My Medical Officer floating period at Kluang hospital

After I completed my House Officer training at Kluang hospital on 5 January 2024, I worked as a floating Medical Officer in the Medical (Internal Medicine) department of Kluang hospital for 4 months and 3 weeks from 6 January 2024 to 26 May 2024. Throughout the floating period, I stayed in the house I rented at Bandar Seri Impian located near Kluang hospital. Here, I am sharing my experience working as a floating Medical Officer (MO).

I always had a high degree of theoretical interest in Internal Medicine. However, I found the large number of patients and heavy workload in the Medical department quite scary. I had initially wanted to join the Anaesthesiology department as an MO. Towards the end of my House Officer training, I spoke to my supervisor in Anaesthesiology regarding that, but she told me that I am more suited for Medical rather than Anaesthesiology. Later, I was informed by Kluang hospital that I had been allocated to Medical for the floating period. I decided to accept it.

The work hours for MOs in the Medical department is from 8AM to 5PM every day, excluding weekends and public holidays. In addition, we have to work about 4-6 oncall shifts every month. Each oncall shift is 33 hours long from 8AM till 5PM of the following day if the following day is a working day, or 24 hours long from 8AM till 8AM of the following day if the following day is a weekend or public holiday. There were regular Continuing Medical Education (CME) sessions for MOs.

I was supposed to begin working as an MO in the Medical department on 6 January 2024. However, as that day was a weekend, I started working only on 7 January 2024. On the first day, I met the Head of Department for an induction briefing before I began working. I was allocated to the back cubicle of the male ward for the first week. The patients in the front and back cubicles are generally quite stable and don't require a lot of management plans as compared to patients in the acute and subacute cubicles.

I was quite fast in reviewing my patients. However, I was still inexperienced in planning the management. I often relied on my specialists to give the management plans during the ward rounds. There were a few patients whom I had to make referrals to sub-specialties in other hospitals. When referring a case, not only I have to present the full history of the case, I also have to come up with a reasonable management plan, which the sub-specialty specialist will then add on or modify if necessary. I found that a really daunting task in the beginning. Thankfully though, my colleagues were quite willing to guide me.

Unlike some MOs, I was generally not too dependent on House Officers (HO). I was willing to carry out most of the active plans myself, including those that are usually done by HOs. I would only get HOs to perform blood taking and to write discharge summaries. On 12 January 2024, I went to Johor Bahru for a short getaway. There, I met up with my friend who had just completed his floating period as an MO in the Medical department of Kluang hospital. He gave me some useful tips for working in the department.

My first ever oncall shift was on 14 January 2024. It was 33 hours long and I was in charge of the male ward. As I was still in the tagging period, I had a senior colleague doing the oncall shift with me and I could seek her help anytime if needed. The oncall shift turned out to be not as bad as what I had expected. None of my patients had any emergencies throughout the night and I could sleep for several hours. Starting from that week, I was in charge of the subacute cubicle of the male ward.

On 17 January 2024, much to my disappointment, I found out that my application for my dream specialty was unsuccessful. That meant I had to continue working as an MO till I complete my compulsory service with the Ministry of Health. On 19 January 2024, it was my first 24-hour oncall shift. I was really busy during daytime as it was a weekend and there were far fewer MOs working compared to working days. Still, I found 24-hour oncall shifts so much more managable than 33-hour oncall shifts. How I wish all oncall shifts are just 24 hours long!

Later that month, I had to perform a central venous line insertion for a patient requiring ionotropic support. Under the guidance of my senior colleague, I successfully inserted the central venous line. On the following day, I had the opportunity to perform a pleural tapping for one of my patients with pleural effusion. I succeeded in performing it under guidance by my specialist. My success in the two procedures gave me a real sense of accomplishment and it boosted my confidence in working as an MO in Medical. Starting from 28 January, I was reallocated to the female ward. Still, I was in charge of the subacute cubicle.

As time went on, I began getting used to working 33-hour oncall shifts. Usually after 5PM, I would have my dinner and take a short nap. At 7PM, I would start doing the night reviews for patients that had to be reviewed 3 times daily, as well as the transfer-in reviews for new patients. The specialist would start the night ward rounds around 8PM which would usually continue until around 9:30PM. After that, I would carry out any urgent plans and then go to sleep. I would let the night-shift HO take the urgent and morning bloods. If there are any emergencies, the nurses would give me a call. Otherwise, I would sleep till 5AM, then I would do the transfer-in reviews for patients admitted over the night. As long as I could sleep for at least 5 hours in total, I wouldn't feel too tired to work from the next morning till 5PM. Despite that, I still really dislike 33-hour oncall shifts.

Around that time, I found out that starting from this year, new HOs would only be allocated to tertiary hospitals. That meant there wouldn't be any new HOs coming to Kluang hospital, and the Medical department would no longer have any HOs in a few months' time. When that happens, oncall shifts for MOs would become much more challenging, as MOs would have to take the morning bloods for patients, significantly reducing the amount of time we could sleep. I was quite concerned about that, and I thought of requesting to switch to the Anaesthesiology department. Unlike Medical, all oncall shifts in Anaesthesiology are only 24 hours long.

One day, I had to make sub-specialty referrals for 2 of my patients. Both cases were quite complicated and I struggled to understand what the sub-specialty specialists were asking me. Consequently, the sub-specialty specialists wanted to speak to my specialist directly instead. My specialist got quite upset about that as he thought that I failed to communicate properly with the sub-specialty specialists for both of the cases.

On 6 February 2024, I escorted a patient to Hospital Sultanah Aminah in Johor Bahru for an angiogram. I hadn't been to Hospital Sultanah Aminah since February 2020 and I was happy to be there again. I bumped up with one of my friends at Hospital Sultanah Aminah. The patient was very stable and there weren't any issues during the angiography and throughout the whole journey. It was 2PM when I arrived back at Kluang hospital. My colleagues had completed all the active plans in the ward and I was so glad about that.

I had 5 days of holidays from 7 to 11 February 2024 for the Chinese New Year. I went back to Kulim to celebrate Chinese New Year with my family members. I had to return to work on 12 February 2024. On that day, one of my patients required a bone marrow aspiration and trephine biopsy (BMAT). Since I had never performed BMAT before, I let my colleague perform it while I observed. The BMAT was quite challenging, as my colleague had to apply quite a lot of force in order to get a satisfactory amount of specimen.

On 13 February 2024, one of my patients required a chest tube insertion. The specialist told one of my colleagues to perform it as it was a high risk case. It turned out to be so difficult. My colleague had to try multiple times before she could insert the chest tube. Right after the procedure, the patient had a desaturation. We had to refer her to the Anaesthesiology team for non-invasive ventilation. In the end, I could only go home at 6:30PM. I had another 4 days of holidays from 14 to 17 February 2024. During that time, I went to Johor Bahru for another getaway.

I had gotten better in planning the management for my patients at that time. During my oncall shift on 23 February 2024, I helped my senior colleague to do the afternoon reviews for the patients at the Coronary Care Unit (CCU). That was my one and only time working at the CCU as an MO. On that night, one of the patients at the CCU required a central venous line insertion. I tried to perform it under guidance of my senior colleague, but I failed after attempting twice. My senior colleague had to take over.

On 27 February 2024, I was finally granted my Full Registration with the UK General Medical Council. The following weeks were quite uneventful. I continued to be in charge of the subacute cubicle of the female ward. None of my patients required any complex procedures or sub-specialty referrals. Throughout March 2024, I had one oncall shift every week. With the dwindling number of HOs in the Medical department, I made sure to rely even lesser on HOs. I began doing blood taking and discharge summaries myself as well. However, I still let the night-shift HO take all of the morning bloods during my oncall shifts.

One day, one of the patients collapsed. My colleague decided to intubate the patient, but she failed after attempting twice. I then attempted the intubation and I succeeded. That was thanks to my experience in Anaesthesiology during House Officer training. On 19 March 2024, I delivered a Continuing Medical Education (CME) presentation on Pain Assessment Tools. Around that time, my specialist told me that she was satisfied with my performance in the wards and thus I had completed my tagging period in the wards. Moving forward, I would be doing solo oncall shifts in the wards and she would start allocating me to the Emergency Department (ED) as well.

For the week from 24 March 2024 to 28 March 2024, I was allocated to the ED for the first time. I didn't have to do ward work or join ward rounds, but I had to be ready to see referrals from the ED at any time. I was tagging at the ED which meant that there was a senior colleague also in charge of the ED which I could seek their opinion or help anytime. Most of the cases referred from the ED weren't too complicated. Whenever there were a large number of referrals or complicated cases, my senior colleague will help me in seeing the cases. I had a good working relationship with the MOs and HOs at the ED.

Starting from 31 March 2024, I was reallocated to ward 7A. Ward 7A was formerly the Covid ward. Since there were no more Covid patients, it had been converted into a general Medical ward where the more stable patients were transferred here. I was in charge of the acute cubicle. As the patients in this ward don't require a lot of management plans, it's quite relaxing working here. On 31 March 2024, I found out that the Ministry of Health would be reallocating me to Sarawak starting from 6 May 2024, exactly 4 months after I began the floating period.

I wrote a letter to appeal to remain in West Malaysia and I managed to submit it before the deadline. A week later, much to my disappointment, the Ministry of Health informed me that my appeal was unsuccessful, which meant that I had to go to Sarawak and work as an MO there till I complete my compulsory service. However, I was allowed to apply to defer my start date in Sarawak for up to 2 weeks, which I did.

The first two weeks of April 2024 was quite relaxing as I only had one 24-hour oncall shift on 10 April 2024. That was first ever solo oncall shift and I was in charge of ward 7A and Periphery. Periphery is where we go to the wards of other specialties to review the patients that they referred to Medical. That oncall shift was quite relaxing. My patients in ward 7A didn't have any significant issues and I only received a few simple referrals from Periphery.

