Finally, the Year 5 placements are out. Took them a while, but hey, what’s new.

Rotation Period	Rotation	Location	Pref #
1: 25/01/2010 – 05/03/2010	Elective	Mount Meru Regional Hospital, Arusha, Tanzania
2: 08/03/2010 – 16/04/2010	Aged Care	Monash Medical Centre (Clayton) – General Medicine (Aged Care)	(1)
3: 19/04/2010 – 28/05/2010	Specialty	Monash Medical Centre (Clayton) – Paediatric Endocrinology	(4)
4: 31/05/2010 – 09/07/2010	Medicine	Frankston Hospital – Cardiology	(5)
5: 12/07/2010 – 20/08/2010	Surgery	Frankston Hospital – General Surgery	(7)
6: 23/08/2010 – 01/10/2010	Emergency	Dandenong Hospital – Emergency	(1)
7: 04/10/2010 – 12/11/2010	Vacation

 

Well I’m not 100% satisfied cos I missed out on Paeds ID which I really wanted, and I’m not ecstatic about the fact that I’m going to spend 12 weeks at Frankston. But I guess things could have been worse, and I shan’t complain too much since I got my 1st choice placements these 2 years. I probably self-saboed by not choosing MMC Cardio as my 1st choice (as evident, my luck for Alfred has disappeared), as I might have had a better chance of getting the 12-week block for MMC Cardio & Paeds ID (and thus avoiding Frankston).

Regardless, one of the seniors who did Frankston Cardio this year told me that it was good, and at least Frankston is nearer to me than Casey or Maroondah. Also, the good news is that I got MMC rotations in 2 & 3, which means I should be able to get decent references for my intern application, especially since I’m quite inclined to apply to Southern Health. Looks like Alfred is quite out-of-reach now given that I won’t be able to get any references from there, unless I have super good results or win some prize next year, or some miracle happens.

What I don’t understand is how some people can get all their 1st choices, while some don’t even get any of their 1st-7th choices for a particular rotation. You would think that by giving us 7 choices, we would at least get 1 of them, but no, apparently not. While I understand that it’s a massive task to allocate 200+ students to 7 rotations that can be in any order, over a wide range of specialties in various hospitals, I do think that there should be some system in place to make things fairer for everyone.

And the final dodgy sentences that were at the end of the emails we got:

- Please note that circumstances may change at hospital sites at any time during the year, which may result in placements being amended or reallocated at any time.
- The Faculty of Medicine, Nursing and Health Sciences reserves the right to allocate students to specific sites based on perceptions of Faculty needs and student academic/health grounds.

Right. I sure hope nothing of the sort happens.

Ah well. It should still be a good year in terms of learning and finally getting more involved with the treating team. Though as we keep saying these days, need to pass this year first!

Yes, I have. The boyfriend’s mum is in town, so I’ve kinda took a hiatus on the studying. Not very good given the fact that the exams are just a mere 3 weeks away. Ah well, time to get back on track NOW. After this blogpost, I mean.

On Wednesday, we went to Miss Marples. My first time after 4 years, finally.

I love the scones and tea! :D

After lunch, I scored a free ice cream with my medical knowledge =) We were looking at some flowers outside this bakery which also sold jam, ice cream etc, when the owner came out to offer us samples of some raspberry sorbet. We went in and had a chat, and it came up in the conversation that I’m studying medicine. So he told me that if I could answer 3 questions, he would give me a free ice cream.

1. How many ventricles are there in the brain?
2. In which organ is the Loop of Henle found?
3. Name 1 type of shunt.

Pretty straightforward, I ought to be shot if I don’t know these basics. So anyway I politely declined the ice cream cos I was so bloated, but he was so nice and insisted that he promised me one. Turns out that he had premature twins, and one of them had hydrocephalus. No wonder. We thought he was some medical personnel or something. Now, this is something you’ll never encounter in Singapore!

That same night, the study buddies gave Daryl a surprise 21st birthday celebration, with tealights that double up as mosquito repellents, haha. And not forgetting the yummy mango cake :D

Thursday was the day of the boyfriend’s graduation ceremony. Not before a morning at Queen Victoria Market and some Bratwurst sausages, YUM. I’ve been eating way too much these few days really, I need to exercise!

Well, stupid me no bring zoom lens + tall people sitting in front of me + low lighting + movement = lousy picture. But trust me when I say this is the boyfriend receiving his scroll.

Congratulations guys! =)

Friday I was in clinic from 9am-4pm – super exhausted and famished after that. But I learnt stuff so that was alright.

We had dinner at Squires Loft on Saturday night. I had enough meat to last me a few days. Enough said.

And finally we made a day trip to Ballarat today. It was interesting and enjoyable, and thankfully the weather held up even though it was rather gusty and there were bouts of cloudiness.

Now, how’s that for a proper update! Back to the books now, hanging in there for the next couple of weeks, please be over soon! :)

Love love love the hospital I’m at now, everything’s so pretty and the people are so nice. I’ve found myself a place for quiet study & free printing, haha.

