Happy Anniversary to the Doctor in Me  ——<<@

Happy Anniversary to me!!! 10 years…wow, how time flies! So many bittersweet memories…ups and downs…and A DECADE has whizzed past! 😮

Reminiscence

When I graduated 10 years ago, I didn’t have the slightest notion that I’d be where I am today. Am nowhere near my original aim (to be a specialist at this juncture of my career). But then..Hey! Why insult myself by comparing myself with others :p 

I’m my own Hero…in the form of the Future Me! So destinations and timelines change, but the GOAL remains.

11.06.2007 – I still remember my hospital director asked me with some concern if I’ll be okay starting on my own when my other 4 Unimates were given postings in pairs. Little did she know what a survivor I had been in the preceding 5 years! I won’t forget the funny advice from my first ever head of department (HOD) either, on day 1 of officially reporting in for work. After enquiring my marital status, “Don’t get married during Housemanship”! Indeed, “Yes, boss! ” :p

I fit in well in every posting & gained and maintained friendships in my colleagues (and even medical students) better than during my undergrad years. To my surprise, the rotating nature of housemanship every 3-4 months suited me best & I actually enjoyed housemanship (contrary to the general complaints about HOship being toughest years of work life). Always thought I was one made for routine and familiarity – Surprise Surprise…

I was equipped with a high dose of nasty people antibody by then though – that definitely helped heaps in getting through internship (and rotten apples of employers many years later)! Little did I know what bends lay in the road ahead for me…career wise.

*

I’ve read somewhere, ‘Imitation is the sincerest form of flattery’. Knowing I inspired some juniors to take up Paediatrics, though I didn’t end up pursuing what I decided on in the 3rd year of my career had felt weird. 

But I’ll never trade my formative working years for anything else – Internship, District posting & Paediatric MOship! They molded me into who I am today. General Practice has been my domain these past 5 years, when I decided to change the direction of my sail…to flyaway. 

*

Over these 10 years, there has been many a day and night I’ve wondered & pondered about numerous things about all in a day’s work…even reached the extent of feeling fed up/ burnt out:

  • Being the punchbag in inter/ intradepartmental ‘wars’. 

  • The critically ill patient you’ve stayed up almost the whole night long who didn’t make it the next day. 

  • The deaths that breaks your heart, holding back tears when breaking the sorrowful news to the family & then crying in the on call room or toilet. 

  • Even when you are unwell and working, but have to hand out MC to people who are visibly healthier than yourself. 

  • The non compliant patient who comes down with a preventable complication & you feel so frustrated but realize you limitations in ‘taking the horse to water but can’t force to drink’. 

  • The ones who make you feel that you care for their health more than themselves. Being verbally & even physically abused by patients because you refuse to bow to their demands. 

Those are just tip of the iceberg.

*

And then, there are the moments of helplessness when you can’t be there/can’t do anything for family members who are ill themselves, when you wonder “What’s the point? ” 

While you are doing your utmost best in caring for someone else’s loved one, you hope & Pray that your loved ones will be in the care of someone who will leave no stones unturned too ^

*
The high stress of dealing with human life doesn’t make any of it easy. To those who think it is a glamorous job, I pity their ignorance. How many people would dream of a job where you deal with all the bodily secretions of another human being? 

All these while being unattached to the patient. Detached attachment was a lesson I’ve learnt well in all these years. 

*

And then there are the social occasions and the day to day life where I prefer not to be asked about my profession. Hate lying you see…in case they happen to be your patient some day :/ The numerous times I try not to roll my eyes at the lame ‘MC joke’! Sigh….

And to not appear ‘lansi’ (proud) nor dumb when you are faced with the “Since you are a Doctor, I have this..list of complaints” and similar lines from relatives, friends & acquaintances. 

Seriously, we think and speak enough about work and diseases and hear enough complaints about ailments and absorb negativity in our day to day work life that we would very much appreciate social conversations which doesn’t revolve around the same. I’m sure I can speak for most doctors who believe in work life balance! There are some who will link everything to medical related things – I like to stay far faraway from them out of work setting :p

Appreciate the majority of my beloved family & friends who do not grab the opportunity for a free consultation during the ‘let my hair down’ or holiday moments! :* However, I don’t mind being contacted/asked for an opinion from close ones, especially in times of need. 

The greatest irony in this is that the nearest and dearest are the ones to ignore our advise & concerns…probably seeing us as their ‘little one’ still. Sighh

*

BUT…despite all these, it is an Honour! To be given the TRUST. Not because you have gained it. But just because from the dawn of times, Doctors have been privy to not only patients’ physical issues, but emotional and mental issues as well. 
Someone who is a complete stranger gives you access to their personal, and often even intimate details (although in some cases it takes abit of an effort to build the initial rapport). 

