Hi! My name is Daniel Lim Jhao Jian. Here is where I share my experience, knowledge and ideas. You are welcome to leave comments and follow my blog. You are free to copy anything from this blog. Please recommend this blog to your friends.

Tuesday 25 August 2020

My MBBS degree

After studying 6 years at NUMed, I have finally received my Bachelor of Medicine and Bachelor of Surgery (MBBS) degree! This journey surely hasn't been an easy one, it required a lot of hard work and determination. Despite that, I can say it's an interesting and rewarding journey. I am really grateful to all those who have been supporting me throughout the journey. I wish I will have great days ahead.

Friday 14 August 2020

My 6th year of MBBS course at NUMed

The MBBS course at Newcastle University Medicine Malaysia (NUMed) is supposed to be 5 years. However, I failed the End of Stage MOSLER assessment in Stage 5 2018/2019 which is my 5th year of MBBS. Consequently, I had to repeat the entire year. The repeat year became my 6th year of MBBS, and it is known as Stage 5 2019/2020. Stage 5 2019/2020 lasted about 11.5 months from 27 August 2019 to 6 August 2020. During Stage 5 2019/2020, I lived at EcoNest which is the accommodation managed by NUMed. Here, I am writing about my experience during Stage 5 2019/2020. In this post, I will be using a two-letter pseudonym to refer to each particular person.

Semester 1 of Stage 5 2019/2020 is the Essential Senior Rotations (ESR), while semester 2 of Stage 5 2019/2020 is the Hospital Based Practice (HBP). ESR consisted of 5 rotations which were Women's Health (WH), Child Health (CH), Mental Health (MH), Primary Care (PC) and Preparation for Practice (P4P). HBP consisted of 3 rotations which were Medicine, Emergency & Orthopaedics (ED Ortho) and Surgery. There were in-course MOSLER assessments during each rotation except P4P and ED Ortho. Summative assessments would count towards the final outcome of Stage 5, while formative assessments would not.

August 2019:

On 20 August, the group list for semester 1 of Stage 5 was released. I was placed in group 6 for WH, CH, MH and P4P. For sessions at the NUMed campus, groups 4, 5 and 6 would be combined, while for sessions at hospitals, I would be with just group 6. Meanwhile, the grouping for PC was not yet known. Apart from me, three other repeat students, TL, LZ and RB, were in group 6. Although I was quite close to TL at that time, the fact that he isn't serious with the studies made me not want to mix with him too much. Meanwhile, LZ and RB also aren't very serious with their studies. I wasn't quite happy about being in group 6. I preferred to be in group 4 or 5 where all of the students were from the new batch. However, NUMed stated that no group change would be allowed so I had to stick with group 6.

My previous year of Stage 5 had been truly disastrous. I set myself several targets for my repeat year of Stage 5, including making many new friends in the new batch, passing every domain in all of the in-course MOSLER assessments, scoring above 80% in the PSA, WriSkE and SBA exams and scoring above 16/24 for every domain in the End of Stage MOSLER assessment. On 25 August, I returned to Johor Bahru and moved into EcoNest. This was my second year staying at EcoNest. I wasn't given the same unit as the previous year, but NUMed helped me move my personal belongings to the new unit. Just like the previous unit, this unit looked really nice. This unit was larger compared to the previous one, which meant that I had to live with more housemates. The size of my room was about the same. On 26 August, my close friend who had graduated came to the NUMed campus to collect his MBBS certificate. I went for lunch with him.

Stage 5 began on 27 August. The first day just consisted of induction lectures at the NUMed campus. All of the repeat students chose to sit in the last row of the lecture theatre, except me. I chose to sit in the first row of the lecture theatre as I wanted to meet new people in the new batch. I didn't feel embarrassed at all about having to repeat Stage 5. Later, PS, someone in the new batch whom I had known for a long time, came to sit beside me. On that afternoon, I and several other repeat students went for lunch in Gelang Patah. There, we met SF, our friend who had graduated and was now a teaching fellow at NUMed. On that night, we again had dinner together at PiringMu, Bukit Indah. At that time, students in the new batch were doing the Elective Assignment. However, I and the other repeat students didn't have to do the Elective Assignment again. Since I scored full marks for my Elective Assignment in the previous year, I shared it with the students in the new batch as a guide for them.

The Women's Health (WH) rotation began on 28 August. It was supposed to begin on 3 September. However, as there were many public holidays in the following weeks, the start date was brought forward to compensate for the loss of teaching. On that day, there were several seminar sessions at NUMed. I met my group mates for the first time. I did very badly in the WH rotation back in Stage 3, but I improved a lot in my previous year of Stage 5. I definitely wanted to keep up with the good work. On 29 August, my group had our first teaching session at Hospital Sultan Ismail (HSI). We were posted to the gynaecology and postnatal wards. The lecturer asked me to deliver teaching on Endometriosis to my group. The lecturer also let us take histories from patients in front of him. He pointed out certain aspects of my history taking that I needed to improve on. We had an evening shift at HSI on that day, but no one stayed back for it. As TL was staying at EcoNest as well, I carpooled with him when travelling to the hospital every day. 30 August was a public holiday.

September 2019:

2 September was a public holiday. On 3 September, my group was posted to the antenatal and gynaecology wards. We had seminar sessions at the NUMed campus on 4 September. During the seminars, there were group discussions and presentations. I delivered the presentations for my group and the lecturers were really satisfied with it. There was a session on perinatal mental health on that afternoon. Around that time, my application to extend the JPA scholarship was approved. JPA would sponsor the tuition fees of my repeat year in full and I would receive 70% of the usual living allowance. On 5 September, my group had a session at HSI in the morning followed by a radiology session at the NUMed campus in the afternoon. Around that time, I had gotten to know quite many of my peers in groups 4 to 6, but I still wasn't close to them. As I was a shy person, I found it difficult to start a conversation with them unless they talked to me first. Therefore, I mostly mixed with TL. A WH lecturer offered me the opportunity to move to group 4 or 5 so that I could meet new people. I wished I could accept the offer, but I had to decline it as I felt it wasn't the right time to switch groups.