Had a slack week with only 2.5 days worth of hospital time, but next week is going to be a busy one with packed clinics & ED shifts. The only off time I have next week is Thurs arvo to go attend the boyfriend’s graduation ceremony. But should be good.

Saw 2 consultants quarrel the other day, it was a very heated argument I must say. In all honesty, I felt my consultant was at no fault at all and it was the other guy who was being as a**hole. Thankfully my consultant is a nice guy and despite being in a bad mood afterwards, he still patiently answered my questions.

Did my first IV after a year’s hiatus. With 5 pairs of eyes (doctors & nurses) watching. The nurse told me afterwards: you know we weren’t stressing you at all right? Yeah right. Did I also mention the fact that it was the last patient on the list and he was a last minute add-on case and we were already running late and that’s the reason why the other consultant was kicking up a fuss? Anyway, luckily I managed it the first time round, and I feel quite proud of myself given that it’s the first time I’m putting a IV into a kid (though he was being sedated at that time).

The Shanghai Masters is going on this week, and I was watching a good match between Nadal & Ljubicic when Ljubicic retired. What a waste, I thought he might have stood a chance though I wanted Nadal to win. Ah well, lucky for Nadal then. Something is wrong, apparently there have been a couple of players who have had to retire during their matches this week, including Roddick. Someone must be 打-ing 小人, haha, I kid.

4 weeks to exams. Studying is going alright for this semester’s stuff, I’m happy that I’m keeping up with the schedule that I’ve set for myself. But I can’t say that I’m confident for the VIA. Well, my brain will retain whatever it can retain I guess.

1 week of lectures coming up, 4 more weeks at another hospital, and that’s the end of 4th year. Oh wait, of course there are still the exams to sit for. Which is kinda freaking me out cos 1) I don’t really have anyone to practise OSCEs with (the group of people I practised with last semester have their own group now, the other people I can ask only want to start practising after the written exams) and given how badly I did in the previous OSCE I’m really quite frightened; and 2) other than our weekly study group sessions, I haven’t been studying for the VIA at all (VIA = vertical integrated assessment = everything from Years 1-4 can be tested).

Anyway, I spent the last 2 weeks on the wards. Paed Surgery was awesome as I got to see a super duper rare case of I-shan’t-say-what-it-is-because-it’s-so-rare-I’m-not-sure-if-I’d-be-breaking-confidentiality-by-talking-about-it. Though I’m sure some of my colleagues know what I’m referring to. Truly amazing, a case that I will remember for life. It’s a reminder of how blessed and lucky we are to be born without any defects because so many many things can go wrong at fertilisation/in utero. The surgeons were really nice too, I feel they didn’t really put on airs unlike some other surgical specialties. I really regret not putting paed surg as one of my selective options now :(

The medical reg/resident were really nice too. They taught us stuff, asked us questions, answered our questions; at least we didn’t feel that we were being ignored. I’m sure many medical students will agree with me that sometimes ward rounds are totally a waste of time because we just follow the team around blindly and no one bothers to tell us what’s going on. Note to self: be nice to medical students in future and teach them stuff.

On a side note: 中秋节快乐!

2 weeks of Paediatrics have passed, and I’ve been to various clinics as well as the ED. I’m enjoying myself, learning heaps every day and getting to interact with children. My little knowledge of Spongebob Squarepants, The Wiggles, Dora the Explorer, AFL etc have come along handy, so that’s pretty good, haha. Seen quite a variety of conditions so far – ranging from the common Asthma & Croup, to the fascinating-to-me-cos-I’ve-never-seen-one-before Kawasaki disease, to the rare Marden-Walker Syndrome (only like 50 cases ever!). Not to mention heaps of PUOs, febrile convulsions and sporting injuries.

It’s a bit annoying because there are too many students and hence we have to take turns to do stuff. We were allocated ED this week, but essentially everyone only landed 1 morning, 1 afternoon & 1 evening shift. Which is waaaay too little in my opinion, given that it’s our rotation for the WEEK. So I actually went in this afternoon, just so I could spend more time there and get more exposure. Thankfully we have really nice doctors so it was a pleasant and fruitful Saturday afternoon :) I’m hoping to go in some time again if the other students are not as keen and thus free up spaces, but we’ll see. Now after spending some time in ED, I can’t decide between Paeds infectious diseases or Paeds ED for my specialty rotation next year!

On the whole, I’m finding things mentally stimulating, and this week in ED has been good as I got to interview plenty of kids & their parents, examine them and then coming up with differential diagnoses (without cheating, since I’m the first one to see the patient). Paeds is a new field, yet not totally a stranger. Some conditions are similar to that of adults, albeit presenting in a different way. Others are unique to neonates, infants or children. I guess the most challenging thing is that the kids can’t really tell you what’s wrong, so you’d have to depend on the parents to give you an accurate history, which sometimes may be a bit skewed towards their own perception of what the problem is. It’s also hard sometimes to examine the kid, especially crying infants.

But yeah, it’s been good so far, and I’m thinking this might be the future direction that I want to take. Though I know I should still be keeping my mind open and not rule out anything yet at this point in time. We’ll see, we’ll see.

