..InsPiRasi HuMaiRa..

dalam ketegasanmu terselit kelembutan..dalam kesungguhanmu terselit seribu duka penderitaan..jerit perihmu menuju puncak kegemilangan..kau..syaukah istimewa..dipagari sinar nur islami..

Archive for the month “July, 2011”

How to Gain Benefit during Elective Programme..

from http://hubpages.com/hub/Medical-Student-Electives-How-to-get-the-most-benefit-from-your-Clinical-Rotation

For most medical students the first clinical rotation is always an emotional time. You go to your assigned hospital in the morning and you really don’t know what to expect. Of course you might have some idea about what goes on at the hospital and what you should do, but even with older friends to give you advice you can still find yourself totally unprepared on the first day.

Benefiting fully from your clinical rotations can make a huge difference in your medical education. This is when we finally get a chance to integrate the knowledge from the books with day-to-day patient interactions.

What to expect?

1. Patient interactions

Patients can be scary for a medical student. Your first encounters will probably be clumsy, but that’s OK. That’s how all the great doctors began their careers. Even your most esteemed university professors had embarrassing moments. You may not find the right words to say to the patient, you may be asked a question you have no idea how to answer. Just relax and take it all in, admit to yourself that you are just a medical student who is there to learn. Patients always miss having someone to talk to so try to be that person. Try to really understand what they are going through and they will be kind to you. If you can’t manage to take an accurate history at first, don’t worry! As you gain more experience everything becomes second-nature.

2. Doctor interactions

Depending on where you live in the world, there may be different approaches to clinical medical education, but the idea remains the same: Students will be following a doctor around the hospital. That’s how it usually is. As time passes you will start to have more responsibilities yourself, but first you must see how things are done.

The doctor responsible for the medical students is usually very kind and will gladly help you out if you are really interested in learning something. Try not to be a know-it-all and be open to learning whatever he/she might teach you. He has years of experience in dealing with patients, in administering drugs etc. Ask many questions, there are no stupid ones.

If you are asked a question about something you haven’t got a clue about, never be afraid to say: “I don’t know”. You are there to learn.

3. Preparation

Try to come to your rotations well-prepared. Reading your textbooks in advance really helps you out by making it easier to integrate everything. Reading attentively creates a structure on which you can add various other knowledge. During clinical rotations, doctors don’t really have the time to give you the information in an organized manner. You will be seeing lots of patients, signs, diseases and procedures in a very short time so you should know the theory in order to ask better questions.

Getting the most out of your Clinical Rotation:

1. Be organized

Being organized helps by not keeping your mind busy with less important things. It’s tough to concentrate on what is being explained if you keep thinking about the errands you haven’t yet run. Try making “to-do” lists and stick with them.

In terms of medical knowledge, set goals for yourself, try to figure out what it is you want to know/be able to do by the end of the rotation. This will help you focus your efforts. A bonus to being organized and geared toward your goals is that you’ll seem like you’re actually busy, not just roaming the halls of the hospital getting in everybody’s way 🙂

2. Ask questions

The best memory aid out there is asking questions. Even if you have already read about a topic, there are always details you might of missed. Don’t hesitate to ask whatever it is you don’t understand. Ask as many as you can because people actually enjoy feeling useful and teaching you things!

3. Know your patients

Try to keep a notebook/file with data concerning the patients in the clinic. This doesn’t need to be official, just have some notes written down. This way you will always know who is who and who has what. If you’re not good with remembering names, this will certainly come in handy when you go talk to a patient. Keep notes about personal things as well, not just disease journals. If it is their birthday, do congratulate them! There is nothing worse than being in the hospital for your birthday. Try to understand what they do for a living, know how many kids they have etc.

Everyone will appreciate it if you do this. Doctors and even nurses often don’t have the time to talk to their patients, but you have more time on your hands and less responsibility. Don’t miss out on this wonderful chance to make a difference!

4. Try to assist in practical procedures

Depending on where you study, the clinical rotations can be more or less oriented towards students learning practical procedures. Knowing how to do simple procedures even as a medical student helps you in many ways:

– you lock in theoretical knowledge by actually doing the procedures you read about

– you gain confidence and motivation

– you develop reflexes. In an emergency situation you will not need to think about what to do next. It will come naturally and you won’t screw up.

5. Ask about research

Medicine would not go anywhere without research. Believe it or not, you are the future of humanity. This may sound as a bit of a burden but in fact, you and your colleagues will decide how we will be treated 50-100 years from now.

