OMG - What I'd Miss

a.k.a O&G - What I've Missed

Today (hopefully this entry autopublish on Monday), I will start my new posting rotation in Psychiatry, the kinda posting labelled as 'vacation' by previous group. The last time we have such vacation posting was during Community Medicine posting at Klinik Kesihatan Sungai Buloh and while we were in HRPZII, where we basically loitering around and came to hospital at our own liberal will. It was such great times. Now being in 4th Year, honeymoon is over.

Never have I experienced such psychologically, mentally, emotionally and physically exhausting rotation as in O&G, where the word tiresome is prominent both to clinical teachers and us. I would say the greatest energy demand majorly extricated from those respected consultants and specialists. This is where my assumption saying "Far soon, being a specialist or consultant, we will have some rest time." This may apply in some private hospital or some department (read: Ophthalmology), but being in O&G, is where it inversely proportionate. This is where you'll see, those higher ranking medical personnel work harder than the lower, (at least that is what I see). They are needed everywhere, in a department where litigation risk at all-time high. I just feel grateful for them having to rush and squeeze little resting portion of their time to take us for teaching. I greatly thankful and appreciate what they did.

So it is understandable for us the students to leave home at 6:15 am for early morning class and leave hospital at 8:00 pm. Believe me, post-call or not, these ObGynist actually arrived early than any other hospital personnel. Maybe as early as 5:30 am. There goes my presumptive thought again, 'being specialist or higher rank warrant you to have more resting time'. You are embarrassingly wrong. The schedule was major haywire because you have to accommodate to their time, please bear in mind that their priority is on their job. For that you need a good Group Leader and assistant who remember all last minute changes. This is where the power of female multitasking and meticulousness greatly utilized in full-throttle.

Day-to-Day Routine

We were divided by 5 group, each will have 1 week rotation to Clinic, Labor Room, Maternal OT, Obstetrics & Gynecology wards during a specified time we call Ward Work. The rest of the time filled with Lecture, Seminar, Case Presentation, Bedside Teaching, Tutorial etc. There is also On-Call from 6 to 9 pm, twice a week. There just handful time where we actually practice Self-Directed Learning (SDL) or fooling around time. There are Log Book to be filled with evaluation and procedure and two case write-ups to be submitted on 5th week.

Most of the time, we need to skip Ward Work to finish our CP and seminar or using our rest time to read for upcoming tutorial. Having a nice sit around for lunch usually a luxury, given first half of the rotation was during fasting month and the rest was where squeezing and replacing schedule at peak time. Since most of us were tired and sleep-deprived, we rather sleep than eat. If lunch even happen at all, it will be around 3 or 4 pm or in a form of sharing pisang, ubi goreng or kuih in seminar room.

Clinical Short-Case Exam

My Obstetric case is PPROM, Gravida 2 Para 1 at 35 week POA. I laid everything down from pertinent points in history, PE to management of patient but it is extremely sad when your examiner choose to ignore certain points and asked you those already-mentioned-points as if you never mentioned them at a first place. It made you look like you forget to mentioned them, and the examiner have to extract that thing from you by asking "What else you forget to mention in history?", and you force your brain so hard trying to recollect every single memory, and retracing each steps and came out with none. "What about abdominal pain? What about fetal movement?", and I was like seriously? I already mentioned that. I lay down everything like projectile diarrhea I think I only stop for air.

Turned out I have to repeat most things I mentioned twice, because my examiner choose not to listen, that it made me look like total dumb. This is where having single-examiner idea sound ridiculous, because your fate lies on one person. Nobody going to argue your mark, no second pair of ears, and what if that single examiner have no predilection on you. I ended up score low mark for a mistake I made not. Dr. J told us that clinical exam is mostly examiner dependent. If the examiner have certain fondness towards you, no matter how suck you are, you can get easy A. But hey, pull your saggy ball sack and nut-up. It's not the first time I have to endure such injustice and sorry things.

My Gynaecology case is actually straight-to-the-point uterine fibroid. It was damn obvious, I even considered it at the back of my mind when I can't get below it on palpation but my sadomasochist brain choose to diagnose it as ovarian tumor, being that was the last thing I read before my turn, and the fact that it was bilateral. Dr. J happened to be nearby, eavesdropping. So at least I have proof that I am not suck at this. I shoot everything in detail down to specific tumor markers for each type of tumor, medical and surgical intervention like TAHBSO + omentectomy etc. I am very proud of myself on how composed I was. Turned out my diagnosis is wrong, but it is less of a worry as PE skill and management are most important. I think I gunned it down.

Ending

Given we were so deeply involved in the process, it just seemed natural to feel sad leaving this posting. Sure there were some low moment, but quoting one of the specialist "You need to fail, you must fail, in order to pass."

THE END