I had a passive oncall shift on 13 April 2024 where I had to stand-by for escorting any patient that needs to be transferred to another hospital from 8AM to 1PM. However, there were no patient transfers on that day so I just stayed at home. Starting from 14 April 2024, I was reallocated back to the female ward. This time, I was in charge of the front cubicle. The next 2 weeks were very busy as I had a total of 5 oncall shifts.

On 17 April 2024, I had my first oncall shift at the ED, where I was in charge of the ED from 5PM till 8AM. It was quite tiring as I was only able to sleep for about 4 hours. I had to admit a patient with thrombosed AV fistula and underlying end-stage renal failure. Worst of all, she was placed in the cubicle which I would be in charge of on the next morning and she would require an internal jugular catether insertion for haemodialysis on the next morning. Thankfully though, my specialist knew that I was quite tired so she told my colleague to insert the internal jugular catether, while I just had to assist her. Internal jugular catether insertion is quite similar to central venous line insertion.

I had another oncall shift at the ED on 26 April 2024. It was very tiring as well, but thankfully that was just a 24-hour oncall shift. My solo oncall shift at ward 7A and Periphery on 3 May 2024 was really busy. There were a large number of patients in ward 7A and I also received several complicated case referrals from Periphery. There was also a patient requiring an exchange of internal jugular catether. Although I had never observed or performed it before, I roughly knew how it should be done. Under guidance of my senior colleague, I managed to perform it successfully.

On 6 May 2024, I was informed that my start date in Sarawak had been deferred till 27 May 2024. My last ever active oncall shift was on 7 May 2024. I was in charge of ward 7A and Periphery. However, as my colleague in charge of the female ward was escorting a patient to Hospital Sultanah Aminah, I had to help her cover the female ward until she's back. There were many new cases in the female ward and I had to do the transfer-in reviews and join the night ward rounds with the specialist. Luckily, ward 7A and Periphery were quite uneventful. I could sleep once my colleague returned around 11:30PM. On that week, I successfully performed another internal jugular catether exchange.

Around that time, the CT scan machine at Kluang hospital broke down unexpectedly. Consequently, all CT scans had to be outsourced to KPJ Kluang. Many of the patients requiring CT brain had to be escorted to KPJ Kluang by an MO. I had a passive oncall shift on 11 May 2024. Around 1PM on that day, I was called to escort a patient from the ED to KPJ Kluang for a CT brain. I had never been to KPJ Kluang before and I was glad to visit it for once. It looks really nice.

On 12 and 13 May 2024, I performed pleural tapping for 2 of my patients. Both were successful and my specialists were quite satisfied with my performance. 23 May 2024 was my last day of work as an MO in the Medical department. On that day, one of my patients required an internal jugular catether insertion. I successfully performed it in my first attempt under guidance of my specialist. I bought some cookies as a gift to the nurses in the wards. I also took photos with the nurses. That marked the end of my journey at Kluang hospital. I left Kluang on 25 May 2024 and flew to Kuching, Sarawak on 26 May 2024.

Conclusions:

My floating period as an MO in the Medical department has been full of stress and challenges. The greatest challenge is certainly those 33-hour oncall shifts. Working as an MO would have been so much better without that. Despite that, I am glad that I performed fairly well as an MO in Medical. I had the opportunity to address the learning gaps from my previous Medical posting in House Officer training, and I gained a lot of clinical experience. It definitely made me much more matured. Following the end of my journey at Kluang hospital, I surely will miss everyone so much.

If you liked this story, you may want to read this too:
https://daniellimjj.blogspot.com/2024/02/my-house-officer-training-at-kluang.html

Kluang: A place I will never forget

The first time I set foot in Kluang was in November 2016, as part of my clinical attachments in Stage 3 of MBBS. My impression about Kluang at that time was that it's a small town with many village-style houses. Subsequently, I went to Kluang several more times in 2017, 2019 and 2020. While I wasn't quite impressed with Kluang, I did have some really good memories with my friends in Kluang and I cherished that so much.

In June 2021, I made the decision to undergo my House Officer training at Kluang hospital. In early August 2021, I confirmed my House Officer placement at Kluang hospital. I rented a house at Bandar Seri Impian which is located near Kluang hospital. It's a partially-furnished new house that looks really nice, and the rental price is quite reasonable.

I moved to Kluang on 21 August 2021. In the beginning, I felt rather uncomfortable about living in Kluang, even though the house I rented was quite nice. During my first few days in Kluang, I went to the 99 Speedmart in Bandar Seri Impian and I explored some of the roads in the area. Somehow, the whole place just felt so weird and isolated. I was even unimpressed with Kluang Mall, a big modern shopping mall. Consequently, I became reluctant to explore Kluang further. I didn't know most parts of Kluang and I had to rely heavily on Google Maps every time I drove out of Bandar Seri Impian. The only part in Kluang I was familiar with was Taman Kluang Indah, located not far from Bandar Seri Impian, and I often went there for my meals.

Previously, I had been living in Johor Bahru for 7 years, with the most recent 3 years in EcoBotanic, a really nice residential area. The fact is that Kluang is much less developed than Johor Bahru, and I found it so difficult to adapt to the huge change in environment. I was also feeling really stressed about having to start House Officer training, which I knew would be very challenging. I really missed my Teaching Fellow post at NUMed, which I just left in July 2021. To add to my stress, Malaysia was under a really strict lockdown at that time due to the really bad Covid-19 situation.

As soon as the Covid-19 lockdown eased in early October 2021, the first place I went to was EcoBotanic in Johor Bahru. I relived my great memories there and I really wished I could just go back to staying there rather than in Kluang. It takes about 1 hour and 45 minutes to drive from Kluang to EcoBotanic. In the following weeks, I travelled to EcoBotanic several more times, as I really missed the place. Each time I went to Johor Bahru, I would watch a newly released movie at TGV Cinema in AEON Bukit Indah. There were no major cinemas in Kluang at that time.

In late October 2021, I began getting used to living in Kluang. I had become familiar with the road to get to Kluang town from Bandar Seri Impian. I started exploring some of the restaurants in Kluang and I felt that most of the food in Kluang are quite good. Other than Kluang Mall, Kluang Parade is another major shopping centre in Kluang. I had the impression that Kluang Parade is very old and I didn't bother to visit it at all. In mid-November 2021, a GSC Cinema was newly open in Kluang Mall. Just a week later, I went there to watch Venom: Let There Be Carnage. Since then, I no longer had to go to Johor Bahru for movies. However, I still went to Johor Bahru regularly as I missed EcoBotanic and the food there.

Starting from December 2021, my grandparents came to live with me in Kluang. I often brought them to Taman Kluang Indah, Kluang Mall and Kluang Market. In February 2022, I and my grandparents celebrated Chinese New Year together in Kluang. In March 2022, I discovered another better road to get to Kluang town from Bandar Seri Impian. During my birthday that month, I still went to EcoBotanic, Johor Bahru as I wanted to celebrate my birthday at my favourite place.

It was starting from April 2022 that I really enjoyed living in Kluang. I began to appreciate the fact that Bandar Seri Impian and the house I rented is actually a very nice place to live in. My House Officer training was really stressful, but I was glad that I could rest and sleep in a nice house after work every day. Bandar Seri Impian has lots of nature scenaries and it felt great to be close to nature. There are also some pine trees in Bandar Seri Impian which made it feel like I am overseas. I also realised that Kluang Mall is actually a very nice shopping mall. Since then, I no longer went to Johor Bahru that frequently. On that month, I installed Astro's high-speed WiFi service at my house in Kluang.

One day in May 2022, I went to the Kluang immigration office to renew my passport. I had just finished working a night shift on that morning and the passport renewal took the entire day. When it was finally done, I was so tired and hungry. However, I suddenly couldn't think of where I should go for my dinner, as I still didn't know many restaurants in Kluang at that time. After contemplating for quite some time, I eventually went to a Chinese restaurant in Taman Kluang Indah.

In August 2022, one of my friends who grew up in Kluang introduced me to several more good restaurants in Kluang. Since then, I could enjoy a better variety of food in Kluang. At that time, I also found another shorter road to get from Bandar Seri Impian to Kluang town. In November 2022, my friend brought me to a steamboat restaurant in Taman Tasik Indah. Taman Tasik Indah and the neighbouring Taman Kluang Perdana are located in a new part of Kluang which looks really nice, comparable to EcoBotanic to a certain extent. However, as the place is quite a distance from Bandar Seri Impian and there wasn't a wide variety of food there, I didn't go there very often.

In January 2023, I once again celebrated Chinese New Year with my family members in Kluang. Around that time, I discovered the Kampung Paya Wet Market. It's newer and nicer than Kluang Market and I often brought my grandparents there since then. In March 2023, I celebrated my birthday in Kluang for the first time. In May 2023, I finally visited Kluang Parade for the first time. It turned out that it looks better than what I had expected. The interior of Kluang Parade looks like some of the older shopping centres in Kuala Lumpur, while the Parkson supermarket inside is quite nicely renovated. However, as it didn't sell much groceries, I didn't bring my family members there often.

In October 2023, a new Lotus's supermarket was open in Kluang, near Taman Tasik Indah and Taman Kluang Perdana. I and my family members like it a lot and we went there regularly. In January 2024, a huge Bin Siang food court with a wide variety of food was newly open in Taman Kluang Perdana. Since then, I went to Taman Kluang Perdana even more often. There was another nice Target Grand supermarket in Taman Kluang Perdana and I went there with my family members several times.