Always ask the doctors about research programs and how to get involved. You may not do an learn very much at first, but you will become open to new ideas. You will learn how to read a medical text critically to judge its value. You may even be taking your first steps towards discovering a cure for cancer. You never know unless you try.

6. Know the hospital staff

Above I mentioned learning patients’ names. It is equally important (or even more important) to know the names of the staff at the hospital. I’m not just talking about the professors and doctors. Everybody is important in a hospital. Learn the names of the nurses, accountants, janitors. Be a people person because medicine is built around interactions with others. You need everybody just as much as they need you. Be gentle and have common-sense and you will get far. Your new friends will help you along the way.


OBsESsO OBs: Part 1

Salam wbt

Alhamdulillah,hari ini(baca:Selasa,12/7) merupakan hari pertama saya memulakan tugasan elektif OBGYN secara rasmi di Hospital Kasr-El-Ainy Cairo University. Hari pertama,penuh semangat di dada! Hehe

Awal-awal pagi lagi,tepat jam 8 pagi,saya memulakan langkah menuju ke hospital. Singgah di Baghal sebentar,ambil laptop yang siap dibaiki oleh sahabat saya. Terima kasih r*h*an.=)) May Allah bless ur kindness.

After that,meneruskan langkah dengan semangatnya ke hospital.  jam 8.20pagi,saya sampai di perkarangan university. Ramai orang lalu lalang,kenderaan bertambah sesak,semput dada dibuatnya! Saya duduk di bangku hadapan masjid university yang tersergam indah,menunggu ketibaan rakan-rakan yang lain. Sambil menunggu,sempat sembang dengan seorang makcik tua yang datang dari Fayoum,semata-mata untuk pembedahan anaknya yang sakit usus katanya. Timbul perasaan sayu dalam hati,anak berumur 5 tahun,kecik-kecik sudah dibedah..no wonder I cannot be a pediatrician kot!haha

Tak lama kemudian,mak cik tu pergi. Sempat dia mendoakan kejayaan saya.ameen mak cik!Moga Allah jua permudahkan urusan hidup mak cik. Tak lama lepas tu,kawan –kawan saya sampai. Lin,Tise! Amboi,kalian semua pakai skirt labuh hari ni!hehe.macam janji ye sume orang.hehe (erk,apa kes masuk cite ni??)

Kisah Labor Room

Ok.dipendekkan cerita,kami sampai di OT  jam 9.15am. kami terus masuk dan cepat-cepat menukar pakaian scrub. Kelihatannya patient agak ramai hari ini. Ada can la tengok banyak kes hari ni.hehe. (that’s typical med student words!haha)

Usai semuanya,kami melangkah masuk ke admission ward,sempat kenal-kenal dengan nurse –nurse pelatih di situ. Walaupun tak sempat nak sembang,senyum-senyum perkenalan pun dah kira ok kan?hehe. kami masuk bilik pertama. Ada satu kes normal delivery. Saya puji doctor tu,sangat cekap buat kerja. Handsome plak tu.opss! hehe. Jeritan seperti ‘haamut’(i wanna die),mush adra(saya tak sanggup),dan pelbagai lagi versi ‘jeritan’ memang selalu kedengaran di sini. Tak henti-henti sebenarnya.saya fikir,diorang jerit-jerit berjangkit ke apa?huhu. doktor-doktor di sini nampak cool je semuanya,agaknya sudah biasa dengan jeritan-jeritan itu semua. Alah bisa,tegal biasa Kadang-kadang fikir,orang arab kan,dioang sangat tough! So,kita pun kene belajar tough macam diorang juga ye.baru lah leh survive betul2 ms kat mesia nanti kan?..=)

Usai satu kes. Saya menjenguk pula bilik kedua. C-section!menarik! sempat tengok dari awal cara-cara anesthesiologist(pakar bius) buat epidural anesthesia. Seronok! Tambah seronok sebab doctor sangat sporting,walaupun sudah bergelar MO,namun sangat BAIK dan SUDI MENGAJAR satu persatu tadi.(fikir2:kenapa saya caps lock dua perkataan tu ye?hmm) Dan semestinya he’s so funny! Tetiba terfikir,kenapa anesth sumenye cool dan ceria,sepanjang yang saya jumpa la..??

