gum fy???

juniors are coming back tomorrow as school begins for them this coming Monday. and am being asked about how to decode the oh-so-ever confusing timetable (with abcd and 1-18 groupings in various permutations @@), how to prepare and what to expect of year 3.

honestly, I couldn’t remember much. maybe cause the academic stuff was muddled with some intense emotions I felt back then, or maybe it was just cause year 3 was really a muddle.

anyhow, i did set a guide for them; but i always have thought that everyone is bound to have different goals and expectations, so regardless of what I say, their year 3 experience and thoughts might be way different than mine.

there’s one thing I should warn them though. please don’t start clerking too many patients in the wards! we want to clerk also ga >< or not all the patients will refuse us (aka clerk larn) when we reach the wards @@

but still, am happy that more people are back and our “medic zoo” will seem more like a complete family. 😉

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Tonight was also the last sermon from Pastor Fernando on the topic of love. am a bit sad that the series of inspiring messages from the pastor are coming to an end; his talks are so interesting and funny (and also the translating pastor! he will be the revival seminar speaker next year and am so looking forward to it!!!! :D). the whole series of sermons will be ready online from this Sept onwards here. The morning and noon sermons are in Cantonese with live Mandarin/Putonghua translation and the night sermons are in English with live Cantonese translation. Definitely worth listening to! (for me, esp the night ones)

Today’s verse was 1 Cor 13:7.

It always protects, always trusts, always hopes, always perseveres. (It refers to love)

On the point of perseverance, he mentioned about a lady, Fanny Crosby, who lost her eyesight to an incompetent doctor who mis-treated her common cold. As she grew up, she came to believe in Christ, and even became a famous hymn writer and wrote more than 8,000 hymns.

Take the world, but give me Jesus,
All its joys are but a name;
But His love abideth ever,
Through eternal years the same.

Refrain
Oh, the height and depth of mercy!
Oh, the length and breadth of love!
Oh, the fullness of redemption,
Pledge of endless life above!

Take the world, but give me Jesus,
Sweetest comfort of my soul;
With my Savior watching o’er me,
I can sing though billows roll.

Take the world, but give me Jesus,
Let me view His constant smile;
Then throughout my pilgrim journey
Light will cheer me all the while.

Take the world, but give me Jesus.
In His cross my trust shall be,
Till, with clearer, brighter vision,
Face to face my Lord I see.

Sometimes I just ask myself, if someone took away my family, all my money, my education, a part of my body, what would I be left with, and what would I truly be.

There’s a chinese worship song that goes 這世界有個千年不變道理,那就是耶穌愛你.

I guess what would be left that I was a precious, loved child of God.

phew.

i had localised headache (?migraine) for around an hour before our summative results were released yesterday afternoon.

so I PASSED!! and am now a year 4 medical student-to-be! All glory to God =)

in a way, i’m thankful that MBBS is not assessed using a bell curve (eg continuous distribution) but rather there is a cut-off passing mark of 60. so i technically don’t have to compete with my classmates in order to get to the next year (although there are still incidents of our class gmail account being hacked/frozen/with its contents deleted every year nearing final exams)

But they do have interesting ways of assessing us.

For year 3, there are basically two parts to our exam: the written paper and also continuous assessment.

As the name suggests, continuous assessments are assessed throughout the year, based on our performances in tutorials, our overall attendance and our clinical competency test (CCT) at the end of every rotation. The continuous assessments are not that scary in my opinion; CCTs might be a bit daunting if one was to be examined by a professor (eg a more notorious/malignant one) with a risk of failing if some physical examination is not performed in a particular way suited to their liking.

The written part consists of three papers which are examined in three consecutive days at the end of year 3. SAQ, minicase and MCQ/EMQ.

SAQ (short answer questions) are mainly regurgitation from lectures/based on common sense. MCQ/EMQ (multiple choice questions/extended matching questions) would be, as a Malaysian would say, hantam only (just pick at random lol) but they usually set more detailed questions compared to SAQ.

minicase is where the fun really is.

in the minicase paper, we are given 3 separate cases to “solve”. (i have heard countless doctors comparing the medical profession to that of detectives solving a crime. they always ask us if we read Sherlock Holmes LOL. anyway i dont xd)

obviously for it to be a case, information is revealed bit by bit. so in the first page, you get some basic information about the patient, his/her chief complaint, what is your differential diagnoses, what questions would you ask and what physical examination you would like to perform.

and then after the time limit of probably 8-20 mins (depending on the length of the questions), they take away your piece of paper.

*take a deep breath*

aaand the give you the next page. with the RELEVANT history taken and physical examination done. so you know what you did right/wrong. almost immediately.

and then they ask you what investigations you would do and quiz you on some medical knowledge along the way.

our first minicase this year nearly killed everyone. i had no idea what was going on until the very last page!

so this is a rough sketch of the case:

first page. 50 year old woman presenting with one week of 39 degree fever. she had been unwell for several years and is unable to walk.

