Dearest adik-adik in Egypt,
First of all, I would like to wish you all the best for the final exams. Hopefully you could answer really well, for those who couldn't, just focus on the next paper and forget about the past papers.
Anyway, Kak Niah dah start my housemanship. Currently, I'm in Hospital Serdang with the pediatrics department. So far, things had been great, although there are times when I feel down, but I keep telling myself that things will get better and I will not allow my job to interfere with my emotions. Working with children is fun, they are innocent small people who are very honest, and seeing them getting better everyday is a great joy!
The reason why I am writing to all of you is because I just want to give a quick briefing of what HOs are expected to do, so that you all tak terkejut when you start work nanti. Honestly Kak niah ckp, first time present depan specialist was a great mess, it's because they present differently here. I mean, the last time when I present depan my specialist in Egypt, they didn't say anything. It was so different back then, I guess it's because we were used to seeing chronic patients, so you tend to tell everything about the history of the patient when you present. But here, it's different because they are "real" patients who come to seek for medical help rather than asking for "money." Tapi apa2 pun, as the days go by, I got used to presenting and mentioning the relevant issues only. Like they always say, the specialists are way older so their attention span is very short and they are not bothered to listen to the non-sense. I was lucky to have nice MOs who always guide me.
* the local grads dont have this problem because they are used to the system here, mmg since medical school they present depan specialist.
Ok, for those who don't understand about the hierarchy of the medical field, this is how it is: HOs are under MOs, so anything you do, you have to refer to MOs, for example, if you come up with a management for the patient, the MOs will monitor your management, so if anything happens, HOs don't get the blaming because anything you do is always under supervision. You are always protected! After two years of HOs, you become a medical officer (MO), and here, you are on your own. But above you is the specialist. You only refer to specialist for difficult cases.
I am sure that for those yang dah masuk clinical year, you notice that kita dekat mesir, ada buku khas for clerking, right? If HF patient, ape nak tanye and so on, we have a template! But here, there is no such thing. I remember masa mula2 clerk patient sini, I didn't know what to ask. But later, I realized that what you ask are all the things that are present in the theory book, it's just that it's in the form of a question. And it's very important that you analyze the complaints, because it can lead you to many differential diagnosis (DDx). Eg. patient coming with a cough, it could be many things, it could URTI symptoms or an asthmatic cough... so how can you differentiate between the two DDx? Again, you have to analyze the cough, ask about the timing of cough and so on. This is the easiest example that I can give right now...
So here, I would like to sarankan to my adik2 to study really hard when you are in medical school. Because when you work, you are expected to know everything! No one will guide you and tell you, "ok, listen to this, this is crepitations, this is rhonchi, this is a murmur..." you are expected to know that!!! So while you are in medical school, you have to start learning about all that. Rajin2 la tengok patients, ye! Jgn relax sangat, because when you work nanti, menyesal tak study betul2. You cannot miss any signs when you work because they are important. I was ever so thankful to Allah for the fact that I went to the extra classes while I was in the 6th year... alhamdulillah sangat2 for that, because I cannot imagine how I'll be if I didn't go to those clinical classes. Yesterday I was asked by my specialist to interpret an ECG! Thank God I could! To me, you have two choices, for those yang tak nak pegi kelas tuition takpe, but you must have a back up system to compensate for the lack of cases that we see... pegi ward sendiri ke, ape2 la, yang penting, you learn something. Like me, in the beginning of 6th year, I knew that I am not the kind who is bothered to go to wards on my own, I wasn't sure whether I was disciplined enough, hence I joined classes with Dr Hawary (for theory of medicine) and Dr Ashraf (for clinical medicine). People might say that I was spoon fed, but I'd like to make it clear, all the spoon feeds paid off ok! And I just don't know how to thank those professors who helped me. So the bottom line is, you have to study hard when you are in medical school! All the knowledge is essential in making the correct diagnosis and managing your patients. So siapa2 yang ada extra money tu, invest in classes rather than travelling, there will be a time when you can travel around the world. Focus on your priority which is a to study!
Oh yeah, before I forget, the myths about HOs being so busy that you don't have time to eat are all not true! Believe it or not, I lunch everyday, and a proper lunch that is, nasi with so many lauk! Again, it boils down to how you manage your work. I am telling you this so that you are not scared about entering your HO days because the last time, I was told that I won't have time to eat! Just be optimistic about life and stay positive!
Ok.. I better end my email here. I have a few things to say, but I'll leave that for later. All the best! If you have anything that you'd like to ask, do email me at nooraniah@gmail. com. I'd be happy to help!
Best Wishes,
Kak Niah.
