Medical school... in a nutshell?

So, helloooooooooooooooooooooooooooo there! Hehe. It feels weird every single time I say hi at the start of my blog post because... is there really anyone reading this lol. It's okay. If it's not anyone else, there's always me who'll someday come back and read what I've written down here haha.

Alright, back to the topic. Real business here, there's no way I can talk about my medical school journey in this one post. I actually wanted to talk about my final year especially about THE MOST INTENSE BATTLE I'VE GONE THROUGH MY WHOLE LIFE. It's necessary to type it with all capital letters to um, just highlight it? Haha. I'm gonna talk about my final Professional 3 exam. If any of my juniors are reading this, I really hope that I won't scare you too much ey? Because even if it's really bad or scary, a lot of people have went through it and nobody has ever died sitting for the exam hahaha. I can now laugh talking about this but definitely not at THAT time :p

Alhamdulillah, Alhamdulillah, Alhamdulillah. To be honest, even the final hurdle was so, so intense and horrifying, the journey was indeed a bliss. It's an amazing path. They say, diamonds are made under pressure, no? Yes, we were put under serious and real pressure, I swear hahaha. I've imagined myself jumping off a cliff every single time I got really stressed out but nope, that's even scarier lol. PLEASE. DO. NOT. EVER. DO. THAT. (or even try!)

To start off this story, I'd tell you about my study group. I didn't really do that well in my 4th year because well, I was stressed out during the first posting. The pressure was overwhelming. It was probably just my anxiety and worrying habit. I was scared if I can't cope with the clinical phase, knowing and realizing that my basic knowledge was not good. I know I should've studied harder but oh, well... :B But I was pure lucky and Alhamdulillah for the rezq Allah had given me, I passed all of my postings. I didn't get good grades but I just pass xD I don't know how did it happened but it did haha.

So then, I got into my final year. Alhamdulillah again, I finally get to resume my study group! Oh I forgot to tell you guys that I had a study group when I was in my 3rd year. Study group masa ada exam Pro je hahaha. Unfortunately, all of us were divided into different postings so we couldn't continue our study group during our 4th year. It's hard because of the different schedule and we can study on our own or with our posting mates since our aim was to pass each postings so it's kind of straight forward. Alhamdulillah for my friends are all very committed to this. It's still difficult to get together and study since we're all in different groups but as I said, everyone was committed and gave their 100% so we made things work. Anis was the one who started the group and gave us a little 'surprise' during our sem break back in August if I'm not mistaken, she started a Facebook group hahahaha. We started slow initially, biasalah kan, baru nak start enjin :p Oh we're a group of 8 members, that's a BIG number. Yes. But it worked during our Pro 2, so if you have good members, insyaAllah, things will go well. So that's rule number 1 to start a study group, you have to get committed group members. If you can't commit, then do not expect people to drag you along. We're talking about the final exam, the exam alone is going to push you to your limits, so don't let any small matters interfere and disturb your focus. Trust me, you have no time for petty things.

In the earlier phase, we only meet twice a week, one session to do our past year questions and another session for clinical practice (short & long case). Things went on for a few months but then we realized that those sessions do not benefit us much so we changed our plan. We all suck at our theory and the long case session was not working so we decided to make notes and share among ourselves which then we'll discuss together to get the most out of it. Things were getting clearer and better that way. Having more people in the group made our discussion even better especially that we came from different groups. So whenever we have doubts/questions, the person who's going through that particular related posting will ask our lecturers/MOs for clarification. That made things easier as well, we don't have to go and get the answer ourselves haha :p And of course, we got our own notes! That's an achievement I'm proud of because I can never make my own notes alone hahaha.

Blood, sweat and tears.

For our practical sessions, after we've changed the long case sessions to notes discussion, we only did short cases. Since there's 8 of us, so we divide ourselves into 2 groups and change group members fortnightly that means after 2 short cases - medical & surgical based. There'll be 1 person performing the examination, 1 person as an examiner and the other 2 will be the observers. Sepanjang study group tu rasa debar every time turn kita perform short case. Your own friends don't look like a friend anymore when they become the examiners hahahaha. Bayangkan lah, kalau dengan kawan pun dah nervous, apatah lagi masa exam dengan real examiners, ketaq lutut woi hahahahaha.


So we followed that routine up until our study week. Aturan exam haritu ada 2 phase; first phase clinical exam; long case, short case then theory; MEQ, OSCE and finally MCQ. Honestly,

the long case exam is one hell of a ride hahahahaha.