And not forgetting,  the occasional ‘darling’ patients, whose mere words or actions reminds you that “It is all worth it”. A simple heartfelt Thank You goes a long way in making our day, trust me. 😀 Knowing we have made a difference, somewhere along the way…touched some lives.

That’s why this is not just another job, but a Passion…a Vocation! That, is the beauty of my Profession. 
When all is said and done, never, ever could I imagine quitting doctoring patients. Doctor = ‘Do cere’ = To Care. 

A special shout out of THANK YOU to all the teachers, mentors, colleagues, nurses & healthcare staffs I’ve had the pleasure to work with in this past decade!  And my regular patients who trust me 😀
Cheers (to myself) to many many more years as a Doctor! May I do no harm & do some good, while maintaining a work life balance _/_ 

And…

*

P.S : How am I celebrating this milestone today? Working, of course! :p Yup…a Sunday! It is a long weekend here (Queen’s Birthday) & I’m definitely making this a milestone to remember…pre, mid & post (work) 😉

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AMC MCQ -Preparation

PART 4 of my IMG’s Road to Australia series.

<< PART 3 : Latest update – of EICS, AMC Portfolio & Fee Structure

 

So far, we have gone through the pre-AMC exam sign-up paperworks & setting up your AMC portfolio.
We have discussed about the English test too (which in my opinion is best taken when things are more certain due to the 2year’s validity period).

Next : Sign up for a date for MCQ (Part 1).
Exam format – Single Best Choice (of 5), with NO negative marking!

What next?

STUDY!! 😀 


The best time to take these exams would be fresh out of medical school – will ace parts 1 & 2 without much trouble, no doubt! However, as doe-eyed hopeful new doctors on board in our respective countries, how many of us would have decided to embark on the road less travelled (upon graduation)?

Studying while working is no joke. Especially if you are taking up self study, and there are no official study breaks. But it isn’t impossible! I have come across a good number of candidates who did it on their own salute.

Introducing the bible for AMC MCQ exam – THE BLUE BOOK!


Beautiful explanation for each question. Some of these questions do get tested, though not much. But it covers the common topics & gives one an idea of how to approach the exam.

To be honest, I hardly touched my copy of this book while I was in Malaysia. Working full time didn’t allow me much time to study. And our so-called study dates ended up being movie dates or chill out sessions – LOL.


My mates and I enrolled for the VMPF preparatory course for Part 1 back in winter 2012, in Melbourne, which is now home to me.
VMPF has since changed name to HEAL.

These 2 are among the providers of AMC Part 1 (MCQ) bridging course:
1/ HEAL – 6 week course. Location : Melbourne & Sydney
2/  https://www.arimgsas.com.au/product/online-mcq/ – 5 week course. Location : Melbourne & Online.
It is interesting to note the latter offers Online tutorials too. I don’t know of anyone who have done it, do share your experience if you have.

Both offer trial exams. Even if you aren’t enrolled for the bridging course, but want to assess where you stand, you may give the trial exams a go.

In short, I found the course helpful though tiring. It was a pseudo-holiday in Melbourne. Mainly I was indoor in a heated room, with 20+ other candidates, stuffing our brains with exam-oriented information. We were learning to tackle the questions, the exam technique. The intensive course and the 2 trial exams (at the beginning & end of the course) prepared me well for my exam which was a couple of weeks after my course ended.

I stayed on for 2 weeks in Melbourne & appeared for my MCQ exam here. Main reason being, if I went home, I knew I would have back to the daily grind. Having study partners in the same library helped!

To date, I don’t know my CBD as well as some holiday-goers do! Still exploring it…

*

I digress. Back to the Blue Book – managed to finish it during the course, and another round during my study break. The notes and approach learnt from my course & discussions helped me Pass Part 1 at the first attempt. In fact, almost everyone I know from my course Passed at the first attempt.


AMC MCQ exam venues – in Australia & overseas. 
My fellow Malaysians, there isn’t a centre in KL. Bangkok or Singapore would be the closest.

All the best to all AMC Candidates!

Link to Frequently Used Terms/ Acronyms

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Zero Tolerance to Abuse/Violence

So, it is now wrong to ask people to not smoke in hospital premises?
Wrong enough to be punched in the hospital itself?
So does it mean healthcare staffs are just supposed to walk around with eyes yet blind, and tune-off to their surroundings, with a “I don’t care attitude!” and don’t voice out anything that is improper? If we dare do anything, we should be prepared to not only be verbally, but physically abused?

