Tuesday, May 17, 2016

The Final Lap of UCC MedSchool



Assalamualaikum. 


Klik acah-acah lagu tema, hehs =)




First of all, I would like to wish you all, welcome to final year! Alhamdulillah, mesti rasa tak sangka, akhirnya dah nak masuk finalmed. So, kalau sebut term “finalmed” tu pun memang dah nervous habis kan? So, insyaAllah akak akan cuba share beberapa tips dan overview mengenai rotation dalam finalmed ni. Semoga korang dapat prepare much more better than us!





Summer:


Okay so masa summer holidays ni, memang korang kena buat elektif pun lah kan? Gunakan cuti summer sebaiknya, paling koman pun khatam kan lah OHCM tu sekali. At least OHCM laa, kalo nak postpone baca Paeds or ObsGynae, okay lagi, tapi OHCM tu penting kena khatam habis before masuk finalmed. And gunakan masa elektif tu sebaiknya, use every opportunities you have throughout your elective to learn something. 


Kalau nak ikut pengalaman akak, akak pernah join klinik warfarin masa elektif PPUM. Memang la bosan and dengar consultation pasal warfarin. And you know what? Time akak short case, examiner suruh consult patient pasal Warfarin! So, jangan pandang remeh, any opportunity you have untuk belajar, okay?




2016-CP5100: Principles and Practice of Surgery


Total marks: 200 = consultant assessment (10) + long case end of rotation (40) + written (MCQ & Data) (70) + short case exam summer (80)


I had my surgery rotation 1 week in SIVUH and 3 weeks in CUH. Alhamdulillah, okay je both Mr O Brien and Prof Redmond. Banyakkan practise ambik history and examination and present the case! Cuba try grab senior Reg or even the consultant untuk dengar history korang. For those in CUH, ada tutorial with Mr O Sullivan yang tutorial dia memang dengar history korang and beliau sangat bagus untuk korang perbaiki your weakness in your history presentation, like what question you missed to ask, uncertainty in your history, etc etc. Penting sebab as you can see above, markah long case quite banyak jugak lah. And dekat ward surgery, get used pasal drains, TPN, central line, fluid, etc etc, so that masa short case you wont be like, “I’ve never seen this before!”


Long case exam is about 40 minutes. After 40 minutes, ada 2 examiners akan dengar your presentation depan patient. Kalau kat CUH, ada Miss Buckley, Mr Marks, Mr Gaffney and sorang lagi anaest kalau tak silap. So, insyaAllah, kalau dah biasa present case, time long case akan smooth je. Masa akak dulu dapat case patient above knee amputation secondary to acute-on-chronic limb ischaemia. Don’t being turned down by the complicated history. Surgeon nak everything in an order and jelas! So, sebab tu bila ambik history especially kalau history of presenting complaint dia complicated, ikut flow dia.


Written paper pulak ada 37 MCQ and 10 SAQ questions in 3hours. Memang rushing jugak hari tu nak jawab sebenarnya. Need a very quick thinking sebab soalan SAQ dia boleh tahan banyak dan panjang lebar jugak. Apa yang akan perasan, bot MCQ for Surgery and module Medicine, banyak gila soalan yang tulis, “the most immediate action”, “the most appropriate initial management”…. So, my advice, bila korang study, have this kind of thinking, so when etc etc happen, apa nak kena buat dulu. So even during your ward round ke apa ke, have this kind of active thinking, and banyakkan tanya the Reg or consultant what is the “MOST APPROPRIATE” sebab banyak soalan MCQ guna term macam ni. Semua jawapan nampak betul, tapi yang mana, again, MOST APPROPRIATE!


Short case exam masa korang dah habis written paper. 4 stations macam tu and each station for just 5 minutes camtu je. Kalau nak share experience sendiri, memang after abes exam tak senang duduk sebab rasa macam, “amende laa aku buat tadi”. My first patient, ada drain kat epigastric area, and bilious. Kinda blur cam okay ada sakit apa pakcik ni kan, and examiner tu keep on asking about the differential but still the differential does not satisfy dia. Haha. And then second station tu images, ada hip fracture, pemberton’s sign and CT pancreatitis. But wait, yang CT pancreatitis tu, akak tak dapat jawab pun sebenarnya, tapi examiner tu tolong punya tolong and sampai lah dia cakap, kalau first patient tadi ada ni, so apa penyakit pakcik tu ada, so there we go, Pancreatitis! Tak pernah pun actually tengok CT pancreatitis. So korang nanti time rotation, show la some enthusiasm sikit tengok radiology images ok. My next station was a man with a swelling at the lateral part of the neck. But examiner suruh buat next exam. Seriously, I have no idea at all apabenda la bump kat leher dia, but what can I do is kept describing the bump bla bla bla. Rasa macam nak je cakap kat examiner “I have never seen this kind of bump before!” Lels. And my last station, ada seorang pakcik with abdominal distension and central venous catheter (CVC). Examiner asked me to examine the abdomen, so apa apa pun, clueless kea pa, describe je dulu. Palpate and the pakcik tu report tenderness, so stop sampai situ je. And then examiner tu cakap, so kalau distension tu bukan fluid, so apa kena mengena distention dengan CVC, I was like, whatttttt tak pernah encounter this kind of scenario pun. Haha. Alhamdulillah, examiner tu memang sangat sangat nak tolong, she kept provoking me until I answered her, enlargement of the kidney, so having renal failure and require haemodialysis via CVC.





