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2025-05-20

My Next 6 Months (Post Housemanship)

What is the biggest challenge you will face in the next six months?

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At the time of writing this article, it is the 8th of April 2025, Day 644 of my Housemanship Journey. I have just completed my Fifth Posting in Medical and is currently on leave as well as due to begin my 6th and Final Posting in Emergency Medicine on the 11th of April 2025.

One posting or rotation lasts for a total of 4 months if there is no extension, for House Officers.

Thus, it’s safe to say that for the upcoming 4 months, my focus would be on leaving and enjoying my final posting and the challenges I would most probably face then would be the completion of my logbook, preparing my presentation for CME and preparing for my end of posting assessments.

But how about for the subsequent 2 months after that?

That’s a grey area for me.

First of all, I do not know myself on the department that I would want to serve in as a Medical Officer as I enjoyed every posting that I have ever rotated in.

Next, the state or hospital that I would be interested in practicing in for at least the next few years. Currently, I am practicing in Hospital Umum Sarawak, otherwise known as Sarawak General Hospital or “SGH”, in Kuching, Sarawak.

Personally, I would like to stay back over here and serve here rather than to go back as I absolutely love it here and feel like this is where I am meant to be.

However, things might change in the future considering that I would want to get married and my partner is living in Peninsular Malaysia. That’s one as well as the consideration of my parents, having grown up as an only child.

Thus, a grey area for me, nevertheless. Me, being comfortable with procrastination has pushed this thought to the back of my head and refused to entertain since I have to submit my full MMC application by the 13th of April 2025.

This means, I have to set my mind on a department as well as my choice of state (location) or hospitals of choice.

Oh dear…

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2025-05-18

Laughing – A Way To Destress

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What makes you laugh?

Laughing – A form of de-stressing activity. To which some may find “distressing”?

Or perhaps I’m just a little unbalanced.

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However, back to the prompt, I would laugh at almost anything actually.

Many would ask me on why do I laugh so easily or on almost anything. Honestly, I have no proper answer for it. Perhaps, the easily justifiable answer would be that it has become a form of my default reaction towards answering people. 

Firstly, it softens my expression, thus making myself seem more approachable (or so I think). Sadly, that also means that sometimes people would not take me seriously. Next, it lightens the situation and prevents a tensed situation from escalating. However, it may also flip the other way around which may further escalate the situation instead as me laughing may deem that I do not take them seriously.

Sometimes, when I am being thrown an insult, I do react by first laughing about it, as a shield for myself and preventing myself from being hurt or at least giving myself some time before digesting the issues. 

Then, there are times, when I am lost in my own world, which is most of the time, I would suddenly remember something funny or find something amusing and start laughing to myself. At times, it may escalate into a hearty laughter to which some might find distressing.

Nevertheless, after a good laugh, I would usually feel better, as they say, it releases endorphins, a “feel good” hormone and thus, “laughter is the best medicine”.

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2025-05-16

My First Hour Of The Day

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What are your morning rituals? What does the first hour of your day look like?

By default I rise around 4-5am. Perhaps out of habit as I usually take my time in the morning. Sadly, this also happens during my off days even when my alarms are off. My body clock is somehow tuned to waking up at such.

As mentioned, I take my time upon waking up. Thus, upon waking up, the rain sounds which I fall asleep to would be playing in the background and I would sit by the side of my bed and slowly make my way to my kitchen which is just across my bed, since I live in a studio unit and put my kettle to boil.

The kettle is usually filled the night before and hence, one thing less for me to think in the morning. This is then followed by my morning bathroom rituals and brushing my teeth.

Usually by then, I would have been much more awake and proceed to consume my iron tablet, vitamin C and making my morning coffee which is a mixture of 3-in-1 sachet and a teaspoon of black coffee since I prefer an even stronger coffee.

If I were working that morning, I would prepare both of my 1.5L of flasks by filling them with cold coffee which I have brewed a day prior for me to bring to work

Why 2 flasks? Well, one is not enough.

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There are days when I’m feeling hungry or in the mood, I would prepare myself breakfast. My go-to-regular is frying egg mixed with mushrooms, chopped chilli and curry leaves and adding them to my breakfast sandwich. During my time being vegetarian, I would usually grill or air-fry my premixed tofu which I have marinated with spices, acting as a burger patty and my breakfast sandwich is prepared. 

