Happy Chinese New Year

 

 

 

 

 

 

 

 

 

Wishing all of you a vibrant, happy and prosperous Chinese New Year. 新年快乐，身体健康！

Of Year 2

For the past six months, I had long distanced my intention in uploading a new post at here. Year 2011 has been a roller coaster ride for me with its ups and down. I have to admit that Year 2 is the toughest academic year for me so far, to the extent of begging for more sleep hours. The study syllabus and contents are really enormous, and to heighten our senses in becoming a “holistic” healthcare provider, the faculty even prepared a few assignments that might at some point regarded as unreasonable and taxing. Moreover, there were a few incidences that made me emofied and stoned until losing my mood to study for couple of weeks. But what matters the most is that I learnt a lot from it, I truly understand the notion of relationship/ties between family and friends. Things do happen in life, they are just part and parcel of life, we just have to face the obstacles and earn ourselves a respect. Generally, I am contented with year 2011 & hoping for the best in 2012.

Here are some highlights that I would like to share in my journey as a medical student :

1) Represented Monash in the 9th intervarsity physiology quiz that held in UM. Albeit our team didn’t emerge as the winner, it was an honour for me to work in tandem with my team mates.

 

 

 

 

 

 

 

 

 

 

2) Donated blood for the first time in my life. It was a great experience for losing out 450mL of blood.

 

3) Met a few inspiring figures that keep on motivating and nurturing me.

 

 

 

 

 

 

 

 

 

 

4) Finally made a trip down to Malacca with a bunch of friends. Malacca is indeed a nice place with scrumptious foods, especially the Nyonya food.

 

 

 

 

 

 

 

 

 

I’m glad that new semester is coming soon, starting right away after Chinese New Year. Deep down there, I will be roaming around the wards where the “art” of medicine will be revealed.

Of Semester 3

It has been nearly two months since I uploaded my last post, as I was busy preparing for my studies, exam and assignments. 5 months of Semester 3 was undoubtedly the best experience I’ve had so far in my medical schooling life. I would say that Year 2 is totally different form Year 1 as you get to learn major system of the body as a whole, eg. cardiovascular system, respiratory system and haematology & all sorts of maladies . Throughout the semester, it’s been a tiring yet packed schedule for me everyday, judging from the timetable itself (8am-5pm) & immense knowledge of topics you have to absorb at the end of week. Someone told me that “Medicine can be a jealous mistress sometimes, you just have to juggle with your time”. At the end of semester, I realize that all the efforts and time that I poured into studies are worth it as the knowledge that I gained are piling up higher and higher each day.

In reality, I am sure that everyone has his/her own idol or mentor in particular area/field.  In this medical arena, I have two mentors, each specifically for internal medicine and surgery. If you are lucky, you might have multiple mentors.

 

 

 

 

I hereby introduce you to my surgical mentor, Associate Prof Dr Kelvin Lim.

MBBS (Newcastle) FRCS (Edinburgh) BDS (London) LDSRCS(England) AMM

Consultant Maxillofacial and Facial Reconstructive Surgeon,Gleneagles Intan Medical Centre

Initially, it was his awesome qualification that impressed me. He was once a dental surgeon before he decided to take up medicine as his true calling. As time goes by, I found out that he is not the type of tutor who only knows how to perform saucerization for every carbuncle, but at the same time he is someone who provides guidance and advices hoping you could make right choices in life and make the most out of it. No doubt that he is good at what he is doing and super-duper smart, he is also the one who is keen on passing down his knowledge to the future batch of medical practitioner. Dr Kelvin has been a leading light in the field of reconstructive surgery here in Malaysia and I am delighted he’s part of Monash community.

Dr Kelvin was part of the surgical team led by Dr Bohdan Pomahac, performed face transplant surgery on Mr. Maki who was severely injured after falling onto the electrified third rail at a Boston subway station. For those who watch Boston med, this procedure is shown in the eighth episode of the series.

