Finding Neverland: September 2009

7th august 2009

For the third professional exam, we were emphasis on our clinical knowledge compared to the theory. for the exam, we have 3 parts that must be full filled before we were allowed to progress to the 3b. the first part was theory paper, which consist of 2 paper. the tricks is, we must pass all 3 parts,which means if we fail in any part of the exam we will required to go supplementary exam.

On the first day it will be the social preventive medicine and on the 2nd day will be the clinical paper(consist of medical, surgical, peads, primary care, o&g and forensic medicine). For the second part, it is an osce where we will have 20 question(3 question on the first day for social preventive medicine osce and 17 station on the day of exam) out of the 17 station, there will be 3 pcm station which is very crucial where we must perform a clinical skills in regards to the patients and questions.

for the third part, is a long case. This is the most challenging where the case vary from very simple URTI to the most complicated co-morbidity or even an undiagnosed patient. In the addition, the examiner also will vary from angels to the malignant. So, what you can hope is, get a good patient, good case and good examiner.

in my 3rd pro examination, for the theory paper, it was though and i hope there will be more time for me to answer the question. Generally, it was fair and we're still able to get the idea of the questions and how to answer them.

the next challenge was osce. i was put in the first group that will be taking the exam early in the morning. as early as 7.00a.m we're already in the exam ward, waiting for the briefing. it was raining and most of us already palpitation and restless due to pressure of previous paper and wondering the questions that will be asked. we were given coloured stickers and were directed to our station line. i started at the first station and will end at the last station, station 17.

as i sat at the seat, i see an ecg on the table, and guess what? out of nowhere i started to shivers and my brain become blur. during that time i cannot thinking a single thing on how to read them. i tried to cool down and try to describe whatever i see on the ecg, the rate,the rhythm and the pattern and i still blurr what is happening in the ecg infront of me. as the limited 5min almost up, i made a decision to 'tembak' the answer. i scribble about myocardiac infarction and later quickly put my answer in the box as i need to move to the next station and actually the answer is mobitz heart block.

on the next station, i saw this 'thing'(an instrument) on the table and at first my minds only telling me 'i hv seen this in the labour room, what the hell is this?' that time i were really depressed and i read 'selawat' a lot before realize it was a forceps that was used in the assisted delivery. i was really thankful and wrote it quickly as the bells aklready ringging. the same thing goes by for the next several station, as example the forniuer gangrene and even the tubal ligation, i was blurred. Luckily, for the pcm prctical, we got how to do spirometry, teaching how to do a breast examination to a patient and tuning fork. it was a success as the night before we have practicing all the possible practical question. at the end of the examination, we were required to be quarantine until the afternoon since other students not yet taking the examination.

the next thing was the long case exam and i was on the last day of exam. the formats was we were given an hour to clerk history and do physical examination + necessary simple investigation. As i walked in to my cubicle i see a malay uncle was sitting on the bed and my heart jumped with joy because it was not a peads cases because i didn't revise my developmental accessment skills, =D As i introduced myself to the patient, he told me he had inguinal hernia. i was relief as i have clerked a history of hernia before and already have an idea what history should i take from this uncle. However, UMMC's patients usually won't have a single problem. He also revealed he had heart valve disease before and now have a prosthetic heart valve. It was significant as i have to take account of his heart disease history into my presentation and also means, i have to do a proper CVS examination to this patient. This will took extra time. At the last 20minutes i was in a rush to complete all the examination and i even did a neurological examination in less than 3minutes. I was thankful to the nurses for helping me taking the blood sugar level while i'm examine the patient.

The bell's rings and now we were given 10minutes to ready our history before being called upon by the examiner. During that time, i didn't have time to rewrite my history as i always did before so i just put the no on the points so i can present my case clearly. Later, i was called into the room and infront of me sitting 2 examiner, which i believe 1 is a surgeon and the other is a medical doctor. I started to present the history and i present the case as a surgical case. At first, i was bombarded with the question by the surgeon but later, after the past medical history of heart disease, the medical doctor take turns bombarded me with more question. it was really tough time for me but i keep my cool and answer as best as i can. after 15minutes, the examiners and i went to the bedside and i was asked to perform inguinal and cvs examination. that is what you will got if u got a double pathology. i was relieve when he said the exam was over and i can go. it was really a relief since my heart is pumping at rate which i believe is tachy and i can feel palpitation since i woke up in the morning.=D

on the friday, the results was already out, and there were tears and joy among us. congratulation to those who passed the exam and to the others, i wish all of you all the best for supplementary exam.i hope we can go to final year together and if there is anyway i can be helpful, please let me know..

11 July 2009 3.30 a.m

as days goes by, we actually didn't realize how much have we left behind. Our time in Klang have come to the end and now for the exam, we were back to um for mbbs phase 3a exam. when we come to this stage, we will started thinking, what have they done in the past 11 months in Klang, coz by this time, there were soo much things to do but soo little time left. I bet everyone feel the same as the exam is around the corner. =D

my fren once told me, 'it have came to an end, yet, i feel like i'm just moving in here yesterday..'
yups, me myself didn't realize it because of our hectic schedule and the craziness we did here. As I remembered, during our posting, we prayed a week will go as fast as possible so we can relax in the weekends and now maybe our pray become true.

then, i started thinking of what have i done here;

openhouse rumah fadya di klang

visits to special needs school

peads posting with prof lee ws n dr chong la

barbeque x3

earth hour

stong expedition

crp bera

medicine posting with dr habibah

medicine posting with dr kt chua

treatment room of kk bukit kuda

with dr haireen

o&g end of posting party

with the end, there always a start and that's how life goes on. now, we were facing a war,our third professional exam. i hope all of my fren and i pass the exam and we're going to final year together. all the best to all of my fren..