The night before your exam will be a very looooong sleepless night xD Sungguh. Haru biru berkecamuk perasaan masa tu hahaha. So basically sebelum tu ada 1 week break. For that whole 1 week, we had case discussions. Guna buku case scenarios yang cover kuning tu if you know what I mean. Then we go by systems and dapat la cover 3 case in one day. Masa ni mencabar weh. We went to the library everyday. Dari pukul 8 pagi sampai 5 petang camtu. Takde afternoon nap ke apa discussion straight. That was the most we can do everyday sebab banyak sangat benda nak discuss. We go by approach; from history taking up to management. Of course ada yang tak ingat, so masa ni bukak balik nota yang kami buat tu. Thank God for the notes, banyak jimat masa. Kalau ada yang tak clear lagi baru check buku.

A short video of how we discuss. However, the topic was kinda... haha. But yeah macam ni lah discussion tersebut hehe.

Long case ni 2 hari. Mine was on the second day as usual sebab ikut namelist. Another good thing about our group besar ni is that memang elok je bahagi 4 orang first day and 4 orang second day. So yang tinggal untuk second day were kak Ida, Syafika and Nisah. Apart from the library, we also had our discussions at surau Nurani at night/when the library is closed. Macam rumah dah surau tu, ada meja study, tong biskut, teddy bear, bantal semualah hahaha. So masa first day long case tu, Syafika, Nisah and me continued our revision; we didn't get to cover psychiatry during the previous discussion so Alhamdulillah sebab dapat second day so sempatlah cover haha. Tapi hari tak semestinya panas sampai ke petang ok. When the 4 members came back, they were so happy Alhamdulillah sebab dapat case yang tau tapi ada jugak yang haru *ehemsiapatuehagaknyaehem* hahaha. Masa Elly, Anis and Dian cerita how their exam went, masa tu Dinie, Laili pun ada sekali join dengar, some of us broke down sebab takut because the next day is our turn! I remember that one of them was me hahahaha yes I cried because I was super scared. Knowing that they went through theirs and now felt so relieved, I got scared because I don't know what's going to happened the day after. My first long case exam was during my Pro 2 which I've failed miserably. That was a nightmare k hahaha.

Masa ni boleh senyum lagi sebab belum exam hahahaha.

Okay, long case exam macam ni. Ada 2 parts; first 1/2 hour with the patient and the next 1/2 hour with the examiners. Dia ada 10 stations, 5 medical (2 medical, 2 paeds, 1 psychiatry) and 5 surgical (2 general surgery, 2 O&G, 1 ortho) base. So sebelum start tu, kita akan cabut undi untuk dapat station mana. Kita akan dapat nombor pastu nanti usher akan datang and bawa candidate dari ruang menunggu tu ke station (where our patient will be at). I got station 1 pastu masa first day Elly dapat station 1 jugak and she got a medical case. So I quickly run through what kind of cases yang common kan sebab masa tu still ada some time before the exam starts. Sekali Prof S from Paeds datang and tanya, "siapa Nur Shahiela Chao & xxx?). Masa tu I macam eh biar betul nama I, bukan case medical ke asal Prof S panggil pulak ni, then slowly I angkat tangan. Sambil senyum, dia cakap, "Nanti awak berdua ikut Dr. XX eh. Good luck!" and she went away. Masa tu I macam,

WHATTTTTTTTTTTT THIS CAN'T BE REAL, BIAR BETULLLLLLL T______T

And yes, memang betul pun. Sila gelakkan diri ini sebab memang berjodoh je dengan paeds tau ha ha ha. Masa tu nampak pulak lecturer paeds lain yang very particular and strict and kalau tanya soalan dia macam specific nak 5 ke 10 jawapan and dia akan tunggu sampai kita dapat jawab baru move on. Wehhhhh not todayyy T_T Hari sebelumnya tu, Anis Elly Dian kata examiners semua yang baik-baik, jenis bagi kita bertenang baru jawab etc. And semua yang garang datang on the second day?! Ingat tak tadi I cakap panas tak sampai ke petang? INILAH HUJAN DI TENGAHARI TUH. Sebelum tu lagi banyak dah nampak lecturer yang garang & strict datang kat tempat exam tu tapi sekarang dah dapat case Paeds pun tak boleh bertenang T______T I tried calming myself down, slowly trying to remember the basics in paeds. Management of asthma... Masa tu dah kelam kabut celaru habis ubat asthma red yellow green weh wuwuwuwu. The only thing I could say to myself was,

Just do your best pastu tawakal. Dah usaha dah pun, bukannya tak study. Don't ruin the chance you're given by panicking and screwing everything. It's just 30 minutes with the examiners. Examiner pun manusia jugak, ada belas kasihan (ayat pujuk diri sendiri T_T)  Anggap je ni clinical teaching. Tau jawab ke tak tau jawab ke kena marah ke apa 30 minit je kena hadap. Then you're done. Have fun.

