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