Post Mortem Exam 3rd Year : Day 2

Community Medicine

I slept only for 2 hours. If i'm not mistaken. But, i'm glad i had finished whatever target that i want to achieve within one day of studying. More than 70 slides spotters, epidemiological cases, exercises on statistics and so on.  I didn't read the theory part because i am depending on what i have read last two weeks during my theory exams. Anyways, i've got plenty of  time to study while waiting for others to finish their viva. I'm somewhat contented of becoming among the last in a row. Any exams will give that extra time to study and gained something from the ones who have the honour to answer first.

So far, i think i did good. Alhamdulillah.

8.30 am- Went to Y Hospital. Waited at lobby. Said on third floor. Went up by foot. Saw no one there. Text my friend, said its not in hospital. Fast paced walk to college building. Climbed three floors before seeing the others. Waited  while sweating profusely.

9.00am- We sat and waited. A chubby looking invigilator came with answer sheets. We filled in our details. 3 sets of papers were given. One for Medico social case, epidemiological case, and spotters.45 minutes were given to answer epidemiological case. I did okay. Forgot the IMR,MMR,CBR values but it was okay. Then, we had spotters. 1 half minutes for each spotter. I answered all. Alhamdulillah. Then, we were told to pick a random paper with patients name and department. I was the first one to pick and i chose the paper which was thrown out of its group. Alhamdulillah again i got paediatric case. Razika,14 year old. We were told to get back to the hall by 11.40am.Owh, plenty of time to take case. :)

10.45am- Rushed to the  hospital straight to 8th floor. Climb becaused waiting for the lift took so much time. Again, sweating profusely upon arriving the deparment. The kid looked flustered and giggled a bit when she saw sweat dripping from my forehead. I looked aroud and there is no one to help me. So i did the examinations first making sure nothing was left. Yes, i did learnt my lesson yesterday. No findings because she was healthy and was about to get discharged. I took  the history by my self even though there is language barrier. I'm thankful because the kid was able to speak little english and i was able to memorize little Kannada.we complement each other.Ngee. (^_^) So, i scribbled on some A$ paper and rushed to the hall 3 minutes away from the hospital. Again, walking from 8th floor down to the third floor up. Arrived with sweating again. Searched a seat directly under a fan. Wrote the case in the answer paper. was told to shift to lecture hall 5. It has air conditioning. Alhamdulillah, i need it so much. Allah, your blessing never end.

11.40am- Case presentation started. I was the last to go. I had a female examiner and she didn't ask much. Only Investigations and treatment of malaria. Any variations in fever grades...She asked why not typhoid ? What differentiates between typhoid and malaria fever? What test to be done in typhoid? How to prevent typhoid?Then, she let me go. Alhamdulillah, it was clean and satisfacory.

1.00pm-Theory viva started. there three examiners altogether. I waited too long and managed to read the book. I just flipped through all the pages quickly as if i can read like Superman. Heheh...(-__-)"

Examiner 1 : Looked hard at the topics to be question and later he came up with ,

 What is sewage disposal types? I answered and he seemed satisfied although i hesitated a bit. Then, he asked "What is incineration?". I was bewildered but answered anyway. Then, the bell rang.

Examiner 2 : The female lady was there yawning. Already sleepy due to rain or maybe she is just so hungry.

Name some Polio Programs. What is Oral Polio vaccine? How does it transfer? What is Intensified Pulse Polio? How to prevent transmission?

Examiner 3 : Its my Head of the department in our college. First thing he asked was," how was your paper? You think you can pass this time?" I said, it was good and i think i can pass with a smile. Then he proceed with the questions. What caught me was his question about if given a choice to work in hospital or in PHC with same salary which one i would choose? I said, " Sir, i would love to go where i was needed. There is more self satisfaction. Anyways, i'm using peoples money to  study and its time for me to give back to community."He agreed and question of my intention so as to impress him by choosing helping the poor and needy. I clarified my intention and he smiled. Alhamdulillah, with that i was let go.

What is emporiatics? what is ergonomics? Which chapter is it? Define Primary health center. What is Multi Purpose worker? What is Mudeliar Committee?  

p/s: The theory part was so random. I t could be anything. Bye, gotta go break fasting. 

Community Medicine: The Practical That I Hate

That day, we have to prepare early as the bus will get going by 8.30 am. That night, i flipped through all the spotters written in the record and memorize each and every answer to the question. That night is the first night that we actually preparing for community medicine practical.So, i had no idea what to do, in detail. I had not made any mistakes before and there is no possible way that i could improve or not to make the same mistakes this time because we never had any exams for practicals before. I can't really blame them for NOT having a LOT of practical exams during sessional. I understood , that it is a tedious job for the department to prepare the materials and allocating houses etc for each student.Not to forget the answer sheet is way difficult for the lecturers to mark, you know the lecturers are very old, true story. Hmm, they say why bother coming to class to teach when students were not even  interested to listen what they say  in class. I've always sit in front and blurr all the time. I've always felt bored and unease with people whispering behind,some were reading novels, the noisy drill at the upper floor and with  teachers yelling in front.