 

Next, my mentor for internal medicine : Dr Arul Durairajah

 

 

 

 

 

 

MD (UKM)  MRCP (UK)  FRCP (Glasgow)

During first year, I didnt get to know him that much. But when comes to Year 2, at the moment when I knew that I got him for my PBL tutor, I was mumbling around that my life would be more miserable and taxing under his group. He is known-good at keeping students for extended hours after each PBL session and giving tonnes of works compared to other PBL groups. Despite all the extra volumes of read up and preparations, he is the one who makes me realized that how important PBL is and changes my perception towards it. Before that, I used to take PBL session for granted, people presenting, you just sit there and listen and then end the session. Now, I would consider PBL & clinical session as a core lesson for the week and I am ready to voice out my opinions and tag along with my group mates for the discussions. He is the one who proves to me that, in order to be successful, it is all about sheer hard work and sometimes it is unrewarding. He teaches us the ways a physician thinks and the proper mindset and attitudes which lead to good practice in future. I wish I can continue having him as my PBL tutor for next sem.

The mediocre teacher tells.

The good teacher explains.

The superior teacher demonstrates.

The great teacher inspires.

Mentoring is part and parcel of medicine. It is about passing down the knowledge and good qualities to the next generation of doctors, hoping that you will have a bunch of good and competent doctors to consult when you are sick. Both tutors above are really inspiring figures, I always tell myself  that I want to be like one of them one day. Anyway, I’ll have to make sure that I have adequate knowledge in both fields of medicine and surgery before I can proceed to next stage.

Till then, I am looking forward to rural week in next sem, where the art of medicine will be revealed.

Tougher entry requirements for medical students

PUTRAJAYA: The Malaysian Medical Council has adopted an “improved set” of minimum requirements for students taking up medical studies.

MMC president Datuk Dr Hasan Abdul Rahman said the Minimum Criteria and Qualification for Entry into a Medical Programme was adopted by the council at its 291st meeting on April 12.

“From this date, an entrant into any medical programme, locally or abroad, has to abide by these requirements to be eligible for registration with the council,” he said.

Dr Hasan advised higher education institutions to adhere strictly to these requirements, as failure to do so might result in their recognition being withdrawn.

According to the criteria, applicants are required to declare if they had been found guilty of any criminal offence or suffered from any serious physical or mental illness or serious communicable disease.

If found to contravene any of these clauses, they would be disqualified from entry into a medical programme.

He said the newly adopted criteria would address the issue of private candidates gaining access to medical schools overseas without satisfying minimum requirements.

In the past, students who could not get into foundation courses locally would circumvent this by doing the course overseas and then return to local private medical schools to do their medical degree, he said.

Some of the examinations requirements are:

Sijil Pelajaran Malaysia (SPM) Bs in Biology, Chemistry, Physics, Mathematics (or Additional Mathematics) and another subject;

General Certificate of Education Ordinary (“O”) levels Bs in Biology, Chemistry, Physics, Mathematics (or Additional Mathematics) and another subject;

Sijil Tinggi Pelajaran Malaysia (STPM) Bs in Biology, Chemistry and Physics (or Mathematics); and

General Certificate of Education Advanced (“A”) levels Bs in Biology, Chemistry and Physics (or Mathematics).

For more details, log on to http://mmc.gov.my and click on “Minimum entrance requirement”.

– The Star

Five-year freeze on new medical courses effective immediately starting 1st May

Five-year freeze on new medical courses effective immediately

By ALYCIA LIM

KUALA LUMPUR: A five-year freeze on new medical courses, to prevent the glut of trainee doctors in the country from worsening, has been approved by the Cabinet and is effective immediately.

Higher Education Minister Datuk Seri Mohamed Khaled Nordin, who announced this Thursday, said the moratorium would not affect the number of medical staff required by the country, and that the focus on quality would be ensured.

“We are looking at a doctor-patient ratio of 1:400 by the year 2020, which fulfils the requirement of an advanced nation.

“From the number of students currently enrolled at the 33 higher education institutions nationwide, we can achieve that target,” he said at a press conference, after signing a Memorandum of Understanding (MoU) between Open University Malaysia and Master Builders Association Malaysia.

Mohamed Khaled added that the current doctor-patient ratio was 1:1000.

“The ministry will focus on monitoring the quality of the medical courses currently offered, and for institutions that do not meet the criteria and skills accreditation, their current recognition may be recalled until they improve.”