Throughout the entire 2023, I only went to Johor Bahru twice. I realised that Kluang actually has a lot of good food that are even better compared to those in Johor Bahru. Some good examples are Penang Hokkien mee, curry fish head, yam rice, bak kut teh, beef noodles, dim sum, lok lok, pork noodles, wan tan mee, curry mee, nasi kandar, nasi Briyani, nasi Arab, satay, apam balik, lemon chicken and grilled fish.

I successfully completed my House Officer training at Kluang hospital on 6 January 2024. I had planned to leave Kluang to pursue my dream specialty after the Chinese New Year in February 2024. However, I later found out that I had to complete my compulsory service with the Ministry of Health first before I could pursue my dream specialty. As a result, I continued working in Kluang hospital for my floating period as a Medical Officer. I requested to remain in Kluang hospital beyond the floating period.

Unfortunately in April 2024, I was informed by the Ministry of Health that I would be reallocated to Sarawak starting from 6 May 2024. I tried submitting an appeal but it was unsuccessful. That meant I had to work as a Medical Officer in Sarawak till I complete my compulsory service. However, I was allowed to defer my start date in Sarawak till 27 May 2024. I had been treasuring every moment of my stay in Kluang. I made sure to go eat at every one of my favourite restaurants in Kluang before leaving. Despite that, time still passed so quickly.

On 25 May 2024, I finally had to leave Kluang for real. Needless to say, I feel very emotional about this. I have been living in Kluang for 2 years and 9 months and I definitely have a lot of great memories here. I really look forward to the day I complete my compulsory service. If I can pursue my dream specialty, I will get to return to Kluang regularly.

If you liked this story, you may want to read this too:
https://daniellimjj.blogspot.com/2019/06/econest-place-i-will-never-forget.html

My 2024 Chinese New Year

I had a truly wonderful Chinese New Year in 2024. It surely is the best Chinese New Year I've had in the recent years. For the first time since 2020, I could go back to my hometown Kulim to celebrate Chinese New Year.

I was working as a Medical Officer at Kluang hospital at that time. I had a total of 9 days of non-continuous holidays, from 7 February 2024 to 11 February 2024 and then from 14 February 2024 to 17 February 2024.

7 February 2024:

It was the start of the 1st part of my holidays. On that night, I had fish head curry for dinner at Restoran Patam. After dinner, I went to Jalan Ismail, Kluang where there were some really nice Chinese New Year decorations.

8 February 2024:

I had lunch at Cheese U in Taman Kluang Indah. I went to Kluang hospital in the afternoon to submit my on-call claims. On that night, I boarded the bus from Kluang Bus Station to Butterworth.

9 February 2024:

I arrived Penang Sentral, Butterworth early in the morning. I then took Grab to Kulim. The last time I went back to Kulim was in January 2021 and I was so glad to be back again. I followed my grandmother to the Kulim Market to do some shopping for Chinese New Year.

After that, I and my grandparents went to Bukit Mertajam and had Hokkien Mee for breakfast at 榕树下饭店. There were so many customers and we had to wait for almost 2 hours. After breakfast, we went to Kedai Makan Pokok Buluh, where I bought curry fish and fried chicken for lunch.

On that evening, my aunt and her family arrived Kulim. I hadn't met them since January 2020 and we had so much to talk. We had a great Chinese New Year Eve dinner together at home. The main dishes were roast pork and steamed chicken. After dinner, I prepared and served lychee drink for everyone.

10 February 2024:

It was the 1st day of Chinese New Year. We had roti canai for breakfast at home. My parents arrived in Kulim on that morning. Some of our relatives came to visit us on that day.

In the afternoon, we went to AutoCity in Juru, Bukit Mertajam and had lunch at The Brew House. After lunch, we went to Häagen Dazs for ice-cream.

On that night, we had a great steamboat dinner together at home. After the steamboat, I once again prepared and served lychee drink for everyone. I wanted to go to the Kwong Hock Keong Temple on that night, but unfortunately it was closed.

11 February 2024:

Early in the morning, I went to the Bukit Mertajam KTM station and boarded the ETS train. I had a 2-hour stopover at Kuala Lumpur Sentral, during which I visited the neighbouring NU Sentral Shopping Mall. There, I had lunch at Nando's. After that, I once again had ice-cream at Häagen Dazs.

I then continued my journey to Gemas. The ETS train was not yet in service to the south of Gemas, so I had to switch to the older train to continue my journey back to Kluang. I was feeling quite tired after returning home, so I just ordered food delivery for my dinner.

12 February 2024:

I had to return to work on that day. Thankfully, the work wasn't too busy so I could leave work on time at 5PM. On that night, I had dinner with my friend at XLL Mala Hotpot. After dinner, we went to Long Du Gong Temple to pray. After that, we went to Kluang Mall where my friend bought some new clothes.

13 February 2024:

It was another work day for me. The work was rather busy and I could only leave work at 6:30PM. After work, I and my friend had Mookata for dinner at Tong Fa Thai Restaurant.

14 February 2024:

It was the start of the 2nd part of my holidays. On that morning, I had bak kut teh for breakfast at Restoran Kon Kee. After that, I drove to Eco Botanic, Johor Bahru for a short getaway. I stayed at Rose Cottage Hotel.

I had lunch at Chow Chow Stir Fry at the ground floor of EcoNest. On that night, I had my favourite Korean fried chicken at Oven & Fried Chicken. After dinner, I went to Eco Galleria. There, I had Mixue ice cream.

15 February 2024:

I had my breakfast at Nasi Lemak Cincai. In the afternoon, I went to AEON Bukit Indah. There, I had Grilled New Zealand Ribeye Steak for lunch at Sizzling Stonegrill. 

On that evening, I met up with one of my NUMed friend at 汆悦麻辣烫. The last time I met her was in January 2022 and we had a lot to catch up. Later that night, I went to Mount Austin for supper. I drove through the EDL highway which gives a really nice view of Johor Bahru city.

16 February 2024:

I had breakfast at UG Kopitiam at the ground floor of EcoNest. On that afternoon, I had lunch at O'Coffee Club Atelier in Puteri Harbour. I then drove back to Kluang. At night, I had dinner at Bin Siang Food Court in Taman Parkland.

17 February 2024:

On that afternoon, I had lunch at Amiratham Indian Restaurant. In the evening, I and my friend went to Wei Guo Ding Zun at Taman Kluang Perdana for a steamboat dinner.

18 February 2024 marked the end of my Chinese New Year holidays.

I celebrated my Chinese New Year across 5 cities, Kluang, Kulim, Bukit Mertajam, Kuala Lumpur and Johor Bahru, which made it really remarkable.

My House Officer training at Kluang hospital

I underwent my House Officer training at Kluang hospital for 2 years and 4 months from 6 September 2021 to 5 January 2024. There were 6 postings in my House Officer training. Throughout my House Officer training, I participated in the NUMed ARCP programme that leads to UK General Medical Council Full Registration. I rented a house at Bandar Seri Impian which is located near Kluang hospital during my House Officer training. Here, I am sharing my experience working as a House Officer.

This is a list of abbreviations I am using in this post:
HO: House Officer
MO: Medical Officer
CME: Continuing Medical Education
Mini-CEX: Mini Clinical Examination
CBD: Case Based Discussion
MCQ: Multiple Choice Questions
O&G: Obstetrics and Gynaecology
CTG: Cardiotocography
PAC: Pregnancy Assessment Centre
OT: Operating Theatre

ABSI: Ankle-Brachial Systolic Index
OSH: Occupational Safety and Health

SOP: Standard Operating Procedure
NICU: Neonatal Intensive Care Unit
ICU: Intensive Care Unit

CCU: Coronary Care Unit
MMC: Malaysian Medical Council
APC: Annual Practising Certificate

1st posting - Medical:

As my House Officer training intake was unexpectedly brought forward by several weeks, I was totally unprepared for the start of my 1st posting. I began my Medical posting on 6 September 2021. In the beginning, I literally didn't know what to do at all. It took me several days to learn about the job scope of HOs. Even then, I didn't know how to carry out a lot of the ward work and I had to constantly ask around. I faced huge difficulties with blood taking, where vast majority of my blood taking attempts failed. Lacking skills in blood taking meant that I was also very poor at intravenous cannulation.

I also had issues with requesting radiological scans. The first time I went to request a scan, I literally just placed the request form on the Radiologist's table and walked off, not knowing that I had to verbally present the case. The Radiologist said that my way of requesting the scan was totally wrong and told me to get a senior colleague to request the scan instead.

I took my off-tag assessment on 21 September 2021. It was disastrous, due to my lack of knowledge about the local clinical protocols and ward work. That, coupled with an extremely stressful work day on 22 September 2021, nearly resulted in me quitting House Officer training. I took 2 days of leave on that week. Thankfully though, I was allowed to work the normal working hours instead of the tagging hours starting from the following week.

On 28 September 2021, it was my first night shift. There were a lot of morning bloods which I had to take, which I thought would be a huge challenge for me due to my poor blood taking skills. But as it turned out, I succeeded in taking vast majority of the morning bloods. My blood taking skills improved tremendously and I was quite proud of myself. Being able to take bloods at my own pace without any pressure during the night shift certainly helped. Since then, I no longer had issues with blood taking.

On 5 October 2021, I retook my off-tag assessment and managed to pass it. However, a specialist complained about me due to the fact that I missed out 2 urgent CT scans ordered by her a few days ago. Consequently, I received a verbal warning and had to continue tagging for the time being. As time went on, my performance continued to improve and I could function properly as a House Officer. I had learnt the lesson not to miss out on any management plans again. On 23 October 2021, I finally completed the tagging period.