Kes C-section kali ni amat rumit sedikit. Layer ke layer di ‘incise’. Namun semuanya hairan,apasal tak jumpa-jumpa lagi uterus ni? Saya rasa semua orang cuak tadi.saya pun turut sama cuak! Panggil Attending,check punya check,rupa-rupanya ada adhesion between urinary bladder and intestine. I donno how possibly it will be?but this case was complicated. The doctors tried as hard as they can and Alhamdulillah,the baby came out normally,although APGAR score was less than 5 during delivery,but after resus,the baby breathe normally. But seriously,this case took a  long period to operate.

Kes ketiga,saya menjengah pula bilik sebelah,kes C-section juga. Breech delivery,APGAR score 9. Cuma yang complicatednya , urinary bladder perforation happen when they tried to close the abdomen. Consult urologist . saya tidak berpeluang melihat kes ini hingga ke akhirnya kerana saya terlibat dengan resus baby,bersama HO peds.-suction,inject vitamin K IM, bersihkan baby (dengan towel),check neonatal reflex,perform general examination untuk neonate .

pembedahan rumit-C/S complicated with urinary bladder perforation,major concern for genito-urinary fistula

Kes empat,kes di bilik sebelah. Kedengaran jeritan patient yang sangat kuat.kesian sangat kat patient sorang ni. Sayu hati saya melihatkan keadaan nya yang dalam kesakitan. Saya masih ingat jika di Malaysia dulu,saya pernah melihat seorang doctor mengajarkan ayat-ayat suci al-Quran dan berselawat during onset of labor.di sini,nampaknya kurang dipraktikkan amalan itu. Mungkin ada,Cuma saya yang tidak berpeluang melihatnya. Dan saya percaya amalan itu ada dipraktikkan di sini. Alhamdulillah,beberapa kali ‘push’,baby keluar dengan mudah. Cuma,yang tidak sedapnya,placenta keluar dalam keadaan yang tak ‘complete’,still having some pieces retained inside uterus. Rupa plasenta yang keluar seolah-olah darah ketul-ketul,ditambah pula dengan darah yang sememangnya membuak-buak keluar dari vagina. OB memang bloody!! Sapa yang takut darah,cuba lah jadi OB! Hehe. Jahitan dilakukan,seingat saya 5 interrupted sutures dilakukan. Buat saya terfikir-wanita,semasa onset of labor,memang sakit yang amat,2nd stage of labor,sakit meneran,3rd stage,sakit buang plasenta/uri,sakit sebab kene ‘stitch’. Allah,segala-galanya memang sakit throughout labor process. Patut la,sakit kedua selepas mati ialah sakit beranak,dan wanita yang melahirkan anak,gugur dosanya setiap kali melahirkan,dan jikalau dia mati semasa melahirkan,maka syahid la terbaik untuknya.Allahu akbar! Begitu besarnya jerit perih pahit maung susah payah mengandung dan melahirkan anak!! Tapi anak muda zaman sekarang???senang-senang je tengking mak,senang-senang terajang mak!apa nak jadi ?(geram nak kasi budak-budak macam ni tengok sndiri keadaan orang bersalin macam mana,dengan syarat tak takut darah la..kang pengsan lak tengok darah nanti)hehe

keletihan..haha(bujet letih..baru 3 jam standing straight..if 36 hours standing and working non-stop,cmne la rupe ai ye?)hehe

Kes kelima,normal delivery lagi. Alhamdulillah,kedua-dua baby dan ibu selamat. 3rd stage of labor,separation of placenta sangat mudah dan cepat for this patient. Alhamdulillah. Sebenarnya,bagi mana-mana doctor dan OB ataupun mid-wife,3rd stage yang paling mendebarkan kerana jika uri tidak keluar selepas 30 minit,risiko maternal mortality memang tinggi. Sebab tu,biasanya praktis di mana-mana Negara sekarang ni,we inject oxytocin/Pitocin at 2nd stage of labor(usually during delivery of shoulder) to help uterine contraction for easy expulsion of placenta at 3rd stage of labor.

Jam 12 tengahari,kami melangkah pulang ke rumah. Esok pastinya mahu pelajari banyak kes lagi!inshallah.

nak balik dah.bye2.sok dtg lg!=)

Target to fullfill during OB rotation

– observe at least 10 normal/breech/twin delivery, 5 C-sec

-CTG setting, CTG reading

-clerking case-means take thorough history

-abdominal palpation,plotting partogram


ok,stay tuned for tomorrow. Inshallah,hope to get a better spirit for tomorrow!need to study !

nota 1 = miss ma family!

Nota 2= plan for the summer project,hopefully it will be successful

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