I make this entry to remind myself what to do and what not to do for exam. So, i shall start from the beginning of community medicine practical revision.

Revision Time - I have to read the 66 spotters, 8 epidemiological exercises and  statistical exercise. It took for about 5 hours to complete revision as well as memorizing everything by heart. Next, flip through all topic related to field case. For example,maternal  infant morbidity, nutrition,housing, primary health center, environment and a little bit of other topics.

What to Bring - Bring stethoscope,scale, calculator, language book for kannada malayalam and a sheet of copied format of field case. 

Our practical exam consist of 5 part. The field visit to local area, case exercise, spotters, case viva and theory viva..

Field Visit-

The bus goes by 8.30 am. We are not supposed to take our record or bag to the field as it may be considered cheating. However, i just kept mine in my bag and carry it in bus. Well, all equipment needed is in there and i am reluctant to leave my lovely beloved new bag without proper supervision in college. Anyway, we arrived at the supposed area by 9 am. and began to go separate ways under lecturers guide to allocated houses. Each student got one house each. All students are required to take the cases independently without help. For international students and students who did not speak local languages, we were told that translators will be allocated for each student during final exam. But, for that day, there were no translators or lecturers to help us with the translation and thus, i had to figure out everything myself. 

 I got an infant case in a house with family of 13 members. We were given 45 minit to finish the family case and the clinical case. I am so lucky because that day, because they can speak Kannada which is very easy to learn and understand. Plus, the family had a card that list all the members in the family. The card states everything i needed.but, the real problem is i had no idea what is it because it is written in Kannada. Thank God, the card had pictures and numbers on them and i simply 'cook' the rest info on the sheet. The vital info such as name,age,occupation, relation, education level,house environment  and income can be easily acquired. The real trouble is when i needed to figure out the nutrition and family planning. If only i bring the language manual book, i think it would be a lot easier to deal with them. I know  my sheet was totally messed up because it was my first time writing it. I forgot the nutrition table and the answer sheet looked horrible and unsystematic. I managed to finish the interview, physical examination of the infant and write the sheet. When i finished, we went to college at 10am. Attendance were taken in the bus  and the case sheets were given to respective guide lecturers.

Case Exercise

This exercise consist of 2 epidemiological case and one statistic case both to be written in separate answer sheet. The limit to answer the question is 40 minutes. From 20 students in the exam hall, i could see that everyone is trying their best to answer as fast and as they could. Some are like me, trying to figure out what to do without a calculator for statistic question. How could i forgot about the most important thing in practical? Pfftt... Obviously, all the equation and formulas should be remembered.

Spotter

Spotter session started at 11 am.For this part, we have to identify each spotter given on the table within 1 minute. 10 spotters from 66 spotters given in the record must be memorized well. No need to remember calories as we can see the spotters right before entering the exam hall. It will be pretty obvious. Pay attention to drugs and parasite spotters. I messed up a lot for drugs and parasite. So study that more!

Field visit case viva is easy. The batch was separated into two groups. Each group for one examiner.I am among the last students.So, i had ample time to read for the viva. Present the case like we usually do in the clinical subject if the examiner ask you to. If not, take your time to think the answer and answer with confidence. Do not hesitate to say that you do not know to questions you have no idea about. Study everything related to the clinical case. Since mine was infant morbidity case, he kept asking about the antropometry measurement. Well, i  didn't have the wight and height scale that time. I decided to cook everything up not realizing that he actually pay attention towards these  silly little things. I am busted for those question and end up giving excuses that i just jot down what the mother had said and i told him about the languange problem. It seems that he doesn't even care. Maybe next time i should just cheat something but make sure whatever i cooked up make some sense. In the end he gave me just 25/35. Well, quite good i think.

Theory viva. Gosh! It could be anything!Just read more on primary health center and diseases. They asked me this:What is primary health center? What is the meaning of disease? How many type of epidemic do you know? How to prevent rheumatic fever? What is transmissible disease? etc...

So, that is all what i can say about practical. i'm  pretty sure that i messed up a lot.

  Otoke?(What to do? = in Korea) 

Want to do it again? Oh hell yeah! I have to have at least one more time to do it right before the finals. Please don't screw it up next time okayh!  

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!

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.





    

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.

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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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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