At that time, I was assigned to a newly opened female ward. Initially, there were only a small number of patients so my work was really relaxing. Later, the number of patients kept increasing, so did my workload. 12 and 13 November 2021 were extremely busy days, where there were only 2 HOs in the ward and I had to manage about 18 patients on my own. On 15 November 2021, I attended a workshop on Peripheral Intravenous Cannulation.

Later that month, a few new HOs joined the Medical posting. Being quite experienced at that time, I could offer them help whenever they required it. On 18 November 2021, I delivered a CME presentation on Malaria. I took the mini-CEX assessment on 28 November 2021 and the CBD assessment on 30 November 2021. Despite not making much preparation for the assessments, I managed to get a great score of 25/30 for the mini-CEX and 29/30 for the CBD.

On 20 and 27 December 2021, I had to do solo night shifts, where I alone was in charge of both male and female wards. I managed to take all of the morning bloods for the patients in both wards. I was also called to the CCU to help with a few of the more difficult blood taking there, which I succeeded. On 31 December 2021, I had to don a full personal protective equipment for the first time to take bloods from a few Covid-19 patients.

On 2 and 3 January 2022 which were my last 2 days of work in the Medical posting, I got assigned to periphery for the first time, where I would go to the wards of other specialties to review the patients that they referred to Medical. I found it quite fun as it gave me a good preview of O&G which is my next posting, and I even had the chance to speak to a few of the HOs in O&G. I successfully completed the Medical posting without any extensions. I was given 2 days of end-of-posting break on 4 and 5 January 2022.

2nd posting - Obstetrics and Gynaecology:

Before starting the Obstetrics and Gynaecology (O&G) posting, I had been hearing from my colleagues that O&G is a really relaxing posting, with claims that "the MOs are super nice", "you will get to eat almost every day" and "you can apply for leaves easily". Consequently, I decided to just take it easy. I started my O&G posting on 6 January 2022. For the 1st half of the posting, I was allocated to the labour room and PAC.

On my first day of O&G posting, I had realised the truth that it isn't nearly as easy as what others were saying. There were so many new clinical skills that I had to learn, such as vaginal examination, artificial rupture of membrane, vaginal delivery and perineal suturing. The MOs didn't really teach me those clinical skills, instead I was expected to be able to perform them well after observing a few times.

I kept struggling to find the os when performing vaginal examination. I found vaginal delivery and perineal suturing extremely difficult, as there are so many steps involved. HOs also have to enter the OT to assist with operations, most commonly caesarean section. I struggled a lot with assisting caesarean sections.

CTGs have to be performed for all patients at the labour room and PAC. It's quite common for there to be some abnormalities in a CTG. HOs are expected to recognise it and to inform the MO about it promptly, together with a full history of the case and the management plan. As a newcomer in O&G, that was a tall order for me.

At any time of the day, a new patient may come in to the PAC. HOs have to clerk every new patient, which is a long and tedious process, requiring half an hour at the minimum. Any of the patients at the labour room and PAC may have an emergency at any time that requires an urgent caesarean section or instrumental delivery. Whenever that happens, we have to stop whatever we are doing and attend to it immediately.

On 20 January 2022, I took my off-tag assessment. Due to my poor CTG interpretation skills, I failed the assessment and had to continue working the tagging hours. Worse still, an incident happened on that day. I was clerking a new patient at the PAC when the handover meeting started. I had to attend the handover meeting since I was told attendance is compulsory, so I couldn't complete the clerking. However, I got scolded by the MOs for that. A nurse also criticised me for not prioritising my patient.

I retook the off-tag assessment on 23 January 2022. I managed to pass it and I could start working the normal work hours. Later that week, one of the MOs gave me some detailed guidance on vaginal examination. I could finally feel the os for the first time. Since then, I was able to properly perform vaginal examination.

Night shifts in O&G are much more challenging compared to the Medical posting. Night shift HOs have to update the progress of all newborn babies admitted to the NICU, join the morning ward rounds and complete all of the discharge summaries on the following morning before they could go home. The exception is on weekends, where night shift HOs are not required to join morning ward rounds and thus can go home at 9AM. Fortunately for me, I was often allocated night shifts on weekends.

In February 2022, I got 3 days of holidays for Chinese New Year. By mid-February 2022, I could function fairly well as a HO in O&G. However, I still felt very stressed working at the labour room and PAC. This was especially the case when a new patient came in before I was done clerking the previous patient, or when two or more patients came at the same time. There was an MO who liked to order HOs around and she always expected her orders to be carried out immediately, even when we were in the middle of doing something else.

I attended the CTG course on 23 February 2022. However, I had to leave midway through the course as I was called to enter the OT. One night in March 2022, I got scolded very badly by one of the MOs due to the fact that I was still poor at perfoming vaginal delivery and perineal suturing. Later that month, I was allocated to the ward for the 1st time. I found working in the ward so much more relaxing compared to the labour room and PAC. There was no need to clerk new patients and usually there were very few active plans or emergencies.

On 1 April 2022, while performing a vaginal examination, I mistakenly inserted my fingers into the patient's rectum. The MO and nurse knew about it and they reported that to the Head of Department. On 12 April 2022, I was told that I had been extended by 2 months in the O&G posting due to my mistake which showed that I lacked clinical competency.

On 13 April 2022, I delivered a CME presentation on Menstrual Disorders and Vaginal Discharge. After I got extended, I put in my efforts to improve on my clinical skills. By May 2022, I could finally perform vaginal delivery satisfactorily. However, I was still poor at perineal suturing.

For the rest of my O&G posting, I was mostly allocated to the ward which was usually quite relaxing. Having a good amount of experience, I could perform quite well as a HO. On 16 June 2022, I had to do a solo night shift as my colleague took an emergency leave. That was really challenging, as I alone had to manage both the ward and the labour room and PAC. Luckily though, not a single new patient came to the PAC throughout the night. I managed to complete all of the work on time and the MOs were quite impressed.

In late June 2022, I took the mini-CEX and CBD assessments. I managed to pass both assessments with a good score of 24/30. On 28 June 2022, I attended the Basic Life Support course. My last day of work in the O&G posting was on 2 July 2022. I was given 3 days of end-of-posting break from 3 to 5 July 2022, during which I went back to Subang Jaya for 2 days and 1 night.

3rd posting - Orthopaedics:

I began my Orthopaedics posting on 6 July 2022. In the beginning, I found Orthopaedics to be rather relaxing posting. Unlike my Medical and O&G postings, I could adapt to the work and function well as a HO in Orthopaedics quite quickly. There were 2 new clinical skills I had to learn, performing ABSI and performing vacuum dressing. I could master both quite easily. After working the tagging hours for 1 week, I could start working the normal hours even though I hadn't taken the off-tag assessment. Night shift HOs are required to join the morning ward rounds and complete all the discharge summaries before they could go home.

Things then started going downhills. One day, when I was about to go home, my colleague told me that I had to take photos of the X-rays of my patient and send them to the WhatsApp group for the specialists to review. After doing it, I received several messages from the MOs saying that the X-ray images were unclear and they wanted me to take the photos again. However, after retaking the X-ray images, they were still unsatisfied. No matter how I tried, I just couldn't get a better image, due to the poor quality of my phone's camera. So much time was wasted and I was so annoyed about that. Eventually, my colleague helped me take the photos using her phone with a better camera.

Passing the off-tag assessment turned out to be so much more difficult than what I had expected. I failed it twice due to my lack of knowledge in Orthopaedics. I had never been interested in Orthopaedics. The 3rd time I took the assessment, I could answer the questions quite well, but towards the end I was asked a difficult question on sepsis. Although I could answer it correctly, my answer was quite a mess. Because of that, the specialist refused to let me pass and told me to reattempt the off-tag assessment with the consultant. The consultant let me pass the off-tag assessment on 27 July 2022, but not before he gave me a long lecture on what he expected of me in this posting, particularly emphasising on attitude.

On 12 August 2022, I got involved in a traumatic urinary catetherisation. My junior colleague was having difficulties inserting a urinary catether due to resistance and she asked for my help. I forced the urinary catether in but I still couldn't insert it fully, then I inflated it. Later, the patient had profuse bleeding from the urinary catether. Due to the traumatic urinary catetherisation, I was issued a warning letter which stated that I must improve my clinical skills or else I would be at risk of an extension. Since then, I had been working to improve my clinical skills, especially urinary catetherisation, which was acknowledged by several MOs.

Later that month, several of my colleagues were tested positive for Covid-19 and had to be quarantined. Consequently, there was a lack of HOs in the Orthopaedic wards. I had to so much work to do and I had to work overtime every day, making me feel really stressed. Worse still, some of the nurses were rather unhelpful, making me argue with them. On 21 September 2022, I took the CBD assessment, where I got a bare minimum passing score of 18/30.

On 23 September 2022, I had a needlestick injury. I was taking a blood culture for a patient, which has to be done in a sterile manner. There was no sharps bin nearby, and I was concerned that going elsewhere to get a sharps bin would compromise my sterility, so I decided to recap a used needle so that I could discard it later. I thought it would be safer this way, but I ended up pricking myself accidentally. I had to make an incident reporting to the OSH department and I was then given post-exposure prophylaxis for HIV. Later, I received a warning letter from the OSH for breaching the safety SOPs.

On 25 September 2022, I attended the Basic Suturing and Flexor Tendon Repair Workshop. On 10 October 2022, I delivered a CME presentation on Acute Major Joint Dislocation. I was delivering the presentation quite well, but midway through my presentation, a senior MO interrupted it and told me to present it again on another day, because I didn't include information about the Hippocratic manoeuvre, an ancient and risky technique for reducing anterior shoulder dislocations that is occasionally still practised nowadays.

