Why

Why did i create this blog?

It started while i was preparing for my final Pro Exam for my medical course. I was the kind of student who preferred to study through powerpoints and blognotes. Furthermore, I did not like to pen my notes down and memorising the facts. Hence, i use blog as an alternative.

Following that, before i started my housemanship, i was in a dilemma over which hospital to choose for as my ground training of 2 years. There were not many references that i could refer to especially of that relating to Miri Hospital. So i thought it might be useful to write and share my journey with others as a houseman as well as keeping it is as my medical notes. .

Why did i choose my current hospital for my training?

There are some seniors of mine who are doing the HOship in East Malaysia and the reviews were encouraging and welcoming. Furthermore, since i was raised in Brunei, Miri was the only town that i was comfortable with. I also chose Miri in order to run away from the KL city which I know can be a distraction for me. (HINT : SHOPPING!).

No SPM Malay? Worry not!

I spent my primary and secondary education back in Brunei Darussalam. While other local Malaysians were supposed to sit for UPSR, PMR and SPM, i sat for PCE, PMB and GCE OLevel instead. This led to a problem for me of not having SPM Malay. Even though i sat for Bahasa Melayu paper in my GCE O Level and got a Distinction 2 for it and sat for Bahasa Kebangsaan papers during my medical school, they were still not adequate and not acceptable as a substitute for the Malay paper. I was told that without it, problems can arise especially if you plan to stay in the government. Your confirmation of service with the government can be delayed and hence, leading to late promotions. 

I have heard of some who did the June SPM Malay paper as a private candidate and some house officers even  attended tuition classes a few weeks prior to the date. I could not imagine how ridiculous it is for us to be learning all those especially after an exhausting work. However, the good news is that your target mark will only be a PASS. 

So, upon starting work in my current hospital as a house officer, i managed to meet up with the admin as well as the Hospital Director regarding this. They were also quite clueless on the matter but how relieved I was upon finding out that there is an alternative paper that can be done! I am very thankful for the hospital administration team for this! 

So earlier this month, 6 of the house officers from Miri Hospital flew all the way to Kuching to sit for Peperiksaan Bahasa Melayu Khas. The good thing was that this was considered as an official trip and hence, you can claim for the expenses (exclusive of shopping of course!). We only stayed there overnight and the exam was done in JPA building. 

The exam consists of 2 sections; written and oral. If you are already comfortable speaking in Malay than you should not worry too much about it. In my opinion, the difficulty level is as that of Primary 6 syllabus and they are all of MCQ or short answer questions. (Thank God for no essay this time!) I really hope these papers can really compensate for the SPM Malay and hence, putting a closure for this issue. 

I hope some people out there with the same prolems will find this post useful. I know not many really know about this matter and not many resources can be found online. Feel free to ask for more if in doubts!

Something to ponder about

Sent my patient for a chest Xray. I call it a right lower lobe HANDneumonia!

A half year pressie!

As a hardworking HO, i deserve this reward! Hahaha

Welcome To My Life

0600 - Alarm clock rings. Snooze, Snooze.

0630 - getting ready to leave, perhaps having a quick munch for breakfast.

0645 - card punched in. Heading towards my ward

0700 - starting my morning round.

0800 - doing round with my MO

0930 - Specialist round!

1200 - Quickie meal. (This slot is optional)

1230 - back to work, completing the uncomplete

1500 - PM round starts again with the MO / Specialist

1700 - time to leave! AS IF.

1830 - this is the time that i ACTUALLY usually go back

2000 - dinner completed. Heading home.

2100 - 2230 - wasting time surfing the net. stalking on friends. window e-shopping. enjoying my mp3 collection.

2330 - time to head to the bunk!

What was I thinking?!?!?!

my friend the other day pointed me at my ridiculous mistake.

can anyone spot it?

Another reminder to soon to be HO

Lately, the nation is shocked with the death of a Houseman in Hospital Kajang. Some said it was a suicidal attempt but other said he might be overdosed with the stimulants since he was on 5 consecutive calls.

I cannot comment much on this matter simpy cause we need two sides of the story before pointing our fingers to whom might be responsible. What i can only mention here is to share my experiences as a half a year HO.

I was one of the lucky lots who managed to Go through the 2 systems. My first posting was O&G which is usually an active call. I usually ended up sleeping about 30mins per night. on very bad days, i could not sleep at all! It was very tiring and exhausting. Imagine this. Today i will be oncall which means i start from 7am and only to go back TOMORROW at 5pm. Then, i continue to work the day after. Then i'll do on call the day after that. I really feel like i did not have a life. I would be doing 8-9 oncalls per month!

