Finally, final year is over… lots of ups and plenty of downs… seriously… a year of full of excitements, surprises, shocks, disappointments, relieves, etc… glad that, it’s all over… and now I can stop worrying about undergraduate… start to think about postgraduate examinations… I have finally earned the title I always wanted after 5 and a half years of study but currently still uncomfortable using it… hope things will get better when I become more competent. From June 2007 till June 2008, I shall summarise the experience here and hope it will stay in my memories… 17 Mini CEXs!!!
It all started with Medicine in Practice 3 (MIP3) with its main objective to get our rusty and nearly rotting brain back to real clinical world. Again, we are the first guinea pigs batch to have this new curriculum installed. Overall, it went well… seriously, I don’t know about the others, it really did help me kick my ass and make my turtle-speed and tiny neurons to fire a tiny mini little voltage of impulse to my brain as a first warning signal… Wearing the blue badge with ‘Final Year Medical Student’ engraved on it for the first time really fascinate me but it did not last very long because I really felt I am worse than a first year. What they expect from a Final Year Medical Students are really not basic… all consultants expect you to be as competent as their registrar… this was seriously terrifying…Furthermore, not knowing what a ‘fag’ was really shocked me; 2 years in Southampton and I have never came across this slang raise the concern of my GP on me… ‘NOT ANOTHER LANGUAGE PROBLEM AGAIN??!?!?!?!’ (I have got this a lot ever since the first day I came to this unfamiliar land L… Yes, my English might not be up to the so called good standard…but I have tried to improve, have I not??) On the other hand, Travelling to Winchester Royal Hampshire Hospital everyday did brought a little income to my constantly running low bank accounts. J (yes, I can still smile because at this stage I am not worried and was still naïve about the cruel, bloody and tearful world of MINI CEXs as we were not required to do any during MIP3)
Thanks to the 2 weeks short breaks after MIP3, the ‘real’ life as a final year medical student (FYMS) officially started… and I was lucky enough (is it?) to start in a place called Chichester… small town 40 minutes away, east of Southampton… My first time living as a nomad… in a strange place called St. Richard’s Hospital. (Info: St. Richard is one of the Catholic Priest from the famous Chichester Cathedral… I think) Starting with my most unfamiliar rotation: Obstetric and Gynaecology for 4 weeks. I was too lucky to be with Mr. Hooker, a magnificent teacher who was very dedicated and allowed me to brush up on my knowledge and skills. Thanks to him, I developed a slight interest in O&G. First week was mostly getting general thoughts of O&G. With the commencement of 2nd week… the rush of adrenaline and fears start to rise when I am supposed to have a Mini CEX with a newly appointed consultant. It was both our first time doing this Mini Cex. Placenta praevia was the case for my very first mini cex. Thank God, everything went on quite smoothly and I got all 4s in all components. Not bad achievement for my first one… Then, here come the 2nd one with a bloody scary consultant, something unexpected: Oophorectomy because of Pre-menstrual syndrome?!?!?!?! How random can that be?!?!?!??! Although I do talk to girls, and I thought I know about PMS, but actually I don’t!!! This was really one of the worst mini cex I ever had. 2 borderline straight !!! with one component which he refused to comment on!!! Sweat just start dripping down… my spine shivered… tears from eyes… this is the panicking moment. One more to go… and I can only afford one more… just one more before needing to repeat the mini cex during final in June 2008. Obesity during pregnancy??!?!?! Even more random… this is the last mini cex for me for Obs and Gynae rotation… luckily, Mr Hooker is so nice and passed me with some 5s. Thanks to him, I earned my first 5 for mini cex… There I ended my obs and gynae attachment, observing a few deliveries, assisted a few, seeing a newborn baby needing emergency resuscitation etc…
The next rotation was Paediatrics for another 4 weeks in the same hospital. Prof. Candy was another lovely consultant. Paediatrics rotation was… I would say… a bit too quiet (3 patients in the whole ward some days). The only exciting thing I can think of is the 31 week born baby in the SCBU which has managed to grow up bits by bits every week. That’s amazing… Mini CEX were uneventful: pneumonia, epilepsy and gastroenteritis. The last assessment just blew us away… fluid balance in paediatrics (seriously, Jill and I was like Huh!?) it is something very important because as houseman, the only thing we do most of the time is fluid prescribing... and I also got my first and only ‘A’ for overall attachment performance. Yipee!! J
Goodbye Chichester and Hello to Bournemouth!!! The land of beaches and bikinis… but it was winter when I was there… so no… there’s nothing to see… It was really a very touristy place with many hotels and nice beaches around. The hospital, I have to say is quite nice… not too big… not too small… with everything inside… except that the biochemical laboratory here do not offer CRP check… which is ridiculous… anyway that’s the technical bits… I was there with wai mun, Jennifer and aida!!! So Bournemouth experience was great… I was in the Cardiology team the 4+4 weeks of my medicine rotation. It was stressful and exciting and I was grilled a lot on Cardiology… which make my knowledge on other specialties such as gastroenterology, respiratory and elderly care a bit toooooo lacking… As some of you should know, I always have some special interest in cardiology, but it’s just too competitive… but well… just as I thought I will be very equipped with knowledge of cardiology and be able to read all sorts of ECGs after the posting, to my despair, unfortunately, it wasn’t the case… I am still not very good with Cardiology… L But thanks to my consultant who is well known to be very strict to his student, I worked like mad and even on weekends. Lots of interesting cases like Marfan Syndrome, HOCM and IVDU with acute limb ischaemia. Joyful time spent with friends there and taking stupid photos around Bournemouth… looking for McDonald in the middle of the night… Oh ya… mini CEXs: Myocardial infarction with valve replacement history, myocardial infarction with history of pericarditis and the craziest of all acute transverse myelitis??!?!?!?!?
