January 1, 2014

Taking that first step...

I wrote this a while ago for my younger brother who's reading Medicine in Egypt, just as a sneak peak into housemanship- just some tips and tricks working as a junior officer in medical field. This will be posted in 2 or 3 entries since the actual draft is quite long. I hope it'll give a rough overview of what's to come for those who will be joining the medical fraternity soon.

Before that, let me wish you Happy New Year! Let's pray 2014 will be more meaningful & beneficial :)


Before I give the overview, just to let you know that to each houseman his or her own experience; everyone faces different things and there are a lot of factors that need to be considered so what I’m writing is solely based on what I have experienced in my 2-years of housemanship. Be informed that I’m jotting this as someone who initially was doing medicine in Australia for a bit then came home to a local private university to graduate- so I am fortunate enough to be given sneak-peak of how a HO life would be during my clinical years and I do understand the anxiety that overseas grads are facing.

Second of all, I’m also jotting this down from a medical officer point of view; just to give a feedback what are some of the expectation of a ‘functional house officer’. I have no intention of scaring any of you but I’d like to prime you on the current situation of a houseman life so that mentally you are prepared of what to expect when you come home.

After you have graduated, you will have roughly 2 to 3 months before you’ll be called to work. Choose wisely of what you want to do during this time because the coming 2 years (if you’re not being extended in any department) will be... kind of gruelling.

Choosing a hospital

First of all, where you choose your housemanship is important. Factors that you need to consider is distant from home, support system & how well you can adapt to new environment, what you expect to achieve by the end of 2 years and what you expect to experience. For the last 2 points, it basically means that, do you want to go to a district or a tertiary/referral centres? Or do you want to go to hospital with computer-based or using BHT/patient’s file. Generally speaking district hospitals have less patients, limited investigations and no sub-specialty- so basically you will have to learn to do investigations within limited resources and need to refer to hospital with facilities or with subspecialties if you encountered patients that needed to be referred.

For example I was doing my housemanship in Batu Pahat Hospital, a district hospital- quite a busy hospital with common cases. Our radiology department have up to CT-scan machine so studies like MRI, barium studies, MCUG all needed to be referred out. If we receive cases like ICB, intussusceptions, coronary artery diseases, oncology cases, these need to be referred to tertiary centers such as HSAJB, HKL, Selayang, IJN and so forth.

If you choose a tertiary centre, sometimes you probably find yourself managing high-profile or rare cases. Your ward may be very busy but you may learn a lot of things. Some hospitals used computer so you have to familiarize yourself on how to clerk with laptops, how to find results via the computer and so forth; the good thing is you don’t have to run to the lab to fetch the results and you can trace patient’s past record easier.

If you choose to go to Sabah and Sarawak, be prepared to learn new dialects. The advantages of going to West Malaysia, you’ll probably be more skilled in terms of procedures i.e. vacuum delivery, Caesarean-section, appendicectomy etc. Once you are allocated a hospital, you will need to report to the hospital right after the induction week finished, and then to Jabatan Kesihatan Negeri. Usually they will be a few days of hospital orientation after you report duty.

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