There are days, despite waking up earlier, I would still miss breakfast, thus instead I would pack it for work

After that is followed by showering and getting ready for work. I usually wash my hair in the mornings daily. Thus, prior leaving for work, I would dry my hair with a hair dryer and style it up in a bun and I’m good to go.

How about if I’m not working on that day or if I’m night shift for that day? 

Usually I proceed with my usual cup of coffee or I would go the extra mile by brewing myself a pot of masala or ginger tea with the tv playing in the background of some random YouTube video on productivity, to which I’m usually not listening to and merely keeping it on in the background for some background noise.

Then, I would proceed to prepare my breakfast and start my day with some writing or studying.

Well, that’s my first hour for the day, or perhaps a little more than that.

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2025-05-14

Iced Tea & Cold Brew Coffee

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What is your favorite drink?

As the title entails, it is Iced Tea and Cold Coffee.

1. Iced Tea

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I fell in love with tea, green tea, black tea and oolong tea in particular when I was 14 years old.

At that time, I was looking into drinks to aid my weight loss and I came across green tea and oolong tea being suitable drinks in facilitating weight loss when consumed without sugar.

Thus, I brewed my first proper sugarless green tea and fell in love with the taste. Ever since then, I started drinking it on a regular basis and it has pretty much replaced water for me.

Did it aid with weight loss?

Perhaps in the beginning, eventually, I continued drinking it because I enjoyed the taste be it warm or cold.

As I started working, I would usually prepare cold brew green tea in order for me to bring to work the following day.

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Why cold?

The environment that I’m working in can get rather warm and considering I am a person who perspires easily, the temperature of the tea eases me and provides immediate rejuvenation.

Even after a long day at work, nothing refreshes me more than a cold brew green tea served in mason jar and a straw.

2. Cold Coffee

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I am a HUGE fan of coffee, black sugarless coffee in particular.

My love for coffee began since I was in primary school, which I think is a bad thing since children are not supposed to consume coffee.

Back then, my mother would used to prepare coffee for my father and milo for me prior to my father sending me off to school and heading to work.

Me and my father would then switch drinks after he has drank half of his drink.

Then, when I turned 14 years old, I started pulling an all nighter or getting up at midnight just to study.

Eventually, I developed immunity towards coffee and is able to fall asleep even after consuming it. Thus, I merely consume it out of addiction and routine.

As I started working, as mentioned in my explanation for cold tea, the environment is rather warm for me to be consuming hot coffee. Hence, I would prepare my mason jars of coffee the night prior and transfer it into my flask the following day.

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2025-05-12

My Grocery List As A Junior Doctor – While I Was In My Vegetarian Phase

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Being a Junior Doctor or a House Officer, we are located the lowest in the hierarchy of medical personnels. That is because we have just started practicing which means there is still a lot for us to learn on top of learning how to be a safe doctor as well as the simple management of the patients’ condition down to their tailored management. Thus, this automatically translates into long hours at work, a mentally and physically tiring journey as well as a reduction in our total night’s sleep.

Are we married to our work? In a way yes and also no.

Not that we want to or that we are workaholics but being in this field, it is an unspoken expectation which seems to have befallen us.

Thus, our so-called “work-life balance” is almost always in disequilibrium and we try our best to destress in whatever way suits us best.

For me, it is cooking and recently, I have embarked on a vegetarian journey for the Lenten season (at the time of writing this article, it was during Lent), as well as a way of trying to be a pinch healthier to my already unhealthy lifestyle.

Since I enjoy making my own meals, I rarely eat outside. Thus, the idea that vegetarian food is a little bit difficult to be obtained or ordered online, does not really bother me.

A bright side to this is that, I’m lacto-ovo-vegetarian, meaning I consume egg amidst being vegetarian as well as dairy products and throughout my vegetarian season, I did not reduce my food portion (which may be bad). Rather, I simply changed my food choices from non-vegetarian to vegetarian and from ordering take-outs to consuming more home prepared meals.

Thus, what are the grocery items that I ensure I stock up on a regular basis?

1. Tofu

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I absolutely CANNOT live without tofu. It is extremely versatile as I could make any kind of dish with it. Most of the time, I would simply dice it and marinade with some spices and air fry it.

At times, when I’m feeling fancy, I would use it as a burger patty as well.

2. Mushrooms

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This is another versatile ingredient. From enoki mushrooms to crab mushrooms, oyster mushrooms or button mushrooms, you name it. I’m a big fan.