The EduCity Educators Conference was held at NUMed on 6 September. As a result, there were no teaching sessions on that day. There was another public holiday on 9 September. On 10 September, my group was posted to the antenatal and gynaecology wards. On 11 September, there were workshops on clinical skills and obstetric emergencies at the NUMed campus. In the evening, I had dinner with my close friend who had graduated. The formative in-course MOSLER assessment was on 12 September. My patient was 32 weeks pregnant and presented with abdominal pain and contractions. I gave the differential diagnosis of preterm labour, Braxton Hicks contractions and placenta abruption. The examiner asked for other differential diagnosis but I couldn't think of anything else. She then said that although the differential diagnosis I gave were very reasonable and preterm labour was the actual diagnosis, I should also think of other medical and surgical diagnosis of abdominal pain unrelated to Obstetrics and Gynaecology. I failed the Clinical & Diagnostic Reasoning domain and passed all other domains.

On 13 September, my group had a session at HSI in the morning followed by a Prescribing Safety Assessment (PSA) practice session at NUMed in the afternoon. On that day, I met the lead of the PC rotation to make a request regarding the grouping. I wanted to be placed in the same group with my peers from group 4 or 5 for PC, and she agreed to consider my request. Around that time, I bought a new cover for my Pixel 2 phone through Lazada. I was really satisfied with its quality. 16 September was another public holiday. My group was posted to the postnatal ward on 17 September. The lecturer taught us how to present a case within one minute. The summative in-course MOSLER assessment for WH was held on 18 and 19 September. I had my MOSLER on 19 September. I offered some guidance on the MOSLER to my peers in groups 4 to 6 who had their MOSLER on that day, and that brought me closer to them.

I got a really complicated case for the MOSLER. My patient had Severe Pre-eclampsia with underlying Essential Hypertension, Gestational Diabetes, Hyperthyroidism and Gastritis. I spent a long time on the history taking and I ran out of time before I could complete the physical examination. The examiner remarked that my knowledge had improved compared to the previous year, but she emphasised that I needed to improve on my time management. Although I got a pass for all 5 domains, I felt quite bad as I didn't perform well. I told myself that I needed to perform better in my oncoming MOSLER's. After the MOSLER, I had lunch with AF, PG, IL, SM and EM who were from groups 4 to 6 at Chego, AEON Tebrau City. I had a great conversation with them during the lunch and I really enjoyed that experience. Since then, they had become my close friends. On 20 September, there was a round-up session. That was the last day of the WH rotation. I watched Doctor Strange on 22 September.

The Child Health (CH) rotation started on 23 September. On that day, there were seminar sessions on respiratory, cardiovascular, gastrointestinal and neurological systems at the NUMed campus. On 24 September, my group was posted to the neonatal ward and neonatal intensive care unit at HSI. Many of the cases at the neonatal ward were jaundice. At that time, the CH lecturers needed a rep for each group. I volunteered to be the rep for group 6. We had a teaching session at the HSI Paediatrics clinic on 25 September. On both days, we went to the Paediatrics ward in the afternoon. On 26 September, we were posted to the neurology ward. On 27 September, we joined the ward rounds at the Paediatrics ward. There were case presentation sessions at the NUMed campus on 30 September. I presented about Coeliac disease. The feedback from the lecturer was that my explanation was good but I should slow down a bit when talking. On that afternoon, there was a seminar session on neonatology and neonatal resuscitation, which involved a few role-play scenarios.

October 2019:

On 1 October, my group was posted to the nephrology & oncology ward in the afternoon. I and TL had lunch together before going to the ward. There was a long wait at the restaurant, causing us to arrive a bit late. After the teaching session ended, I clerked a case before returning home. My group was posted to the Paediatrics ward on 2 October. On 3 October, there were seminar sessions on musculoskeletal system and paediatric fluid prescription. 4 October was a public holiday. I submitted my application for the UK Foundation Programme (UKFP) 2020 on that day. As part of the application, I had to sit for the Situational Judgement Test (SJT) which would only be held at Newcastle University UK. As flying to UK and back would cost more than RM4000, I decided not to take the SJT. I actually had no plans to join UKFP 2020 and I was just applying for fun. At that time, I was quite close to some of my peers in groups 4 and 5 but I was still shy with the others. I often took the initiative to assist my peers in group 6 whenever they didn't understand a particular topic, bringing me closer to them. Whenever TL found out that I was teaching them, he would interrupt it and then ask me to repeat everything to him. I was quite annoyed with TL and I became unwilling to teach him anything.

On 7 October, my group was posted to the Day Care of HSI. I was driving on that day. TL overslept and I had to wait for him since we were carpooling. As a result, I was late for the teaching session. The cases there were mostly leukaemia and other malignancies. Later on that day, it was the formative in-course MOSLER assessment. I got a case of meningitis. The examiner asked me about the complications of meningitis. I answered brain abscess and sensorineural deafness. However, I missed out on hydrocephalus which is a common and important complication. I ended up failing the Management domain and passing all other domains. When it was time to leave, it was raining heavily. I had parked my car near the back entrance. TL wanted me to get to the car myself and then drive to the HSI lobby to pick him up, claiming that he couldn't get wet as he would fall sick easily. I agreed with his request, but in return I wanted him to walk with me up until the back entrance. However, he refused to do so no matter what, yet he insisted that I do what he wanted me to do. I thought of just leaving him at HSI and drive home myself, but I didn't want to create an enemy at that time so I relented in the end.

On 8 October, my group was posted to the Paediatric cardiology ward at Hospital Sultanah Aminah (HSA). There, we saw a few cases of congenital heart disease. On that afternoon, there were case presentations at NUMed. The summative in-course MOSLER assessment for CH was on 9 October. I got the same examiner as the one I got during my MOSLER in Stage 3 and in my previous year of Stage 5, which was a huge coincidence. The examiner told me to bring along a tendon hammer and my peers were quite shocked to hear that. My patient had fever and fits without any other symptoms. I gave Simple Febrile Seizures and Encephalitis as my differential diagnosis. The examiner asked me which one would be my first diagnosis, to which I answered Encephalitis. She then said that it was wrong to put Encephalitis as the first diagnosis as it's quite uncommon and my patient looked well which wouldn't be suggestive of it. In the end, she still gave me a pass for all 5 domains.

