Wow

Another week passed by!
Yay!

I've just gotten wind of my housemenship schedule...next up is....


SURGERY!!!

I'm having a headache just thinking about it. Hearing about the department from my friends, its absolutely terrible. But that's for later. For now, I have to concentrate on Orthopedics.

From what I realized, Russian grads (or possibly, just me) are quite horrid in Orthopedics. The main thing we have to do is clerk, get a concise and correct history of the patient's illness and examine them. But a lot of the physical examination skills we never learned in Nizhny, or at least I never did.

I have to read and read and read, so that I don't end up being the "target" again. Tomorrow I'm supposed to be Trauma 2 - the backup housemen for OT in case they decide to open 2 rooms for surgery. I'm hoping that they don't, but my luck kind of sucks so I'm prepared to be called in either way. :( I hate surgeries because they make me nervous. Being in the operation room with surgeons who expect a shit load from you is traumatizing. I sure hope its not Dr L or Dr A. Actually I hope its NONE of the Dr As (We have so many!). Ugh, I'm not sure who I'm rooting for. I just really really don't want to go in the OT!

On Saturday I'm S2 for OT, meaning that I'm going to be the person in the OT from 9am til 9pm for all emergency cases. I don't know who the MO will be. One of the Dr As? Dr S? Dr L?? No idea. I don't understand the MO's timetable.

Off tag

A week and a half has since passed since i'm off tag. As I probably mentioned in the previous posts, tagging is the 2 week period when you first enter a department and are required to work longer hours and " tag" along with your fellow houseman to get the flow of how things work.

This week has been hectic, and a bit disappointing. I'm still not getting better at cannulation. And the finer workings of the ortho department still eludes me. My presentation skills are also very lacking. It's very very frustrating for me. I always forget the patients cases and don't know the latest investigations and their results when the MOs ask for them.

I'm hoping I'll get better soon, but at the rate im going I really doubt it.

Yet another week breezes past...

Yet another week of housemanship breezed past me. I've been in Orthopaedics Department for a total of...3 weeks now? I'm still nowhere to being comfortable being in the wards. Whenever I think about going back to work the next day, I have palpitations and wish I was doing something else.

Medicine might not be for me.

Its taking me a long time to adjust to the working life, and I'm wondering how long is normal. Am I taking a longer time than usual? Than other people? Orthopaedics is supposedly the "easiest" department, why am I feeling like I'm such a blur case most of the time then? I'm making mistakes left and right, even in WRITING the damn cases back.

T_T

I need some guidance. I need time off. I need my other half. I need my friends. I need to bitch about stuff. Ugh, I need to get a grip on this...!!

My day off

Today is my day off. As taggers in the Orthopaedics Dept, we get one day break a week! :) It might not seem like much, but its much better than some of my friends who are unlucky enough to be working every single day. Tagging is the period when you first enter a department, so you're supposed to "tag" along with your seniors. I was so blur on my first day of work, but now I guess I'm coping a lot better than before.

As house officers, we are expected to do most/all of the ward work and plan the management of the patients (to be confirmed/changed by the medical officers or specialists during their rounds). So I arrive at 6.30 am daily to review the patients before the MOs make their rounds. This Monday, our "boss" Mr. Soh is expected to be back from his leave though, so things are going to get tougher! I'll have to know the patients very well because my seniors have said that he sometimes asks a lot of questions about the case.

After ward rounds, we do ward work. :D Ward work kind of sucks because everything is haywire. That's because other people will cross off the work even though it wasn't them who completed it, and then sometimes a mistake will be made and some blood was not taken or an ECG was missed, etc etc. I'd much prefer it if the person doing the work crosses it off the list herself, but this is the way things are done so....

Orthopaedics is very very new to me. In Russia, the only orthopaedics/trauma we learn are about the types of fractures and how to diagnose fracture from looking at the X-Ray. So now I'm having quite a bit of a problem trying to learn the proper and correct management for patients. Here in MGH (and possibly throughout Malaysia??), if patient has DFU or any other infection associated with DM, you start them on IV Unasyn 1.5g tds. If no DM, then IV Cloxa 1g qid. There's also Zinnat, Zinacef, Flagyl...those things I haven't figured out their indications yet. :D

Pain...for pain management...I'm really lost!! Usually the patients are on Cap Tramal 50mg tds. Some of the patients who complain of joint pain, they are started on T. Arcoxia 90mg or C. Celebrex 200mg. Some are started on Voltaren ( + Gelusil ). The finer points of pain management still eludes me, after one week. I need to learn more!!

the first week....

As luck would have it, I'm posted to Orthopaedics Dept of MGH..

The workload is so-so, but I'm still quite stressed because the absolute zero knowledge I have in this field. Diabetic foot ulcers are as common as they come in my ward, which makes it a little easier. But when it comes to fractures, I'm as blur as the patient!!

My MOs are really nice, I feel so bad for being a bad HO. I don't even know how to do certain basic things, but I'm learning. Orthopaedics might be considered relaxing to most, but there's still time for me to learn if I learn fast!!

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Hi, Its me again.

A week has gone by since I reported for duty at the hospital. And I still know shit.

:'(

Its not that I'm complaining that I have a lot of free time and holidays right now, but I hate being left out. Right now it seems that my colleagues are out taking blood, doing ABGs, putting in a central line (okay, maybe not this but STILL) and I'm still exactly where I was a week ago - feeling like a MEDICAL STUDENT.

I want to learn new things...

Its been a long time!

お久しぶり!　

Its been awhile since my last post, so long that I don't even remember when it was or what it was about! This post is going to be mainly about housemanship - HO, in short. In Malaysia, its compulsory to undergo these 2 years of Housemanship (HOship) where you will be placed in 6 different departments (4 months each - minimum). I'm currently posted in Orthopedics. The other departments available are Medical, Surgery, Obstetrics&Gynaecology, Paediatrics and Accident&Emergency. You will only be posted at A&E after your 4th posting... ^^

I'm quite lucky to be posted in Malacca, since the hospital staff are so kind to organize for us an orientation program. All in, we have to be given briefing about the Pathology Department, Infection Control, Imaging & Diagnostics, Pharmaceutical Department, Forensics and also Archiving Departments. So that effectively lets me start "working" on the 2nd of November. My colleagues were not so lucky, some of them are starting this Thursday! It'll be tough, going for orientation and then continuing on with the tagging!

There's a lot of things you'll need for your first day to lapor diri. A LOT. You'll need to fill in a shit load of forms - no kidding. Make sure you get pictures (6 at least). Photocopy your diploma, MMC letter and IC in multiples. I'm talking like 7-8 copies! Anyway the hospital will give you a checklist of what is necessary for you to photocopy and all. But the KWSP (EPF), go do your account earlier if you have the chance. Its annoying to leave and go do the account, come back, etc.

Okay, that's enough rambling for today. I"m so tired!!