Betul, aku pesan kat diri sendiri have fun walaupun I know that's not the best advice I could give at that moment hahahaha. Boleh tahan tenang jugak la lepas tu. Then bila sampai station, I saw my patient, he's around secondary school age. Masa tu mula balik fikir, apa common cases yang libatkan paeds of an older age group? TAK TERFIKIR PAPE. He's got no attachments and doesn't look sick. I was guessing that he's an outpatient. Lagipun dia tak pakai baju ward. Once the bell rang, I greeted him and his mother. Tanya la apa khabar, datang harini sebab apa then his mother told that he came to participate in the exam je, tak sakit apa pun. So what I guessed was right. Okay. Then I asked if he has any underlying medical condition? And his mom answered,

Oh ada. Dia ada kencing manis.

You know what I felt at that time? I wish I could stop the time and scream and just sit in the corner of the room and reflect on what have I done in my life T_________T Ingat hujan di tengahari tadi tu hujan rintik-rintik je? No bro, hujan lebat kilat sabung-menyabung semua siap. We did a note for diabetes mellitus (DM) under paeds posting, thanks to Anis (nota sikit punya cantik ok *nangis dalam penyesalan*) but I skip that note because I thought macam jarang nampak kat ward patient paeds yang ada DM. SO GUYS, JUST STUDY SEMUA. SEMUAAAAA. Jangan ada anggapan macam I sebab look what happened. Paling tak boleh blah sebab nota tu banyak kali macam terkeluar bila I revise topics paeds -_- Ambil pengajaran daripada kisah ni adik-adik, jangan ambil mudah. Oh lagi satu, case DM in paeds biasanya jumpa kat klinik so again guys, do not skip clinic sessions (I didn't skip the sessions but I didn't go to paeds endocrine clinic T_T) I just did my best then, clerk je lah style adult punya. Masa buat PE pulak, findings semua normal, I pun tak tau nak buat macam mana sebab for DM patients, full PE memang banyak kena tengok. Dah nak habis masa tu, I pun tawakal je. Present je apa yang ada.


Alhamdulillah, habis awal sikit so ada la masa 10 minit untuk susun history apa yang patut, pastikan tak gagap etc. Masa ni usher (MO paeds) datang tanya dah siap ke, masa tinggal lagi 10 minit. He was super nice. Masa tu nampak kot macam serabut je hahaha he told me to just calm down and present whatever I have and not to panic. Then bila habis masa, Dr. H (usher jugak) came and said time's up and I have to go to the examiner's room. Sebab I tau Dr H sebelum ni, I ask if I can know who my examiners are and she told me straight away. They were Prof S. and Prof Z. Hujan lebat kilat sabung-menyabung tadi terus berhenti, nampaklah pelangi sikit *kesat air mata penyesalan tadi* :') Alhamdulillah. I was so so so relieved. Although belum exam lagi, even 1 markah pun takde lagi tapi at least that made me calm. Both lecturers were nice. Fast forward, I finish presenting, didn't get to answer a few questions, stumbled on a few points I've presented but I'm done! Masa bunyi loceng tu, Prof S said, "nasib baik dah bunyi loceng, kalau tak saya nak tanya lagi ni." I just smiled sheepishly and leave the room hahahaha.


So that was long case. Phew panjang kan cerita long case je tu haha. Ni nak sambung pasal short case pulak. So for short case pulak, we have to do 3 short cases. Since long case I dapat medical base, so short case dapat surgical base la. 1 ortho, 1 O&G and 1 general surgery. Many people said it's better to get surgical base for short case because the findings are clear cut. I agree with that BUT PE for surgical banyakkkkk sangattttt unlike medical. Medical has lesser PE but findings are harder to get and interpret. So, dua-dua sama je susah dia :') Alhamdulillah lagi sekali, us 8 were divided equally jugak untuk medical and surgical ni. So sekarang geng surgery terdiri daripada Nisah, Elly, Dian and I. To be honest, short case ni lagi menakutkan sebab banyak PE satu and banyak yang tak pernah perform on real patients. O&G okay lah sebab ada abdominal examination je, cuma nak dapat the correct diagnosis tu kena hati-hati sikit sebab kalau tak dapat finding, salahlah diagnosis. But ortho and general surgery... banyak sangat PE under 2 postings ni. Mana taknya, logbook posting surgery pun tebal bukan main lagi, semua short case je. Macam-macam ada. Ortho pulak, kalau salah technique, tak dapat finding or tak boleh appreciate finding, habislah stuck. Begitulah.


