5th year: the UPM experience

Hi juniors and colleagues who might be reading this! Ok first things first, I’ve never written an article for a blog or whatever and I don’t even have a blog myself so I guess I can call this article my first ‘entry’? Haha. I was approached by Nazirah this past Friday (yesterday actually) to write about ‘experiences during 5th year’ to be shared with juniors so that you guys may have a basic idea of what’s it gonna be when u guys come to 5th year. Hmmmm 5th year? what about 5th year ey? I guess when you first come to 5th year you’re kinda gonna feel good about yourself (yelah dah senior kan, royal senior plak tu among all the UPM med students :b) and plus you get to ‘interrogate’ your juniors during senior day (which has been a tradition ever since UPM started its med program, but no offense juniors it’s just for entertainment we’re all good people at heart actually haha).

But along the way, as you go through all the postings during 5th year (Medicine, Surgery, Senior Psy, Dermatology, O&G, Paeds, Ortho, Anaes, A&E) you’ll realize that whats important during 5th year is for you to so called ‘connect the dots’ or ‘put the pieces of the puzzle together’. You see, when you come to 3rd year to start your clinical phase it’s about you learning how to take a history, and how to examine patients and talking to them. That’s about it. 

But when you come to 5th year, it’s a totally different story. When you’re a 5th year med student it’s all about you getting a thorough and good history (or as we like to write it ‘hx’) so as to sorta rule out all the possible differential diagnoses (or the short form ‘ddx’) and at the same time arranging and presenting the hx to hopefully impress the lecturers/examiners. The same goes to when you do a physical exam, it’s all about showmanship and how you interact with the patient in front of the examiners, and how thorough you have been examining the patient for the current problem (the so called chief complaint a.k.a c/c) and also complications (short form : cx) that may arise. 

Its different from 3rd yr in a sense that when u get e.g. a cardio case, you may have to do a cranial or peripheral nerve exam as well as fundoscopy to detect possible signs of complications, as may occur in a patient with longstanding diabetes, hypertension, and hypercholesterolemia. So again, it’s all about you being able to diagnose the current problem as well as considering possible complications that may arise (don’t worry guys I was not a good student myself during 3rd year as I spent most of my time just playing around but I started to see the ‘art’ if I may of hx taking and examining during 4^th year and from then on I kinda improved dramatically, but it all comes down to you're willing to put effort or not to achieve it). 

Plus it is during 5th year that you start to learn how to manage the patient’s disease and problems, and what are the things u need to do (referral etc) in order to achieve just that. And whats more important, with all the info you have managed to gather, you’d want to train yourself to be less nervous when presenting and be confident. Trust me guys, when you get nervous everything you may know before entering the room to present to the examiners/lecturers will somehow conveniently disappear, and you’ll only realize that you know the thing AFTER you get out of the room after you have finished presenting. Trust me I know. So please control your nervousness ‘cos it's gonna be a waste if you present badly when in actual fact you know for sure you can do better. Practice presenting to friends from now, so you’d get used to presenting and hopefully you’ll get less nervous when the time comes. 

And people have asked me, ‘Is it stressful being a med student, a final year some more when you need to know everything before going to the exams?’. Truthfully it is stressful, even more when we’re just 7 weeks away now from Professional 3 (ok today is 26th Feb 2011) but remember, other people have passed, so why can’t you, right? Whatever it is you can only put effort into revising and remembering all the things you have learnt for these past 5 years (and concentrate on the more common diseases encountered first) and hopefully you’ll do ok during the exams. 

Ok enough about exams lol (now I'm getting stressed out writing this ‘entry’ haha). Apart from the countless exams you’ll encounter during  5th yr (yes you do have exams at the end of each posting excluding senior Psy, Anaes, and A&E) what you need to do is enjoy your life more, huhu. ‘Cos when you're a student you have more time, and you get to socialize and meet friends more so you better make use of the time you have and just have fun ok? Loosen up, life is much more than just about exams and everything. ‘Cos it’s no use if you just dedicate your whole time to just reading and and studying, you’ll be what Malays say ‘Katak bawah tempurung’. Get to know whats happening in the world around you, make friends and have fun, and enjoy life more (I personally find that if I don’t do things other than studying my brain doesn’t get the creativity and fun it craves on a daily basis lol). Reward yourself after you have been putting a lot of effort studying. This is what keeps you going. If you just study and study and study, you’ll get fed up and you may lose interest altogether. 

And remember this, great doctors are not the most knowledgeable people, but those who know how to talk to patients and have good rapport with their pts. This is just basic human to human interaction. Most of the time the patient feels ‘cured’ and relieved just by getting reassurance from time to time from his/her doctor. What I'm trying to say is you can memorize a whole textbook, you can be a so called ‘gold medal’ student or whatever but when it comes to real life what counts is how good you interact with the patient and his/her family, and how well you show to the patient that you care like hell about his/her problems. Medicine is a life-long learning process, and even when you start to work you’ll still be learning. More so ‘cos that’s the time when you’re actually practicing.

