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So today's entry is about my journey as a 3rd year medical student. Well sekarang aku tengah cuti, dah habis dah pun sem 6 boleh dikatakan aku dah officially habis 3rd year but not so official yet sebab result written exam aku belum keluar lagi. So yes, kalau fail aku kena resit, fail lagi *nauzubillahminzalik, aku kena repeat year-which is worst nightmare for us,medical student.
So 3rd year is actually a quite challenging year-this is a transition year, daripada preclinical year where kau duduk je kat kampus tadah apa yg lecturers cakap into applying those knowledge in real world. So what to expect?
Dekat CUCMS, 3rd Year MBBS ada 5 posting. 2 posting for Sem 5 and 3 posting for sem 6.
Those 5 postings are :
1. Community Medicine
2. Obstetric & Gynaecology
3. Surgery
4. Paediatric
5. Internal Medicine
List yg aku susun kat atas tu based on my group's rotation. Sebab ada 5 posting, so batch kitorang was divided into 5 groups. My group is Group 1. So ikut turutan lah, kitorang start dgn Commed then proceed to 2,3,4,5 which lasted with Internal Med (Kitorang panggil IM je)
Group 2 started with IM, Group 3 with Pediatric, Group 4 with Surgery and Group 5 with Ong, so nanti rotate lah, lps group 1 habis commed we'll go to Ong and Group 2 will go to Commed. Like that? That's how it worked.
In each group, we will then further divided into subgroup depend on berapa banya hospital kita kena pergi. Okaylah satu posting took 2 months to complete. Usually minggu 1st belajar dulu kat kampus and then 4weeks posting kat hospital then 8th week is when End of Posting examination will be conducted ( EOP in short- where Dr akan bagi kita patient untuk kita clerk( take history) and buat PE/Physical Examination . It will be conducted in hospital with real patient )
So for my batch punya posting :-
Commmed : RC Sepang ( tak pecah subgroup as kitorang bertapa je kat sana )
O&G - Hospital Putrajaya & Hospital Manjung ( 2 subgroups )
Surgery - Hospital Kajang, Hospital Angkatan Tentera Terendak, Hospital Manjung ( 3 subgroups )
Paediatric - Hospital Putrajaya & Hospital Manjung ( 2 subgroups )
Internal Medicine - Hospital Kajang/Banting , Hospital Putrajaya , Hospitak Terendak
So this subgroups akan rotate jgk, contohnya bila dah habis week 1 ( theory ) untuk posting O&G, subroup Putrajaya akan pi HPJ utk lapor diri while subgroup Manjung will travel to Manjung and lapor diri kat Hospital Manjung. After 3 week, the Manjung subgroup balik and lapor diri kat HPJ and vice versa. Got it?
1. Community Medicine
Im so sorry to say that this is my least fav posting. But nilah satu2nya posting yang kitorang tak pecah group so group 1 which consist of 29 persons semua ada.
During this posting, we need to go to Nilai/Sepang wheere kitorang punya Resource Cente
(kira macam base of the Commed) kat situ and we're expected to stay in Desa Palma, Nilai.
I dont like this posting because aku tak rasa macam medical student. Kerja aku type type and type all the time, well Commed is basically pasal kita nk buat research. So in order to buat research kita kena lah cari tempat dulu- cari community yg kita nk buat reseach- and of course kena ada tajuk , objektif dan hipotesis- so basically cara nak buat proposal and eventually buat proposal, cari journal and cari literature review and then present the literature review from valid journal and also present the proposal, then you begin to conduct survey in community. But of course before that kau kena lukis banner, kne reka and print flyers and etc etc.
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| Banner-in-the-making |
So basically Commed involve cooperation, hard work, planning , creativity and senang sweat tears blood semua kena perah habis habisan. The part yang paling menyeksakan is the deadline. Yup the deadline lah yang buat kitorang semua lebam bijik mata and stay up sampai pagi buat report.
Apart from that, well Commed fun jugaklah, kita berkerjasama dengan org pejabat kesihatan, so dpt belajar apa aktiviti yg diorang buat. Antaranya :-
- cara fogging
- cara ambik sampel jentik-jentik
- cara ambil sampel makanan kat kedai-kedai
- melawat perkampungan orang asli dan tengok tandas diorang macam mana
- pergi rumah ke rumah buat medical check up and lawat ibu-ibu yang baru bersalin
- pergi KLIA belajar pasal bahagian kesihatan kat sana
- pergi kilang keropok tengok apa hazard yang ada semasa memproses makanan and banyak lagi kalau nak list mmg panjang benor.