So, I’m back from my mentor week. I have no clue why they sent us out there when everyone else had a mentor practising in metropolitan Melbourne. It turned out to be more like a rural placement than a mentor week, as there were a few doctors whom we followed on different days, rather than just having 1 mentor (which is the actual purpose of having a mentor week, to give us the 1-on-1 experience). Nonetheless, I enjoyed myself overall, as everyone was really nice :)

Basically we had half a day of theatre & half a day of clinics every day for the week. I got to see a wide variety of stuff that I haven’t gotten to see yet – vaginal hysterectomy, anterior & posterior vaginal repairs, TVT, bilateral salpingo-oophorectomy (laparoscopy-turned-laparotomy. Ask me if you want details cos I don’t want to get into trouble for saying the wrong things here), colposcopy, gynae stuff in clinics. In one of the D&Cs, the consultant allowed me to scrape the uterus after he finished to give me an idea of how it should feel like. He also let me put in a Mirena, under his close guidance of course. And also I got like 5 pap smears in 3 days, haha, needn’t have worried so much.

Unforunately, I felt there wasn’t much teaching – like in clinics, we don’t discuss each patient after seeing them. Of course, if I had any questions, they’d gladly answer and explain. But otherwise, I don’t really get asked if I have any questions, and I barely get asked questions, which is not very stimulating. (or I get asked weird questions which I have absolutely no clue! For example, we saw this patient who came for a follow-up after her Caesarean. We were examining the scar, and she was mentioning how she still feels numb in the centre of the scar. So the consultant was telling her that the nerves will take a while to regrow from the edge back into the centre, and he asked me the rate of nerve growth. I was like, WHAT?! I thought nerves don’t regenerate. So I said I didn’t know the answer. Apparently, according to him, they grow back at a rate of 1mm/day, so given that the scar looked about 10cm, we calculated that it’ll take 100 days for her to get the sensation back. Right.)

But I was talking to Wing, and we were saying that this happens everywhere. There are only a handful of doctors who are really keen on teaching. I guess in a way I don’t really blame them given specific circumstances, like say if the clinic is really busy and you are rushing for time. But if you are running ahead of time and have 15 minutes to spare before the next patient arrives, is it so hard for you to just give me a mini-tute on something? So anyway, we came to the conclusion that we shall be good teachers in future and help students, since we were once in their shoes.

On the last night they took us out to dinner, which I thought was really nice of them. The food was yum and we got to hear so many stories, including about horses & Xrays and cats & anti-venom ;)

Well, I guess this pretty much concludes the 9-week rotation. There’s still 1 more week to go next week, but to be honest I kinda had enough already so I doubt I’ll be going in much next week. Bring on Paeds already!

Well it’s been 3 weeks since I last posted, but nothing exciting has been happening, apart from the usual clinics & tutes & what-nots. I haven’t been to theatre in a while but it’s all pretty much repetitive at where I am anyway, we don’t get those massive tumours or cysts to cut out, just the simple D&Cs, hysteroscopies and laparoscopies.

I’m happy that I completed my logbook (which reminds me, I better go photocopy it just in case it gets lost), and I’m heading off to Warrnambool tmr for my mentor week. Don’t understand why they have to send us out there, it’s a 4-hour drive away. Hope it will be a good week.

Disclaimer: This is just a collection of memorable conversations over the past week with various people, and of course I’m not going to mention any names. Guess if you want, but confidentiality I must maintain just to keep myself safe.

(On the subject of large-for-gestational-age babies & the risk of shoulder dystocia) There are 2 kinda of obstetricians: those who prevent a mess, and those who clean up the mess.

(Speaking really quickly like a choo-train) I’m sorry I don’t have much time to teach you, you know how it is here. But I will try, and I will share with you my thoughts, because I’m not happy about the way these people are being managed.

(Phone beeping away all day, texting in between patients) I really should take this a bit more seriously. My mother’s worried, she wants me to get married. But I don’t know if I’m serious about this girl or not. She shouldn’t be texting me, she’s a teacher.

(Speaking to the resident over the phone about this lady who is 40+ weeks, who presented last week with hypertension and was prescribed labetalol) Let me tell you what’s wrong with this. She should have been induced last week. Whoever managed her last week: if it’s a junior, he should be taught; if it’s a senior, he should be whacked on the head.

Him: I always tell my students about the top 10 rarest things I’ve ever seen.
Me: Ah. I saw something pretty rare on the 1st week, a unicornuate uterus
Him: I don’t mean to crush your bubble, but that’s not really rare at all.

(While the patient is pushing and we are getting ready to catch the baby) Ok, remember, whatever it is, close your mouth.

(Patient, after pushing for a while) I don’t want to do this anymore, can you just please suck the baby out?

In the ideal clinic, we will have consultants, registrars, residents, and a room for you medical students to interview and examine the patients to present to one of us. But this is not ideal at all.

*********

Oh well. Almost halfway through o&g, and so far study progress has been good. Logbook progress is alright, just that I haven’t done any pap smears at all (and I need to do 5, YIKES!), and I need a forceps or vacuum delivery which we can never predict. I need some luck please please!