4th year : internal medicine osce

Hola gorgeous!

Sebelum kita mulakan sesi hari ini, I would like to invite you readers to take a moment to pause and think reaaaally hard on what can we do to help our Muslim brothers and sisters in Gaza.

Harini akak nak share pasal osce internal med. sempat lagi ni you still have around 1 month kan untuk exam. So, what you should do, during bed side teaching.. Ask the doctor to show you (if you haven't seen) to do PE for

- abdominal

- chest (anterior)

- chest (posterior)

- precordium

and then, like I always tell you, VOLUNTEER to perform PE under your attending's supervision. Then, you keep doing it on your patient. During my exam, all I was asked to do was "Palpate the abdomen". Yes, your exam question COULD be that focused. 

When I was in Basma, my second last day.. Ada seorang doc ni, I forgot his name and he taught us how to do PE for OSCE. Suddenly PE become amaaaaazingly teratur dan not that difficult. So, whenever possible, ask the doctor what examiners are looking for masa PE.

You know, kadang-kadang basic things macam WIPE la...ape la... Ok, to make it even easier, once you know apa point2 penting, you number them. And when you practice on your patient, you just ikut flow yang you dah susun, and voila! You will not be missing a thing. Systematic is key here.

e.g. : Regarding precordium - know where to put you staethoscope, and whether to use bell or diaphragm. Do you have to know how murmur sounds like? NOPE. you wont be losing marks for not being able to diagnose or to recognize a murmur. ingat ye, fourth year is all about APPROACH, taking GOOD history and executing a systematic PE.

reference : Mac Leod's and not to forget what your doctors teach you in rounds.

As for OSCE - it would be good if you know the relevance of the question you asked. sebab it will prevent you from asking soalan merapu during OSCE. And, if you're not so lucky examiner might even ask you about why you ask such question. I regret sangat habit suka pilih case. You know, I go to the nurse station, ok harini nak tengok case unstabl angina, room 7,12,15. I go patient shopping. I'd say you'll benefit better if you don't know what's wrong and stick through one patient until you figure out what's his or her problem.

OK selamat maju jaya for your first OSCE :-)

p.s : inshaAllah kalau sempat untuk paeds akan menyusul

p.p.s : as always, brothers and sisters, you are most welcomed to share your thoughts. :-)

ini bukan iklan produk

Biasa tak bila bukak newsfeed facebook tengok kawan you post "Lose weight now, ask me how!" hehe.

I personally tak percaya in whatsoever product yang ada di pasaran. And I have doubts about their safety actually. TBH, protein shake pun I tak berani minum so I replace it with chocolate milk - the closest substitute to protein shake you could get, but go easy on it sebab gulaaaaaa...

Ok, this year alone, I've tried few things. One that has been tested and proven is Jillian Michael's 30 Day Shred Programme. Mind you I just did the workout with no specific meal plan. My weight did not go down, but I did lost inches!

Then, due to poor planning, I went off track. I was going to do beachbody series, but their system is quite complicated and not as fun as jillian's.

Few months later, I tried Paul Mc Kenna's hypnosis and..hmmm... I believed it worked! Lost 7kgs but the weight comes back fairly quick because lepas raya I have this eat-all-I-can policy... hehe.. also I got lazy to listen to the audio.and I'm back to eating depan PC, which i super duper unhealthy...

Then I read Kevin Zhari's book... Just to get the idea of his method. It was kinda ok la... cuma nak kira-kira, catat-catat ni, paham-paham je la kan... So, I think combination from Mc Kenna's book and Kevin's might work wonders!

Ok, purpose of this post is that...I would like to share with you that I am not on my week 2 doing Jillian Michaels' Ripped in 30. It was difficult, sebab before ni kita buat with support group from US kan... now buat sorang je. So, I teringin nak buat same support group untuk kita-kita aje. ewah..

we'll motivate each other, share knowledge, experience and tips. strictly working out + healthy eating. NO shoercuts allowed! All workout is available for download, and kalau malas download, I am more than happy to welcome you to my house to copy them. After all, winter-winter dan keadaan kurang aman ni, susah kan nak keluar pergi gym or jogging2... SO, please spread the word, if interested bolehlah message I kat facebook!

disclaimer : I belum ada significant loss lagi, I just nak cari kawan je..hehe

dua ratus lima puluh enam : day 54

now, where were we? day 54! kejap je kan dah dekat dua bulan dah... cuti banyak pulak tu in between... hehe.. Alhamdulillah sekarang ni I dah start rotation Anaesthesiology.

memang best ye sebab kalau dah dari kecik cita-cita nak jadi surgeon dapat masuk OT tu rasa macam budak dapat pergi zoo or playground..hehe.. tapi dah duduk dalam OT terus tukar cita-cita? Our day start as early as 8 a.m.. kalau sampai OT around 8.15 usually part anaes dah berlalu pun, so tunggu la untuk next surgery pulak... group I around 9.30 akan start seminar. Lepas seminar boleh balik, and you can also hang around in the OT and see other surgery. Best kannnnn!

First and second day, I was in Gynae, then Urology... Harini I duduk dekat general surgery, so I saw 2 laparoscopic cholecystectomy + hernia repair... tapi hernia tu tak tengok habis sebab I was exhausted berdiri lama... 1st case tu acute cholecystitis, start around 8.15, 9.40 I pergi seminar... 11 am I balik OT tu still tak habis lagi oi! And that team have one patient after another...

First day and second day tak ada drama sangat lagi... Harini baru ada drama sikit, most probably sebab muqim general surgery? And I witnessed consultant anaes yelled at the residence, technician. I pun kena buli dengan consultant tu.. Suruh cakap arab ammi kampung.... The whole OT were laughing at me sebab not only doc tu suruh cakap, siap suruh buat gaya... mommyyyyyyy... worse than kena marah tau perasaan dia!

Tapi takpe la, belajar banyak... I also learnt a lot from technician.. technician laparoscopy and technician anaes. Technician ni bukan tahu mesen je, dengan anatomy semua tau sekali. Siap bagi opinion pulak dekat attending. (?)

Sabar je la, round radio minat radio...round anaes minat anaes.!