On 12 October 2022, I was told by the consultant that I had been extended for 1 month in the Orthopaedics posting due to the fact that I had received 2 warning letters. He also felt that I had poor attitude, as evidenced by my lack of interest during his ward rounds and my arguments with the nurses. On 17 October 2022, I delivered my CME presentation once again. The senior MO was still not fully satisfied but she let me complete the presentation. On 31 October 2022, I delivered another CME presentation on Septicaemia and Hypovolaemic Shock.

On 1 November 2022, I took the mini-CEX assessment and got a great score of 25/30. Throughout November 2022, there was once again a shortage of HOs in Orthopaedics. To make matters worse, the wards kept having unstable patients which required a lot of time to manage. I had to work overtime quite frequently. At that time, I had become quite good at performing wound desloughing and skeletal tractions. My last day of work in the Orthopaedics rotation was on 2 December 2022. I had 3 days of end-of-posting break from 3 to 5 December 2022.

4th posting - Surgical:

Long before I entered the Surgical posting, I had been hearing scary stories about it. Surgical is widely considered to be the most challenging posting at my hospital. Therefore, I was quite scared about starting the posting. I began the Surgical posting on 6 December 2022.

In Surgical, it's compulsory to review all patients in the wards 3 times daily. While there usually weren't that many active plans in the Surgical wards, HOs are expected to complete all important active plans as well as the afternoon reviews by 2PM every day. For that to happen, all HOs have to work very fast. I struggled with that a lot in the beginning and I got scolded by the MOs and specialists several times.

On 8 December 2022, one of my patient with ascites was undergoing an ultrasound-guided pigtail insertion by the Radiology team. However, the patient kept being very uncooperative, so the Radiology team abandoned the procedure. Right after the patient was pushed back to the ward, an MO told me to perform a peritoneal tapping for that patient. I replied that I didn't know how to perform peritoneal tapping, and I was scolded by the MO.

Unlike other postings, HOs in Surgical have to perform referrals to sub-specialties such as Neurosurgical, Urology and Vascular Surgery for patients requiring referrals. Despite the challenges, I managed to pass the off-tag assessment just 10 days after I started the posting, as I found the assessment rather easy. That was the shortest time it took for me to off tag among all postings. Still, I had to work the tagging hours for a total of 14 days.

Night shift HOs have to join the morning ward rounds before they could go home, but they are not required to do the discharge summaries. As I found working in the wards so stressful, I preferred working in the Clinic, Daycare, Operating Theatre and Emergency Department. As time went on, I could work faster and function better in the wards. In January 2023, I got 3 days of holidays for Chinese New Year. On 24 January 2023, it was my first solo night shift. I struggled with it, but thankfully the MO was quite helpful.

On 8 February 2023, I took the mini-CEX assessment and got a rather good score of 23/30. As I was pre-occupied with the assessment, I didn't remember the cases in the wards. Consequently, I couldn't present the cases to the senior MO during the night reviews. I got scolded by the MO and I had to submit an explanation letter. After that incident, I put in my efforts to improve my performance in the posting and that was acknowledged by the senior MO.

One day, one of my patients was in sepsis and the MO told me to insert a urinary catether for him. Just as I was going to insert the urinary catether, the daughter of another patient came and ask me about his condition. I told her to wait and explained that I was attending to an emergency, but she insisted on an immediate answer. I refused to entertain her further. Later, she made a complaint about me.

On 23 February 2023, I took the MCQ examination. It was quite difficult and I failed it. I had to resit for the MCQ examination on 27 February 2023, and thankfully I passed it this time. On 28 February 2023, I went to see a patient at the Medical ward that was referred to the Surgical team. The patient's family member said that he seemed to be getting worse after he was admitted to the ward and asked me why. I explained that I was from the Surgical team and told them to ask the Medical team for further information. They got annoyed and they threatened to hit me. Later, I made an incident reporting regarding that.

Thanks to the fact that there were plenty of HOs in the Surgical posting during my time, I could get a replacement holiday or annual leave once every 2 weeks. On 11 March 2023, I was told that I had been extended by 1 month in the Surgical posting due to the previous complaint I got from a patient's daughter. The senior MO gave me some helpful feedback regarding my shortcomings, and I worked to address them.

On 6 April 2023, it was my CBD assessment and I got a great score of 25/30. In the following week, the senior MO got me to assist him with conducting the 2023 Trauma Audit. I collected data by reviewing the patient records, analysed the data and then created a presentation. It was really interesting and I was so glad to be given the opportunity to participate. I received myCPD points for that.

At that time, I had become very experienced and thus could perform very well as a HO in Surgical. On 21 April 2023, I had to do a solo night shift. It was a busy night shift with several emergencies, but I managed to handle them quite well. 1 May 2023 was my last day of work in the Surgical posting. I had 4 days of end-of-posting break from 2 to 5 May 2023, during which I returned to Subang Jaya for 3 days and 2 nights.

5th posting - Paediatrics:

Before joining the Paediatrics posting, I had the impression that working at the NICU is very stressful while working at the Paediatric ward is quite relaxing. I started the Paediatrics posting on 6 May 2023. My 1st week of tagging was in the ward while my 2nd week of tagging was in the NICU. Just like the Surgical posting, all patients in the Paediatric ward and NICU must be reviewed 3 times daily.

An important new skill to learn is Paediatric blood taking, which is different from that of adults in some ways. As I had a bit of experience performing blood taking from neonates during my O&G posting previously, I could pick it up quite easily. For most children older than 6 months, an assistant is required when taking blood as the child will keep resisting and moving about.

After I started working at the NICU, I realised that it isn't nearly as bad as what I had expected previously. Despite the large number of patients, there weren't a lot of active plans usually and the nurses there were very willing to assist HOs in performing clinical procedures. The only challenge was that HOs in NICU may get called to the OT or labour room for neonatal resuscitation at any time. I felt very stressed with performing neonatal resuscitation in the beginning.

On 21 May 2023, I took the off-tag assessment and managed to pass it in my first attempt. For next 7 weeks, I was allocated to the NICU. On 23 May 2023, I attended the Neonatal Resuscitation Programme course at the NICU. My first night shift was on that night. Night shift HOs are allowed to go home on time provided that they have completed all of their work, including taking all morning bloods.

As time went on, I became quite skilled at performing neonatal resuscitation and I no longer found it stressful. Despite being quite good at Paediatric blood taking, I was still struggling with intravenous cannulation where my attempts often failed. Intravenous cannulation was often performed by the nurses at NICU and therefore I didn't have much experience performing it. I then took my MO's advice to practice doing it more. Another clinical skill I found challenging was urinary catetherisation for urine cultures.

On 18 June 2023, I delivered a CME presentation on Paediatric Emergencies: Respiratory Failure and Shock. Later that month, several of the blood cultures taken by me were contaminated due to inadequate sterility during the procedure and I had to write an explanation letter for that. After that incident, I always took extra care to ensure sterility when taking blood cultures.

In early July 2023, I got reallocated to the Paediatric ward for the rest of the posting. Working in the ward was actually much more challenging compared to the NICU. There were much more active plans in the ward. Worse still, the nurses in the ward often couldn't assist with performing clinical procedures as there were a limited number of nurses and they were very busy with their work. On 6 July 2023, 2 new patients with urinary tract infection were admitted to the wards, both requiring urine cultures by urinary catetherisation. Due to my lack of experience, it took me a long time to perform it. In the end, I had to work overtime till 12:15AM.

On 15 July 2023, I starting feeling feverish and tired. After taking some rest during work and getting help from my friend, I could finish all my work on that day. On the following day, I visited the outpatient clinic at my hospital and the doctor suspected I had Dengue fever. Although my Dengue rapid combo test was negative, my blood counts were suggestive. I didn't have to be hospitalised and I was given 3 days of sick leave from 16 to 18 July 2023. I felt much better and could resume work on 19 July 2023.

In the following weeks, there was a shortage of HOs, with only 2 or 3 HOs working in the ward every day. As a result, my work became extremely busy and I had to work overtime a lot. Thankfully, the MOs were quite willing to help with the active plans and afternoon reviews. I also had to do solo night shifts every week. That was quite challenging as I had to manage both the ward and NICU on my own and there was a lot of work to do.

On 8 August 2023, it was the mini-CEX assessment and I passed it with a good score of 24/30. On 13 August 2023, I delivered another CME presentation on Child with Bleeding Problems. Later that month, several new HOs joined the Paediatrics posting and I finally didn't have to do solo night shifts anymore. At that time, I had become very good at performing intravenous cannulations and urinary catetherisations. I could also work much faster in the ward.

One night around 10PM, I and my colleague were told by the MO to take a blood culture and urine culture for a patient before going home. My colleague assisted me and I managed to do it all in just 15 minutes. I and my colleague could go home before 10:30PM and she was quite glad about that. On 22 August 2023, I took the CBD assessment and managed to get an excellent score of 28/30. I successfully completed the posting without any extensions. 2 September 2023 was my last day of work in the Paediatrics posting. I had 3 days of end-of-posting break from 3 to 5 September 2023.

6th posting - Anaesthesiology:

My 6th posting was an elective posting where I could choose either Emergency Medicine or Anaesthesiology. I chose Anaesthesiology as I found it more suited for me compared to Emergency Medicine. I started the Anaesthesiology posting on 6 September 2023. My 1st week of tagging was in the OT while my 2nd week of tagging was in the ICU. I submitted my application for MMC Full Registration at that time.

There were several new skills I had to learn, particularly intubation, general anaesthesia, spinal anaesthesia, arterial line insertion and central venous line insertion. I could pick up arterial line insertion quite easily, but I found the other skills quite challenging. Thankfully though, the MOs and specialists were always willing to teach HOs, motivating me to learn. Knowledge in physiology and pharmacology are very important for Anaesthesiology. I already had a good amount of knowledge in them and I worked to gain even more knowledge.