On 10 October, there was a session on Paediatrics life support. I did the CPR very well and the lecturer was quite impressed. On that afternoon, there was a role play session on medical ethics. I did the role play with PG and IL from group 4. The last day of the CH rotation was on 11 October. There was an end of rotation quiz where I managed to answer all of the questions correctly. There were also a child and adolescent mental health session and a PSA practice session. Around that time, we were deciding on a student rep for groups 4 to 6 who would represent us in the Student Staff Committee. As no one wanted to volunteer for it, we decided to draw lots. A guy who was absent on that day got selected as the student rep. However, he wasn't happy about it and he disputed the outcome. In the end, IL decided to become the student rep. Had I been selected as the student rep, I would have accepted it gracefully unlike that guy.

The Mental Health (MH) rotation started on 14 October. There was a seminar session on Management in Mental Health at the NUMed campus. Once again, I volunteered to be the rep for group 6 in this rotation. In my previous year of Stage 5, I failed a domain of the in-course MOSLER for MH because of a simple mistake and I felt bad about that. Therefore, I wanted to redeem for that by doing well in the in-course MOSLER this time. On 15 October, my group was posted to Cure and Care (C&C) Rehabilitation Centre. There, I clerked two patients with substance misuse disorders. We were posted to HSI on 16 October. The lecturer paired me with SM who was from the new batch. We went to the outpatient clinics, where we saw a case of Alzheimer's dementia and had the opportunity to perform cognitive assessment on the patient. On 17 October, there was a seminar session on eating disorders including anorexia nervosa, bulimia nervosa and binge eating disorder. That was followed by a Balint group session. 

On 18 October, there was a lecture on psychological management by a clinical psychologist. My peers were quite satisfied with the lecture, unlike in the previous year. After that, there was a community mental health team simulation session. The session involved group discussions which were really interesting. On 19 October, the lead of the PC rotation informed me that my group request had been declined. The other PC lecturers weren't happy with my request as they felt that the PC rotation isn't a socialising platform and they wanted me to focus on my studies considering that I was a repeat student. I was so sad and disappointed about that. I really wanted to be in the same group with my peers from groups 4 and 5 so that I could get closer to them, but now the opportunity just vanished. I regretted not accepting the WH lecturer's offer for me to move to group 4 or 5 back then. I was having symptoms of depression, which was ironic that it happened during my MH rotation. For 2 days, I couldn't do any studies.

Later, I realised that if I still don't study because of my sadness, I would fail the in-course MOSLER once again. I definitely didn't want that to happen, so I decided that I mustn't let my sadness affect my studies no matter what. I got myself back to studying for the in-course MOSLER. I also realised another thing. In my current group, DD, SD and SM were from the new batch and they were very nice, so I could just get close to them. While that might not be as fun as being in the same group with those from groups 4 and 5, it would still be a great experience. By thinking of things in a different way, I managed to overcome the sadness. This is actually how cognitive behavioural therapy (CBT) treats depression. On 20 October, I had lunch with PS who was from group 5. On 21 October, my group was posted to Permai hospital. I was teamed up with DD and SD. I started having casual conversations with them and we soon became close friends. We went to the inpatient wards and clerked a case of Schizophrenia and a case of Mania.

My group was posted to HSI on 22 October. I clerked cases of Delirium and Post Traumatic Stress Disorder at the wards. On 23 October, we were posted to Permai Hospital again. I went to the outpatient clinics and observed the consultations of a few patients, all of which were coming for follow-up. I then brought one of the patients to a room where I took a full history and performed a mental state examination. He had Bipolar Affective Disorder. That was my last day of hospital session for semester 1. There was a seminar session on deliberate self harm on 24 October. On 25 October, we had a communication skills session. I performed quite well during the session. On that afternoon, there was a PSA practice session. 28 October was a public holiday. We had a campus clerking session on 29 October. Patients with mental health conditions were brought to the NUMed campus. We clerked cases of Alcohol Dependance Syndrome, Bipolar Depression and Panic Disorder. The lecturer let us do a formative in-course MOSLER assessment for one of the cases. She was quite satisfied with my performance. After that, we also discussed the other cases with the lecturer.

Around that time, the group list for the PC rotation was released. It turned out that I still got placed in the same group with my peers from group 4, even though my request was declined earlier. I was so happy about that. The summative in-course MOSLER assessment for MH was held on 30 and 31 October at the NUMed campus. I had my MOSLER on 31 October. I got the same examiner as the one I got during my MOSLER in the previous year. My patient had Depression and my task was to take a history about his initial presentation. I made sure not to repeat the mistake I made in the previous year where I didn't read the task carefully. I performed quite well in the MOSLER and the examiner gave me a pass for all 5 domains. I was glad that she was able to see my improvements. There was a Single Best Answer (SBA) practice session on that afternoon. SM wanted to switch to my group for the PC rotation, and I definitely agreed with that.

November 2019:

On 1 November, there was a round-up session and that marked the end of the MH rotation. At that time, SC from group 4 made batik cake and distributed it to her friends. CL and NB who were from group 5 let me try a piece of the batik cake and I really liked it. Looking back, my experience with the MH rotation this year was much better compared to the previous year. I had the opportunity to see a wide range of mental health conditions and I did get the most out of every session. Later on that day, the group list for semester 2 was released. It was the same as the semester 1 grouping, so I would be in the same group with those from group 6 again. The Student Staff Committee released it so early in order to give students who wanted to swap groups the opportunity to do so. Swaps would only be allowed between students of the same gender and race. I decided to use that opportunity to switch groups so that I could be in the same group with my peers from groups 4 and 5. I asked AF if he could swap groups with me, and he said that he would consider it. On that evening, I watched Terminator: Dark Fate at TGV Cinemas, Bukit Indah.

On 4 November, the Primary Care (PC) rotation started. I was in the same group with EM, SC and SM for PC. For the first week, my group was posted to Klinik Kesihatan Mahmoodiah (KKM). I built a good relationship with my group mates and soon enough, they had become my close friends. On that week, I clerked cases of Otitis Externa, Type 2 Diabetes, Infected Acne and Asthma at KKM. On 5 November, AF agreed to swap groups with me for semester 2. I was overjoyed. I informed IL in the Student Staff Committee about that and she made the swap. I would be in the same group with IL and she was fine with it. On 7 November, there was a prescribing in primary care session at the NUMed campus. During the session, there were several rounds of Kahoot quizzes which were really fun and intense. EM won two rounds. In the end, I won the final round successfully. 8 November was a public holiday.