Oh ye exam commed (EOP) dia dalam bentuk viva. Macam interview session gitu. Kau dikelilingi lecturer and lecturer tanya soalan pasal commed and kau jawablah dengan yakinnya on the spot *berpeluh-peluhlah resah gelisah masa ni.
Overall it's not too bad sebab you can gain lots of knowledge and new information but this is the posting yang aku paling stress so I dont like it.
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| Ni contoh literature review from our group's proposal plus comment lecturer kat tepi |
2. O& G ( Sakit Puan )
To be honest I look forward for ong posting. bukan apa, kitorang start dengan commed kot, tak merasa lagi suasana hospital so of course la eksaited kan?
My subgroup first started at HPJ, kitorang dibahagikan kepada 3 pulak daripada subgroup tu sebab ada 2 wad ong and satu lagi kitorang kena pergi dekat Pusat bersalin berisiko rendah (PBBR),
Yang penting masa posting ni, korang kena bawak :
- Pinard stethoscope/ Pinnard horn /fetoscope -utk dengar hearbeat baby dalam kandungan.
- tape/pita pengukur -sebab nak kena ukur lah berapa cm dah kandungan.
Yang lain macam stethoscope, pentorch, matric card, clerking book, tendon hammer, jam tu tengoklah kesesuaian bila nk bawak. Nak bawak semua sekali pun bisa aja dong (recommended)
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| Pinard stethoscope /fetoscope |
Time Ong kalau korang passionate memang banyak lah boleh belajar, kat situ lah baru belajar kena tahu ambik suntikan apa, Last Menstrual Period tu penting, minggu scan , basically History of Presenting Illness (HOPI) plus History of Current Pregnancy (HOCP) dengan History of Past Pregnancy (HOPP) tu penting plus dengan Menstrual History lah kan.
For books, I really recommend these two books ( gambar kat bawah ), Aku guna 2 buku ni je, sebab buku ni buku UM (Universiti Malaya ), so buku ni cover semua yang common kat Malaysia. Tapi depend pada orang la. Setengah orang suka guna Buku Ten Teachers la, Oxford la blabla depend pada korang lah, banyak je buku lain.
Tapi my mistake untuk posting Ong ni rasanya sebab aku banyak clerk ibu mengandung and post-natal je, aku kurang clerk gynae patient- ada cancer cervix ke, cyst ke, bukan taknak tapi masa tu aku lebih fokus untuk buat PE bagi pregnant mother. . Alhamdulillah patient semua cooperative. Kawan aku yang laki ada patient bagi buat Vaginal Examination kot, aku pulek yang tak dapat chance, takpelah rezeki dia.
As for my EOP exam , I got patient yg dpt Braxton-Hicks contraction /false contraction.
3. Surgery
Definitely one of my fav posting but honestly I couldnt imagine being a surgeon one day, well sebab kena berdiri lama. Sakit pinggang takyah cakap la rasa macam orang tua pulak hmmph.
Tapi banyak la kena cover topic in surgery and during my posting, I really recommend you guys untuk guna BMJ Practice, kalau students CUCMS biasanya boleh dapat akses free tapi tak sure pulak kalau student lain. Library akan send email bagi password untuk bukak BMJ melalui MyAthens. So use it wisely!
Oh selain daripada BMJ, I also use buku Essential surgery untuk writen exam, but sebab banyak kan kena cover, dia tak macam O&G yg specific, so I suggest you guys to buat study group and divide topic, so beban kurang sikit. Boleh je korang nak guna buku lain- Bailey & Love yang maha tebal tu ke or buku hijau yg perpetua apa entah nama dia but yang tu takde la lengkap sangat. Essential surgery boleh dapat kat Kamal Bookstore, haritu harga dia dalam RM 118 ( beli tahun ni )
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| 5th edition |
Oh ye, my EOP exam, aku dapat patient yang burst abdomen with history of laparoscopic appendectomy so kne inspect lah wound dia. Question yang ditanya ranging from wound inspetion-appendicitis-antibiotic . Nak cakap okay, macam so-s0 lah sebab aku tak ingat jawapan untuk soalan last dia so last impression dr kat aku not so good. Hmmph, nasib badann.
4. Paediatric ( Kanak-kanak )
Oklah before pergi hospital, tanam dalam jiwa yang kita kena ambik hati budak-budak. So how? of course tak lain tak bukan belilah TOYS! Benda ni memang boleh menyenangkan kerja korang tau, tengah budak tu nangis kau keluarkanlah itik muncung tu komfem dio perati and lama2 berhentilah nangis tuh.
