Friday, 3 July 2015

O&G Elective posting in HTJ

Assalamualaikum sume,

dgn Dr. Farhana yg byk tunjuk ajar. =)
Alhamdulillah atas segala nikmat yg dikurniakan Allah dan kesempatan bertemu Ramadhan..Salam 17 Ramadhan suda..da nk msk fasa terakhir da xlama lg..momentum kne laju ckt ye..

Alhamdulillah juga sbb da berjaya tamatkan elektif O&G kt Hospital Tuanku Jaafar selama sebulan..ilmu dan pengalaman yg xboleh dilupakan.. pahit manis sume ade..FYI, the O&G healthcare in HTJ is very advanced compared dgn negara lain sebab kt HTJ diabetic moms are induced at 37 weeks when in fact benda tu bru ade dlm NICE guideline. hebat! so, few life lessons utk take note drp doctors in HTJ sepanjang elektif, :

1. Attitude is the most important thing.
Dr. A: why do u wanna become a doctor? (Ssambil bg this article for us to read)
what do you think about this? and why this happened?

One out of five doctors undergoing their housemanship quits annually in Malaysia and some are working as waiters, running pasar malam stalls and even an air stewardess. - 
Among the reasons cited for dropping out include unsuitability for the profession, misconception of a doctor’s life, inability to work long hours and suffering from burnout.
Your intention need to be right in the first place.. and attitude tu kne jg. jgn dok cpt sgt mengadu, complain etc. prepare la wahai diri. =.=

 2. Determination and passionate
Dr. L: Being a doctor means you are not going to have a normal social life and free time like your other friends. Sometimes, when there is too much workload, you may feel like you wanna give up especially during surgical rotation. 
Me: So, how do you survived doc?
Dr. L: Being determined!

3. Mothers first! baby second.
The first MO that I met during my elective posting advised to attend the pass handover meeting everyday at 7.30am. And I was like so surprised! mihi..never thought that it would be that early.

Then after attending it, I realised the importance of that meeting and I learnt so much about management issues and the attitude to deal with it and obviously how to present cases to the HOD. from the antenatal history,labour progress to intra-op and post-delivery with Apgar score, base excess, NICU/SCN admission etc. to sum up case yg common are:

1. Gestational Diabetes Mellitus. ni doc sume akn monitor very closely on the Blood Sugar Profile(BSP), ultrasound scan, nephro tour, dietician and pharmacist.

2. Pre-eclampsia; MgSO4 for cerebral protection and seizure prophylaxis. prohylaxis aspirin kalau high risk.

3. Preterm prelabour rupture of membrane. dilemma arised whether to do expectant managament or deliver baby tp premature? haa.O&G ni mmg byk kne wt decision wisely and always prioritize the mother first. next is the baby.

4. Hyperemesis gravidarum quite common jgk. always trace urine feme and treat with hartman solution.

5. Placenta Praevia; staging and management of delivery. selalunye C-sec.

6. Labour room plak: kne master how to plot partogram, staging of labour-know the primary and seconday labour dysfunction etc. PPH is second leading cause of maternal mortality in Msia after venous thromboembolism. pernah encounter sekali. tp in this 4 weeks elective je, almost every week ade 1/2 case of PPH. plg severe 1.2L.

and the list goes onn...hee..

4. Independence motivates you
Actually ok je wt elektif sorg2. walaupun third week tu da dpt gang, yong jei jeng, classmate from kgv. but ok je. because ble sorg2 u become more curious to learn more.. instead of dgn kwn sbb da in comfort zone. maybe, aku je yg dua2 pn ok. as long as you know what your are going to do, you will be fine.

5. Smile and introduce yourself politely
Most of the time, doc baik2 je nk mengajar sume..especially specialist yg da biasa dgn students mcm Prof. Zain, Dr. Jamal* etc.. ramai sgt nk mention satu2..smoga Allah membalas jasa baik dorg dgn sebaik2 kebaikan ats segala ilmu yg diajar. Amin..

sekian. selamat beribadah kwn2. =)