I try my best to stock up on fresh mushrooms. However, since I go through it pretty fast, I would usually fall back to dried mushrooms since it is readily available in the mart of my residential area.

3. Eggs

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Luckily, I chose to be lacto-ovo-vegetarian, meaning if I ran out of ingredients, I could pretty much add egg, be it just cracking them into my broth or frying them.

4. Bird’s Eye Chilli

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Bird’s eye chilli or “cili padi” as we call it in Malaysia.

I am a big fan of spicy food and since I go through chilli powder pretty fast, I started incorporating them into my dishes.

Be warned though, if you’re not a fan of spicy dishes, adding one too many may render the dish unconsumable.

5. Rolled Oats

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This usually takes some time before it finishes.

Since I am a “heavy eater”, I started substituting my rice with rolled oats instead, which is something I started doing 2 years ago.

I’m not a big fan of having my oats with milk as I find it rather sweet or sometimes just bland for my palate. Instead, I prefer savoury dishes and the oats complements most of the dishes well.

6. Curry Leaves

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This does not really serve any purpose except I merely enjoy the aroma emitting when I sizzle it with oil, adding a nice aroma to my dishes.

7. Random Vegetables – Cabbage, Leafy Vegetables, Potatoes, Cabbage

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I started eating greens again.

I have always loved eating vegetables. However, it is not easily obtained since I do not have a car, I rarely go out and the nearby residential mart does not sell them.

Thus, I order online, I usually have a few fallback vegetables which I would add to my cart which are cabbages, any leafy vegetables, potatoes and aubergines.

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Cabbage is another versatile vegetable as I could add it to my curry dishes and it does not wilt immediately, as an extra ingredient in my stir fried noodles as well as when I cook “okonomiyaki”.

These are my food grocery list by default. I’m not exactly a health conscious person despite being a doctor myself nor do I reduce my food portion. It is merely a step for me to try and be a little bit healthier which is sustainable for me and hopefully in time, it deems fruitful.

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2025-05-10

My Teenage Years

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Describe a phase in life that was difficult to say goodbye to.

Upon reading this prompt, I was reminded of my high school days. The first year of high school was very tough for me in terms of adjusting to a new school, cultures and subjects.

I went from a comfortable place to a different one without any guidance nor advice and I went from being a senior to a freshie all over again, which I did not like.

In addition to that, I had a very bad temper and used to talk back to my seniors which did not aid in my reputation. Well, that was the first year, things started getting better the following year onwards and my grades picked up. I have accustomed myself to the flow.

It was during my teenage years that I met my good friends whom I still keep contact to this day albeit not meeting much.

Looking back, I enjoyed my routine and studying very much. Waking up early was the hardest part of the day, which surprisingly isn’t one for me now, I have transitioned into an early riser.

This is followed by shower, preparing my breakfast and lunch for school, which mostly just includes me grabbing bread or biscuits and stuffing it in my bag and wait for my parents to send me off to school, which is usually my dad. He would send me off prior going to work.

I was truly blessed to have experience that.

In school, it was about attending classes, completing homework or assignments, gossiping with my friends or attending extra-curricular activities. However, the place I truly enjoyed spending my time was in the library. Thus, if I were to bunk class, I would lock myself inside the library and just study or read. The perks of being a librarian. Thankfully, my teacher-in-charge of the library always had my back if I were to be questioned regarding my whereabouts.

After school, my mother would be the one who usually picks me up from school and most of the time, we would eat outside. Occasionally, she does cook at home and as I am writing this reflection, I truly miss these simple heartwarming dishes.

This is then followed by me showering, completing my homework, studying, chilling, going out with my mom and getting ready for tuition or extra classes which are usually in the evenings or on alternate days.

Life was simple and predictable. I remembered attending multiple tuition classes during the week, mainly because I was bored being at home as I was not allowed to simply go out with my friends as I pleased. Thus, I looked forward to those evenings.

Holidays and weekends were the things I looked forward to as well and I enjoyed recuperating or simply helping my parents out with their chores, watching movies or TV shows, studying with music, writing and playing video games.

Surprisingly, what aid me in studying back in high school was due to video games. Perhaps it was the way I “destress” and it drives my mind.

I was not allowed to work during the holidays as my parents feared that once I get the taste of my own earnings, studying will no longer be a priority. However, my pocket money wasn’t great either. But I still got by and occasionally, my dad would slip in some money without my mom knowing just so I could enjoy a nice meal across the road with my friend.