Oh yes, some of my friend pun beli stickers, so kalau budak2 behave, diorang bagi sticker yang macam2 bentuk yang menarik & colourful. Tak payah membazir beli benda mahal2, Toys yang aku guna ada 3 jenis je , satu yang jenis pensel yang hujung dia tu ada muka kartun katak ke teddy bear ke. Second itik- alah tak kesah lah hewan lain pun asalkan bila kau pegang tu dia bunyi. 3rd bola- yang ni budak2 laki suka tapi yang ni tak payah pun takpe, aku pun jarang bawak, berat weh poket nak kena bawak banyak2.
Buku yang penting untuk posting ni is paediatric protocol, semua pasal Paeds boleh dapat kat dalam tu such as jadual immunisasi, Development milestone punya table (wajib tau ). Other alternative can try buku Illustrated Paeds or orang panggil buku Sunflower or yang lagi complete is buku Nelson. Boleh beli kat Kamal Bookstore gak.
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| Those are table developmental milestone- Better HAFAL |
Well kalau budak2 tak sahlah kalau korang tak bawak pentorch, biasanya kan nk kena checklah tonsil inflamer throat injected, so bawaklah. Menangis tu perkara biasa, so kalau time dia tak nangis tu cepat2 lah auscultate, okay?
Aku suggest korang belajar macam kawan aku sorang yang selalu dapat dekan ni, well untuk Paeds dia buat satu buku pasal all diseases yg common in Paeds, and macam contoh on Kawasaki Disease, so dia akan print and paste the pic in the book. So during written exam senang lah , xyah belek buku Paeds yg tebal
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| This is his notebook. |
As for my EOP, aku dapat patient AGE, soalan yang prof tanya was :
- Suspected causative agent- Rotavirus
- Pathogenesis - damage to the villous border of intestine and blabla explain lah in detail
- Explain in detail how Rotavirus causes perianal excoriation and abdominal bloating
- Is patient dehydrated - Yup moderate dehydration - How to calculate - google lah panjang nak explain those pasal fluid deficit and maintenance
- What's the management ? -Half saline and detail pasal kandungan & percentage dia
- Other management ? - change to soymilk
5. Internal Madicine
IM is soooooo wide. Bagi aku lagi wide daripada surgery. eh tapi paeds pun sama wide je. Oh well feeling dia lain sebab aku tak rasa stress in paeds, sebab tengok muka baby dah cair.
IM memang aku focus on disease, clerk patient leptospirosis balik baca leptospirosis, tapi aku macam rasa cara study aku salah, actually from my observation, better baca dulu and baru clerk patient. Contoh korang baca heart failure so esok azamlah untuk cari patient yg ada heart failure, macam tu lagi smooth actually sebab kau dah ada dalam mind apa yang nak tanya patient, adakah symptoms yang dia ada sama macam yang korang baca, like that.
As for reference, IM aku nasihatkan korang untuk guna CPG ( Clinical Practice Guideline). Download lah semua and khatamkan benda tu. Most Specialist punya soalan, jawapan dia korang boleh dapat kat CPG. Kawan aku ada yang print HO guidebook, yang tu pun quite useful jugak tapi aku tak print la pulek.
Selain it, aku just guna buku Talley o' connor clinical examination dengan BMJ Practice.
Specialist in Hospital Kajang ada advised kitorang untuk beli buku case file for IM which aku beli, and aku rasa very very useful as korang akan faham the disease dengan lagi mendalam.
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| now dah fifth edition, RM 69 something kat Kamal |
For EOP, mine dekat hospital tentera Terendak, got patient NSTEMI secondary to anemia. Pt ada malena, so definitive management dia dah jadi PPI ( Proton Pump Inhibitor) bukan dual anti-platelet and investigation tekankan pasal anemia dia. Okaylah so-so jugak exam tapi banyak jugaklah lecturer tanya yang aku tergagap-gagap nak jawab.
So thats all.
Apa-apapun 3rd year for me bukan tahun untuk honeymoon. Ni tahun where kau kena tau banyak benda and tulis notes sebanyak yang mungkin, sebab 5th year nanti akan ulang balik benda sama, so better lah buat notes awal2 so nanti belek nota lama jelah. right?
Ok Sayonara. Hope my sharing is helpful!
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| My groupmates in 3rd Year which makes my year bearable :) |
2 ulasan
Saya nak tanya. Student clinical cucms kena cari rumah sewa di setiap kawasan posying ataupun tempat penginapan disediakan oleh pihak universiti?
ReplyDeleteTempat penginapan uni sediakan
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