I really enjoyed working in the ICU. Just like the NICU, the nurses were very willing to assist in performing clinical procedures. As the ICU only had 9 beds, there wouldn't be too many patients or active plans. All patients in the ICU had to be reviewed 4 times daily. HOs are only allowed to review patients together with MOs or specialists during ward rounds, so we didn't have to come early in the morning to review patients.

On 19 September 2023, I took the off-tag assessment. Although I managed to pass it in my first attempt, there were certain areas which I had to improve my knowledge on. There were far fewer HOs in Anaesthesiology compared to other postings. However, as HOs only play a supportive role with the main focus on training, the workload is quite low. All night shifts were solo night shifts, but we would only be allocated to either one of OT, ICU or periphery, making it quite relaxing. We were allowed to have a lunch break and leave work on time every day, unless if there were emergencies.

There were frequent CME sessions in the Anaesthesiology posting. On 4 October 2023, I attended a course on Hands On Clinical Documentation Writing and Coding. On 22 October 2023, I was allocated to periphery for the first time. I had to go to the wards or ED to review the patients that were referred to Anaesthesiology. What makes it challenging is that any new patient could be referred at any time and the referral could be for an emergency intubation. However, we didn't have to carry out most of the active plans in periphery as it would be done by the primary team.

On 7 November 2023, I was finally granted my MMC Full Registration. I then proceeded with applying for my APC. Although I could perform very well as a HO in the ICU and was quite good at inserting arterial lines, I was still not skilled at performing intubation and spinal anaesthesia. Therefore, my mentor decided to allocate me to the OT more often. On 11 November 2023, I successfully performed intubation for the first time. Since then, I became much more confident with intubation.

I got a replacement holiday or annual leave once every 2 weeks. On 20 November 2023, I attended a course on Tracheostomy Care. During the course, there was an online quiz. I won the 3rd place in the quiz and got a desk lamp as the prize. On 21 November 2023, I delivered a CME presentation on Acute Pain Management. On 22 November 2023, I was granted my APC for 2024.

In the following week, I started having flu-like symptoms and lethargy. Later, my cough and sore throat worsened and my family members had similar symptoms as well. There was a Covid-19 outbreak at that time and our symptoms were suggestive of Covid-19, but our Covid RTK tests were all negative. I had to take 5 days of leave from 2 to 6 December 2023.

On 11 December 2023, I took the MCQ examination and managed to pass it. On 12 December 2023, it was the mini-CEX assessment which I passed with a good score of 25/30. On 19 December 2023, I delivered another CME presentation on Basic Pharmacology of Anaesthesia Related Drugs. At that time, I had performed intubation and spinal anaesthesia many times and I was quite experienced in them.

On 27 December 2023, I took the CBD assessment and got a great score of 25/30. I successfully completed the posting without any extensions. With that, I had successfully completed the entire House Officer training. 2 January 2024 was my last day of work in the Anaesthesiology posting. I had 3 days of end-of-posting break from 3 to 5 January 2024.

Conclusions:

Working as a House Officer is really stressful and challenging. However, I definitely gained a lot of clinical skills and knowledge. They will be very useful for me, regardless of which specialty I am pursuing in the future. The House Officer training at Kluang hospital is one with high standards. After completing House Officer training, I successfully gained Full Registration with the UK General Medical Council and I am eligible to apply for General Registration with the Medical Council of Ireland.

I performed particularly well in the Anaesthesiology and Paediatrics postings and I am proud of myself for that. Anaesthesiology and Paediatrics surely are my favourite postings. I am glad to have some really nice friends with me during my House Officer training. They definitely made the experience much more bearable. I cherish my time with them so much and I hope I will cross paths with them again in the future.

If you liked this story, you may want to read these too:

https://daniellimjj.blogspot.com/2024/05/my-medical-officer-floating-period-at.html
https://daniellimjj.blogspot.com/2021/08/my-teaching-fellowship-at-numed.html

My GMC Full Registration

As a Newcastle University Medicine Malaysia (NUMed) graduate undergoing House Officer training at Kluang hospital, I am eligible to apply for Full Registration with the UK General Medical Council (GMC) after completing 3 postings, through the ARCP programme.

On 6 December 2022, I completed the 3rd posting of my House Officer training in Orthopaedics, fulfilling the requirements for the ARCP. That was after I got extended by 2 months in the Obstetrics and Gynaecology (O&G) posting and 1 month in the Orthopaedics posting.

The next ARCP meeting would be held in June 2023. On 10 May 2023, I submitted all of the required documents to the ARCP panel, well ahead of the deadline. In late June 2023 after the ARCP meeting took place, my batchmates received the outcome of their ARCP, but I didn't receive it.

On 7 July 2023, much to my disappointment, I was informed that my ARCP was unsuccessful due to the fact that I required extensions in the O&G and Orthopaedics postings and some concerns were raised by my clinical supervisors in those postings.

Consequently, the ARCP panel required me to complete another posting in House Officer training without an extension and with a satisfactory logbook and clinical supervisor's report. As I got extended by 1 month in my 4th posting in Surgical as well, that posting couldn't be taken into consideration.

I had received an offer for the highly competitive F2 Stand-alone Programme in UK due to begin in August 2023, which was subject to GMC Full Registration. Due to my unsuccessful ARCP, I couldn't get GMC Full Registration in time to join the F2 Stand-alone Programme. I had no choice but to withdraw from it.

On 6 September 2023, I successfully completed my 5th posting in Paediatrics without any extensions. I received my clinical supervisor's report for Paediatrics on 31 October 2023. I then submitted my Paediatrics logbook and clinical supervisor's report to the ARCP panel.

The next ARCP meeting was supposed to be held in December 2023. However, it got postponed to the next month due to unforeseen circumstances. On 6 January 2024, I successfully completed my 6th posting in Anaesthesiology without any extensions and successfully completed the whole of House Officer training.

In late January 2024 after the ARCP meeting took place, the ARCP panel informed me that they would also like to review the logbook and clinical supervisor's report for my 6th posting as well as my Certificate of Completion of Housemanship Training (CCHT). I received my clinical supervisor's report for Anaesthesiology and my CCHT on 1 February 2024. I then submitted both documents to the ARCP panel.

On 9 February 2024, the ARCP panel finally informed me that my ARCP was successful. I had been granted a Certificate of Experience which enabled me to apply for Full Registration with GMC. On 11 February 2024, I submitted my application for GMC Full Registration.

GMC then informed me that as part of my application for Full Registration, they required a completed Postgraduate Professional Experience (PPE) form and a Certificate of Good Standing (COGS) from the Malaysian Medical Council (MMC).

I submitted the PPE form promptly and applied for a COGS from MMC. On 25 February 2024, MMC approved my application for COGS and sent it to GMC. On 27 February 2024, I was finally granted GMC Full Registration.

With GMC Full Registration and having completed 2 years of House Officer training, I am eligible to apply for specialty training programmes in UK. From now on, I will always have a backup option available. For now, I have no plans to go to the UK, as I intend to complete my compulsory service with the Ministry of Health of Malaysia.

End of my House Officer training

After 2 years and 4 months, I have finally completed my House Officer training at Kluang hospital on 6 January 2024. I surely gained a lot of clinical experience, skills and knowledge. This journey has been one full of stress and challenges. Despite that, I have always persevered just so that I can achieve my dream. Thanks to all those who have been giving me continuous support and encouragement.

You can read about my House Officer training experience here:
https://daniellimjj.blogspot.com/2024/02/my-house-officer-training-at-kluang.html

My MMC Full Registration and APC

Following the completion the 5th posting of my House Officer training on 6 September 2023, I have gained my Full Registration with the Malaysian Medical Council (MMC). Subsequently, I have also gained my Annual Practising Certificate (APC) for 2024.

With this, I am now ready to pursue my dreams!

A weird dream (Nov 2023)

On 8 November 2023, I had a really weird dream.

In my dream, my hospital organised an exchange programme for House Officers. Selected House Officers would be sent to work at hospitals in various locations all over the world, while trainee doctors from those countries would come to Malaysia and work at our hospital.

I was one of the House Officers selected for the exchange programme. I saw the name list which stated that I would be sent to London, UK. I was so excited and I quickly agreed to join the programme. The flight tickets were funded and arranged by the government, all I had to do was to board the plane with my personal belongings. 

On the plane, I looked through the name list for the exchange programme once again. I was shocked to find out that I had made a terrible oversight earlier. It's my colleague, not me, that would be sent to London, UK. Instead, I would actually be sent to Ulaanbaatar, Mongolia! I didn't even realise that I boarded the flight to Ulaanbaatar.

That made me feel quite scared. Mongolia has a very different living environment and culture compared to Malaysia, and I have never been to Mongolia before. Mongolia also doesn't have a developed healthcare system, so working as a doctor there would surely be challenging. Unfortunately, there was no turning back for me at that point.

After landing in Ulaanbaatar, a car came to fetch me from the airport. Travelling through Ulaanbaatar, I could see a lot of forests and villages which looked quite similar to those in Malaysia. Surprisingly, I didn't see any deserts or yurts (round tents) which Mongolia is famous for. I wondered, is that really Ulaanbaatar?

At one point of the journey, the main road ahead was closed for construction works. To bypass that, the driver made a turn into a smaller road and drove through a few villages. The rural scenes looked quite nice and were reminiscent of those in Kluang. I thought, perhaps being sent to Ulaanbaatar isn't that bad after all.

After some time, we emerged back onto the main road and continued our journey. The driver told me that Ulaanbaatar was fast developing and that's why there's a lot of road constructions. He also said he was sure I would like the place after staying there for some time.

Then, I arrived at the townhood where the hospital was located. There was a sharp change in the surrounding environment. There was no more forests, as that was a desert area. Still, I didn't see any yurts. There were a few concrete buildings, with their signboards written in Mongolian Cyrillic.