So I guess the take home message that I want you to have is continue to learn and learn, and develop that sense of empathy and giving a damn about the patient’s problems, ‘cos when you're able to do all that you’ll be just fine. Trust me. Have a good day guys and good luck!

Syafeeq Faeez, 5thyr 2010/2011

Memory and Instinct

(Picture taken from Google Image)

I should probably write the first article to encourage more to come along.

I'll be the first to admit it. I feel I don't deserve to pass my professional exam. Not that I'm not grateful to lecturers or God, without them no way I would've been able to pass. No, rather, I feel like I lack the knowledge and thinking ability that I've always imagined a third year should have.

When I was a first year, I used to look at the third years as if they're the most amazing people ever and wonder how they ever passed their exams because I was struggling and had convinced myself that coming from Physics stream, I was more handicapped than most since I hardly studied in my years as a student. I remember every time we had a Problem Based Learning (PBL) class, a chief complaint was given, and we're supposed to give a rundown of differentials. And I remember saying to a mate of mine, "I can't wait until I'm a second year and we've gone through all these systems. Then, we can do this PBL thing properly. Time tu dah tau semua, baru boleh diagnose semua benda." Kononnya lah.

Now that I'm a third year, every day is PBL day, and every person in hospital is a PBL patient. And I'm still no better off than that first year girl who feels like she has no clue as to where to start diagnosing her patient. Now I think, "I can't wait until I'm a specialist. Then I can diagnose the patient intelligently." And then I'd wonder about how lost I'd feel like when I actually am a specialist...

Now and again, I have first years coming up to me, asking me, "How do you memorise all this stuff?!"

I wish I knew then memorising is a basic skill, and not even the most important skill, whereby the most important, the crux of a doctor's neurological software is the ability to think. Bak kata Mr. Gee, "Common sense is not so common."

How we used to memorise time tables from two to twelve to be able to do complex calculations properly until the ability to calculate 1897 x 789 becomes a basic function in us as a human being is exactly how we should treat medical knowledge. After being exposed to a certain problem, a brain's structure changes in a certain way so that the next couple of times we try to solve the problem again, the thought process that occurs in our brain is faster, almost automatic, as if by instinct. For example, monkeys solve true-false problems faster when they are taught the concept of one and zero!

Just like how log, calculus, etc is the next step in maths after learning how to multiply and divide, thinking and diagnosing is the next step after knowing all that medical jargon and information. Interpretation of signs and symptoms, prognosticating, treating, referring is the next step after knowing all your values, your facts, your texts. After all, you don't want to examine a sick patient infront of you and still be thinking mainly about whether you're doing the steps correct! It should be a given, and what you should be doing already is collecting clues.

It doesn't matter if you're from the Physics stream, if you're a monkey, you can learn medicine, anyone can. Don't think you're a better human being than most just because you're taking the medical course. (Yes, there are people who act like it!) It just takes unfailing will to continue to memorise and learn until it becomes instinctual on top of a powerful internal drive to be able to think, not just for your sake to pass exams, but for the patients you're facing in the future.

I hope first years remember that. That exams are just exams. That if you pass exams, viva, repeat papers, whatever it is, well done, no-one cares, no-one's looking at your pointer. I hope they know the things they're learning aren't for exams, but for that Holy Grail of a medical career: the development of a professional medical instinct. Here's to hoping that we all reach that point some day in our lives.

Nazirah, 3rdyr 2010/2011

Hello sunshine, the Earth says, "Hello!"

(Gambar sekadar hiasan)

It's a brand new dawn, brand new day, brand new light for all of us. This is the first post; the first sign of many good things to come.

This site was created so that UPM MD students can find references, seniors's blogs, share opinions, and network easier, as well as to perhaps generate revenue if any sponsors are interested in supporting our planned events.

Any students from the UPM MD course can submit an article, whether a written opinion article or a link to a particular good medical discovery, whatever it is, send it over to putramedicclub@gmail.com, and we'll review it and post it within the week.

We would very much like to see articles regarding the medical students's experience in medical school, especially in UPM. We feel that it's great thing to disseminate knowledge and experience so that juniors or future applicants to the UPM's medical school have an idea of what they're getting into. For example, you can write about the first time you set foot in medical school, your first day of ophthalmology posting, whatever you want! However, the articles do have to be filtered so that a standard is maintained, therefore we do expect correct grammar and spelling as well as accurate facts when referring to events, as opposed to merely being gossip. Any articles in English and Bahasa Malaysia are very much welcomed. Articles can be edited by the website managers without prior notice.

If there are any suggestions for links of medical references, seniors's blogs, other medical students's blogs that anyone feels useful and relevant to include on the side bar, feel free to comment on this post. I've been trying to find the link for Prof Chris's forum for ages. If anyone has that link, pleast post it.

Let's crack on, shall we?

Nazirah, 3rdyr 2010/2011