Assalamualaikum wbt
Salam Ramadhan Al Mubarak everyone *salam, peluk cium laga pipi*
Alhamdulillah dah 6 hari puasa. Siapa yang dah ponteng puasa boleh la start kira pengurangan duit raya memasing. Dah 6 hari puasa baru nak update blog hehe. Takpe belum seminggu puasa lagi :P
Alhamdulillah, I am getting close to Malaysia yeayy *lompat bintang*. This year 2 minggu puasa kat Jatinangor tunggu result exam. Cuak tak? Cuak la. Tiket dah beli. Kang kalau tak pass mau aku nangis. Nangis ahh sebab mahal kot tiket aku huwarghhh. Balik Malaysia ni aku boleh isytihar bankrup dekat diri sendiri. Ini pun ada lagi seminggu nak puasa kat sini, aku dah plan nak makan maggi untuk buka puasa. Sahur guna air mineral je iskiskisk. Cehh padahal semalam baru buat pau goreng inti kacang merah kakakakaka. Ala tu sebab nak habiskan barang dekat dapur. Kang kalau tak habis takkan nak buang. Membazir kan amalan syaitan.
Exam habis on Friday a week ago with Compre PHOP as our last paper. 3 weeks exam from 16 May - 3 June. Subhanallah rasa terbeban dia. Rasa burden umpama nak jatuh dua-dua belah bahu. Tu baru exam ain. Kau punya dosa yang berat tu kau tak kira huwarghhh.
I dont know why, as the time passed by, exam is getting harder. Eh no. The exam is not getting harder. What we should learn tu yang getting more and more. Makin banyak dan makin susah. The last 2 system was Gastrointestinal (GIS) and Genitourinary (GUS) system. These 2 systems really break me inside and outside. Aku rasa bukan aku sorang je yang rasa macam tu. Semua orang pun sama.
Jadual exam
Aku bila buat jadual ni aku tak nampak benda lain dah. Aku nampak 'Pulang, marilah pulang je' hahahaha. For the first time in 3 years, compre MDE is on the first week of exam days. Compre MDE GIS-GUS was on 20th May masa tu.
Compre MDE tu ialah 200 MCQ questions. Ada soalan dan ada pilihan jawapan dari A-E. Kengkadang A-J. Haaa pilih-pilih jawapan jangan tak pilih. Tak cukup pemadam nak buat dadu? SEbab tu fungsi aku bawak 2-3 pemadam hahaha. Rasa cam senang kan sebab dah ada pilihan jawapan. Tapi korang kena tgk soalan dia. Adakan soalan dia straight to the point atau soalan dia penuh dengan medical terms sampai aku pun pening gak kengkadang. Selalunya dia akan bagi soalan situation. Contohnya macam
' A 23 years old woman ccome to your clinic with chief complaint of not urinating since 2 days ago. She does not experienced any pain on flank region or lower abdomen. She was having bla bla bla bla... From physical appearance she looks .... experienced pain upon palpation on .... Her vital sign is BP.. HR.. Pulse .. Temp.. Her urinalysis exam shows ...... Has family history of ..... (soalan dia panjang sangat sampai 10 lines, ada state semua sign and symptom)... '
Lepas dah bagi situation semua baru dia soalan,
' What is the diagnosis for this patient '
' What is the best management for this patient '
' What is the risk factor of this patient '
' Why she is not urinating '
' What is actually happening to this patient '
' What is the etiology (cause) '
Ini antara soalan straight forward yang dia bagi. Kalau dia taknak straight forward. Dia bagi soalan basic science yang kena la fikir. Kalau pening, tak boleh la fikir haha. Compre ni ok sebab ada pilihan jawapan. So it will narrow down our scope of answer. Tapi masalah yang tak best dia ialah, dia boleh tanya dari macam-macam source. Kalau buku text selalu ada box kecik kan tepi-tepi page tu haaaa kat situlah selalunya soalan dia muncul. Tapi tak bermakna semua soalan dari situ. Ada 200 soalan. Kalau 100 soalan semua style macam yg atas ni tak ke mabuk nak baca haha.
ni selalunya rupa before compre exam. terabur sebab kena guna semua buku nak cari jawapan
Next exam yang paling menakutkan sudah semestinya OSCE which was on 25th May (2nd week). OSCE is a skill's exam. Which require us to master all the skills we learned throuigh out the semester. During the exam, kitorang akan masuk dalam skills lab. Dalam skills lab akan ada lagi 11-13 bilik kecil. So satu round exam tu akan ada satu batch students consist of 12-14 students yang exam serentak. Untuk satu round. Satu round usually ada 12-14 stations. Sem ni ada 15 skills yang kena hafal and master. Hafal la prosedur, try to do it and kena take care of everything dari sterile (bersih) and non sterile (tak bersih) principle sampai la informed consent and greetings to the patient.
