I actually don’t think I’ve had enough of the psychiatry/fam med rotation.
and yet my CCTs (end of block clinical competency test) for psychiatry and fam med are this coming friday and saturday respectively. ><
We had no prior exposure to psychiatry whatsoever before this rotation, so it was as exciting as when i first started medicine in year 3 (enlarged liver! pansystolic murmur! BASAL CREPITATIONS!!!) We saw more common illnesses like schizophrenia, bipolar disorder and depression to problems like eating disorders (anorexia nervosa) and gender identity disorders.
Unlike in other specialties, the patient’s history do not usually come easy; a patient with delusions that someone was following him would probably not tell you about it unless he trusted you a lot because he truly believed that someone was following him and not that problem actually was due to his disease! But it’s fun in a way that you don’t really know what to expect for each interview; even the same patients may vary in their mental state on a day to day basis.
In psychi/fam med (which comprises of 6 weeks of psychiatry and 2 weeks of family medicine), we have to travel. A lot. Good thing for me is that I get to travel around HK to places I would not otherwise go.
Light rail to CPH (Castle Peak Hospital) in Tuen Mun, New Territories. Those people are walking to the opposite platform. much more convenient than the flyovers we have for our KTM lol
Castle Peak Hospital. Looks like a resort in there. Really scenic and relaxing, I’m serious! (except that it’s very very very heavily guarded lest patients escape. with multiple checkpoints inside the building)
We were not spared from travelling for family medicine as well. Charlene & I had 4 days at TSW (Tin Shui Wai) Community Health Clinic which was equally far from CPH (1.5 hour single journey ride from hall).
And on our 2nd last day, we stopped by Hong Kong Wetland Park to do some bird-watching. Entrance fee for full time students is 15 HKD so it was okay la.
caught in the act of mudskippering.
wow have you ever seen such a big patch of nature in Hong Kong?
Albeit being almost completely physically drained from all the travelling (alongside other commitments), TSW clinic was worth it. Staff were so hospitable to us students. Nurse manager let us have a go at an IM injection and ECG, and the doctors were AWESOME.
Charlene and I with two Dr. Chans. Awesome teachers 🙂
In family medicine examination, we are supposed to ask the patient’s ICEs for the consultation (Ideas, Concerns, Expectations) to find out what the patient truly wanted. The doctors were so good that they didn’t have to ask explicit ICE questions to get to the bottom of it. And we didn’t get scolding even though we did pretty badly in the developmental assessment of a 3 year old paediatric patient whose parents came in complaining that he had speech delay. with a very very agitated father. (In this case, the “patient” was the father so to speak. So the doctor tried to figure out the father’s ICEs)
The doctor touched on some medical ethics issues faced in general practice (I digress but I’m beginning to appreciate the importance of medical ethics as the years go by. Ultimately it’s knowing your duties and the law. and how to avoid being sued.) Like prescibing a sick leave and approving disability allowance. Substance abusers coming to one’s private clinic to “stock up” on their supply.
Well anyways. better enjoy my week before my next block: medicine. BIG BIG sigh.