How can I not mention about IPL in between my medicine posting… IPL stands for Inter-professional Learning. University of Southampton’s unique curriculum with great objectives, which is to achieve collaboration in between different professionals to create a more effective health care system. However, the method of carrying out this curriculum had proved to be imperfect and create lots of doubts and critics among medical students. So far, I have not heard any positive comment on this… especially not favourable by taking away two weeks of our most precious study break before final to fit this in our final year!!! I have to say, it was the first time experience as for us the IMU transferred students. Other than the ‘holidays’ that we have during our IPL time… there’s nothing good about it… and why is it have to be in between our medicine attachment??!? Why can’t it be in between the big blocks of attachment?? The worst thing about this curriculum is… you are not suppose to give bad feedback about them, because if you do so… you would be asked to see the board members of School of Medicine and apologise to them!!! How ridiculous!! Where are student’s opinion rights???!
Then followed by two weeks break to Lisbon and Scotland which I have talked about in my previous post…
SSU in Neurology and Opthalmology in Southampton General Hospital were uneventful and boring… so I shall not talk much about it … besides I attempted a lumbar puncture on a poor guy from the Royal Army… haha… and performed mini surgery like opening up tear duct and chancre excision…
Psychiatry in Southampton was not very memorable either… The first question my consultant asked me when he saw me for the first time was whether I am looking at psychiatry as a career… and I answered him honestly NO WAY!!! Then he set the bar low and let me passed my psychiatry posting :P Mini CEXs with Obsessive Compulsive Disorder, Depression Suicide Risk and Alcohol Dependence which I scored a clean all 4s in all components… well well… not great… but anyway.. can’t ask for more… Glad that psychiatry posting was over quite quickly…
Then here come Surgery with Kathleen and Joanne in Pompey for three days before Easter break!!! ( Easter break was in Windermere.)Finally a Malaysian Chinese Surgeon as our lead consultant… Mr. Toh must be the nicest surgeon I ever met… even sat down and had lunch with us !!! But I was put down to need more readings when I did not know what is a spigelian hernia and boerhaave syndrome :( Mini CEXs were again a dramatic one… Got a 3 from a registrar for me not knowing one point (Anorexia) in Alvarado Scoring System for Appendicitis and not knowing how to define specificity and sensitivity properly. It really sent a cold shiver to my back because knowing of all mini CEXs, everyone know mini CEXs in Surgery in Finals is the toughest to pass with Prof Primrose potentially as one of the examiner… I became a bookworm and drown myself in books… maybe that’s why I start to develop some interest in surgery :P Thanks to Mr Toh who did my second mini CEXs (ascending cholangitis), I got passed it with no borderlines. The last one with Mr. Gibbs was really a close and eventful one!!! Renal transplant Henoche Scholein Purpura… knew nothing about it… serious grilling because I bleeped him because he was 9 minutes late… but seriously, I have never feel so relieve after the mini cex with him…
GP posting, something that I would not expect to have problems in… was however the worst mini cex ever!!! The first mini cex with unknown gastroenteritis was straightforward… the second one was a killer… Septic arthritis!!! I took the normal history proceed on performing physical examination… after being prompted… I checked the temperature and checked the blood pressure… I was being penalised for not react fast enough, not doing the temperature first… BAD SHAPE!!! I nearly wanted to quit medicine after this !!!! Luckily I was given second chance… and this time it was a hypertension case which is straight forward…. This conclude my mini CEX life as a FYMS…. Phewwww… -_-‘’
NO… it’s not over yet… there was still the final exam to come!!! MY GOD!!! 2 weeks study break to cover what we have studied for the past 5 years… it’s just way tooo short!!! Sleep… study…. Sleep… study…. Sleep … study… that’s my routine for that two weeks… I have to attend some revision course in the hospital too in the first week… but surprisingly those two weeks was so fast gone… the day before the first paper… Navin the last king of Ipoh gave me teaching on random topics… one of the topics we talked about was autism… and he gave me an example of a autism kid… trust me… this example cannot be any closer to the real question in the EMQ the next day!!! It’s exactly the same… sometime I really wonder, have Navin actually seen the paper before… the reason why I said that was because, in my intermediate exam, he taught me on multiple sclerosis and endometriosis a few days before the exam, and those are the topics being asked!!!! Sometime, I really wonder… Hmmmmm….
Two days of written paper passed without me realising… (NO WAY!! ) Those were the longest day in my life… Free seating in final is a bit unusual, but who cares… anyway… me and navin and randy decided to sit in the same seat for all 4 papers… and chase people away if our seats were taken… u can say we were over obsessed!! I think we were crazy… hahaha…
OSCE preparation were again taxing… we have nearly 2 weeks in total to prepare for it… talk talk talk talk talk talk talk… hahaha… memorizing phrases and sentences were all I do during that period!!! 16 stations of 5 minutes each was not long … quick and scary… but glad it’s over…
At least it all bears fruit at the end!!! So what’s next?? MRCS?? MRCP?? MRCOG??? MRCCH?? Dorchester here I come!!!
Life goes on …