In December, he had said the moratorium would prohibit the launch of new medical programmes in the country, with existing medical schools encouraged to focus more on quality.

On Nov 27, The Star had highlighted concerns over the glut on the number of housemen and the quality of fresh medical graduates.

As of Jan 31, Malaysia has 33 higher education institutions offering medical courses, including 11 public higher education institutions and 22 private ones.

Medical fraternity welcomes temporary freeze on new medical courses

KUALA LUMPUR: The Malaysian Medical Association (MMA) welcomed the Higher Education Ministry’s decision in imposing a five year freeze on new medical courses on institutions of higher learning in the country.

Its president, Dr David Quek, said the move would give enough time for institutions of higher learning in the country to produce experienced and quality medical graduates.

“Medical graduates cannot be produced at the drop of a hat, without proper planning, like the teaching force, training facilities and clinical items. It is impossible,” he said when contacted by Bernama here Friday.

He said this in response to a Thursday announcement by Higher Education Minister Datuk Seri Mohamed Khaled Nordin that a freeze of five years on new medical courses had been imposed on institutions of higher learning in the country.

The moratorium was decided based on several factors, including the marked increase in the number of medical graduates, competency of housemen, teaching staff and teaching hospitals.

Chairman of the Medical Dean’s Council, Prof Datuk Dr Nik Mohd Nasri Nik Ismail, said the council members unanimously agreed with the government’s decision as there were already enough medical courses in the country.

“There has to be some control. There are about 33 public and private institutions of higher learning which offer medical courses and this is enough to meet the country’s need for medical doctors in future,” he added.

Dr Nik Mohd Nasri, who is the Dean of Universiti Sains Islam Malaysia’s Medical Faculty, said that during the moratorium, there was a need for public institutions of higher learning to improve and enhance medical studies at their respective faculties.

“After three years, we will review the situation to see if the freeze is still necessary.

“The Dean’s Council will discuss the matter with the Higher Education Department and the Malaysian Medical Council,” he added.

– Bernama

Gouty Arthritis

Back to January during Chinese New Year Celebration, I paid a few visits to my friends and their families in conjunction with this prosperous and joyful celebration. Throughout all these visits, what captivated me the most was that I had an interesting encounter with a 50++ year-old gentleman with a hot red, swollen and enlargement of his right ankle. In the spur of the moment, the first idea which came into my mind regarding the swollen ankle was it could be due to bruises during sports contact since the gentleman is very active in sport events especially basketball. This gentleman is actually one of my friends’ dad. Therefore, I have a fairly good overview on his family background.

After taking the  gentleman’s daily nutrition and activities into consideration, I found out that he was a person who would overindulge himself in alcohol and red meats/seafood especially in dinner/formal occasion during the weekend. I was adamant that it had to be something related to his nutrition (alcoholism/seafood) that played a key role in the development of symptoms. With my curiosity of mind, I double-checked with his wife about his condition. And the answer turned out to be GOUTY ARTHRITIS.

Gouty arthritis is a disease that results when too much of crystals of uric acid (monosodium urate) form in the tissues of the body. It is characterized by recurring attacks of joint inflammation (arthritis). Patient with gout either produce too much uric acid or more commonly have a problem in removing it from the body.

Courtesy of Ms C.Shaw Lee

Hot, red and swollen right ankle was observed.

Result of the gentleman’s medical report:

1. High C-Reactive protein (CRP) – Quantitative : 11.91    (normal ref : 0-20 mg/L)

CRP is produced by the liver. It is not a specific test. It can reveal that you have inflammation  somewhere in your body, but it cannot pinpoint the exact location.

2. High uric acid level : 514   (normal ref : 210-420 umol/L)

3. High erythrocyte sedimentation rate (ESR) : 38   (normal ref : 0-20 mm/hr)

It is also a non-specific test, indirectly measures how much inflammation is in the body.

 Before that, this gentleman consulted a Chinese tabib. The diagnosis given by the Chinese tabib was  骨打结 (knot bone??) and treatment to it was using a hairdryer to reduce the swollen and tenderness.