Then, with the introduction of the shift systems, i do feel a bit of relief. My average calls drop to 5-6 per month. We are allowed to go back by noon considering that our job is done. Of course, we lose a few hundred ringgits allowances but the rest worth em all.

for now, i do not complain much on the workload. I dont whine with my oncalls. In fact, i am grateful with the shift. The number of new housemen coming in is also rising. Hence, more manpower is around to distribute the job.

I am not sure how hell life in the hospitals can be but i guess to those who are still looking for hospitals to choose, please do come to the East Malaysia. I do not recommend however going to the big hospitals such as Sarawak General Hospitals and Queen Elizabeth. My hypothesis is that The less HOs there are in the hospital, the less likelihood that the seniors will trash you simply because they appreciate the manpower and they know you work hard.

So, be adventurous and please be mentally and physically prepared before you embark on the housemanship. It's tough and challenging. You've been warned.

Anyway, before i go, the picture above is a view of KK from the plane during my KK visit last weekend! Well, when you work hard, travelling is the way to go!

Things that should have been mentioned during medical school

Working life is a bit different in compared to that of a student. Sure we were taught of the diseases but there are certain things that are new to me.

For instance, when you work later on, you have to learn on how to fill in numerous amount of forms. If we order blood sample, you should be familiarise with the KKM form. If your patient has dengue, you have to fill up the "Notification form". Referral to other departments also require form filling. As Miri General Hospital is still not computerised, you need to fill it by hand. At this point, i surely appreciate free pens. So, Please bring extra pens in your bag and also smooth pens will be an advantage. My current favourite is Faber Castell Grip X5.

Other things that you need to learn is how to be confident. Family members will always ask the current state of the patient. So you need to clear up their head by explaining the prognosis and the current plan. Be aware that patient's confidentiality still is a priority. Dont feel pressurise if there is a YB for instance asking about the patient's condition. If they are not related, dont spill out everything.

Some patients can also keep you crazy with their never ending complaints. Headache, stomachache, chest pain are a few examples of common complaint. Some of these should be taken seriously based on the patient's premorbid status. Otherwise, some just require verbal reassurance.

You should also be familiar on how to refer cases. As a houseman, you need to sell your stories to your MO. If it is not convincing, be prepared for some scoldings or rejections.

There are some other things tht i can list but i'll stop here. Dont worry, i'll continue some other days. Bye!

Good Friday

Tomorrow will be a public holiday in Sabah and Sarawak since it is a Good Friday. We do not have such celebration in the peninsula though. This is another uniqueness that i learn throughout my 6 months being away from Cyberjaya. Ive learnt some of the culture and the language here. It is also interesting to know about the subgroup of the natives here; Iban, Kenyah, Melanau, Bidayuh, Penan and Kayan. I still do not know how to distinguish each of them though.

Since i am oncall tonight or 'night shift', ive got some spare time to blog. Heard that new batches of Housemen will be starting soon. Hoping for some to come and join us here. Hey, It is not a bad place to work afterall. I've survived my 6 months, Alhamdulillah and i havent regretted my choice.

Anyway, I will be away this weekend to visit Kota Kinabalu. It will be my first time there and i cannot wait to shop! Hahaha Otherwise, I am praying hard to have a bearable and Good call tonight! Wish me luck peoplee!!

significance of the Q wave

Q wave is the first downward deflection after P wave. it simply denotes the absence of electrical impulse which usually caused by an MI. It takes a few hours to days for it to develop, hence it is one of the ways to determine the occurence of MI.

Q Wave can persistently be there unless reperfusion takes place early. Therefore, persistent Q wave indicates presence of previous MI.

Midway through medical

In a few days time, it marks my 6th month as a houseman. Time really flies and all thanks to God for being there with me to survive through this whole ordeal.

At the beginning of this 2nd posting, honestly i was sceptical about it. Medical in my dictionary is equivalent to the word "BORING" and "YAWNING". nothing makes sense since i cannot imagine of the pathophysiology. How am i suppose to imagine calcium going in and out of the channels and causing the symptoms? It is not as pictographic  as the one for instance in O&G. furthemore, medical books consist of mainly texts. Another yawn factor there.

However, after going through this posting, i kinda have some ideas on how to manage the patients. Though not as crystal clear but at least i can handle the common presentations. Oh, workload wise; it can be more tiring than in O&G since we have to handle more patients but i am thankful for having supportive seniors and superiors.

Another thing to keep in mind is that this posting bears a lot of risk. I notice quite a lot of the patients have infectious blood borne disease; Hep B, Hep C and HIV. hence, universal precaution is vital in preenting needle stick injury. Life is precious so please donttake this likely.

Alright then. Those are all for my ramblings today. Ive been motovating to regularly update my blog but i havent got the determination. Perhaps i am mentally tired nowadays. Bye then!