Kitorang ada 10 minit for every station. 1 minute untuk baca soalan, and 9 minutes to perform the procedure. So bila nak start exam tu kitorang akan start dengan berdiri depan bilik memasing ikut turutan nama. Pastu nnt buzzer bunyi, means we have 1 minute to read the questions. Contoh question ialah,
' A 24 years old man is brought into emergency room with bleeding after involve in accident. The pulse is bla bla... the BP is bla bla bla... Please identify the ACLS classification (bleeding stage) and perform IV line treatment (masukkan air dlm badan thru vein)... '
K dah baca so you know what to do once you go inside the room. Oh lupa nak cakap for each room ada doctor yang akan jaga to evaluate your skills. So kalau doctor tu rasa kau tak competent, dia fail kan lah kau iskiskisk. But we did have the guideline on what aspect we would be evaluated. So kalau kita follow betul-betul the guideline, should be no problem. K dah baca soalan ehh.
Pastu buzzer bunyi lagi. K now you have 9 minutes to perform whatever the question asked you to do. So masuk dalam terus perform. Takde masa kau nak borak-borak dengan doctor. Ada 9 minutes je. Terus greet patient, explain what you gonna do, prepare equipments and perform. Even takde patient pun, ada mannequin je duduk tegak stare at you. You have to act like it is a real patient. Haaa cakaplah dengan mannequin. Kalau masa IV line masa tu takde mannequin manusia pun. Ada tgn mannequin je haha. Haaa kau buat informed consent dengan tangan tu tau haha. So kau pun buat la segala benda yang kau nak buat tu at the same time kena cakap what you gonna do. Contohnya,
' ok first i identified the ACLS, and then i prepare equipments.... next i will find the vein.. i put on torniquet ..... '
Kena cakap and buat baru markah full. Habis 9 minutes, buzzer bunyi lagi which means kena pergi bilik sebelah and terus baca soalan. Soalan lain eh. Ada 12 station means ada 12 soalan means ada 12 skills you need to perform. Buzzer bunyi tu means your 1 minute has started. If you done earlier, kau boleh la duduk dalam bilik tu sementara tunggu buzzer bunyi.
So repeat the same process sampai la habis round satu skills lab haha. The result will be out on the nex day. Result akan tunjuk whether you pass or fail for each station. Kalau pass semua, alhamdulillah. Kalau ada station tak pass, boleh repeat that station on the next day. Depends berapa banyak tak lepas. Kalau tak lepas satu, so esoknya tu ulang satu station je la. Kalau tak lepas dua, repeat dua.
ni rutin before OSCE. For each equipments, function lain-lain. Nama pun lain.
During OSCE if you salah guna equipments or lupa nama, may lead to fail okay.
Alhamdulillah, i passed all the station masa tu. Aku dah azam nak buat one shot je OSCE kali ni. Dah lama tak dpt one shot ni. Last dpt one shot OSCE masa first year kakaka. Masuk 2nd year semua fail satu station. Kali ni baru dpt one shot balik haha. Aku rasa maybe sebab kali ni punya OSCE more to like hand-thing. Maksudnya banyak kena perform instead of cakap. So i am more to handy person. kalau kena cakap banyak-banyak ni aku lemah sikit haha. So i find this time punya OSCE quit okay sebab banyak hand-things.