The stress back then were focused on exams and completing homework. Occasionally, life dramas do get in the way, all part and parcel of being a “teenager”, having crushes, jealousy and bullying.

However, for the most part, I enjoyed my teenage years and looking back, I wouldn’t change a thing except to be more disciplined in my studying and to learn more.

Those years flew by rather quickly. Before I knew it, I was a senior and the stress of choosing a major or course and the university applications kicked in. Over the years, I’ve accumulated multiple fond memories with my friends as well which were a mixed of beautiful ones, silly and extremely foolish ones, which we do look back and laugh about during our meet-ups.

If you are reading this, I hope that you did enjoy your teenage years as much as I did too. If you are a teenager, do not fill your time with just studying, immerse yourself in extracurricular activities as well and discover new habits. It is the season of discovering yourself, and hopefully in years to come when you do look back and ponder, it will be filled with sweet memories as well.

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2025-04-28

Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department

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Upon entering the Medical Posting, I was stationed into the “Peri-Medical Pool”. My “birthplace”, so-called.

Prior to entering the Medical Posting, many of my colleagues commented that the Peri-Medical pool is probably one of the worst place to enter considering that it is rather hectic, busy and messy, not to mention the joblist is never ending.

The working shift for a Medical House Officer is as such:

  • Short Day (SD): 7am till 6pm
  • Long Day (LD): 7am till 10pm
  • Night Shift (ON): 8pm till 9am

The Emergency Department in Hospital Umum Sarawak is rather huge and consists of:

  • Green Zone
  • EDAU
  • CSSD
  • Yellow Zone
  • Yellow Respi Zone
  • Green Yellow Zone
  • Red Zone I
  • Res Zone II
  • Decon

Usually a House Officer is allocated to take care of more than one zones.

For example:

  • Green Zone / EDAY / CSSD
  • Yellow Zone / Green Yellow Zone
  • Red Zone I / Red Zone II / Yellow Respi Zone

When the amount of manpower is high, the job gets done quickly and keeping track of the patients is easier.

However, in days where we are stretched thin it is rather difficult.

The Day Shift

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Since I entered the Peri Medical Pool on my Day 1 of tagging in the Medical Posting, my working hours were from 7am till 10pm every day till I offtagged.

I begin my day by first tracing the casenotes of the patients in the zone I am allocated to, snap pictures of the chest x-rays, any relevant radiological reports as well as to trace their bloods.

If bloods were not taken or not in the system, we would then proceed to “summon” the post-night team for help with their bloods.

After all the patients have been traced and the Google Lists have been updated (this is to aid us during our rounds as well as following up on their location later, to ensure that they are not being missed), then I would proceed with my morning reviews.

The morning reviews are just as usual as any morning ward reviews, rounds with the Medical Officer and Specialists and finally carrying out any active joblists.

Since we are in the emergency department, there is usually no afternoon reviews. It depends on the medical officer. Most of the time, rounds are just once daily.

After we are done with our morning joblists, we have to actively screen through the patients in our allocated zones as there is constant movement of the patients in both in and out of the emergency department.

Thus, this means assisting the current on-call team for the day with any STAT bloods or STAT radiological requests as well as updating their progress.

On most days, it is manageable despite the chaos. However, on days where we are lacking in manpower, the difficulty sets in.

The Night Shift

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The night shift begins at 8pm till 9am the following day or until we are done with our “summons”.

I was blessed enough to have gone through perimedical with a partner. Thus, there were two House Officers allocated for the night shift.

As night House Officers in Peri-Medical. We are expected to continue screening through all the casenotes for any new joblist or patients in all the zones in the Emergency Department as well as to assist in any procedures, take STAT bloods or request STAT radiological procedures.

In addition to that, we also have to cover the main building and the side building. This means, if there are any medical patients lodging in non-medical wards, we are in charge of them as well. Most of the time, it is just new transfer ins, sometimes, it is attending to any acute issues.

This is then followed by taking the coming mornings or bloods of the stranded patients in the Emergency Department of the lodging patients.

The amount of patients in the Medical Department is extremely high and thus, the medical patients can be stranded up to days in the Emergency Department which can even last till they are being discharged.

Thus, this ensures that the patients are being continued on their treatment irregardless of their location within the hospital.