Obviously, western medicine and traditional chinese medicine have their own pros and cons , and each of them has its own explanation for the underlying causes of a disease. I am not saying that traditional chinese medicine doesn’t work at all or we should ignore it in the field of medicine. We should approach conventional and complementary medicines in an integrated way, considering about the positive and negative effects of both of it.

Treatment for gouty arthritis:

1. NSAID – anti-inflammatory effect

2. Allopurinol – inhibit uric acid synthesis

3. Probenecid – increase uric acid secretion

4. Colchicine – inhibit migration of leukocyte into the joint

I hope that this gentleman is recuperating well and listen to my words to cut down on his alcohol amount before it becomes chronic or even worse. Better late than never.

Liow: Students can study anywhere after changes to Medical Act

The Star, Friday March 11, 2011

KUALA LUMPUR: Malaysian students will be able to study medicine in any institution in the world when amendments are made to the Medical Act 1971.

However, they will now have to sit for a licensing examination before being registered with the Malaysian Medical Council (MMC).

Among the amendments to the Act involves abolishing the Second Schedule, which lists the 375 recognised medical institutions from 34 countries now, said Health Minister Datuk Seri Liow Tiong Lai.

When the schedule is scrapped, medical students will be free to study in any institution of their choice — but would first need to obtain the “No Objection” certificate from the Ministry of Higher Education.

“The amendments will only apply to new medical students and not those who are already in existing courses,” said Liow when replying to a question from Dr Tan Seng Giaw (DAP-Kepong) in the Dewan Rakyat yesterday.

On the issue of quality, Liow admitted that it would be difficult to regularly monitor the medical courses offered by the institutions since it would be expensive to send evaluation panels overseas.

Malaysian Medical Association (MMA) president Dr David Quek said the association supported the move but said students and parents must choose foreign universities carefully.

“Although they can choose any university they want to go to, they still need to come back and sit for the (licensing) exam, which may include clinical examination.

“The exam will ensure that only those who pass are able to practise as doctors,” he said, adding that this would also reduce complaints of bias and remove unfair labels, especially against lesser-known foreign universities.

He added that students studying in local medical schools should also sit for the exam.

A local practitioner, who declined to be named, expressed concern that the quality of medical education might be jeopardised given the high number of local medical schools.

A medical lecturer at Universiti Malaya said the amendments would push students to study locally, and the situation must be monitored to ensure schools were up to mark.

Physicians for Social Responsibility vice-president Datuk Dr Abdul Hamid Abdul Kadir said students attending local schools that had tie-ups with foreign institutions should also be subjected to the exam.

– The Star

 

Recently, there is an outbreak of the Adenovirus infection which claimed the life of a 25-year-old trainee constable at Kuala Lumpur Police Training Centre (Pulapol). This could be an indication for flu-like outbreak. Adenoviruses are spread like the common cold. The viruses can be spreaded from person to person via coughing or sneezing, and causes symptoms of respiratory illness such as common cold, pneumonia and bronchitis.

A friendly reminder to everyone : Take good care of your own personal hygiene and maintain your surrounding cleanliness to refrain yourself from contracting this infection.

 

Not in gainful employment

Aunty : ” Hey boy, Which course are you studying now? ”

Me : ” Oh, Hi Aunty, I am studying medicine. ”

Aunty : ” That’s good career. You have made a good decision to guarantee your future .”

Above conversation is the lines which I was asked by many aunties and uncles during the last holidays. To them, they still think that medicine  is a career which guarantees one’s future and good life with money . I personally think that a career in medicine is no longer lucrative and rewarding anymore as the noble values and quality of medical doctors are in the nosedive.

For the past two years, tons of  private medical college/uni have been mushrooming in Malaysia. Indirectly, more and more students are paving their pathway into this medical profession, even some mediocre students can get a prestigious title “DR” in front of their name. Hence, by the year 2015, the number of doctors is going to be one- fold of the amount of doctors today. By then,  we would be seeing jobless medical students mumbling around the street.