I wasn't in the same group with TL for PC. Around that time, I realised that mixing with my friends in the new batch is so much more fun than mixing with TL. I started feeling that the time I spent with TL is so meaningless and is just a waste of time. TL wasn't quite happy about my group switch for semester 2 as he wanted to be in the same group with me. I made it clear to him that I would be sticking with my new group no matter what. Out of my expectation, TL was able to get someone to swap groups with him, enabling him to join my new group for semester 2. I didn't quite like that but there was nothing I could do. For the second and third weeks, my group was posted to Klinik Kesihatan Gelang Patah (KKGP). I had never been to KKGP in the previous years. I clerked a case of Osteoarthritis with Simple Back Pain on 11 November and a case of Stroke on 12 November.

On 13 November, my group was split up as our lecturer was on leave. I joined PG's group which was posted to Klinik Kesihatan Pekan Nenas. Pekan Nenas is quite a distance away. There, I could see the banners of various political parties as the Tanjung Piai by-election would be taking place soon and Pekan Nenas is part of the Tanjung Piai parliamentary constituency. I clerked a case of Complex Regional Pain Syndrome on that day and it was a great experience being with that group. On 14 November, I clerked a case of Chronic Cholecystitis at KKGP. There was a session about ethics in primary care at NUMed on 15 November. I volunteered to do case 4 which was about a patient's family members refusing antibiotic treatment for his pneumonia. On that evening, it was the NUMed Cultural Fest 2019 and I attended it. Some of my friends were there as well. There, many food stalls were set up by students where each stall represented a particular culture. I bought food from some of the stalls and the food was quite tasty. On 18 November, I clerked a case of Bowel Obstruction at KKGP. My lecturer subsequently referred the patient for admission to hospital. On that afternoon, I had lunch with my group in Gelang Patah.

The summative in-course MOSLER assessment for PC was held on 19 and 20 November. For my group, those doing it on 20 November would be getting a stricter examiner. We decided to draw lots for that and it turned out that I would be having my MOSLER on 20 November. I accepted it gracefully and viewed it as a learning opportunity. In the MOSLER, my patient came for follow-up of Hypertension and Hyperlipidaemia. I performed quite well in the MOSLER and the examiner gave me a pass for all 5 domains. With that, I had passed all domains in at least 4 in-course MOSLER's so I fulfilled the requirements for proceeding to the final exams. However, I wouldn't stop at that and I definitely wanted to pass all domains in the next 2 in-course MOSLER's as well. After the MOSLER, the lecturer taught my group on how to write a referral letter. On 21 November, there was a talk on diabetes at KKGP and we listened to it. On 22 November, there was a session on advanced communication at NUMed. That was the end of the PC rotation. SC gave me a box of batik cake at that time.

On 25 November, it was the start of the Preparation for Practice (P4P) rotation. There were introductory lectures and a prescribing session on that day. Unlike the other rotations in semester 1, P4P had no in-course MOSLER assessment and all sessions in P4P were held at the NUMed campus with groups 4 to 6. Therefore, me and my peers could relax for quite some time. Many of the sessions in P4P were optional. Among the repeat students, TL chose to attend only some of the sessions while RB and LZ chose to skip all of the sessions. However, I wanted to attend all of the sessions in P4P as I found it really fun in the previous year. On 26 November, there was a role play session on patient journey. That was followed by a PSA practice session which involved group discussions and competitions. On 27 November, there was a teaching practice session where we had to give a presentation on any topic not related to Medicine. I chose to present about iPad vs Laptops. I was the last student to do the presentation but my peers still paid good attention to my presentation. I featured the presentations of several of my friends on my Instagram story.

During P4P, I had plenty of opportunities to interact with everyone in groups 4 to 6. I became quite close to them and I was no longer shy. I didn't want to mix with TL anymore as I felt that he isn't sincere in any friendship and that he is just taking advantage of me. Around that time, a new outlet of AnMour Cafe was open near EcoNest. Previously, the nearest outlet was in Bukit Indah and I often went there as I really loved the burgers. On 28 November, TL suddenly phoned me and said that he wanted to have lunch with me at AnMour Cafe. I had to go to HSBC Bank in Bukit Indah to do something important at that time. However, TL simply told me to do it on another day and insisted that I have lunch with him on that day. I refused to give in to him and it took more than 20 minutes for him to give up. There was a self-directed learning session on 29 November. I watched Sully: Miracle on the Hudson on 30 November.

December 2019:

On 2 December, there was a role play session on shared decision making. There was an SBAR communication practice session on 3 December. The bad day on call session was on 4 December. It consisted of a simulated scenario where I was a house officer who had multiple tasks to perform at a very busy ward. I was formatively assessed on my ability to work under pressure and to prioritise the more important tasks. One of my simulated patients died of cardiac arrest as I didn't know how to operate a defibrillator. Although I didn't perform very well in the session, I still enjoyed it and I gained valuable experience from it. After the session, I had a discussion with DD and SD regarding our group presentations on the following week. Around that time, McDonald's opened a new outlet near NUMed.

There was a medical defence debate session on 5 December. It was very interesting and I voiced out my opinion enthusiastically. After the session, I wanted to go to the new McDonald's for the first time. As soon as I drove out of NUMed, I received a phone call from TL and I just ignored it. However, I realised that he was just behind me in his car. TL then tailgated me, forcing me to stop my car by the roadside. He wanted me to have lunch with him at a fish head noodle restaurant. I really didn't feel like having fish head noodles at that time as I wanted to have burgers. I suggested going to AnMour Cafe but he refused. I got really annoyed with him. Eventually, TL suggested going to Black Coffee and I reluctantly agreed. During lunch, I told him that I would once again switch to another group for semester 2 if he continues to annoy me. As TL really wanted to be in the same group with me, he got panicked after hearing what I said.