Gosh…we weren’t given that manual in med-school!
Should we incorporate SELF DEFENCE as a subject in all healthcare related modules?

Praying for the speedy recovery of surgeon, Mr Pritzwald-Stegmann ^ 

Sharing some snippets from this article from The-Age-Victoria’s :

http://www.theage.com.au/victoria/box-hill-hospital-employee-in-critical-condition-after-serious-assault-20170531-gwgz8g.html

“Mr Pritzwald-Stegmann is aged in his 40s and is the father of two young children.

It is believed he was on his way home at the end of his shift and became concerned about people smoking near the hospital doors when the assault occurred.”

“Detective Senior Sergeant Ian Shepherd said the surgeon was hit in the face and fell to the ground unconscious.

Mr Pritzwald-Stegmann was stabilised at Box Hill Hospital before being transferred to The Alfred where he underwent surgery on Tuesday night. He remained in a critical condition in intensive care on Wednesday.”

Violence in Victorian hospitals

  • An October 2016 Fairfax Media analysis of health services’ annual reports showed there were 8627 reports of occupational violence in Victoria’s public hospitals in the year to July, and of those 1166 resulted in staff injury or illness.
  • April 2017: A nurse at the Royal Melbourne Hospital was allegedly held hostage at knife point and by a 60-year-old male patient.
  • October 2016: A patient angry about waiting for care drove their four-wheel-drive through the glass doors of the emergency department at Sunshine Hospital. In a separate incident at the same hospital, a patient slit their wrists, sprayed blood on staff and punched a nurse in the face repeatedly.
  • April 2016: A patient cornered two staff in a trauma ward at Royal Melbourne Hospital and punched a nurse in the face.
  • February 2014: Neurosurgeon Michael Wong was stabbed up to 30 times in the foyer of Footscray Hospital as he arrived for work.
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The Companion who was on his phone

As I invited a little girl clutching onto her mom into her room, they were followed closely behind by ?patient’s dad or her mom’s partner. He was on his phone, loudly yacking away. I was irritated, but chose to ignore him as he seemed to be coming to the end of the conversation. It was only halfway through work, I didn’t want to spoil my day

Few minutes into the consult, I thought he was about to end the call when telling whoever it was that he is at the doctors, but horrors of all horrors, it was just a comment – not to excuse himself. And he seemed to be speaking louder and louder (or maybe I was hallucinating the volume, due to my irritation).

Me : Excuse me, can you continue your conversation outside please. I am trying to have a consult here.
He : Oh ya, of course.
And walked out.

Few minutes later Mr Rude walks in and as I was explaining things to the mom, he was making sarcastic comments aimed at her, or maybe it was towards me I wonder
eg: “Can you remember that or do you need it written down?”. It is my style to give patients things in writing as trust me, they forget half the things by the time they walk out of the practice.

She kept quiet & ignored his comments. Up till then, I too was ignoring him and focusing on explaining to my patient’s mom about my diagnosis & management. And then he said something like “All the doctors hate me anyways”.

Me (to him) : What was that?
He : I wasn’t speaking to you. I was speaking to her.
Me : In case you didn’t realize, this is a consultation and I’m having a conversation with her.
He was wise enough to ignore me & not turn it into a fight.

Continued some yada-yada to his partner (patient’s mom) while measuring his height himself, while I was printing out script and explaining instructions on consuming the medication to mom.

I didn’t hear what he asked her. I only heard her reply “No”.
“Then why do I need to come and wait at the F***ing doctors for 45 minutes?” he stomped out.

Earlier, as mom was coughing as well, I offered to have a quick look at her after the little girl.  By then, I was just staring at him.

Mom : How high was her temperature?
I rattled the digits (once again). She thanked me and headed out after Mr Rude.

Now, now this is why manners are essential!
Please inculcate them in your kids as early as possible to prevent them turning into this kind of morons!


I can’t expect anything civilized from a moron who has no courtesy to switch off his phone when in doctor’s consult room, can I?

Usually it is the patient who will be on the phone (fair enough, to kill time while waiting – been there done that myself). Most of them would have enough courtesy to end the call when their names are called, while a handful would continue talking till we reach my room, and a rare few even after being seated – as if my job is to wait for them to complete their call because I made them wait, right. I don’t entertain these kinda nonsense anyway.

Only once recently, the patient said it was an important call and was happy for me to take the next patient in first.

Next time anyone walks to my room without switching off their phone, I’m going to throw them right out! That is my right, no matter how long you have been waiting for your turn. As if doctors purposely make patients wait!

*

For the records, they waited 30minutes, not 45.
I have seen the patient before. I didn’t record anything about rude parents. I made sure I documented today’s incident in the notes.