2016-CP5200: Principles and Practice of Internal Medicine and General Practice


Total marks: 400 = long case medicine + GP + geriatrics + consultant assessment (100) + written mcq (75) + written data (50) + radiology 6 mins (25) + short cases summer (150)


I had my medicine rotation in Mallow General Hospital. So every week ada consultant lain-lain and alhamdulillah Mallow memang a very good place for bedside teaching! For long case exam, pun sama 40 minutes, but my consultant at that time, he was very generous bagi sampai 1 jam. So depends lah jugak kat mana korang buat medicine. Again, it is just for 4 weeks! And GP 4 weeks and geriatrics 2 weeks. Sebab tu awal-awal akak dah pesan, mohon khatamkan OHCM masa cuti summer, got the points, yeah? And bila ada OPD, please attends, sebab banyak patient short case ni from OPD, yang memang dia ada obvious signs semua. Same for surgery jugak, pergi la OPD, so you know nak examine hernia, thyroid, and other lumps and bumps!


For written exam, MCQ belah pagi and Data belah petang. For MCQ, haha memang tricky habis soalan dia. Lagi tricky daripada yang buat kat passmedicine. The medschool really want to test your intelligence, not only your knowledge. For Data, ada 5 soalan. Each question worth 10 marks. Almost semuanya ada 3 cabang soalan. Time kitorang soalan dia... Soalan 1, pasal safe administer drug and anaphylaxis. Soalan 2, pasal drug medication semua akak hentam saje labu... Soalan 3, pasal massive pleural effusion. Soalan 4, pasal CT brain infarction. Soalan 5, pasal patient hypoglycemic.


For short case exam, 30 minit. But can be shorter than that. Short case ni dia banyak centre. So ada yang kat CUH, Mercy, Bons, Kerry, Waterford, Micthelstown, Bantry, Clonmel and Mallow. So, akak punya kat Mercy and memang ada 3 patients je untuk go through. Akak dapat patient with recurrent chest infection, a.fib and multiple sclerosis. Dia test on so many areas, the way you examine, the way you take focused history, the way you prescribe medication. So pasal medication, ambik tahu la pasal tazocin, l dopa ke, warfarin ke apa. Ok. In term of preparation, practise! Throughout rotation, banyakkan jumpa patient and praktis. Sebab examiner boleh beza orang yang biasa buat exam dengan tak biasa buat exam ni. So, watch out!


In general, for medicine, korang kena keep with the knowledge through out the year, jangan tinggal. Always buat MCQ semua. Time GP, jangan rileks rileks sangat, sebab dalam MCQ, banyak gak soalan yang GP-based. So, study sungguh-sungguh time free kat GP tu. MCQ semuanya clinical-based question. Jangan lupa ada question pasal Derm jugak, so mohon study. So final year, treat yourself like you are an intern and know what to do immediately.





2016-CP5300: Principles and Practice of Paediatrics and Child Health


Total marks: 200 = consultant assessment (10) + case presentation (10) + OSCE (60) + written essay (90) + EMQ (30)


I had my Paeds rotation first 2 weeks in Waterford with Dr Dhani and the last 2 weeks in CUH with Dr Mullane and Dr Ni Chroinin. So nanti korang pun camtu ada dua minggu kat CUH, dua minggu lagi kat hospital selain CUH. For case presentation, rileks sikit sebab you can choose any new patient you clerked kat assessment unit untuk present masa ward round depan consultant you are attached with. 


Untuk OSCE Paeds, separuh dari korang akan buat bulan November, separuh lagi buat in the middle of final exam. So, untuk OSCE Paeds ni ada 6 stations semuanya. Untuk akak, akak dapat case abdominal pain for history, video seizures + meningitis signs + developmental, respiratory exam on healthy kid, UTI for history, primitive reflex exam on baby mannequin and Chest X Ray Pneumonia. Advice akak, praktis laa ambik history banyak banyak time rotation, so that bila nak dekat OSCE, especially those yang OSCE masa finals exam, korang lebih confident untuk OSCE. And biasa biasakan juga buat examination dengan budak-budak dekat ward. And disamping korang study, tengok laa video. Macam akak prepare tengok video stridor, wheeze, grunting, sekali keluar pasal seizure, hehe.