[a picture of bilaterally swollen legs up to the thigh]

question: what is the abnormality seen. what might be the possible causes of the abnormality.

okay so the fever might be infective/neoplastic. one week? and no other foci of infection? or none mentioned? with bilaterally swollen limbs?

we learn that bilateral means that the disease is systemic. and it’s usually heart failure/renal failure/liver failure/severe malnutrition. okaaay but infective??? how how how

anyway i just answered (BILATERAL!!??!) lymphedema due to neoplastic (those that would cause lymphadenopathy eg lymphoma) and infective cause (TB?). cause these seem to me that it would relate to fever as well. just that bilateral lymphedema is just so ODD.

second page. she is from Vietnam (? or some other southeast asian country i forgot). she has splenomegaly. reduced serum haptoglobin (indicating intravascular haemolysis). anaemia.

question: what two causes would explain the reason for the anaemia? how could these new information relate to the abnormality seen in page 1? what would be the next investigation you would do?

FINE. you don’t tell me what’s going on. just keep asking me questions la. for the anaemia one i just answered what i saw in the page, eg pooling of blood (hypersplenism) due to splenomegaly and also intravascular haemolysis. but i was still thinking along the lines of lymphoma and how it could have been lymphedema and the haemolysis would be AIHA? (autoimmune haemolytic anaemia?) like cold agglutinin disease or something. and since i was thinking along the lines of AIHA, i decided to do Coomb’s test.

third page. a peripheral blood smear was done.

facepalm. so it’s malaria!!!! gg. which led to renal failure and hence the swollen legs. gosh i didn’t even know malaria would cause renal failure, only haemolysis.

note: i couldn’t remember the case in detail so i think i missed out quite a lot of questions ><

anyway. just posted it up as a case sharing i suppose. and also it’s alright that i didn’t know cause i still passed anyway *does crazy dance*

one more week of lazing around at home before my sarawak attachment in june! i’ll make sure to check for malaria if i ever see legs that swollen again lol.

Examsssss

…one month from now i will be having year 3 finals.

can’t believe how fast time flies. and two years from now i’m supposed to know everything a doctor needs to know to diagnose and treat patients (or refer them to relevant specialties lol)

ARGHHH i’m so unprepared. and incompetent. and my temper is getting a wee bit out of control lately due to the overwhelming exam stress.

惟 獨 從 上 頭 來 的 智 慧 、 先 是 清 潔 、 後 是 和 平 、 溫 良 柔 順 、 滿 有 憐 憫 、 多 結 善 果 、 沒 有 偏 見 、 沒 有 假 冒 。~雅 各 書 3:16-17

I really, really need peace, strength and wisdom from God.

the best things about year 3…

… undoubtedly, are the patients.

honestly, the hospital is mostly a dull and dreary place with patients with both physical and emotional needs. But sometimes, we just meet the cutest patients.

Today when I performed cranial nerve examination and asked the patient to open his mouth and say “aaah” to look for any deviation of the uvula, i noticed that he had two uvulae! we were all so curious and excited and took turns looking at his uvula and he was like “yeah i have two uvulae, is it that strange?” (好出奇咩?) He even asked me the purposes of some of the nerve examinations.

Another time was simply an instruction error by one of my colleagues when we were doing lower limb motor examination. He asked the patient to extend his toe (可唔可以翘起你既脚趾公) but he ended up asking the patient to extend his uterus (可唔可以翘起你既趾公/子宫) It’s so hard to suppress laughter sometimes! I later met him in another peripheral hospital (where he was doing rehabilitation for his stroke). He still remembered me as the girl who kept laughing!

We had another patient who faked his leg reflexes (after tapping his knee, his hip would flex as well!!). His “faking” was discovered when my colleague missed his patellar tendon (where we are supposed to hit; to elicit the extension of the knee joint) and he STILL had a reflex! He later asked us if we were playing a joke on him (你地玩我啊) but it was actually the exact opposite =.=

But mainly the patients are very nice to us and although we clerk them like vultures looking out for prey, they usually let us do physical examination or at least reject us politely when they are too tired/were being asked to do physical examination wayyy too many times @@

Block A is ending soon (in 2.5 weeks) and Year 3 is ending soon!! can’t believe how fast this year passed by. It seemed like i have not done much this year (compared to my hardcore studying last year!) but i just want summer to come quickly!! excited for my trip to Sarawak for electives with 3 of my other classmates where we will do attachment at Sarawak General Hospital + play during the weekends!

Note to self: word hard and keep the faith!

p/s. my name ALWAYS gets pronounced wrongly by doctors during roll call; especially those who try to put a cantonese tone to my name. They usually stop at my surname (Yeoh) and my groupmates always call me “Yo” after that.