On 6 December, there was a SBA practice session followed by a role play session on dealing with angry patients. After that, a national student survey was held at the lecture theatre. On that afternoon, my close friend who had graduated came to NUMed and I had lunch with him. I watched Aladdin (2019) on 8 December. On 9 December, there were role play and group presentation sessions on end-of-life. I, DD and SD presented about end-of-life issues for Malay culture. There was an organ donation role play session on 10 December. The evidence-based medicine group presentation session was on 11 December. I and my friends presented our critical appraisal of aromatherapy. On 12 December, there was a seminar session on consent and capacity. During the session, we were asked to explain to each other about how to ride a bicycle. After that, we had a session on death certificates. That was the last day of both the P4P rotation and ESR. At that time, TL was trying to stick to me, but I didn't want to entertain him much.

The NUMed Ball 2019 was held at Pulai Springs Resort on 13 December. Quite a number of the students in my batch attended it, but most of my close friends didn't attend. A few of my friends who had graduated and were working as NUMed teaching fellows also attended it. I sat in the same table with those in my batch. The food and performances were great. I took photos with my friends as well as everyone else in my batch who were at the ball. I met a girl from UK during the ball and I took photos with her as well. This was the 5th ball I attended in NUMed. There was 3 weeks of winter break from 14 December to 5 January. I went back to Subang Jaya on 14 December. On 15 December, I had a reunion with a few of my friends who had graduated. We had a potluck and I brought roasted chicken. I went back to Kulim on 17 December. I then returned to Subang Jaya on 22 December. Around that time, some of the students in my batch travelled to UK to take the Situational Judgement Test (SJT). On 27 December, I watched Iron Man 3. On 30 December, I watched Star Wars IX: The Rise of Skywalker at TGV Cinemas, Sunway Pyramid.

January 2020:

On 1 January, I subscribed to PassMedicine for the first time, which gives me access to many practice questions for the PSA and SBA exams. On 5 January, I returned to Johor Bahru. Semester 2 of Stage 5 started on 6 January. The SJT was held at Gateshead Leisure Centre in Newcastle, UK on that day. Those sitting for the SJT were given 2 additional days of break. My close friend who had graduated came to NUMed on that evening and I had dinner with him. On that week, there were induction lectures and practice sessions for the Prescribing Safety Assessment (PSA). On 7 January, I was taught by SF who was a NUMed teaching fellow and her teaching was great. Around that time, my UKFP 2020 application was automatically withdrawn as I didn't take the SJT. In this semester, about half of the sessions were assistantships while the other half were teaching sessions. For the assistantships, no lecturers would be present and we were expected to find learning opportunities by ourselves at the hospital. 

The Medicine rotation began on 12 January. I was in the same group with TL and IL for this rotation. On the first week, my group was posted to the coronary care unit (CCU) of HSI. No lecturers were there, but our attendance would be taken by the staffs at the CCU. A Stage 4 student was doing her Student Selected Component there. We joined the ward rounds every day. The cardiology consultant would sometimes ask us some questions to test our medical knowledge. We saw a few cases of heart failure and malignant hypertension. I had some really bad memories at the CCU in the previous year and I was glad that I had a much better experience this time. At that time, I still carpooled with TL when travelling to the hospital every day. However, unlike the previous semester, he now had the habit of driving quite recklessly at times, which made me quite scared.

On 16 January, there were Written Skills Examination (WriSkE) and communication skills practice sessions at the NUMed campus. I volunteered to do one of the cases for the communication skills. On that afternoon, there were seminar sessions on endocrinology, infectious diseases and renal medicine. I was busy preparing for the PSA exam at that time. I did a lot of PSA practice questions and I revised my clinical knowledge for all of the specialties. What I really feared about the PSA was the time limit. We had to answer 60 questions within 2 hours, which was quite short a time. Starting from this year, marks are no longer given for the date, time and signature in the Prescribing section, which makes the PSA more difficult to score well. On the second week, my group had teaching sessions at HSA. We saw several cardiac and respiratory cases in the wards. I had the opportunity to practise performing neurological examination on a patient with positive signs. I went for lunch with TL and IL during break time on 21 January.

On 22 January, TL was driving and he wanted to have lunch at a restaurant quite a distance from HSA after the session. He reassured me that going there wouldn't take a lot of time, so I agreed to follow him. IL chose not to join us for lunch. That restaurant turned out to be closed. Although several other restaurants were open at that place, TL didn't like them and he wanted to go to another faraway restaurant instead. I got really upset as that would waste a lot of time. I told TL in a really serious tone that we should stop carpooling if he wants to keep wasting my time and that I would be very happy to get down of his car right away and return home by Grab. Eventually, he reluctantly agreed to have lunch at one of the restaurants nearby. On 23 January, there was an acute care simulation session at NUMed. I got a case of Diabetic Ketoacidosis and I managed it quite well. That was followed by a seminar session on medical emergencies. On that evening, I went to Popular Bookstore in AEON Bukit Indah and bought a set of 10 really nice Chinese New Year cards. I wanted to give them to my friends, like I did in the previous year.

There was 4 days of break for the Chinese New Year from 24 January to 27 January. I went back to Kulim on 24 January and celebrated the Chinese New Year with my family. I was studying for the PSA even during Chinese New Year. I returned to Johor Bahru on 27 January. Around that time, certain parts of the world started having outbreaks of Covid-19 and Malaysia reported the first cases. I wasn't really worried about the Covid-19 as I didn't expect it to spread widely in Malaysia. On 28 and 29 January, my group had teaching sessions at HSI. We had the opportunity to see a case of Systemic Sclerosis which is quite rare. On one occasion, TL suddenly brought up my tragedy in the previous year. He said that I should just accept the truth that the tragedy happened because I lacked influence compared to other students. I was quite upset with TL and I decided to stop carpooling with him since then. There were WriSkE and communication skills practice sessions at NUMed on 30 January. That was followed by seminar sessions on haematology, oncology and rheumatology. At that time, I gave the Chinese New Year cards to IL, NB, CL, PG and YM. They were very happy to receive it.

February 2020:

The Prescribing Safety Assessment (PSA) was on 3 February. It was delivered online at the NUMed IT cluster. The PSA was a bit more difficult compared to the previous year, but I could answer it better this time as I was well prepared. I was quite confident of passing the PSA. After that, there was a photography session for my batch. We took photos in front of Bell's court and at the lecture theatre. It was really fun. I did revision for physical examinations on 4 February. On 5 February, it was the summative in-course MOSLER assessment for Medicine, held at HSI. I drove to the hospital myself starting from that day. I got a case of Haemorrhagic Stroke. I forgot to ask about seizures in the history taking and the examiner said that it was important for the case. My performance was otherwise good and I got a pass for all 5 domains. With that, I passed all domains in 5 in-course MOSLER's. TL came and asked me "Where's my Chinese New Year card?", to which I replied bluntly "There's none. I never intended to give you one." After the MOSLER, I had lunch with TL, IL and PG in Mount Austin.

