Berbeza Realiti

Assalamualaikum W.B.T

Well, it's been quite long since my last post. Sesungguhnya there were so many things occurred since my last presence in this blog.

One of the biggest changes is that, I am no longer studying in Egypt. Due to some circumstances, I choose to continue medicine in Malaysia. It was not an easy decision. Stress tau dak nak buat pilihan! Masa nak isi borang stress, masa dah dapat keputusan masuk mana pun stress, bila dah masuk universiti baru pun stress, bila dah start blajar pun stress.

But one of the main reason I chose to stay in Malaysia is because of my istikharah. Istikharah is really powerful you know... Allah bagi ketenangan walaupun kita tahu benda ni bukan benda senang. Ingat jadi transfer credit student ni senang ke? Nak adapt dengan new friends, new lecturers, new surrounding, new systems.. Awal-awal ada yang dah psiko suruh balik Egypt smula. Trust me, it's not easy. Seriously not!!

However, Allah je ada kuasa bagi ketenangan dan kekuatan kat diri ni. That's why I always remind myself, to be happy and contented with istikharah. Berbahagia dengan istikharah. Beriman dengan ayat Allah bahawa setiap kesusahan ada kesenangan.

So, it's been like a month and half I'm here. Kehidupan sebagai student medic di Mesir dan Malaysia memang berbeza.

Here in Malaysia, basically no more spoon feeding. Not everything will be thought, mentioned by the lecturer. Lecturer will only give you sparks, but the one who should lit up the candle is you.

So to my friends who are studying in Egypt, don't worry. Rasanya lah based on my observation and theory, you guys tak payah risau sangatlah dengan clinical skills macam taking bp, buat venupuncture, buat physical examination. Clinical skills macam tu memang boleh acquire. I tried venupuncture few times, tapi failed. So takpelah, praktis lagi. Nanti kalau ada free time rajin2 la pergi attachment kalau you guys nak acquire clinical skills. Banyak lagi procedure kena tahu and buat. Bila dah jadi HO memang kerja amik darah je tiap2 hari...

You guys just kena RAJIN practice and have CONFIDENCE. Make sure tahu theory dia and then try to practice it. But there are few things yang make me concern la. These are few things that I want to point out:

1. Take proper history
Rasanya semua makruf je kan. History is the basic of diagnosis. Based on history, memang banyak la clue to make a diagnosis. Kalau boleh for every chief complaint, try to explain it more using SOCRATES method. I know kat Egypt, ada language barrier kan? But please try to clerk them jugak.

Takpelah kalau tak faham satu habuk mak cik pak cik tu cakap apa, but you have to train your brain to ask proper and related question regarding chief complaint. For example if patient complained having dyspnea, so what other related symptoms that you should ask to help you reach diagnosis or to exclude unrelated system? Train your brain to work, not memorizing the questions.

Kalau history cantik, diagnosis pun cantik.

2. Try to present cases
Lepas dah clerk (taking history) from patient, haa rajin-rajin la present cases. Ingat present cases ni saje-saje suka?
Bila patient first masuk hospital, orang pertama yang kena clerk and do all physical examination adalah HO. Lepas tu HO present case kat MO then to specialist. During ward round with specialist, specialist biasanya mana ada masa nak review case lama-lama. So kita kena pandai guide MO and specialist towards our diagnosis. Kalau tak kena cara present haa kena lah "why don't you mention this to me at the first place!" or sometimes they will say, "I don't have much time, just tell me what is important." Haa jangan gagap ye. Kesian patient nanti tak dapat proper review from specialist.

3. Try to synchronize your theory with your clinical findings.
Kalau boleh jangan lah hafal buku. Try to understand then apply it.

4. Rajin pergi ward round.
Hmm since aku pun tak penah pergi ward round kat Egypt, so I'm not sure macam mana procedurenya... But, kalau boleh pergi la ward round. Haa kalau pergi ward round tu, jangan la just tengok patient je. "Oooh patient CKD macam ni, patient CCF macam ni." Try la buat PE. Kalau tak dapat consent buat PE, haa learn to observe. Observe patient ni under nasal prong or neb, given TPN ke, given Normal Saline ke, Keep NBM ke. Lepas observe tu, jangan balik rumah minum susu pastu tidor. Try lah cari dia punya indication, contraindication. Bak kata one of my lecturer, "Everything in the wards is for you to learn."Tengok la sekali lab result, cxr, kub xray anything that available...

Same case with tengok procedure or surgery. That is not the time for you to take picture then post it at FB or instagram. Tahu, excited kan? But before you join any procedure, check la dulu latar belakang patient, his presenting illness, indication of procedure, complication bla bla bla.. At least you gain something.

5. Respect your lecturer!
Tahu kekadang ngantuk lah, boring la dalam kelas. Tapi bertahanlah... Appreciate their knowledge :) Not everything you can learn from the book.

6. Belajar manage patient
For every diagnosis, tahu the general management, investigation yang kena buat. FBC, RP, LFT, ESR.. Pastu belajar interpret result. Urea high, creatinine high but it was not proportionate.. So what is possible causes?

That's all I wanted to share. Aku pun tak pandai lagi. Banyak lagi nak belajar. Jadi sama-sama doakan...

Alright. I'm sleepy. Good night people.

For those who miss me (ada ke haha!), I'm surviving, contented and enjoying my new life :)

Kasr Al Ainy and UIA