Oh well. Back to prepping tutorial!

gaan gui

gaan gui / 艰巨 / churr = physically & mentally draining

Medicine is a craaaazy block. Or maybe I’m putting too much pressure on myself, I don’t know. Anyway the workload is crazy and we learn so much in a day. Which is pretty exhilarating although gaan gui! The joy of being able to correctly interpret the pathology in an ECG is just indescribable (but i’m more often only partially correct xd)

Been physically exhausted lately too, having to wake up in the wee hours of morning (6.15am to be exact!), clerk cases in wards from 7am tilll 8.30am when I will have a one hr whole class lecture and then off to other tutorials/teaching clinics. and the studying goes on after classes. @@

Oh well they are closing wards for 1 week for year 4 & 5 exams so I can sort of take a rest for a while and concentrate on revising (untouched!!) lecture notes. But honestly the things we learn now are really interesting and requires much more critical thinking and regurgitation compared to year 1 and 2, which is challenging but I believe as it is said in the Bible “We can do ANYTHING through Christ who gives us strength – Philippians 4:13” I know relying on God will make it possible!!!

:’)

Amanda's birthday celebration with Japanese Hotpot!!! yumss

Amanda’s birthday celebration with Japanese Hotpot!!! yumss

2013-02-17 00.24.21

Suat Hoon visiting HK!!! Great to meet up with you my dear ❤

Okay gotta go back to study. Oh by the way a nice song that I am currently listening to that really gives me strength =)

Ask and it will be given to you; seek and you will find; knock and the door will be opened to you. For everyone who asks receives; the one who seeks finds; and to the one who knocks, the door will be opened. ~Matthew 7:7-8

Lord please give me strength in times of struggles and pain. With you by my side, i know i face nothing alone. ❤

so fast??!!

Year 3 is FAST. it’s so fast that I can’t believe I’m almost done with my 2nd rotation in Junior Clerkship (multi-disciplinary) with my CCT in less that 2 weeks’ time (!!!)

Things I learned:

1. Don’t form an impression of anyone based on others’ opinions. After being taught by an infamously “malignant” paediatrics doctor, he turned out to be witty, forthright, and all the more willing to scold us if it could help us learn, albeit the hard way. And he treated his young patients with meticulous care. He was such an awesome doctor  =)

2. One can learn a lot simply by observing the patient, before touching the patient. and oh the history too. our Microbiology professor came up with a working diagnosis of polycystic ovary syndrome based on the fact that the patient was obese with irregular menses, hypertension, had some level of hirsutism and was divorced but childless (in which he postulated was the cause of the divorce leading to the assumption of infertility!)

3. Christian holistic care. Which comprises of biological + psychological + social + SPIRITUAL aspect of caring for a patient. Currently reading a book entitled Jesus M.D and it’s about a missionary doctor working in Kenya and how he relates the life of a doctor to that of Jesus, the Great Physician in our lives. Been spending two sundays clerking medicine wards (although I don’t have to in this rotation) just to spend more time with patients; since technically only medical students have the time to spend time talking to them. and many patients simply have no way to vent their worries may it be about their health or other matters. managed to pray for a male patient and hoping God will continue using me to do His work =)

4. There’s always something to learn even from the worst doctor (in terms of clinical competency and professional ethics). just a not so excellent doctor from family medicine attachment @@

5. Went through another emotional rollercoaster last week and I had never been so angry in my life before. But God being amazing as He is, used His words to make me understand my own emotions and how to deal with it properly. I was so shocked to read that God was grieved that I was angry! then I was like oh ok i really shouldn’t make God worry :/

And do not grieve the Holy Spirit of God, with whom you were sealed for the day of redemption. Get rid of all bitterness, rage and anger, brawling and slander, along with every form of malice. Be kind and compassionate to one another, forgiving each other, just as in Christ God forgave you.~ Ephesians 4:30-32

6. You never knew how God will use your pain and suffering to help another bro/sis grow in Christ. And how time and God changes everything :’)

Some random photos!

Art therapy as part of our family medicine workshop! Not gonna offer interpretation on my artwork XD

Art therapy as part of our family medicine workshop! Not gonna offer interpretation on my artwork XD

Health Advocacy Project @ Mongkok! Getting petitions signed for the government to help fund prevention of drug abuse among teenagers

Health Advocacy Project @ Mongkok! Getting petitions signed for the government to help fund prevention of drug abuse among teenagers

Apple strudel & dinner with Tina @ Sai wan!  Great time catching up and sharing <3

Apple strudel & dinner with Tina @ Sai wan! Great time catching up and sharing ❤

Randomness. The battle of coke vs coke zero

Randomness. The battle of coke vs coke zero

Cute Charlene! smart way to prevent food from being stolen in hall pantry XD

Cute Charlene! smart way to prevent food from being stolen in hall pantry XD

my classmates met Jacky Cheung in the wards! He was giving out angpaos to the patients in the vascular surgery ward =)

my classmates met Jacky Cheung in the wards! He was giving out angpaos to the patients in the vascular surgery ward =)