On 6 February, there was an acute care simulation session at NUMed. I got a case of Anaphylactic Shock. Although I completed all the required management steps, the lecturer remarked that I could have given the IM Adrenaline faster. There was a radiology session on that afternoon. The following week was the assistantships at HSA. Around that time, I decided to move to another group for the ED Ortho and Surgery rotations as I really didn't want to be in the same group with TL. NB and CL agreed to let me join their group. As I had a good relationship with PG and IL, my decision to switch groups was a difficult one. I explained my decision to PG and IL, emphasising that I had absolutely no issues with them, and they were very understanding. However, NUMed said that I couldn't switch groups for ED Ortho as it was too late to make a change, so I remained in the same group for ED Ortho. Meanwhile, NUMed agreed to consider my request to switch groups for Surgery and I would be informed of the outcome later on.

On 7 February, I met up with my close friend who had graduated and we had dinner. I watched Joker (2019) on 8 February and Ready Player One on 11 February. On 13 February, there were seminar sessions on neurology, gastroenterology, cardiology and respiratory medicine at NUMed. That was the end of the Medicine rotation. On 14 February, there was a lecture on Fractures. I received my entry ticket for the NUMed Graduation Ball 2020 on that day. The ball would be held on 3 April and I was so glad about it as it would have been very emotional if it was held after the final exams. Most of my close friends would be attending the ball and I was looking forward to it. The Emergency & Orthopaedics (ED Ortho) rotation started on 16 February. I was in the same group with TL, IL, PG and SC for ED Ortho. For the first week, my group had assistantships at the Emergency Department (ED) of HSA. At the ED, we had opportunities to perform various kinds of clinical procedures. Year 3 students and Monash University students were there as well, making the ED quite crowded.

Around that time, I rewatched Captain America: Civil War and Avengers: Age of Ultron, both of which I first watched a few years ago. For the second and third weeks, my group had teaching sessions for Orthopaedics and we were posted to HSI. I was glad that the lecturer didn't change the venue of any teaching session to HSA like what happened in the previous year, as everyone in my group preferred to be at HSI. We saw many cases of fractures in the wards. I found Orthopaedics to be the most difficult among all subjects. Every day, I had lunch with my group after the session and that brought me even closer to IL, PG and SC. TL joined every time but I mostly ignored him. On 26 February, the PSA results was released. I passed it successfully, getting a score of 87% while the pass mark was 61%. I was overjoyed about getting such a high score. I got the PSA certificate for the second time as I had received one in the previous year.

There were weekly WriSkE practice sessions at NUMed run by the clinical teaching fellows. I attended it for the first time on 27 February. Malaysia reported a new case of Covid-19 on that day after there had been no cases for the past 10 days. At that time, the lecturer offered my group an extra teaching session. We weren't very keen on that, but we felt that it wasn't nice to decline his offer. When discussing the date and time for the session, TL kept saying that it mustn't be held between Friday and Monday as he would be back in his hometown, but we couldn't find any other suitable time. Then, I said that since TL had been returning to his hometown every single week, he should just skip it for once. He replied rudely "I already bought my flight ticket. Are you gonna pay for it?" I made it clear to TL that there were timetabled sessions on Friday, Sunday and Monday, so by returning to his hometown at that time, he was actually on an unauthorised absence and I could make a report to NUMed anytime. In the end, my group unanimously agreed on not having the extra session and we apologised to the lecturer. On 28 February, there was a seminar session on Radiology in Orthopaedics at NUMed.

March 2020:

Malaysia reported 7 new cases of Covid-19 on 2 March and 14 new cases on 3 March. I was feeling a bit worried about the Covid-19 situation and I started paying attention to the number of new cases every day. On 5 March, there was a WriSkE practice session. I forgot about it and didn't attend, which made me feel quite bad. The next two weeks were the assistantships and my group was posted to the ED of Kluang Hospital. We travelled to Kluang on 7 March. I dared not drive to Kluang myself, so I decided to follow IL. TL followed along too, while PG followed SC. We stayed at Extreme Boutique Hotel in Kluang. It's a very nice hotel, better than Ailang Hotel which students used to stay in the previous years. I was supposed to be in the same room with TL, but TL chose to book his own room and I was so glad about that. A few other groups were in Kluang too. On that evening, we went for dinner at Hey Bro Burger. On 8 March, there were very few patients at the ED of Kluang Hospital. We had lunch at Tangkak Beef Noodles on that afternoon. My close friend who had graduated lives in Kluang. I met up with him and we had dinner at Spiced Mala Hotpot. Meanwhile, my group mates went to Kluang Mall.

On 9 March, we spent several hours at the ED. We performed some clinical procedures and got some of the competencies in our logbooks signed off. On that evening, we had dinner at Cheese U. TL kept talking about cars despite the fact that no one in my group was interested to listen. Later at night, TL suddenly said that he had a personal emergency and asked IL to send him back to Johor Bahru immediately. He wouldn't tell what happened exactly, but I thought it was a genuine emergency. My group had made great plans for the next 2 days, and it got disrupted because of that. On 10 March, I went to the medical wards of Kluang hospital to practice history taking and physical examination while PG and SC stayed at the ED. I clerked cases of Asthma, Gastroesophageal Reflux Disease, Heart Failure and Prolapsed Intervertebral Disc. After that, I went to the ED and did some clinical procedures. I, PG and SC went for dinner at Restoran Sri Cahaya on that evening. One of SC's friend from another group joined us and I got to know her. After dinner, we wanted to have Murtabak but we couldn't find the stall no matter what.