The night shift as a perimedical house officer can get rather hectic if there are back-to-back influx of new patients in the Emergency Department, tons of coming mornings as well as acute issues in the ward.

In the morning, the “summoned” list can get rather extensive and chaotic as well and can be rather endless.

Hence, on top of the constant walking about the whole hospital, it can get rather tiring. But like I said, it is doable and manageable.

In fact, I enjoyed life as a perimedical house officer a lot.

If you are due to join Peri-Medical, fret not. Keep yourselves equipped with necessary forms and just work quick and as fast as you can.

On some days, one might get lost in the sea of chaos. However, stay strong and know that help is always within reach and that you are not alone.

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2025-04-11

Working on New Year’s Day (2025)

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This will be the second year in a row that I’ve chosen to work on New Year’s Day. If you’ve read my previous similar article last year, I’ve mentioned how my father has this tradition of working on New Year’s Day every year, ever since he started working at the age of 18. It is something that I’ve adapted as well.

This year, I began my year in the Department of Medical which is my Fifth Posting in my Housemanship Journey. I entered this department on the 11th of December last year.

Having just off-tagged the week before, I was still allocated in my first pool which is the Perimedical Pool.

Looking back as it is currently April 2025, at the time of writing this article, I do not quite remember where I was allocated to. I think that I was most probably taking care of the stranded Medical patients in the main building.

Thankfully, I remembered it not being a hectic day and I was allocated the “short day” shift, meaning that I had the opportunity to return home at 6pm.

Considering it was New Year’s Day which is a Public Holiday here, things were rather slow and tuned down.

Thus, it was a rather slowed down and uneventful day, ending with me returning home on time and unwinding early.

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2025-04-07

Surviving Tagging And Finally Celebrating Christmas In The Medical Posting – Housemanship Diaries

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In the Medical Posting, seniors were required to tag for a minimum of 10 days prior to off-tag while juniors had to tag for a full 14 days.

I was due to have my off-tag assessment and in the Medical Posting, we were required to off-tag with Physicians, meaning the specialists.

Tagging everyday in the Medical Posting was rather annoying for me since we had to stay until 10pm and being a regular early riser, I would start feeling sleepy around 8pm as that is the time I start to unwind and go to bed.

However, I can’t because I am still tagging. On top of that, since I am tagging, I would be too exhausted by the time I reach home to even consider studying. I had to prioritise my sleep more or I would crash.

Thus, I tagged for a total of 12 days which consisted of two off days. Thus, in reality, I only actually tagged for 10 full days.

In order to officially off-tag, I had to have my logbook signed by the physician who assessed me as well as to have each procedure filled and countersigned by the medical officers.

Long story short, I finally off-tagged on Christmas Eve and did not realised that I have been allocated an off day on the 25th of December.

This was perfect as my parents flew in on the 24th night. Thus, upon having officially off-tagged, I left and started getting ready to travel to the airport to meet my parents.

The following day of course was Christmas which was well spent with my parents.

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2025-03-22

My First Day In Medical Posting – Tagging Day 1 | Housemanship Diaries

Tell us about your first day at something — school, work, as a parent, etc.

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Finally, my much awaited posting… Medical!

Ever since I was a first poster, I have always looked forward towards the Medical Posting but one I decided to keep as my last as I wanted tolearn and understand the posting rather than just “float” through.

This served as a disadvantage in other postings as when it came to simple management of hyperkalemia or hypokalemia, I wouldn’t know, neither hypoglycaemia or hyperglycaemia.

Instead, I simply memorised my way in terms of the simple management and “referred to Medical” rather than actually learning to correct them myself in other postings.

Thus, I went complex and complicated first prior to building my way up.

My first day in this much awaited posting was on the 11th of December 2024. I had just completed the Surgical Posting and was on a 5-days-break.

On my first day, I was allocated into the “Perimedical Pool”. Deemed as probably the “worst place” to be allocated in. Thus, as usual, the fear starts creeping in.

I started asking around in regards to my job scope as well as the superiors.

Most of them advised to just arrive on time, which I did, at 7am sharp.

That morning, I was allocated to handle the “Yellow Respi” zone of the Emergency Department.

Thankfully, I had a good friend who was my partner for the day.

We began with tracing x-rays of the patients as well as their blood investigations.

After we have gone through all of the patients, we began with our morning reviews while awaiting our medical officer and specialist.

