Wednesday, September 21, 2011

The Real-life Medical Syllabus


Today is my 57th day at work.

The wall art reads, "Dr Yusoff was here." 

I realized that I haven't been writing about the medical posting itself.

Internal Medicine in the real world is all about medical emergencies. And when we say medical emergencies, there's only two words associated with them - Sarawak handbook.

It's the ultimate guide to medical life, used by MO's and HO's everywhere.

What you find in there is what you'll find out there. From the very dramatic status epilepticus to the very silent hypertensive emergency, every topic is covered and presented well. Plus, the mid-posting and end-posting assessments will cover medical emergencies usually.

Another awesome mini textbook is the Oxford handbook - complete, concise, can fit in the white coat pocket.

If you're tech-savvy, then your smartphone should already have Medscape.


ACS (UA, NSTEMI, STEMI), CCF, APO, CVA (ACA, MCA, PCA; SAH, SDH, EDH), AEBA, AECOAD, URTI, CAP, HAP, HCAP, PTB, DM, DKA, HPT, DF, ARF, CKD, CLD, AGE, UTI, RVD - to put it simply, those with abbreviations are encountererd on a daily basis*.

My post-shift jajan binge collection - also encountered on a daily basis.

The main diseases need to be understood thoroughly - from the various presentations to the investigations to the management and progress.

Honestly, it's hard to focus on the subjects of the posting if you're a first poster since you'll be more focused on adjusting to the system and the associated life (or lack thereof).

To overload or not to overload? - that is the question. 

The management part is a bit tricky in the beginning, but after a few encounters with the same disease in a variety of presentations, it'll become second nature. Understanding the disease process and pharmacodynamics of the medications will help tremendously, rather than blind memorization of the treatment.

So kids, learn your stuff well while you still have the free time.  

 Free time well-spent.

It took me around one month to get settled in - even then, I still get scolded at times for reasons associated with lack of comprehension of (and adaptation to) the system.

Holding on to important things in the crucial moments. 

As for the compulsory procedures, my logbook is still free of signatures (and my midposting assessment is next Monday, haha). So far, I've done one chest tube insertion and one peritoneal tapping. And oh, countless CPRs (personally managed two resuscitations by myself while the MO is busy somewhere else).

Learning the system, one leaf at a time.

There's a lot to cover in medical posting - and honestly, I don't mind a one-month extension as I can get more medical exposure and training.

*This list is not exhaustive - I can't find an abbreviation for epilepsy, leptospirosis, melioidosis, deliberate self-harm (paraquat, organophosphate, corrosive agent ingestion), alleged snake bite, dehydration, non-compliance. And let's not forget the medical emergencies.


mongue said...

problem is, you cant get 1 month extension. the least they can give you is 3 months. in medical hkl, every HO is needed to go to work everyday and yes including sat and sunday. thats why an extension in medical hkl will literally kill you.

its good to hear you're settling well mate. all the best.

im said...

ade ke 1 month extension? yg aku tau 3-months biasenye..