11 March was our last day in Kluang and we didn't go to the hospital on that day. SC would be going back to her hometown so she couldn't send me and PG back to Johor Bahru. PG had to follow RB while I had to follow AF. I had the opportunity to know IG, AF's friend in his group, and I had a great conversation with her. I, AF and IG went for lunch at Tangkak Beef Noodles. Then, we had desserts at Kluang Railway Coffee before returning to Johor Bahru. I definitely had a very great experience in Kluang, which made me feel really attached to my group (with the exception of TL). As a result, I found it really difficult to separate with them for the Surgery rotation. NUMed still hadn't informed me the outcome of my request to switch groups. After thinking about it carefully, I decided that I no longer wanted to switch groups. At that time, the Tabligh cluster of Covid-19 had just been identified and it was likely that the Covid-19 would be spreading more widely in Malaysia. I was quite worried about it. 

On 13 March, there was a revision session on headaches, Hyperthyroidism, Coeliac Disease and MEN Syndrome at the NUMed campus. On that day, I heard of the news that University of Cambridge had decided to cancel their final clinical exams due to the Covid-19 situation. I really hoped that NUMed would be cancelling our End of Stage MOSLER as well, as it was my weak point that caused me to fail the previous year. At that time, TL told me about his personal emergency in Kluang. What happened was that his hotel room was haunted! I was furious to know that. Just because of something so silly like that, TL went to the extent of asking IL to send him back to Johor Bahru so late at night. TL definitely wouldn't want to go to Kluang again. Without him, my next week in Kluang with my group would surely be even more fun and I was looking forward to that so much. PG had told me that her friends from another group would be in Kluang as well and I wanted to get to know them. IL planned to travel to Kluang on 15 March and I would be following her again.

On 14 March, a NUMed staff suddenly messaged me and asked for the phone numbers of every one in my group. I saw the message only after some time and I phoned back to ask for the reason. However, the staff said that she already got their numbers and that she would contact us later if required, without giving any extra information. I was quite confused about what was going on. I wondered, could it be related to the Covid-19? Later, NUMed sent an email to inform that they had suspended all clinical placements due to the rapidly worsening Covid-19 situation. As a result, my group wouldn't be going to Kluang any more. Just as I was feeling really sad about missing a great week in Kluang, my group received another bad news. It turned out that one of the patients admitted to the ED of Kluang hospital on 10 March had just been tested positive for Covid-19! As we were there on 10 March, the NUMed staff had given our phone numbers to the contact tracing team. It was really horrifying for us.

On 15 March, Malaysia reported 190 new cases of Covid-19, up from 41 on the previous day. I watched Avengers (2012) on that night, to help give myself some relief from the stress of the Covid-19 situation. On 16 March, my group got in touch with a member of the contact tracing team and he asked us about the details of our activities at Kluang hospital. Eventually, he decided that I, PG, SC, SM, AF and IG had to undergo home quarantine for 2 weeks, as we had close contact with the Covid-19 patient. As TL and IL had left Kluang before 10 March, they didn't have to be home quarantined. Essentially, TL got saved by the ghost in his hotel room! I filled up the home quarantine form and submitted it to the Johor Bahru District Health Office. It was located in the same compound as Klinik Kesihatan Ibu dan Anak which I went there once during Stage 4. PG, SC, SM and IG were later told to do the Covid-19 test, but for some reason I and AF weren't told to do the test. 

At that time, many medical schools in UK were cancelling all their final exams. On 17 March, NUMed announced that all campus teaching and all exams would be cancelled. Many Stage 5 students would be allowed to graduate early without sitting for any exams, but a small number of students would require further assessment. They didn't have information on who would require further assessment or what would be the format of the further assessment, as the decision would be made by Newcastle University UK. While the End of Stage MOSLER got cancelled as I wished, I wasn't feeling happy. The fact that all campus teaching was cancelled meant that I wouldn't get to see my friends in NUMed again. This sudden and unexpected separation made me feel really sad. Meanwhile, the Stage 4 students would no longer get to do their Student Selected Component and Elective in UK, which was really unfortunate. On 18 March, the Movement Control Order (MCO) was implemented in Malaysia. My annoying housemate returned to his hometown right before the MCO started and I was so glad about that. Throughout my home quarantine, I had to order food delivery for every meal.

The NUMed MBBS degree is regulated by both the UK General Medical Council (GMC) and Malaysian Medical Council (MMC). On 19 March, NUMed informed that it is a GMC requirement for all students have signed off all competencies in the logbook. On 20 March, NUMed informed that although the GMC had approved the cancellation of final exams, it wasn't known whether the MMC would allow final exams to be cancelled. Therefore, everyone in Stage 5 was advised to continue studying for the final exams as usual. That was an indication that final exams might be reinstated. I realised that the reinstatement of final exams would give me the opportunity to meet my friends in NUMed again. I would rather sit for the End of Stage MOSLER than to not see my friends again. I was feeling hopeful and I began doing revision for the WriSkE, SBA and End of Stage MOSLER at that time. My birthday is on 23 March. I couldn't go out to celebrate as I was still under home quarantine. Instead, I ordered food delivery from McDonald's. Compared to the previous year, more people wished me this year, including my close friends in the new batch. Therefore, I still had a great birthday.

I never got called to do the Covid-19 test and my home quarantine ended on 25 March. My friends were tested negative for Covid-19 and their home quarantine ended at the same time. I went to buy a birthday cake for myself. There weren't many places I could go to. Under the MCO, dine-ins at restaurants weren't allowed so many of the restaurants in EcoBotanic were closed. The NUMed campus had to be closed completely. I hardly went out and I spent most of the time at EcoNest. For my meals, I ordered either take-away or food delivery. Thanks to the fact that EcoNest is a very nice place and has excellent facilities, it made the home quarantine and MCO much more bearable for me. The cleaning service for EcoNest had to be stopped. Some students returned to their hometowns around that time, but I didn't. Starting from 28 March, NUMed provided free lunch and dinner every day for students who were still in Johor Bahru. The taste of the food was so-so, but I was really grateful to NUMed. On 31 March, I watched 我的少女时代 online. Although the reviews of the movie were very good, I didn't like certain parts of the storyline. 