The medical officer arrived and started reviewing the patients with my friend. Here I was, on Day 1, extremely blur.

I introduced myself to the medical officer and he proceeded to tell me to go about my own reviews while he assessed the other patients with my friend.

Alright, here we go again, just like in every posting. Just how and what am I going to review?

Soon, the specialist came and I proceeded to follow the rounds as I was used to in the Surgical Posting where we all followed the grand rounds.

Instead, I was again asked to proceed with reviewing the other patients in the other cubicle while they go about their rounds.

Feeling quite lost and left out, I proceeded as such. Before I knew it, I reviewed all the patients in that particular cubicle just in time when the medical officer and the specialist came.

Thus, I started presenting and writing, still being tuned to the work culture in the Surgical Posting.

Just like rounds in the other postings, we presented, followed, write and after rounds, proceeded with discharges and carrying out the active joblists.

Surprisingly, I had time for lunch.

Afternoon rounds started at 2pm with just the medical officer and my superior was more than kind enough to start explaining and teaching me as to why certain things are as such.

After the PM rounds, I proceeded to screen through the casenotes and update the list of patients in my zone as well as to take any STAT bloods. Before 6pm, I went for my early dinner.

Considering I was tagging, I had to stay till 10pm whereas the rest who are “Short Day” or “SD” went home by 6pm. Thus, from 6pm till 10pm, I was actively screening through the casenotes in the Yellow Zone, Yellow Respi Zone, Red Zone, Red Zone 2, CSSD, EDOU, Green Yellow Zone and updating the list as well as to take any needed STAT bloods which mainly included blood cultures.

A little before 10pm, I approached one of the medical officers to get my signature for the day and went home.

That concludes my first day of tagging in the Medical Posting which surprisingly turned out rather well. For the first day at least.

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2025-03-20

My Morning Routine Being A House Officer Leader In The Surgical Posting | Housemanship Diaries

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There are three main leaders in the Surgical Posting. One is in charge of curating the weekly schedule, the other, in charge of ward and cubicle / bed allocations as well as to reallocate if there are any people who took emergency leaves or medical leaves and the third one, in charge of our attendance at work.

I was the daily allocator. Being the “allocator”, I would be in charge of designating the house officers to the selected cubicles of both the male and female surgical wards (MSW and FSW), the Peri, EMOT and ETD as well as to look for substitutes if there are any last minute changes or leaves.

Usually, I will prep my allocation in advance after the schedule leader has done the schedule and make necessary changes along the way. The leader in charge of the schedule usually determines which person works the night shift and when as well as to approve any leaves. Usually, the house officers will be divided into their respective wards.

The night before, I usually run through the suggested allocation in the “Leaders Group” with the medical officers in charge of the House Officers to screen through.

After receiving the green light from them or making necessary adjustments, I would then upload the list in the House Officer’s group. Thus, they would then know where they would be covering.

The list is usually sent in the “MOHO” group, meaning the group containing the House Officers and Medical Officers at 6:30 a.m.

Thus, I would wake up and be on standby at 5am everyday, even on my off days as I would wait for any messages should anybody take medical leaves or emergency leaves and make the necessary adjustments needed.

At 6:30 a.m sharp, I forward the daily allocation into the “MOHO” group.

If I happened to be working on that day, I would pause in between work just to send and then go about my work.

However, if I happened to be on leave or having my off days, I would then return to sleep or go about my other activities after 6:30 a.m.

It was an interesting experience having had the privilege to hold the position as one of the posting leaders.

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2025-03-16

My Experience as A Plastics House Officer | Housemanship Diaries

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When I entered the Surgical Posting, we initially did not have the privilege of experiencing subspecialities like other batches.

This was due to the fact that there were lack of house officers.

However, mid-Nov, there was redirection of House Officer allocation and suddenly, the posting was overflowed with House Officers.

Hence, subspecialities were reintroduced. The subspecialities reintroduced are neurosurgical, plastics and urology.

Ever since my first posting in Orthopeaedics, I’ve always wanted to experience being in Plastics after assisting my medical officer at that time with SSG.

Thus, during my final weeks, I was given the priviledge.

The Burn Ward is located at Level 3 of the Main Building, and is able to host at most, 10 patients, with each patient having their own room/cubicle.

Usually the burnt patients are kept at Burn Ward whereas other patients who are admitted for AVF creation or SSG are placed at Surgical Ward.