Oncall then comes the word Jonah / Hot

Once you enter the housemanship, you might think life will go on like a breeze. Well, one think that you should be preparing yourself into is the ONCALL. This routine will always be stuck in your life once you obtain the title Dr in front your name. Even the consultant will be put on the oncall schedule. So please correct your understanding on how your life will if you choose to take medicine. 


In Malaysia we have come out with few terms which can help your colleagues to prepare mentally on how the night would be. If you are regarded as a Jonah, then be prepared for restless or sleepless nights since it will usually be eventful. To put it into simple word, you are basically a patient magnet. Admissions will be non-stop or if it isnt, then perhaps your current patients in the wards will be problematic. Since i am in the medical posting, the common complaints will either be chest pain, shortness of breath, abdominal pain, CBD pain or  headache in the middle of the night. 


In Sabah or Sarawak meanwhile,  they don't use the word Jonah but instead, they are more used to the word "HOT". This word can also be used for the MOs or Specialist and even the nurses. As for myself, i used to be HOT in the previous posting. I seldom got to sleep due to non-stop admissions. Nurses dont really like it if i am oncall. HAHA but what i like about that despite being tired is that i feel proud by the end of the day since i survive the whole ordeal. 


Other thing that comes with the word Hot / Jonah is the superstitions. Some believe that you should take your shower during the night session to prevent the Hotness. Some also would avoid wearing light/bright coloured clothes and that also to include your innerwear! But throughout my observation, personality can also affect the situation. I notice that those who are easily agitated and have temper management would also lead to hotness oncall. 


I am really interested in knowing what other superstitions that other hospital practices in. I do not fully believe in it though. Guess those are all for this time fellas. I am going to enter my oncall in a few hours time. Meanwhile, enjoy a few shots through my iPhone camera of life in Miri.  

Posting numero 2

26th Jan 2012 is my first day of tagging in Medical posting. When you think about it, i have done my housemanship for 4 months already! Im glad and grateful to God for letting me to get through my first posting successfully. I hope He will still be guiding me for this posting.

So, for today, I noticed that being a 2nd poster does have the benefits. For instance you dont feel that tired by 10pm. Whoopss, it might still be too early to judge that but we'll see!

Otherwise, the procedures and form fillings are something that i am already getting used to. It's just that i need to get used to be seeing male patients!

Ending the first posting!

It's 22nd Jan today! I am glad to announce that I will be ending my current 1st posting in a few days time! I must say that it did feel short and that i have wasted the opportunity to master the posting. It is a mistake that i must not repeat in the next posting; to be proactive and to learn how to do as many procedures as possible.

Otherwise, since I have spent almost 1 month in the gynae ward, i am already feeling comfortable of it. Things becomr easier and faster to handle. The followings are the common cases in gynae ward :

1. Miscarriages
2. Hyperemesis gravidarum
3. Ectopic pregnancy
4. PV bleeding
5. Gynaeoncology
6. Insulin commencement for Pregnant mothers
7. Post SVD complications; episiotomy wound breakdown, retained POC and maternal pyrexia

Before i forget, i want to remind the first poster of this : to send SKT forms and your logbook at least 2 weeks before u end your posting.

ketua darjah

since i am currently the most senior houseman in the posting, i have been chosen to be the HO leader. it is definitely not an easy job. i have to come out with the oncall timetable, something that is easier to say than done. i have to make sure i distribute the days evenly and not being biased. at the same time, i have to fulfill the wishes of those planning to have holidays during the festive season.

since Chinese New Year is 2/3 weeks away, many of them were asking for leave and that remain us with only few housemen left. Thank God for His mercy, He has given us with new housemen coming in. Even though i have to make changes to the timetable whenever new faces come in but i do appreciate the extra man power.

otherwise, i am currently working in a gynae ward. Not as fun as it should have been to me. Gynae ward gives a different environment compared to the maternity ward. The patients consist of the terminally ill patients who refuse further management as well as those who fear their unborn babies will end up being miscarriaged. For a houseman, Gynae ward involves some "medical elements" such as management of electrolyte imbalance, fluid regime, analgesia level to be given to patients. We also have to do quite a lot of referrals to the surgical, medical and radiological department who kinda not keen on having extra work. There are times that i make successful referrals and i still fail in some.

Since i am close to the end, i am sad to leave the current department. I have heard of other postings, having to deal with emotional stresses dealing with the colleagues and senior doctors who like to torment the housemen who are not at par to their eyes. I am glad that my current dept treat housemen as their working colleagues and treat us professionally. Such a good posting to start my housemanship with.

Well, well, to those who wonder, i am going to a killer posting next; MEDICINE. throughout my medical school, i am definitely not interested in the posting. it is such a complicated topic, creating a lot of differentials just for a symptom. i hope i can finish my 4 months posting there without difficulties. Hence i should be mentally and physically prepared for my 4 months of....... struggles.... NOW!