to Juniors...the Anecdotes

Well I've heard that my juniors of BMS will be going for clinical training soon. Saya nak ucapkan, good luck ya'all. I just want to give you tips some might find useful. This the least I can help.

1. Clinical Examination by Talley O'Connor - kepada sesiapa yang nak pergi posting Medical, buku ini sangat direkomen oleh specialists. Dah banyak dah recommend buku ni. They swore by it. Some of the specialist even go to such extent baca ketiga-tiga triad of clinical examination book to compare them, these book are Hutchinson, Mcleod and Talley O'Connor, they still swore by it. So it is good to have one. You can use it for Surgical posting too.

2. Oxford Pocketbook of Clinical Medicine - buku ni adalah insurans nyawa anda. It is good to have one in your pocket. It gave you such notion yang you have an information at your disposal which is in your whitecoat pocket. Walaupun korang jarang baca, at least bila keadaan mendesak, anda ada something to fall onto rather than flat surface of tarmac.

3. Stethoscope - need I say more. Please be acquaintace to it. Cara pakai yang betul. Which is for which. Bila nak guna bell, bila nak guna diaphragm. It is good to stretch the newly bought stethoscope kalau tak nanti bila pakai telinga jadi sakit.

4. Tendon Hammer - It is good to have one, tapi tiada keperluan untuk menyangkutkannya di whitecoat sepanjang masa, kerana ia sangat sangat lucu. Saya dah nampak banyak kawan-kawan yang tahan malu kalau benda tu asyik-asyik je jatuh. So keep it in your backpack only carry it to a bedside if you want do neuro examination.

5. Torchpen - Kalau ada yang boleh adjust intensity lagi bagus. Jangan beli torch pen yang sangat giler-giler terang you might ended up making your patient uncomfortable. Silap-silap haribulan kalau patient tu ada history epilepsy, mampus korang bila dia fit kat situ jugak.

6. Notepad - buatlah nota kecil sendiri dan bawalah buku kecil untuk catatan random knowledge yang korang boleh gather masa follow ward round.

7. Jargons - get acquaintance to some common medical abbreviation. Buat satu buku kecil to keep all the list of words you've learned and gathered, so you can refer to them anytime if you have short-term memory like me.

Contoh yang common yang korang boleh jumpa di hospital-hospital di malaysia;

• DRNM - Dual Rhythm No Murmur (= normal heart sounds S1 S2, no added sounds, no murmur),
• A/E or a/e - Air Entry,
• R/A or R.A = room air,
• NBM - Nil By Mouth (= not to be feed),
• NPO - Non Par Oral (= same with NBM),
• Hx - History,
• # - fracture,
• AAA - Abdominal Aortic Anaeurysm (= not to be palpated by medical students)
• qid/QID - quater in die or, (= four times a day)
• TDS - ter de sumendus (= three times a day)
• BDS - bid in die sumendus or BID - bis in die (= twice a day) also means 'brought in dead' in forensic department.
• OD - once daily. OD also means right eye in ophthal department.
• T - temperature

...well basically every department has their own abbreviation and symbols you just have to keep acquaintance with. It was an agreed abbrev in between department staff to make it easier for houseman to write in BHT (which is a file containing information about patient that gathered during clerking, progress, plan of management, lab result etc). For medical student, this is the bible at which we referred to so we can complement our own history taking and copy the lab result for case write-up purpose.

8. Confident - Fake it like pro. Walaupun kita rasa banyak tak tahu ape benda, jangan rasa intimidated by other medical students from other university atau dengan house officer (houseman). Mereka juga as intimidated by us, so keep your confident level at high therapeutic dose. Avoid toxicity though.

9. Clerk in Group - at least two not more than three, so you can help each other regarding what questions that you missed or how to appropriately ask them. For a male student, having a female partner also useful as chaperon when you do physical examination. Female student less likely to be worried clerking opposite sex, because they are less keen to file a report.

10. Speak Up or Shut Up - if you know the answer to the questions asked by the doctor, answer them. If you think you have a vague recollection, try to answer them. But if you completely be at lost, don't answer "I DON'T KNOW" but rather "I'M NOT SURE". There is a vast different impact these two phrases can convey.

...otherwise you should be okey