The timing for us House Officers is from 7am till 6pm, Sunday till Friday with an off day on Saturday.

During my time in Plastics, I would usually arrive on time at 7am and proceed to trace the bloods first. After all the bloods have been traced, I would proceed to help out with morning reviews.

Morning reviews are usually done by the postcall medical officer. This is then followed by rounds with the surgeons, usually starting with the acute or rather, the intubated patients followed by the rest.

Rounds at Burn Ward is only once daily. After morning rounds, we would gather at the “Handover Room” whereby the patients who are not in the Burn Ward but is being seen by Plastics as another team or as a primary team are being handed over in terms of case and progress as well as the newly admitted ones.

Next, we will proceed to follow the “Peri rounds” and change dressings if needed. Usually after the Peri rounds is when us House Officers go about our joblists in terms of posting case, referrals or bloodtakings or imaging request.

The rest of the day could be pretty chill if there is nothing going on but usually, there would be new patients to be transferred in, take blood or any post-op patients to be reviewed.

Sometimes there are cases being called and we are more than welcome to join the operation. In between, there are arterial blood gases (ABGs) to be take in between or bloods to be sent.

Finally, in the evening, prior to leaving at the end of our shift, we would prep the coming mornings and leave them nearby before informing in our Surgical House Officer’s group in regards to the “coming mornings”.

My time in Plastics was rather short-lived and I felt that there was so much more to be learnt. But my time spent there was extremely wonderful and the medical officers and surgeons were more than helpful and welcoming towards the new people into their team.

Definitely, a department that I would want to return to.

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2025-02-09

The Wards In The Surgical Department | Sarawak General Hospital

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The main General Surgery wards in this hospital is located on the 7th floor of the main building which are Male Surgical Ward (MSW) and Female Surgical Ward (FSW).

I entered my General Surgery Posting during a time whereby there were no House Officers being allocated into sub-specialities. The only so-called “sub-specialities” that were available were “Vascular” and “Hepatobiliary Team – HPB”. Both of which are added under General Surgery.

Other teams such as Neurosurgery, Plastics, Urology and Paeds Surgery did not have House Officers. It wasn’t till towards the end of my service in this Posting that it was reintroduced.

Thus, our exposure towards the wards in General Surgery were limited but also made it pretty easy for us to manage.

1. Male Surgical Ward, MSW

Located on the 7th floor of the main building, it is considered the ward which is feared and avoided by many but is also where I’ve spent most of my time while being in this posting.

As the name suggests, it is mainly for male patients with underlying surgical issues or at least being managed by Surgical as the primary team.

This ward is usually avoided by many due to the overwhelming amount of patients which is twice the amount in Female Surgical Ward.

Twice the amount usually meant twice the amount of drama as well as the usual chaos.

My journey in General Surgery ended with my service in this particular ward.

2. Female Surgical Ward, FSW

This ward is also situated on the 7th floor of the main building and it is opposite the Male Surgical Ward, MSW.

As per its namesake, it mainly consists of female patients with underlying surgical issues or at least being managed by surgical team as the primary team.

Albeit it being a “Female” Surgical Ward, there would occasionally be male patients being treated there as the beds in the other wards are usually filled, causing an overflow of patients into this ward.

I started my tagging days in this particular ward and I would consider this ward relatively chiller and laid back compared to the other.

3. Vascular Ward

The Vascular Ward is located on Level 3 of the main building.

If you have done the Paediatrics Posting, it is situated in the same location as “Paeds Nursery Level 1″.

The ward is essentially divided into two, catering to both the Paediatrics Team as well as the Vascular Team.

4. Vascular Extension Ward

The Vascular Ward could only cater to at most, 10 patients. Thus, if there were any more patients to be managed under the Vascular Team, they would be placed in the Vascular Extension Ward or in the main surgical wards.

The Vascular Extension is located on the second floor of the main building, inside the Urology Ward which is situated opposite the emergency department, ETD.

During my service period in General Surgery, I have paid a few visits to the Vascular Ward and Vascular Extension Ward. However, I have never served my time there as I was not allocated to be the House Officer in the Vascular Team and also because it was a team I was avoiding.

Upon my exit from this posting, the sub-specialities were reintroduced again and House Officers were being allocated to other teams.

Thus, if you are due to experience the General Surgery Posting, I hope that you will find it as enjoyable as I did especially while working in the Male Surgical Ward.

