person.





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Friday, July 8, 2011

FIN

Finally, the moment i've been waiting has to come to an end.

It feels like nothing. I dont even get palpitations or cold clamy hands.

Finally i came to the end of my journey of traveling in the most dreaded, most hateful, most volatile subject known to medical students.

And that subject is M.I.C.R.O.B.I.O.L.O.G.Y.

Gosh,how much i tried and tried to study to every little details for exam,still, it wont suffice.

I've got tables and mind maps and videos and websites to aid in memorising it, still , it is so volatile.

Trying to by heart the book are as difficult as trying to breath in a deep cold air...


And when the time comes for our knowledge to be tested, mind and mouth doesnt seem to sync well as if the impulses were stranded midway through the axons.


During preparation, we ought to believe that we can do it. Yes, i've memorised it. Yes, i am okay. However, when the examiner stood and looked deep into your dark eyes, brain cortex processed the question and produce the answer. The answer lingers and float aimlessly in front of our eyes. The lips tried to move the muscles and form a word. Only a word...

If we had not listen to our teachers, it may be difficult... The worst teacher can still be teaching us things that looked soo trivial which may became the cause of of our failure.

If we had a bad teacher,we just need to become a better student.
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Friday, July 1, 2011

SURVIVAL TIPS FOR HOUSE OFFICERS / INTERNS


by Dr Harlina Halizah Siraj

A compilation of survival tips for new medical doctors. I started writing these tips on my page since June 23 and dedicated them to my students  -  Medic Alumni UKM. I pray that these words could reach out to those who are really needing support and strength to continue the struggle.

Love from Dr Harlina Halizah Siraj, alumni HO General Hospital Kuala Lumpur (GHKL) - Aug 1991 to July 1992

SURVIVAL TIPS FOR HOUSE OFFICER: Tip no. 1 - Set your intentions right. It's neither about the money, the highly respected position and the power. It is about PUBLIC SERVITUDE, serving those who are in need of healthcare. Only after you have served well, then only you could deserve the rewards, privileges and rights allocated for medical practitioners! Welcome on board!

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no. 2 - Have the right attitudes. Being the most junior officer in the team, you really have a lot to catch up and learn. Never pretend that you know all. Never hesitate to admit that you do not know, to ask questions and assistance. Respect those who are more experienced than you. People with the right attitudes are welcome wherever they go, always...all the time! 

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no. 3 - Put on your best smile and outstanding manners. Greet everyone with a cheerful salam. No matter how busy you are, don't forget to move your temporo-mandibular joints and carve out a big smile. It will stimulate a fountain of endorphins in your neuron synapses, and aha...the feel-good feeling will set in. Don't believe this? Just try....just do it.

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no. 4 - Work extra hard to convince people that you are reliable, responsible, accountable and able to complete tasks and meet expectations - within the first two weeks! Once people know you're committed, you'll gain their trust, respect & cooperation. Just mark my words!

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no.5 - Refresh your inner self with daily, constant and effective spiritual input. For Muslim, don't ever neglect your 5 times daily prayers, no matter how busy you are. You really need that 5 -10 minutes regular breaks. It acts as a cooling oasis for you to rejuvenate.

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no.6 : Mend your bruised heart and dented self-esteem, quickly and effectively - each time you received unpleasant reminders of your incompetency & shortcoming from your seniors. It's a part and parcel of the job. Admit your mistakes, but PLEASE, try hard not to repeat them. To err is human, but to keep doing the same error is a major blunder!

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no.7 : Keep in touch with your loved ones - parents, spouses, close friends, teachers etc. Don't shut out your life, which mainly linger around your wards, call roster and private room now. There is more to life out there than just work or crashing into bed to recover from sleep deprivation.

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no.8 : Make friend with the nurses. Never ever be their enemy. Life would be much easier if you know how to win their hearts. Dr Meena (Paeds MO) gave me this very precious advice : Harlina, be nice to these people (nurses). They will decide whether you will have your meals or not during your calls. Yesss, I later realized how true that advice was!

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no.9 : Forgive those who raised their voices at you. They might be angry patients, stressed-up MOs, overwhelmed colleagues, frustrated consultants, irritated nurses etc. Nobody had ever shouted at you before,eh? Being a HO, anticipate your first experience here. Forgive them, forget them and live on. After all, we're all just humans living in the same pressure cooker!

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no.10 - Thank God for the honour of being His instrument/tool of Mercy to mankind. A great opportunity is at your doorstep to catapult your good self to be bigger than life. Grab that opportunity and seize the golden moments. Nothing compares with the feeling of satisfaction whenever your patients & relatives say : Thank you, Doc

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no. 11 - Handle yourself well when dealing with difficult people. Feeling victimized, bullied and discriminated? After reflecting on yourself, I suggest you pluck some courage to meet face-to-face. Clarify, admit your mistakes and make peace. InsyaAllah, things will be fine.

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no. 12 - Treat your patients as if they are your own parents/relatives. Just as how you would like any doctor to treat your parents, that's exactly how you should treat your patients now. Remember, what comes around, goes around! Motivate your patients always, you'll feel the positive energy seeping into you too.

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no. 13 - Express your love to your spouse everyday, using his/her love language. Let him/her know how much his/her support & understanding means to you. Share your ups and downs, laughter & tears. Thank Allah everyday for sending you this special person. Those who are still unmarried, what's keeping you, guys?

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no. 14 - Be sincere in treating your patients, be gentle and caring. Control your anger and frustration, avoid explosive emotional outburst in front of your patients. If you really need to release the steam, do it in the washroom with the tap running (peace, Mother Earth)- I consider that as an effective form of anger management!

SURVIVAL TIPS FOR HOUSE OFFICER : Tip no. 15 - Keep abreast with what's happening around you - medical & non-medical, locally and globally. Read the papers, journals & magazines, listen to the news bulletin, engage in general discussions. Have your own opinions. You're a doctor now! People wanna know what's going on in your brain.

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