Some people got curious on how a doctor’s
life is recently and I received some messages on that, especially after the
COVID war started. Well, there are some negative comments and questions in
between, which I don’t quite understand why. Anyway, 'm going to share my
experience of being a house officer in a Malaysian Hospital for the past 2
years today, which was pretty much a roller coaster in my life.
I started my career since May 2017, in a public
hospital in the northern region. I belong to the 3rd cohort of
contract medical doctors under the Ministry of Health Malaysia (KKM). Before we
reported ourselves to the government, I had a long hiatus for almost a year
since my graduation in June 2016 . Yes, ’'m a public university graduate by the
way, so the long hiatus is not tied to factors such as race, being a local or
overseas graduate; basically, everyone faces the same problem.
What did I do during the long hiatus, or rather,
during the gap year? Well I travelled to
a lot of places during the break, and this includes spending a month in Taiwan,
joining some volunteer programmes, and working in a office in between. As to
the question of why did I notget myself
involved in some medical related job
scope, Well we are prohibited from that actually. I’m considered lucky to get a
job in an office, as many of my friends had to work as a grab driver, or even a
cleaner to support their life. Most of us did not come from a wealthy family
and we struggled to live for the past 1 year.
In November 2016, we went for our interview
in respective our states,had our portfolio ready, brushed up our knowledge, in
hope of creating agood impression on the interviewers. After the interview and
another long wait, we received our official placement email from the
government, and was instructed to start our service from May 2017. Before the
reporting date, we went for a week long programme of ‘ Program Transformasi
Minda’ , and basically had our last honeymoon before the hell like 2 years for
housemanship began.
So now, what did I go though for the past 2
years for housemanship??
It is a mixture of tear and blood,cheer, gains and losses. I almost gave up in the beginning part, as it was so tough and so pressuring that I felt suffocated. But trust me, be determined to go through this, as all the training made me a better doctor to survive in this field.
It is a mixture of tear and blood,cheer, gains and losses. I almost gave up in the beginning part, as it was so tough and so pressuring that I felt suffocated. But trust me, be determined to go through this, as all the training made me a better doctor to survive in this field.
As part of the government requirements, we
have to complete 2 years housemanship with 6 rotations in order to become a
medical officer. The mandatory ones are orthopaedics, medical, paediatrics,
obstetrics and gynaecology and generalsurgery. We then have options for
emergency medicine, anaesthesiology and intensive care medicine, community medicine
and psychiatryas the electives and I chose to go on with anaesthesiology.
Please be mindful that the elective option is hospital based.
I started my housemanship journey with
medical -> obstetrics and gynaecology -> orthopaedics -> paediatrics
-> surgery -> anaesthesiology. After my completion of housemanship, I
joined paediatrics, which was the department I love the most ( still loving it
till now). Before I started my work, I always wished to be a surgeon, as I love
the feeling of saving livesfrom the operation theatres ( too much of drama and
movie I guess). I studied for MRCS and I even bought a set of basic suture set
myself. But things didn’ go with what I wished, as I found myself hating the
life in the operation theatre for long hours andthe toxic working environment.
I had a bad time honestly.
So my tips? Don set your target too fast before you join the department, many of my friends wished to be a neurosurgeon, a cardiothoracic surgeon, a gynaecologist in the beginning, but they ended up something totally unrelated and yet they are successful on that. Enjoy the life of housemanship, and explore the different fields. Pick one that suits you the most during the end of housemanship and go for it.
I made up my mind for paediatrics after I
joined as a fourth poster. To be honest, I got so much influence from my
seniors in this field, and they have
guided me a lot, in building up my confidence in this field since housemanship.
The starting point wasn’t easy at all, to pass the tagging process inf
paediatrics, we have to complete the Direct Observed Procedure with 2
assessments. I failed my neonatal assessment during the first attempt, and I
could not master the peripheral cannula insertion skill. The babies are so tiny
and their veins are so fragile, and as a houseman, only 2 poke attempts are
allowed and the department was very strict on this. I was one of the poor
performing ones in the beginning.
The tagging was 7 days in arow for
paediatrics, with a break of one day, then another 7 days consecutively in the
Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) for neonatal
rotation. It was physically and mentally torturing andI would say it was the
worst tagging period among the 6 postings. Paediatric is a busy department, we
don’t get regular lunch and dinner time partly due to endless cases withlengthy clerking. Everything
hase to be precise, and there is no standard practice or dosing for each baby,
everything is fully customised. I worked
from 6am-10pm for 14 days and it was really exhausting. Failure to pass my
tagging assessment almost made me suffered an emotional breakdown.
