3rd year. First posting : O&G

Assalammualaikum wbt

Dah lama tak update belog ni gara-gara busy yang melanda. heh. Alasan.

Nak tulis sikit perkongsian pengalaman sepanjang 3rd year ukm. Aku akan cerita sikit la pasal postings, pasal exam, dan pengalaman yang sangat berharga yang kitorang satu batch dapat rasa. Apa yang kitorang buat, macam mana kitorang overcome certain situations yang tak memihak kepada kami.

Postings 3rd year ukm ada 4 which are Surgery, Obstetric and Gynaecology (O&G), Internal Medicine and Public Health. 2 postings run in one semester.

So here, aku start cerita dengan O&G dulu kot..

my first 3 labours that I conducted. (halfway..haha)

Rambut serabai sebab stay after class and stay at labour room.

My first semester for 3rd year I started with O&G. Dalam syllabus ukm for ong ni antara yang paling busy kalau tengok log book dia. Ya Allah, menangis weyh nak isi. (tipu, aku tak nangis pun). Basically dalam log book tu kau kena conduct 5 deliveries. Yang mana for delivery baby ni aku tak pernah conduct full labour lah 5 ni. Mostly assist. Pernah conduct sampai keluar kepala masa rotation of baby head tu, then masa nak tarik badan dengan umbilical cord tu mostly aku agak cuak sikit sebab badan baby tu sangatlah licin. Kang tak pepasal gelabah time tu  jatuh anak orang, habis aku..Huhu. So, aku conduct halfway la untuk 5 tu. Tapi pengalaman paling best dalam o&g ni adalah azankan/iqamatkan baby. Ya Allah, meremang bulu roma nak qamatkan or azankan anak orang. Biasanya aku amik peluang ni kalau ayah dia tak masuk dalam labour room or mak dia suruh, or nurse suruh. Or aku tanya sendiri doktor, boleh tak kalau nak azankan? hehe. Tak sabar nak ada anak sendiri LETTEW. errr (pandang kiri kanan, garu kepala)

ong best jugak sebab ada baby-baby comel.

Baby miscarrage, die in utero, and macam2 yang buat korang tak tido 

malam pun ada. Rezeki masing-masing. Moga adik-adik ni membesar dgan baik. Aminn.

Lain-lain tu biasalah, perform episiotomy surture (if you are confident enough). Biasanya nurse tu bagi la kau try satu ke dua surture, lepas tu lain2 midwife tu sambung or MO yg buat. aku buat tak? mestilah buat..dekat model workshop je. haha. Tak berani weyh! kalau nak try surture, boleh je pergi jahit light cases of trauma dekat ER. Try la kebolehan kau. Haaa..yang ni ok la.. Berani? Lepas tu insertion canulla, blood taking, catheter insertion, vaginal exam, speculum. Ni semua kau kena buat la. Part of benda2 yg you have to practise macam abdominal examination dengan basic overall physical examination. Ok la kot? huhu

my first and very bad try of episiotomy surture. haha..Buruk gila!

Pagi before round biasanya aku datang awal clerk cases (lantakla kau nak cakap poyo ke apa, tapi serious aku buat..ahha), Then ikut ward round aku akan dengar management from specialist. Lain2 punya discussion aku malas sngat nak amik port. Then hafal cases yang ada dalam ward untuk that day. Depends la aku ikut obs or gynae. Tapi sedih la sebab gynae tak banyak cases dekat Hospital Kulim. :( Then lepas tu biasanya akan ada bedsite teaching. Sorang clerk, present, buat physical examination depan specialist, then present your findings. Specialist akan betulkan kau punya findings sikit-sikit, comment on the way u examine patient, tanya korang investigations, then management. Itu yang diorang buat masa bedsite. Kalau hari masuk OT, korang boleh la join. Cases yang menarik nak join OT for O&G dekat kulim ni macam fibroid, twins, emergency on cord prolapse. Lain2 macam molar tu apa semua malas la nak tengok. Lagipun observe je. Nothing much you can do in the operation theatre. (as a medical student).

Kalau hari clinic, join clinic. Clinic o&g agak boring la sebab case ulang-ulang dengan agak basic. Tapi basic ni la kalau kau tak tahu terkial-kial nak jawab dengan specialist. Tapi best la sebab nurse-nurse dia baik. Bila tolong diorang, siap kupaskan aku mangga lagi. Makan-makan. Kalau ada makanan free meeting boleh la tibai join sekaki dengan makcik2 nurse tu..hehe

Then tengah hari ada lecture. (masa yang paling mengantuk gila). Selalu jugak aku kena marah tido time lecturer ajar. Muahaha. *tapi lepas tu baca balik la weh. Kalau tak de lecturer biasanya akan lepak dalam library or any room that you can read your books or notes. Petang kalau ada consultant yang free, kalau untung ada la class. Kalau kau bosan baca buku, masuk la labour room. Study dengan HO ke, MO ke. Tolong amik darah ke, hantar ABG kat lab ke..Then after maghrib or isya, biasanya kitorang ada rotation sesama kitorang untuk pergi labour room (so, tak de lah crowded dalam labour room tu). Seminggu 2 kali (if you willing to come on weekend) or sekali. Balik dari labour room study pulak benda yang MO tanya. Sebab esok kau nak present dekat diorang pulak. Huhu. Memang penat lah!

while waiting for labours, study dekat labour room.

For examinations. We got short case (clinical OSCE), long case, continuous assessment (1 short case report, 1 long case report, 1 normal ctg report, and 1 abnormal ctg report..hamik kau!), theory and written OSCE. Yang mana, kalau korang fail any one of this compartment, korang akan consider fail terus. Tak kesahlah theory korang power gila nak mati ke apa, kalau korang fail clinical osce, and tak boleh backup with your written osce, consider fail postings. Menyesal tak amik medic?

For short case, lecturer from UKM akan dtg and asses kitorang dekat sini. Patient from kulim hospital. During my short case, I got uterus smaller than date. A patient with  big midline scar on her abdomen. The diagnosis was preterm prelabour rupture of membrane (PPROM). Luckily i got my diagnosis right and perform-boleh-la-kot? With slight hyperthyroidism sign that shown by my hand (ketuk tangan!)

Muka happy sebab lecturer ukm baik hati bagi aku pass short case.

(walaupun rasa buat macam teruk gila)

For long case exam, I got a patient with stable stage 3-4 placenta praevia. And management of bleeding placenta praevia. Ok lah kot.

For theory paper, all paper come from ukm. Susah jugakla soalan dia. huhu.. we got one best answer (OBA), multiple choice question (MCQ) and key featured questions (KFQ). Kalau fail any one of this compartment, considered you fail this posting. Contoh, your OBA is less then half, but others ok..So, fail lah (even you pass your short case)..kejam tak?? huhu..Mostly diorang cakap KFQ paling susah. Entahlah. Depends. Diagnosis masa tu PPROM, cervical cancer, diverticulitis kot, ke miscarrage entah?. Entahlah. Lupa. Dah lama la postings. Haih..kena ketuk ni kepala sikit..

Written osce we got a CTG, diverticulitis, Mc Robert position, rotation of baby head, cervical ca, stages of labour. then ada PPD station. Hurm..

Basically obs and gynae considered as ok la. Tak susah sangat. Best jugak posting obs gynae. Tapi dekat malaysia ni susah sikit kot lelaki nak jadi specialist o&g.

Nanti bila aku rajin aku tulis pasal surgery pulak.