Posted in All in a Day's Work, Oz GP | Leave a comment

MC writer?

Friday the 26th May 2017 – half past 10pm.

A patient walked in declaring he needs mc for yesterday and today.

He was coughing.

After my yada yada trying to take history which he wasn’t cooperating with, I told him we can’t backdate MC. Anyway I need to examine him before giving one for today.

“I don’t need examination. I just need MC” he said arrogantly.

I just looked at him sarcastically smiling “Really? Suit yourself. My job isn’t to hand out MCs”

He “So who can give me for yesterday?”

I just reiterated my stand in fewer words & pointed to the door.

*

TGIF, eh?
Thank God for the day off on the morrow instead!

Posted in All in a Day's Work, Down Under, Oz GP | Leave a comment

Latest update – of EICS, AMC Portfolio & Fee Structure

Here is the long overdue PART 3 of my IMG’s Road to Australia series:

<<Part 2 : Getting Started – of AMC forms, EICS & English test

I chose to change tracks when I was almost entering the 4th decade of my life.
I know of others who did it at an older age. How old is too old? Well, NEVER – I’d say.

Rules keep changing. 1 of the reason I stopped updating on this topic is that I was getting confused with the ever changing rules.

But if you are determined to embark on the Road to Australia, please do it sooner rather than later. You might have family situations, financial issues, and any other hurdles at all in your way. But then if we let it be, excuses will keep building up over the weeks, months, and years. Before you know it, procrastination will only end up in things changing the very next year! And then, we hear the complaints….sigh.


At that point, it is futile to get frustrated and point fingers, or worse still cursing AHPRA or AMC, often even the country! There are alot of imperfect things in the system, especially when it concerns IMGs, but my Q for the complainers is, if you come from a perfect background, WHY MIGRATE? Stay in your comfort zones.

Save up the money, and just do it – asap!

***

Please remember, every 1st of July, exam fees skyrocket! With each new financial year, it only goes one way. Fees & Charges

1st July 2017 onwards, they are phasing out on the EICS verification – http://www.amc.org.au/assessment/psv, to be replaced with EPIC.

EPIC Fee explained.

I don’t remember paying anything for my EICS verification, and the good news is there is no expiration date for it. But if your alma mater is known to be tardy, please chase them up…bug them relentlessly until they respond to EICS.

Quoting from AMC Website:

Processing delays also occur when an overseas training institution is slow to respond or does not respond to verification requests. The AMC has compiled a list of overseas institutions that have not responded to requests or that have been particularly slow to respond. The institutions listed did not respond to more than 60% of all EICS requests sent to them from the AMC from January 2013 to December 2014. The AMC will update this list as it receives data from the Educational Commission for Foreign Medical Graduates (ECFMG) on the EICS request response rates of overseas institutions.

Regardless of whether your overseas medical training institution is listed (PDF 101KB), we recommend that you contact the authorised person/s at the institution to confirm that they will complete the EICS verification request and return it to the ECFMG for processing. The ECFMG will advise the AMC of the outcome and the AMC will notify you of it by email.

Latest AMC Portfolio summarized.

P.S: This isn’t a cheap journey. Especially if you come from a country where the exhange rate burns a hole in your pockets. Don’t say that you haven’t be warned. So, please make sure you have enough emergency funds & balance back home when you are investing (that’s what I see it as) in this pathway.

Posted in Down Under, IMG in Australia | 2 Comments

Uwek…

Patient X, a teenager, was waiting in middle waiting area. She was next. 

But there was a child who was feeling ‘sick’ in the front waiting area. As I was calling her name she was wailing and vomiting (into vomit bag).

While I walked the child and her family into my room, patient X’s mom asked if X wasn’t my next patient? 

I apologized and said since the child is vomiting, I’ll see her first and attend to X right after. Thanking them for understanding, I was starting to walk away when

X’s mom : We would like to be seen in a different room. 

Me : oh…if you can’t wait, its okay…please tell receptionist. If any other doctor become available earlier, you can see them. 

X’s mom : No we can wait for you. But see us in a different room. We don’t want to catch what she (glancing at the child) has.

Me : She vomited in the front area. You don’t catch vomit.

X’s mom : You don’t? 

Me : shook my heads 

(internally rolling my eyes big time) 

As we (the little child, family & I) walked down to my room, I apologized to the child’s mom & asked that she ignores X’s mom’s comments. 

*

I have no words to express my shock & disgust. 

*

Lol…what about us doctors, who gets coughed on, by sharing that small space in consultation room with all sick patient? Maybe we should start consulting in open area, to protect ourselves

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