Oh lepas tu, short case ni giliran dia diterbalikkan. Siapa yang long case first day, short case sesi petang and long case second day, short case sesi pagi. So dalam extra masa untuk prepare long case, masa untuk short case pulak pendek. Basically, I have only the remaining hours after my long case until Subuh esoknya. Lebih kurang macam tu lah hahaha. Less than 24 hours senang cerita. Gila tak gila, exam tetap exam haha. And me, of course lah banyak tak tau. Masa tu otak memang macam span. We started as early as we could after our long case exam (faham tak nak bersedih ke nak reflect balik apa jadi masa long case tu pun tak sempat), we aim to go through semua PE yang wujud especially yang tak pernah perform irl (read: sebelum ni nampak tajuk je skip #padanmuka). By around 9 PM that day, me and Nisah dah penat. Pulun long case tak hilang penat lagi, kena drill untuk short case pulak. Masa ni, I berhutang budi sangat dengan Dian & Elly sebab dorang suruh kami tidur dulu and later bangun balik while they continue revising and tengok video on PEs that we don't know. Around 2am lebih kurang, we gathered again at the surau, Elly and Dian were there waiting and taught us straight away. Sampai pukul 4 ke 5AM camtu, they were already exhausted, so they went to sleep while Nisah and I sambung sikit lagi. Masa ni kan kitorang dua orang amik short naps in between sebab kejap-kejap battery habis, otak tak boleh function T___T Sungguh, masa exam ni lah baru betul-betul belajar banyak. PE macam untuk varicose veins, hernia, stoma (ni sebenarnya kat ward banyak je tapi tak pernah betul-betul examine) baru tau nak examine properly. #thatswhyyouneedexams #reflectionoftheday


Fast forward to the exam, my first case was from ortho. Foot drop. I stammer A LOT. Even perkataan scar pun tak boleh keluar masa tu, just imagine -_- Prof A was actually nice, I had my short case exam masa 5th year ortho posting with him jugak. Dia macam jenis yang chill je tapi I macam kabut sangat hahaha. Biasalah first station. Second station was from O&G. A case of twins. Ni dapat external examiner, garang and strict. Nervous yang baru nak kurang tadi, nervous balik hahaha. Masa ni macam haih entah la apa jadi 2 station ni. Short case pun tak boleh confident pass ke ni. Takpelah, satu je lagi dah nak habis exam. So for general surgery, dapat examination of stoma. First of all, my examiners were Dr. R who was my surgery posting supervisor (very niceeeee) and Prof. I who I've been admiring since he gave us a lecture during 3rd year xD So examiner factor settle. Oh and ada sorang MO join sekali, segan la jugak but haih takpelah. When I greet the patient, he was superrrrr friendly and bagi like 200% cooperation. Patient factor pun settle. Now, all that's left is me. I started slow jugak awal-awal tu and then the examiners were like, "okay good. Alright, good. Yes, good". Weh masa ni confidence level boost up jadi confident sungguh weh, suara steady je kuat, flow pun lancar je, takde sekat-sekat lupa steps ke apa, findings semua dapat. Then offer untuk buka stoma bag for inspection pun tak takut. At that particular moment, I rasa itu moment I paling confident selama hidup 24 tahun ni hahahaha. I glanced to my examiners once in a while as I present, they were smiling ok, they were genuinely smiling *nangis kegembiraan*. Masa ni lagi lah semangat. Tapi slacking satu je part last, Dr tanya what kind of problem this patient with that age would probably have, I tak tau :( Teka banyak tapi takde yang kena LOL. Actually ada terfikir satu disease tapi sebab I was not familiar with it, so I tak sebut la sebab takut jawapan menyimpang jauh pulak and it turns out to be the RIGHT answer -_- After that, Dr. R said that I did well and he was happy to be my examiner while Prof I smiled and said good job. Dr. R ni kalau dia happy memang nampak macam happy and cheerful punya type tu haa faham tak. Prof I cakap good job pun dah rasa macam oh my God, heart are you okay jangan cair sekarang hahahaha ok just joking xD After both of them left, jumpa MO yang join tadi tu and he said that I was good and the examiners were happy. Lagilahhhhh rasa macam nak skipping sambil menyanyi keluar daripada exam place tu tau tak hahahaha. I was extremely relieved, happy and thankful masa tu. Alhamdulillah for such a good ending despite of a rough starting haha.

Ada je study foot drop ni haa tapi still tak perform jugak -_- Ni nota Hana Maisarah hehe

Okay habis cerita pasal short case dalam satu perenggan yang panjang bahaha. I think this post has to be continued in another post kot. Post ni panjang sangat pulak. So till next time, bye!