Forutnately, my medical officer detected my
problem, and she counselled me. I got another off day as a break, so I could
really cool myself down. I cant really recall back the days that I had, it was
awful, the training was tough. But, all these nightmares made me a capable
paediatric officer today Although I wouldn’t say I’m an excellent one, I still
have a long way to go but I able to carry out my job scope competently nowadays.
Im not an obsessive-compulsive personality type of person but I will make sure
all the little kiddos under my care get appropriate treatment. I love to play with them. Their bright smiles
and cheerful laughters during discharge are my biggest achievement.
And
I am really thankful to my family and my teammates to go through this with me, colleagues
such as Iylia, Feena, Wahidah and Nina. We formed a strong team, and we get
good feedback from the medical officers, specialists and consultants. My
seniors colleagues still label us as the “strongest team” despite us having
left the department for more than a year haha. I built my confidence in
paediatrics in the middle of theposting, which I was given a chance to perform“
in- out Survanta”, to standby independently before a senior attending arrives and
many more. At the end of my posting, I had a conversation with my specialists
and consultants, and they encouraged me to join this field.
I was a bit nervous to make a decision at
that moment,as I still hold on my wish to be a surgeon. Until I did my surgical
posting, things changed. Although it was my passion in the beginning, it turned
out to become a nightmare during my housemanship posting. Long hours of
operation theatre, humiliation from the seniors are among the reasons that I have
decided to quit my dream as a surgeon . As a senior in the posting, I was given
high expectation and I really enjoyed it when I was given the task to take care of appointed patients. In mid posting, I was transferred to another
district hospital as “ attachment house officer”to learn on palliative care,
and to be in charged of pre operation carefor 5 weeks. It was the happiest
moment during my housemanship.
After the 5 weeks posting I got transferred
back and joined the team to take care of patients in the intensive care unit.
Well I guess I was too high profile back then, and things deteriorated to the
point where I was backstabbed by some irresponsible people, with non existential,
baseless ill intent accusations. I was being judged immediately, without a
chance to defend myself. Those medical officers who worked with my previously,
decided not to stand up for me at that moment. I was barred from some surgical
procedures back then. It was
demotivating and I will never forget what that person had done. Guess who was
the one who brought me back to my feet back in the end? She was a senior
medical officer, Dr F, who was labelled as a “malignant” medical officer from
Obstetric and Gynaecology department. We had a short conversation when we met
in the operation theatre that time, and I felt thankful for that. My seniors
from paediatric back me up at the same time. It doesn’t stop my path just here.
I finally decided my path during the end of
my 5th posting in surgery andtook my MRCPCH 1A and 1B exam during my
6th posting as an anaesthesiology house officer. Thankfully my
supervisor in anaesthesia was very considerate on my situation and she listed
me in the operational theatre schedule for 2 weeks during my preparation for
the exam, so I could have enough time for study and preparation. Couldn’t
imagine if I was scheduled for intensive care unit (ICU) rotation that time,
with that heavy workload and high pressure working environment, I probably will
have gottenmad. Don’t get it wrong, I love my ICU rotation at the same time. I
learnt on ventilator settings, intubation skills, brushed up my cannula
insertion skill and the other invasive procedures undersupervision at the same
time, spinal anaesthesia etc during the posting. Saving life after
cardiopulmonary resuscitation, along wiht the adrenaline rush as we try to
bring back life to a patient on the verge of death gave a huge satisfaction.
My medical officers encouraged me to stay
back for anaesthesiology posting that time, but I decided to go with paediatrics.
Did I pass my exam? Yes I did, and I managed to attempt for my part 2A during
my floating period, although I failed it in the end. The reason why I choose
not to be a anaesthesiology although I enjoy the process? Well I have a very
negative mindset when I manage adult patients, which I think it is not fair to
some of them when comes to treatment.
Most of the cases we got were fluid overload due to noncompliance to
fluid restriction, disease complication form missed medications, and midnight
motor vehicles trauma cases. I get very upset to treat them when they did not
take good care of themselves at the first place, and it really affected my
judgement. But being a doctor, we shouldn’t judge the patient, we should save
lives regardless. That is the reason why I gaveup to pursue adult medicine, and
got myself into paediatrics, to save the lives of the little angels.
It is a bit lengthy here but these are part
of my life during my housemanship. I Will try to recall back my experience
during my 1st, 2nd and 3rd posting next time.
In short, be firm on what you wish to be, and do not quit if you still hold on to that passion in themedical field.
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