Friday, June 26, 2009

Final Med

It was 7 years since the fateful SPM results that allowed me to embark upon this journey I call ‘life’ today. One signature sealed my fate, and I saw myself being dragged to the pits of INTEC with its dingy toilets, mouldy mattresses, and even a midnight robbery, to be whisked off to the romantic streets of Dublin, with its 30min Catholic masses, oh-so-gorgeous Jesuit priests, Swiss guards of the Vatican, and the cheeky-grey-eyed violinist on Grafton street!
It’s been 2.5 yrs since I’ve returned to Penang, and Penang’s grown on me.
I started off 2009 with a slow trot, easing into the year that I’ve long awaited, envying my friends who have already graduated, knowing that I’m at the very last leg, but boy was it gonna be a super duper mountaineous hurdle to jump… with every chance in the world to tumble and fall flat on my face.
Momentum was gained when I stepped into Surgery from GP, the surgeons were very inspiring (particularly this one whose dedication and sacrifice for his passion spurred me,and I only hope I can have even half his zeal- well I found him dangerously attractive too! ). I was in the wards at 6.15 am, and most days ended at 4pm, sometimes 5 and a few times at 6! But it was exhilarating! Eager teachers had to be met with enthusiasm… yet, I couldn’t quite muster up the knowledge I wanted to have in my head, despite the hours I clocked in. sure, I knew some answers to some lecturer’s questions, but there were some I didn’t have a clue abt, even at the end of our 6 week rotation. I was at ill-ease, but I had no choice, I had to pick up with pace, cause time and tide waits for no man, and Medicine was here!

There were 2 complications at this point:

a. the mere thought of sheer workload of medicine was enough to knock the wind out of me… there was nephrology, neurology, cardiology, each of which we had a week’s rotation in Penang GH, then one week for infectious disease, haematology (like thalassaemia, leukaemia, etc) and rheumatology (like rheumatoid arthritis, SLE), but the first 2 weeks was in Taiping GH, where we were supposed to cover Respiratory medicine, endocrinology- this meant we would be missing out on teachings by our Prof of Medicine who was a genius in respiratory medicine and our dean, who was the go-to-man for endocrinology! We ended up covering a lot of cardiology though we had a designated week for cardio on the 6th week. Being in a foreign place was not easy, studying in the hotel room. Then there was the issue on which book to use. Personally, I like to employ one book, as a basic skeleton, cover that, and then add the pomp and grandeur to that. I didn’t have a core text I used in 3rd year, some ppl advised to use Oxford Clinical Handbook, others Baby kumar and clark, but I was one who needed the basics clearly outlined for me before delving into the fundamentals of each disease- I was too afraid of being quizzed on diseases that I neglected to study. So by the end of 6 weeks, I had jumped from book to book, and I had my thoughts all jumbled up as well. It was strewn everywhere (just like Gracie’s desk!! J) I was panicking,
furthermore, I seem to not be able to keep up with the occasional tutorials we had at PMC, whilst surgery had afternoon tutorials with daily ward bedside teachings, for Medicine, we had 2-3 ward teachings per day, and 2 tutorials per week, taught by our own colleagues. I knew I was grossly inadequate to face the final exams. Each field was continents away from the next, neurology was Asia with its diverse culture and aberrations, with Cardiology being the African dessert, unchartered territory for me, yet somehow widely engaging- findings weren’t obvious or demonstratable on a photograph for 20-30 ppl to witness at one go, but an art unique to what one individual’s ears can pick up. One might be the only one able to pick up a murmur very easily in one patient, but miss it entirely though 7 others could detect it. The challenge cardiology posed was one that, surmounted, could boost even the biggest egos doctors and medical students are famed for! Respiratory medicine seemed okay because, the more I knew a field, the more I knew I didn’t know. Respiratory medicine had no formal structure of designated tutors, so I felt it was safe, little did I know! Then there was Dr Kok… It was truly an experience to study under the top student from UM (I very openly admire students who come out of local universities, because the 2 months I spent in form 6 in St John’s institution, while it was merely a peek into what my friends had to cover, it was enough to instil in me a eternity of admiration for those who jumped those hoops and hurdles, and especially for those who did it gallantly without breaking a sweat i.e. those who got into medical school la…
b, Secondly, Medicine rotation lasted 6 weeks, after which we had 2 weeks before our final exam! That means I had to cram in revision for surgery on top of all those scary subjects. Mr Lam, another product of the local university scene who only further emphasised and punctuated my admiration, was so kind to take us for one revision class on May 1st! then Han and I would haunt the surgical wards at 7am before our medicine wards (officially to practise our hernia, thyroid, breast, abdominal, peripheral vascular disease examination, and primarily to oogle the hot surgeon I was speaking abt previouslyJ)

The exams were designed to assess and scrutinise our knowledge from every view. Our general understanding of each field as a whole, skimming all diseases, delving into the rarer ones in Written- MCQ, then letting us talk in Short notes, testing our thinking on the spot with MEQs- they would give us the first sheet of questions which we were to complete in approx. 5 mins, then we had to place those sheets facedown on the floor, and tackle the next sheet! Regurgitating totally from memory, information contained in previous papers. There were X-Rays to tackle, pathophysiology(to the diagnosis we thought was right- i.e if we were wrong, not only did we lose marks for the wrong diagnosis, we lost marks for the pathophysiology too!) to map out…
Then there were clinicals, Long cases approx 1 hour to clerk and 20 mins to be examined on just ONE topic out of all the multitudes of topics we studied, if we were unlucky enough to get a rare disease we just flipped the pages of, that’s 80 mins of purgatory! Then there was osce, 5-7mins to just physically examine the patient (in surgery emphasis was on technique, in medicine we had to come up with our diagnosis at the end of it!!!)
So with THE exam to which I have been working towards for 7 years, if not my entire life and which would license me to do what I think I wanna do for life, looming ahead, I had to do my best, despite all my inadequacies…