It is indeed hectic and busy and going home on time is almost unheard of. Albeit MSW being an extremely busy ward, the medical officers I worked with as well as the specialists were kind, helpful and willing to teach.

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2025-02-03

My First Day Back At Work After A 6-Week-Break | Housemanship Diaries

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I officially returned to work on the 2nd of October 2024.

Initially, I was stationed to work the morning shift at ward. However, a colleague of mine decided to take a sick leave on that day when she was initially stationed as the House Officer in the Emergency Department, ETD HO.

Being the Allocation Leader in this department, it is my duty to immediately look for a replacement and to update in the group with the medical officers. Not one person came to mind and I felt bad since it was a friend of mine who took a sick leave or did I feel comfortable dragging another person to cover this shift since it is a shift most people avoided.

Thus, I offered to be the ETD HO myself. It was during an anaemic House Officer period and there were only one House Officer stationed at the Emergency Department.

Hence, I went to work and stocked up my necessary supplies before meeting the post night House Officer in the Emergency Department to receive my handover.

Of all days, it had to be one whereby no coming mornings (bloods) were taken for the patients and there were a lot of active job-lists not being carried out. Not to mention scans to be requested the following morning.

Basically, there were a ton of “shits” being thrown to me and if I do not settle it myself or to push my post night colleague to help me, I would be in a mess for the day.

Imagine having just returned to work to this. Without thinking much, I started identifying the patients who had bloods to be taken and proceeded to take all of them and sent it off. After sending them off, I started preparing for scans and called the radiology medical officer oncall to present my case.

Finally, after I thought I was done, I decided to review the stranded patients.

Normally, the stranded patients should be reviewed around 7am as we would begin our morning rounds around 7:30am till 8am. Thankfully, it was the weekend and rounds began much later.

I went through my list of stranded patients and there were almost 20. 20 stranded patients at various locations.

Would I have the time to review all of them? What about the active joblists or scans? Can I rely on my post night colleague? What if there is a new case?

I remembered it being a rainy day and the referrals were initially from wards and not from the Emergency Department (ETD).

Perhaps it would be a slow day. I thought to myself.

But, I thought too soon.

Soon, referrals started piling up. My medical officer’s phone (MO) was blowing up with calls. Other sub-specialities kept reaching out for me to help them out and at one point, me and my medical officer had to split to ensure we got everything done to the best that we could.

I wished that I could literally divide myself but I couldn’t. On top of that, my right foot started to ache. I just came back from a 6-week-break. I can’t afford to go on anther few weeks. If I do, just when am I going to end this posting?

I recalled it being a terribly hectic day and I felt bad as I was mostly away, having been dragged away by other sub-specialities, escorting patients or carrying out the active job-lists. I could not really be by my medical officer’s (MO) side to see the cases.

Finally, the end of my shift approached. 7pm and my night colleague came for handover.

Despite it being the evening already, the fire was still burning strong, referrals did not stop coming in and I still had tasks to complete or I would be handing over “shits” to my night colleague.

Finally, it was around 8-9pm, I can’t really remember as I was following night rounds with the OT call medical officer and registrar. My medical officer told me to return home since the following day, I would be morning shift.

I remembered returning home that day, somewhat unsatisfied with myself. No doubt that it was a tough day, but I could definitely do better. If only my leg did not slow me. The pain seems to increase with every step I took and with every exertion I made.

However, as I remembered, I was blessed to have an angel as my medical officer oncall for that day. Instead of shaming me or being sarcastic or mentioning that I could do better, she simply thanked me for putting my best effort on the first day back and welcomed me back.

It’s angels like this who makes me want to try to be better the following day.

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2024-01-01
Daily writing prompt What are your biggest challenges? View all responses

My biggest challenge is always getting around my innate need to procrastinate. There are things to do, so does Robert do them? Eventually, but for now? He does something else that is entirely unrelated. 

I feel as though the whole post-gastric bypass plan to establish an exercise and eating/drinking routine has helped but it hasn’t fixed my brain entirely yet. I may get there someday but it’s going to take time and effort. Also, I can’t procrastinate through the process. You understand, of course.

And there you have it, the first daily writing prompt of 2024. That doesn’t mean anything, I am just trying to get into the habit of typing 2024 instead of 2023. It’s going to take a while to burn the new year into my tiny little brain. You understand, of course.

https://robertjames1971.blog/2024/01/01/fun-with-time-management/

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