I began feeling uncomfortable about being in a desert area. After the driver dropped me off at the hospital residences, the first thing in my mind was to get some food, as I was feeling hungry. I didn't even bother taking a look around the residences or the hospital. There was only one restaurant in that area, so I went there straight away.

As it turned out, the staffs at that restaurant could only speak Mongolian, not English or Chinese. I don't know Mongolian at all and I couldn't communicate with them no matter how I tried. They then refused to entertain me further. In the end, I left the restaurant without getting to eat anything. There was nowhere else I could get food, and I was so hungry.

I felt really jealous of my colleague who got sent to London, UK. This question kept going through my mind "Why did they send me to Mongolia instead of UK?" I then decided that I should leave the exchange programme and return to Malaysia as soon as possible.

I wanted to immediately send a message to my hospital to tell them to bring me back to Malaysia. I knew I had to provide a good reason for that, so I thought hard to come up with one. Then, I suddenly woke up from my dream. I was so glad that it's just a dream.

P/S:

In reality, November 2023 is the penultimate month of my housemanship at Kluang hospital. This dream may reflect the uncertainty regarding my future after completing housemanship. In the dream, I had no control over whether I would get selected for the exchange programme, where I would be sent to for the exchange programme, and whether I could quit the programme.

Being sent to Mongolia and feeling so scared about it in the dream could be a representation of my fear of being allocated to a district hospital in a rural area as a Medical Officer. Several of my friends from NUMed are currently working in UK and they are enjoying it a lot, which might be why I got jealous of my colleague who got sent to UK in the dream.

Lately, I have been going around exploring Kluang, especially the rural areas. That was probably the reason I dreamt about travelling through the rural areas in Ulaanbaatar and reminiscing about Kluang. I was feeling really hungry in the dream probably because working as a doctor often requires me to work long hours without having lunch.

If you liked this story, you may want to read this too:

https://daniellimjj.blogspot.com/2022/12/a-weird-dream-jul-2022.html

NUMed MedX talk presentation slides

Since 2021, I have delivered several medical lectures as part of the MedX talk series of the NUMed Medical Education (MedEd) Society. The presentation slides of the lectures are available here. They are based on the UK guidelines.

Title: Bleeding Problems in Children

Date: 19 October 2023

Link: https://www.dropbox.com/scl/fi/3tmivhobgznljq6ku2qo4/Bleeding-Problems-in-Children.pptx?rlkey=oqxtmj198lkv4suvpii1tf9lh&dl=0

Title: Intestinal Obstruction

Date: 25 February 2023

Link: https://www.dropbox.com/scl/fi/sduakhz08da67pzf0uoox/Intestinal-Obstruction-MedX.pptx?rlkey=tirlx6ecoqenzajw0vqxsq7bi&dl=0

Title: Menstrual Disorders and Vaginal Discharge

Date: 19 April 2022

Link: https://www.dropbox.com/scl/fi/xmct6qs4df84i11654i8b/Menstrual-Disorders-and-Vaginal-Discharge-MedX.pptx?rlkey=14zk6rlwv3j7n1wjommh2i3bf&dl=0

Title: Haematological Malignancies

Date: 28 November 2021

Link: https://www.dropbox.com/scl/fi/yq6sh690qi2tq3avjykva/Hematological-Malignancies.pptx?rlkey=qls9nkvkggc54shksgdgzk9qf&dl=0

Title: Acute Red Eye

Date: 3 April 2021

Link: https://www.dropbox.com/scl/fi/q703ib1m5rhn63cgkwap2/Acute-Red-Eye.pptx?rlkey=r96qpjrofklns5osgjsyf2swr&dl=0

Title: IV Fluid Management in Adults

Date: 27 March 2021

Link: https://www.dropbox.com/scl/fi/vplsmdegf529xfjcq2278/IV-Fluid-Management-in-Adults.pptx?rlkey=pn1urzpig31zabptj9a2w4l6t&dl=0

Why I chose Anaesthesiology?

For the elective posting of my housemanship, I chose to do Anaesthesiology. Why did I make this decision?

During the orientation at the start of my housemanship, we were told that the 6th posting of housemanship is an elective posting, where we could choose either one of Emergency Medicine, Anaesthesiology, General Practice and Psychiatry. I had always found General Practice and Psychiatry quite interesting, and the work is generally quite relaxing in these two specialties.

I immediately told myself that I must choose General Practice or Psychiatry. However, much to my disappointment, I soon found out that at my hospital, only Emergency Medicine and Anaesthesiology are available for the elective posting. I didn't like either Emergency Medicine or Anaesthesiology. 

Anaesthesiology is an area of Medicine which I had very little exposure to. There was no Anaest rotation in my MBBS course, and I hardly ever read up anything about it. I always had the impression that Anaesthesiology is very difficult because there's so many things to learn.

On the other hand, Emergency Medicine requires doctors to work very fast, which I had always been very bad at. I need to think before doing something, or else I would make mistakes or omissions. However, patients going to the Emergency Department may be very ill which requires urgent treatment.

Having to choose between Emergency Medicine and Anaesthesiology, I felt that Emergency Medicine surely would be more suited for me. At least, I had good theoretical knowledge in Emergency Medicine, unlike Anaesthesiology which I had so little knowledge in. Therefore, I made the preliminary decision to choose Emergency Medicine for the elective posting.

During my 1st housemanship posting in Medical, I often had contact with the Anaest team, who will come to review and manage the acutely ill and unstable patients in the Medical ward. I found the Anaest team quite terrifying. Whenever I saw them, I knew it meant there's some unstable patients which require a lot of work to manage. I also never really understood the Anaest management plans which looked so complicated. That made me want to stay away from doing Anaesthesiology.

Meanwhile, I had very little exposure to the Emergency Department throughout my Medical posting, so I didn't know how working there is like. House Officers in the Medical posting generally only work in the wards and they rarely get called to the Emergency Department.

After I got into my 2nd posting in Obstetrics and Gynaecology, I was allocated to the labour room and pregnancy assessment centre (PAC) for the first 3 months. I found the labour room and PAC a very stressful place to work at. For each patient that comes to the PAC, we have to take a full history, do abdominal and vaginal examination, insert an IV cannula, take bloods, perform CTG and plan the management. We also have to document everything properly in the clerking sheet and present the case to an MO.

Clerking a new patient at the PAC is a long and tedious process, taking 30 minutes at the minimum. Patients may come to the PAC at any time of the day and it's impossible to predict that at all. Sometimes, a new patient may come in before I'm done clerking a previous patient, or two or more patients may come at the same time. Whenever that happened, I would get panicked as I knew there would be a lot of work awaiting me.

House officers have always been told to prioritise the work when it gets busy. However, even with job prioritisation, we still have to complete all of the work at the end of the day. We are also expected to work fast and to multitask, which is something I'm very bad at.

Any of the patients at the labour room and PAC may have an emergency at any time, with common examples being pathological CTG, meconium stained liquor and bleeding. Whenever that happens, we have to stop doing whatever we are doing and attend to it immediately. I don't like leaving my work uncompleted and resuming later, as that greatly increases the risk of making mistakes and omissions, yet I'm forced to do so during an emergency.

I soon realised that the PAC is basically the Emergency Department for Obstetrics and Gynaecology. I felt that working at the real Emergency Department (ED) would surely be very stressful in a similar way, in fact it likely would be even worse than the PAC. Patients with all kinds of conditions of any specialty may come to the ED anytime, and we need to be able to manage them quickly and appropriately. I began to think that Emergency Medicine isn't for me.

By April 2022, I had decided that I wouldn't want to do Emergency Medicine for my elective posting of housemanship. That meant my only option would be Anaesthesiology. I began exploring Anaesthesiology. Whenever I entered the operating theatre for caesarean sections, I would take a look at how the Anaest team performs spinal or general anaesthesia. I could gain a bit of understanding about anaesthesia and I found it rather interesting.

In the subsequent Orthopaedics and Surgical postings, I often had to go to the ED to see new cases. I never enjoyed working at the ED, as I found the work environment there so stressful, especially when there's a lot of patients. I was even more convinced that I mustn't do Emergency Medicine.

The Anaest team reviews and manages the acutely ill and unstable patients in the Orthopaedic and Surgical wards as well. I made it a point to get to know and understand the management plans by the Anaest team. I also made sure to properly carry out the plans and communicate with the Anaest MOs regarding that. That enabled me to know the Anaest MOs better, and I felt that most of them are actually quite nice. I no longer found the Anaest team terrifying.

Later, an Orthopaedic consultant remarked that he thinks I'm not suitable to do Anaesthesiology, so my only option would be Emergency Medicine which I should prepare for. I don't agree with what he said at all and I am determined to prove him wrong. That gave me the push for doing Anaesthesiology.

My friends who did the Anaesthesiology posting at my hospital gave really good remarks regarding it. According to them, Anaest has a really nice work environment, and the Anaest MOs and specialists are very willing to teach and guide house officers. Moreover, the workload in Anaest is generally quite manageable and house officers in Anaest rarely have to work overtime. That made the Anaest posting even more attractive for me.

A widely touted advantage of doing Emergency Medicine for the elective posting is that it gives us the opportunity to work as locum doctors at the ED of private hospitals, getting an additional source of income. Most private hospitals will only hire doctors with work experience in Emergency Medicine to work at their ED. 

While I appreciate that it may be beneficial to some people, I personally have zero interest in it. I just don't like working at EDs, whether at public or private hospitals. The work experience as a locum doctor also contributes nothing towards becoming a registered specialist. Therefore, there's no reason for me to do Emergency Medicine at all.