OSCE list
1. Administering NG tube
2. History taking and Physical exam Diarrhea
3. Breastfeeding counseling
4. History taking and Physical exam Acute abdomen
5. History taking and Physical exam Jaundice
6. History taking and Physical exam Groin and Lump
7. IV line administration
8. Suprapubic puncture
9. Catheterisation
10. History taking and physical exam Kidney
11. Venereological exam
12. Circumcision
13. Digital Rectal examination
14. Gram staining of urethral discharge
15. Pediatric BP measurement (nak ukur BP budak kecik dengan org dewasa lain tau haha)
Next, exam yang paaaaalingggg scary would be SOOCA. It is very hard tau. It is an oral exam. As you know, throught out the semester, our tutorial would be discussing on a case. This semester ada 14 case. Banyak gilaaaa. Rasa nak pengsan, rasa nak muntah time hafal tu. Bukan setakat nak hafal. Nak faham lagi kang doctor tanya kau boleh la menggagau ain.
SOOCA list
1. Peptic ulcer and Gastroesophageal Reflux Disease (GERD)
2. Acute diarrhea
3. Appendicitis
4. Protein Energy Malnutrition (Marasmus)
5. Colorectal cancer and Hemorrhoid
6. Hepatitis B
7. Cholangitis (Case dengan nama paling panjang dan tongue-twsiter)
8. Acute Post Streptococcal Glomerulonephritis
9. Acute Kidney Injury et causal severe dehydraytion
10. Chronic Kideny Disease et causal Diabetic Kidney Disease
11. Hypertension
12. Renal calculi (case SOOCA guwe)
13. Primary Syphilis
14. Acute Pyelonephritis
Time SOOCA, first kena masuk bilik kuarantin. Lepastu masuk bilik lain untuk prepare flip chart. Flip chart ni ialah kertas mahjong yang kau dah tulis concept map of the case, case review dan juga every Learning Issue. Learning Issue ialah perkara-perkara yang kita explain for that case. Before masuk nak buat flip chart kena pick card. Atas card ada nombor soalan. Dapat card pergi terus dekat meja yang ada nombor yang sama. Atas meja ada soalan. Dalam soalan tu lah case yang kita dapat. Macam biasa dalam soalan tu dia akan bagi all the history taking, physical exam, lab exam, supporting exam dan segalanya. Last sekali dia bagi diagnosis, management and treatment also prognosis. K dah baca semua silalah buat flipchart. 30 minutes untuk buat flipchart.
Apa masalah dekat SOOCA ni? masalahnya ialah dia oral exam. You will be evaluated by 2 doctors inside the exam room. Which means if doctor tu nak tanya pape regarding the case, dia akan tanya on the spot and you have to answer on the spot. Dah la nak jawab on the spot, pastu kalau tak tahu nak buat apa? nangis ahh. Because of that, you have to understand and remember each cases. Ada 14 cases. Sila hafal semua sebab time undi bukannya boleh minta nak case apa haha. Dah la hafal sampai 14, tapi yang nak kena present depan doctor ni 1 je haha. To understand each case tu pun susah sebenarnya. Apatah lagi nak hafal all 14. Aku hafal dari case 1 sampai 14. Sampai case 14 bila nak ulang balik case 1 dah lupa. Kau rasa patut tak aku flip segala benda yang ada keliling aku. Kadang tu belum sampai case 14, sampai case 4 dah lupa case 1 lol.
It is hard. Very hard a tell you. Bila nak faham case tu you have to go very deep. What cause each symptom in the patient. Kalau patient demam, kenapa dia demam? Sebab inflammatory mediators. What mediators? Mediator ada banyak kay. Banyak sangat. Kay demam sebab ada pyrogens. What cause pyrogend to be secreted out? How the mechanisms and bla bla bla. Kalau patient ada pain, what cause pain? Nerve? what nerve? Inflammation? What cause inflammation? kalau ada itchy? what cause itchy? Histamine. What cause histamine to be secreted out?
Thats literally 1/100 that you shoould. Belum part management lagi. Belum part treatment and drugs. There's a lot and lot more to understand, to know and to read. Siapa yang kata medic tu just baca je memang aku rasa nak tendang. Dulu time sekolah study Biology boleh lah setakat nak baca dik oi. Sekarang ni kalau aku baca je tak jadi apa la.