For written essays and EMQ, compare dengan previous years, rasanya tahun ni banyak soalan yang boleh goreng in term of bab assessment. So, do practise buat soalan past years although most likely memang tak keluar past years. But as long as you get used of writing essays, insyaAllah time exam, lebih flowy je untuk korang tulis. Written essay kena buat 6 essays in 3 hours, so pandai ppandai lah bajet masa for each essay. Pasal EMQ pulak, jangan simpan harapan nak semak semula jawapan sebab memang tak sempat! EMQ dia pretty tricky, memang dia test betul betul kefahaman kita very deep. So study elok-elok and banyakkan jawab sample EMQ especially yang genetic genetic disorder whatsoever syndromes bagai!




2016-CP5400: Principles and Practices of Obstetrics and Gynaecology


Total marks: 200 = continuous assessment (20) + attachement (10) + presentation (10) + long case exam summer (80) + essay with MCQ (80)


I had my ObsGynae rotation dekat Clonmel which is quite relax jugak lah. Logbook dia lagi banyak dari zaman 4th year ye, jadi harap maklum… Tapi insyaAllah mampu je. Diorang faham je kadang tak dapat cukup sign untuk observe normal delivery, especially male students… Akak memang enjoy rotations Obsgynae sebab logbook tu banyak make you go to different places, so takde lah just stuck ambik history je. Rajin rajin pergi klinik, you will learn a lot especially from gynae clinic, lagi mudah faham management and ingat. Doktor obsgynae kat Clonmel banyak foreigner and super duper nice! 


For written paper, ada 8 essays dan 45 soalan MCQ dalam masa 3 jam. Kena praktis jawab past papers sebab banyak soalan recycle from previous year jugak. Jadi insyaAllah kalau praktis and praktis, insyaAllah bila nak buat essay nanti pun smooth je. Actually quite rushing jugak, sebab nak kena buat satu essay like in 15-20 minuts. Akak spent 2 jam untuk jawab essays dan 1 jam lagi untuk soalan MCQ. So, please manage your time well.


Kalo long case surgery and medicine masa end of rotation, long obsgynae masa summer exam. So the format is 30 minit with the patient, and then 10 minit lagi with the examiners yang akan tanya soalan viva. Most of korang akan dapat postnatal patient, so jangan lupa prepare template postnatal, akak just guna template dalam impey. And yeah akak dapat patient post natal pun. And then time viva, examiner tanya pasal VBAC and ovarian cancer and cyst stuffs. So, for preparation long case, banyak banyak kanlah ambik history time korang rotation. Korang pun tahu kan obsgynae punya history banyak bits and pieces here and there. So keep on practise, and present history for improvement. And praktis juga palpate pregnant mother time rotation jugak ok!





2016-MX5090: Research and Professionalism in Medicine II


Total marks : 200 = FYP presentation + Write Up


So nothing much nak describe pun, basically pasal research project and intern shadow 2 minggu. General advice, jangan lengah-lengahkan buat FYP, tu je laa… And practise a lot before FYP presentation, make sure you understand your project very well, especially everything you are going to deliver during the presentation. As for the write up, draft, draft and draft again! Until supervisor puas hati. I’m glad I have Dr Liam O’Connell yang very dedicated and committed with my project throughout the year. Kena present depan dia, FYP powerpoint semua dia check, write up pun dia proofread kan dulu before submit. 





From the very bottom of my heart….

Final year is indeed a very tough journey, mentally, physically and emotionally! So, kalau banyak benda nak pesan pun, akak just nak pesan satu benda, BE PATIENT or SABAR!

Sabar lah dengan segala macam dugaan, kesempitan masa, kepenatan, kena marah ke whatsoever.. Sebab Allah berfirman dalam al-Quran, minta pertolongan Allah dengan solat dan SABAR!

InsyaAllah dengan kesabaran yang tinggi, insyaAllah ada barakahnya dalam perjuangan yang getir ini.. At the same time, saling tengok-tengokkan kawan masing-masing. In finalmed, kita semua kena kerjasama nak the whole batch pass the medschool. 

And kalau nak any help, just give a shout to any newly unemployed young doctors, insyaAllah we will be so happy to help you gais semua…

Tu je, sorry for the very panjang lebar, ALL THE BEST korang!!


Waasalamualaikum.

1 comment:

AreHadi82 said...

selamat datang ke dunia pekerjaan... selamat menjadi doktor... semoga Allah Taala bantu... Amin...