In June 2023, I made the firm decision to do Anaesthesiology for my elective posting of housemanship and I communicated my decision to the hospital. I then received confirmation in August 2023 that I have been placed in Anaesthesiology. I started the Anaest posting on 6 September 2023.

Anaesthesiology has a rather steep learning curve compared to other postings, as there's many new things to learn. Despite that, the enthusiasm of the MOs and specialists in teaching and guiding house officers has enabled me to gain a lot of new knowledge and skills without much difficulties. I am confident that I will be able to master Anaesthesiology.

I hope the Anaest posting will be a great and satisfying ending to my housemanship.

My first time voting in an election

When the 1999 Malaysian general election was held, I was only 4 years old. I had absolutely no knowledge about it. The 2004 Malaysian general election was the first time where I knew what an election is. However, I didn't really understand its significance, and I got annoyed when I kept hearing people talking about the election.

By the time of the 2008 and 2013 Malaysian general elections, I had understood the importance of elections. I closely followed the news of the 2008 and 2013 elections. However, I still had little understanding about the parliamentary system in Malaysia.

The 2018 Malaysian general election was the first in which I was eligible to vote. Automatic voter registration hadn't been implemented for that election. I was in Year 4 of MBBS at that time. Considering that I would be in UK for my medical electives during the time of the election, I decided there was no point in registering for the election.

Although I was aware that it's possible to vote overseas, I felt that it was too big of an hassle so I didn't sign up for it. Due to the extensive news coverage of the election, I finally understood for the first time how the parliamentary system works in Malaysia. I told myself I should vote in the next election.

In September 2020, I found out from my friend that voter registration can be done easily through the MySPR website. I finally registered as a voter for the first time. I then got the confirmation that I would be voting in the Subang parliamentary constituency and in the Subang Jaya state constituency for Selangor.

I started my housemanship at Kluang hospital in August 2021. During the 2022 Malaysian general election, I was in the Orthopaedics posting and there was a lack of House Officers in the department. As a result, I couldn't apply for leave to go back to Selangor to vote in the election.

Since I am a healthcare worker, I could vote in the election through post. However, before I could complete the application process for postal voting, its deadline had passed. In the end, I couldn't vote in the 2022 Malaysian general election.

In the subsequent 2023 Selangor state election, I was determined to vote. I was in the Paediatrics posting during this election. Once again, there was a lack of House Officers which made it difficult for me to apply for leave. Therefore, I decided to vote through post.

As soon as the application for postal voting was open, I quickly applied for it, not wanting to miss the deadline again. I applied through the MySPR website, and as part of the application, I had to let my Head of Department sign the application form to verify that I would be working on the polling day.

My application for postal voting was approved. On 2 August 2023, shortly after the nomination day for the 2023 Selangor state election, the ballot paper was delivered to my house in Kluang through Poslaju. I then voted and returned the ballot paper. The polling day was on 12 August 2023.

I am glad to have exercised my responsibility as a voter for the first time. I certainly will be voting in future elections as well.

Dark mode for this blog

In view of the popularity of dark mode, I have now switched my blog to dark mode. This should help reduce eye strain and glare when you are reading it in low-light conditions and help reduce battery consumption.

Thanks for your continuous support!

NUMed ARCP Reflections Sample

Newcastle University Medicine Malaysia (NUMed) graduates who are undergoing House Officer training in Malaysia and joining the UK General Medical Council (GMC) Full Registration programme have to submit 3 pieces of reflections for the Annual Review of Competency Progression (ARCP).

Here, I am sharing my ARCP reflections. They are in a single PDF file. You may use them as a guide if you are seeking to apply for GMC Full Registration. However, please note that plagiarism is strictly prohibited.

Link:

https://drive.google.com/file/d/1-DSqUMGcNPbKSKBzLCFdbJw0dkma7_JS/view?usp=sharing

GMC Full Registration programme for NUMed graduates

Newcastle University Medicine Malaysia (NUMed) runs a programme that enables its graduates to gain Full Registration with the UK General Medical Council (GMC) after completing a year of House Officer training at one of the 8 approved hospitals in Malaysia. This programme recognises the House Officer training as being equivalent to Foundation Year 1 (F1) in UK.

I underwent House Officer training at Hospital Enche' Besar Hajjah Khalsom, Kluang and I gained GMC Full Registration through the programme. Here, I would like to share some guidance for the programme.

The requirements for getting GMC Full Registration through the programme:

- You must be a graduate of the NUMed MBBS course.

- You must undergo House Officer training at one of the 8 hospitals approved by GMC:

(i) University of Malaya Medical Centre (UMMC), Kuala Lumpur

(ii) Hospital Enche' Besar Hajjah Khalsom (HEBHK), Kluang

(iii) Hospital Sultan Ismail (HSI), Johor Bahru

(iv) Hospital Sultanah Aminah (HSA), Johor Bahru

(v) Penang General Hospital

(vi) Hospital Sibu

(vii) Sarawak General Hospital, Kuching

(viii) Queen Elizabeth Hospital, Kota Kinabalu

- You must have Provisional Registration with GMC by the time you start working as a House Officer.

- You must complete 3 postings in your House Officer training successfully and keep the complete logbooks for the 3 postings.

- You must complete the Additional Procedures Form.

- You must complete the Your School Your Say (YSYS) survey and the Equality and Diversity (E&D) module.

- You must complete 3 pieces of reflective accounts. A sample of the reflective accounts is available here: https://daniellimjj.blogspot.com/2023/07/numed-arcp-reflections-sample.html

- You must keep in contact with NUMed and update NUMed regarding your progress in House Officer training when necessary.

The procedure for getting GMC Full Registration:

1. After you get a place for House Officer training at one of the approved hospitals, apply for Provisional Registration with GMC as soon as possible. You have to apply through GMC Online and pay GBP52 to GMC.

2. Email NUMed to inform that you would like to register for the programme. NUMed will send you the application form, Additional Procedures Form and Template for Reflections.

3. Complete the application form and pay RM2000 to NUMed. This should be done within 3 months of starting your House Officer training.

4. Within the first year of your House Officer training, complete the Additional Procedures Form and ensure that it is properly signed and stamped. You also have to write 3 pieces of reflective accounts based on the Template for Reflections.

5. At some point during your House Officer training, NUMed will send you the links for Your School Your Say (YSYS) survey and Equality and Diversity (E&D) module. Complete them accordingly.

6. If you have any extensions or unanticipated absence in your House Officer training, you need to inform NUMed about that promptly.

7. You have to complete 3 postings in House Officer training successfully. Ensure that you have complete logbooks that are properly signed and stamped for the 3 postings.

8. Once you have completed all of the above, you have to inform NUMed about that.

9. You will undergo the Annual Review of Competence Progression (ARCP). NUMed will inform you the date of the ARCP.

10. Once you are successful in the ARCP, you will be granted a Certificate of Experience which enables you to apply for Full Registration with GMC.

11. To apply for GMC Full Registration, you have to go to GMC Online and pay GBP166 to GMC.

12. GMC will send you a Postgraduate Professional Experience (PPE) form which you have to complete. You also have to apply for a Certificate of Good Standing (COGS) from the Malaysian Medical Council (MMC) through MeRITS, which requires you to pay RM500.

13. Once MMC approves your COGS and sends it to GMC, you will be granted GMC Full Registration.

The benefits of GMC Full Registration:

- Right after you gained GMC Full Registration, you are eligible to apply for the Foundation Year 2 (F2) Stand-alone programme in UK. After completing F2, you may apply for specialty training programmes in UK.

- There are also various locum posts in UK you can apply for with GMC Full Registration.

- If you choose to complete the 2nd year of House Officer training in Malaysia after gaining GMC Full Registration, you may apply for specialty training programmes in UK directly.

- Some other countries recognise GMC Full Registration, so you may be able to practise Medicine in those countries.

- Unlike GMC Provisional Registration, GMC Full Registration doesn't expire and is valid indefinitely.

Other information:

- In addition to this programme, NUMed graduates have the option of joining the 2-year UK Foundation Programme (UKFP).

- NUMed graduates are exempted from taking the PLAB, IELTS and OET when applying for Provisional Registration or Full Registration with GMC.

- House Officer training in Malaysia is only open to Malaysian citizens. Therefore, non-Malaysian citizens are unable to join the programme.

- If you do not fulfill every single one of the requirements for the programme (e.g. you are not a NUMed graduate or you are doing House Officer training at a hospital not approved by GMC), you are not eligible to join it.

- If you are not eligible for the programme, it may still be possible for you to apply for GMC Full Registration provided that you have completed a year of House Officer training at any hospital. In that case, you need to apply to GMC directly and they can take into consideration your work experience as a House Officer. However, the process is quite complicated and there is no guarantee of success.

- Other hospitals may be added to the list of hospitals approved by GMC in the future, but no information on that is available currently.

For more information on this programme, go to these pages:

https://madeinheene.hee.nhs.uk/Portals/0/PG%20Dean/Malaysia/Appendix%20F_Information%20for%20Hospitals%20participating.pdf

https://madeinheene.hee.nhs.uk/Portals/0/PG%20Dean/Malaysia/Final%20NUMED%20HEE%20NE%20%20-%20Malaysian%20Housemanship%20report%20%20on%20website.pdf

https://madeinheene.hee.nhs.uk/Portals/0/OPERATIONAL%20GUIDE_NUMed%20HEE%20NE%20Malaysian%20Housemanship_Final_May%202017%20-%20Copy.pdf

https://madeinheene.hee.nhs.uk/Portals/0/PG%20Dean/Malaysia/Quality%20Management%20-%20Malaysian%20Housemanship1.pdf

You can read about my experience with this programme here:
https://daniellimjj.blogspot.com/2022/12/my-gmc-full-registration.html