Bila present depan doctor, ada 20 minutes nak present. Within 20 minutes tu doctor boleh tanya macam-macam. When is said macam-macam, it means soalan yang kau tak pernah dengar pun ada. Sebab apa? Sebab usually doctor yang evaluate kau tu ialah specialist on that area. Let say dapat case Heart Failure, doctor yang tunggu dalam bilik tu ialah cardiologist. Nice isn't it? Let say dapat case Cardiac Arrythmia, doctor yang tunggu dalam bilik, tunggu kita present tu ialah cardiologist yang ajar Electrocardiogram (ECG). Dapat case Uretelolithiasis (batu dalam slauran kencing) macam aku masa tu, doctor yang tunggu and evaluate aku masa tu dan tentunya Urologist haha. Thats why diorg akan tanya banyak sangat soalan. Kalau diorang nak tanya la. Sebab diorang lagi banyak experience and knowledge. So you can grab this chance untuk tanya macam-macam kat dia sebenarnya haha. Tapi depends gak kalau doctor baik, dia cool je. Kalau dapat doctor garang alamatnya diam macam tikus je la.
Kau kena present what actually happen in this disease. Daripada benda yang normal sampai la benda yang tak normal. Kenapa disease ni jadi? Apa je organ-organ yang telibat. Macam mana dia boleh jadi. Macam mana signs and symptoms dia boleh jadi. Macam mana nak treat patient. Macam mana nak manage patient dari segi makanan, penjagaan and etc. Kalau patient tak boleh kencing kena explain menchanism of urination. Macam mana manusia boleh kencing? K kenapa pulak dalam case patient tak boleh kencing. Its like kau explain something dekat org yang tak tahu pape. Bezanya examiner depan aku tu tahu semua benda and pretend tak tahu pape hahaha
haaaa hafal jangan tak hafal. Benda ni pun kena hafal tau.
The result would be given on the spot. Whether you pass or fail. Scary kan? Hahahaha. Kalau doctor baik usually dia bagitahu markah sekali. So sedih la kalau fail tu. Sometimes tak fikir pun markah berapa. Fikir nak lulus je. Because the torture tu rasa macam nak meletop kepala. Aku everytime habis SOOCA mesti rasa macam kepala nak meletup hahahaha
Papepun alhamdulillah exam dah habis. Exam kali ni memang the hardest for me. Not just me. For everyone kot. Aku nampak semua orang macam dah nak give up bila time SOOCA. Sebab for the first time jugak dia letak exam tu on the last week. So semua orang dah exhausted. Selalunya its on the first week. So macam stamina tu ada lagi la. Tapi bila letak last week. Rasa penat sangat. Dia punya nervous tayah cerita. Rasa macam terbang je bila jalan. Tak rasa kaki sebab nervous sgt. Tidur tak lena, nak buat apa pun tak kena. Semua orang nampak sangat exhausted. Pagi SOOCA tu semua org voice out memasing tak habis study, memasing risau and takut. Bukan sebab kitorang tak study. Maybe that is one of the reason. Tapi mostly aku rasa sebab everyone rasa macam tak cukup. You know the feeling of kau dah baca everything but you still dont think it is enough. And tak mungkin kau boleh faham everything in one go. Rasa macam tak cukup because its a lot. Sangat banyak.
I am also almost give up sebenarnya. Maybe sebab otak dah penat, badan dah penat bila masuk the 3rd week of exam tu. But the the biggest exam is still in front. Bila prepare for SOOCA tu rasa exhausted sgt, I drank 2 mug of Nescafe everyday. Bukan Nescafe yang mild tau. Nescafe Rich with stronger and double effect yang warna hijau tu packet dia. For almost 3 weeks minum tu. Rasa je badan tak sihat and so on. Kebetulan time SOOCA aku ada ulcer kat lidah. Pastu gusi bengkak semua. Mulut dah la nak digunakan untuk hafal. Pastu boleh pulak mulut tu sakit. Hahihhh dugaan betul.
And finally i am free from exam yeayyyyyy...
Kesian Ati kena dengan aku meroyan time exam haha. Ehh tiap kali aku meroyan stress pun dia kena dengar sebenarnya hahahaha. And now she's in the middle of exam weeks. Ti, aku doakan kau boleh jawab semua soalan dengan cemerlang. Aku doa kau ingat semua benda yang kau study and semua benda yang kau hafal. Semoga kita sama-sama dapat result yang terbaik Insha Allah.
Dah habis bebel. Next entry would be much more exciting dengan hashtag #adeapadgnbali hahahaha
Have a good day everyone.
Jangan ponteng puasa kayy hahaha
Assalamualaikum :)