” With the current rate at which Malaysian doctors are graduating from medical schools, both locally and abroad, the country will reach its overall doctor population target of one doctor for 600 population within three to four years, and a ratio of one doctor for about 400 population or less by 2020.There will have to be 5,000 to 7,000 Medical Officer posts in the public sector available annually within the next five years for the young doctors after completion of their housemenship training, and after that it will be anybody’s guess.If there are insufficient posts, how many can be absorbed by the private sector, which is already saturated in many areas?There will be no employment problems for doctors of good quality, but the prospect of unemployment is a possibility for the mediocre, and possibly, some of the average ones.”. – by Dr Milton Lum from Board of Medical Defence Malaysia.

So what do you guys think was the reason for the surplussing of medical doctors nowadays? One of the reason is the sudden mushrooming of medical schools over the past decade which results in a shortage of qualified and experienced lecturers to accommodate the increasing the increasing number of medical students. There are today 28 medical colleges operating in the country, all of which are recognised by the accreditation authority, Malaysian Quality Assurance. Below is the evidence of lacking human teaching resources in one of the running private medical college in Malaysia :

 

Since there are some many medical graduates out there and that would mean the competition will become more immense, I have no choice but to agree with the fact that : Only the fittest will survive.

IS THE QUALITY OF OUR MEDICAL DOCTORS GOING DOWN THE DRAIN ?

Click here for the full article.

Every year, top scorers in A-level, SAM or other pre-u courses are fighting for a place in varsities. Due to limited seats in local public universities, many private medical colleges are being set up every year in order to cater those top scorers. But do they really have what it takes to be a good doctor?

Unfortunately, for some mediocre students who failed to excel in their pre-u course would opt for a “short-cut” way to get a medical degree in lesser known foreign medical universities , usually in Asia and Eastern Europe. The thing that needs to be concerned is with the entry requirement standard for these lesser known uni is lowered, the chances for the mediocre students to obtain the ‘ prestigious’ medical degree seems to be getting easier. The above article showing the true story and condition, and this is the shocking issue which is happening in Malaysia these days.

According to the report,  some of these housemen do not even know how to take a patient’s blood pressure or take a proper case history or insert an intravenous drip. These might sound preposterous to some senior doctors as these are the basic things a medical student needs to know before graduating from medical school.

Again, medicine is a peculiar field. A slight mistake can jeopardize or harm the patient’s life.

“An incompetent lawyer will make you lose your case, An incompetent computer technician will bugger up your laptop. An incompetent financial advisor will make you lose your money. An incompetent doctor can make you lose your life. That’s the difference. Patients are not our playthings on which we ‘practice and learn’.

Signing off,

Cyn

Time to Say Goodbye

Before heading back to my hometown, I attended MUMeds Dinner  which was held at Renaissance Hotel near KL Central. MUMeds Dinner  is an annual event which organized by MUMeds itself, and is one of the  highlights of the year.  The dinner is for the Year 1 and Year 2 students and serves as a last chance for all of us to bid goodbye to our fellow colleagues.

I was personally pissed off with KL congested traffic. It took me one-and-a-half hour to reach the hotel albeit I departed two hours earlier. Upon reaching at the hotel ballroom, I saw many of my peers dressed up nicely, all with a blazer on or a beautiful dress on. After a while, the dinner was served, accompanied by music and some performances from our peers. We chit-chat as usual while enjoying our foods. There were also some excitement for us such as lucky draws and prizes for best categories. Overall, the dinner was nicely done, however, I wasn’t satisfied with the venue. I hope this year the dinner can be held somewhere near Sunway to avoid traffic jam or somewhere else that have beautiful scenery.

 

 

 

 

 

 

 

 

 

 

Throughout the one year in uni, I get to know lots of friends with different personalities. Almost everyone of them is trying to find ways to improve him/herself. There is sense of reminiscence when I looked back the past time we had together. For instance, studying together during the weekend & have ‘mamak’ food for our lunch, studying our ass off for exam, having dinner everyday and etc.

I would like to further extend my gratitude to two year-2 students, Akmez & Fahad. Both of them have been helping out the year 1 a lot, thanks again for their guidance and directions. I think this was the first time they had steamboat in Malaysia. Haha… Best of luck to both of you in JB.

Looking forward to seeing you guys when new semester commences, I am certain that year 2 is gonna be exciting for all of us.