April 2020:

On 3 April, many Stage 5 students in Newcastle University UK graduated from the MBBS course, except for those who required further assessment. NUMed couldn't do the same as they hadn't received the approval from MMC. The NUMed Graduation Ball 2020 was supposed to be held on that night, but it was suspended until further notice due to the Covid-19 situation. There was 2 weeks of Easter break from 4 April to 19 April. Considering the Covid-19 situation, I decided not to go back to Subang Jaya or Kulim. On 6 April, SF who was a NUMed teaching fellow created a WhatsApp group for all those who were thinking of applying for the teaching fellow post. I was interested in applying so I joined the group. I found out that many of my close friends in the new batch were also in the group, which made the teaching fellow post even more attractive for me. I bought a new cover for my iPad Air 3 through Lazada at that time.

Around that time, MMC published a guidance to medical schools which stated that final exams must be carried out. That meant it wouldn't be possible for NUMed students to graduate without sitting for final exams. On 16 April, a lecturer informed that the final exams would be postponed until the MCO ends. On 20 April, the Surgery rotation started. All of the sessions would be held online through Zoom. NUMed kept me in the same group as the previous rotation which was what I wanted. I was so glad to be able to meet and interact with PG, IL and SC during the online sessions as I hadn't seen them for quite some time. Meanwhile, I completely ignored TL. For the first week, there were lectures on various topics of surgery. On 23 April, the MCO got extended for a third time and with no end to it in sight, some students began suggesting that NUMed carry out the final exams online. I voiced out my opposition to online exams. NUMed then promised to make a decision about the final exams within a few days.

For the second week, my group had seminar sessions on Head & Neck Surgery, Surgical Malignancies, Gastrointestinal Surgery and Pre- & Post-operative Care. On 27 April, the Ministry of Higher Education published a document stating that face-to-face sessions at universities would not be allowed until the government gives the approval. That might cause further delays to the final exams at NUMed. On 28 April, NUMed officially announced that all Stage 5 students would have to sit for final exams which included WriSkE, SBA and End of Stage MOSLER. The format of the WriSkE and SBA would be the same as the previous year, while the MOSLER would be modified to use simulated patients instead of real patients. NUMed planned to have the final exams on campus some time in August and promised to give us at least 3 weeks notice of the definite exam dates.

I felt that the decision made by NUMed was quite fair and I fully supported it. I was so glad that NUMed didn't choose to have online exams. However, some students were unhappy with NUMed's decision, as having the final exams in August meant that we would graduate late. They called for the final exams to be held online in May or June, which I opposed. Later, someone found out that students in Newcastle University UK who required further assessment would be taking it online in May. On 29 April, when I was having my lunch, I suddenly noticed that I was a receiving a large number of WhatsApp messages. There was a discussion about the final exams among the whole batch. Someone in my batch had created a poll on "Do you agree with the current proposal?" and we had to vote within 30 minutes. He didn't make it clear what "the current proposal" meant, and I thought that it referred to the announcement made by NUMed on the previous day, so I voted Yes.

However, he then clarified that "the current proposal" referred to the proposal by one of the students, OP, to have the final exams online in May or June. I didn't notice her proposal as there were so many messages. I was definitely against having online exams and I was outraged by the vagueness of the poll's wording. He then allowed me to change my vote to No. Some of the students kept persuading everyone to vote Yes in the poll. I opposed that very strongly and I got criticised by a few students. The support for having online exams was particularly strong among the repeat students and students planning to join UKFP 2020. The outcome of the poll showed that 78% of the students supported the proposal to have online exams. OP sent an email to NUMed with her proposal and the poll outcome. Meanwhile, I sent an email to NUMed to express my full support for the decision they had made regarding the final exams. 

Later, I apologised to everyone in my batch for being a bit too harsh in my earlier messages and explained the reasons I was strongly against online exams. I pointed out that any computer or internet connection issues would affect our performance in online exams. Besides, to prevent cheating, online exams might either be designed such that each question is only displayed for a fixed amount of time or require the use of a proctoring software which would have a high system requirement, both of which would disadvantage us. Although the PSA was also delivered online, it didn't have these issues as it was held at NUMed under full invigilation, unlike online final exams which would have to be taken from home due to the Covid-19 situation. As OP didn't get a positive response from NUMed, she wanted to escalate the issue directly to Newcastle University UK. However, some students were against that as they feared it might be a professionalism issue. RG personal attacked me with some really harsh words because of my opposition to online exams, and I stopped being friends with him. 

May 2020:

NUMed informed that students staying at EcoNest would be allowed to continue staying at no additional charges even after the tenancy ends in June. On 4 May, the MCO got replaced with the Conditional MCO (CMCO). Under the CMCO, dine-ins at restaurants were allowed and many economic sectors were allowed to resume operations. The first shop I went to dine in was LYM Tea at the ground floor of EcoNest. For the third week of Surgery rotation, my group had seminar sessions on Vascular Surgery, Genitourinary Surgery, Gastrointestinal Surgery and Fluid Prescriptions. At that time, there were several WriSkE practice sessions conducted by the clinical teaching fellows through Zoom and I attended all of the sessions.

On 5 May, NUMed had a Zoom meeting with everyone in my batch regarding the final exams. NUMed stated that for the online SBA exam taken by UK students, there would be only 72 seconds to answer each question, down from 108 seconds per question in the paper-based SBA exam, so they felt that it wouldn't be suitable for us. At that point, many students stopped supporting online exams. I had planned to voice out against online exams during the meeting, but I felt there was no need to do so anymore. NUMed told us that with the CMCO replacing the MCO, they were hopeful that the final exams could be held on campus before August. They also stated that current repeat students would be given another opportunity to repeat Stage 5 if they fail the final exams again. With that, I didn't have to worry about dropping out of MBBS anymore.

Newcastle University UK would be having another Zoom meeting about the final exams with a few representatives from my batch. NUMed wanted 1 representative from the repeat students and 5 representatives from the new batch. I nominated NB to be one of the representatives. For the repeat students, although someone had agreed to be the representative, RG insisted to be another representative. Much to my delight, RG's nomination was rejected by NUMed. At that time, someone found out that for Newcastle University UK students, the WriSkE would be incorporated into the End of Stage MOSLER. He proposed that the same should be done for NUMed students, which I opposed as we weren't familiar with that format and it wouldn't benefit us in any way. Some other students opposed it as well. On 6 May, NUMed resumed the cleaning service for EcoNest.

On 8 May, NUMed created a poll on whether we wanted the final exams to be held in July or August. I actually preferred to have the exams in August so that I could have more time to prepare, but I voted July as I knew that many students were concerned of delayed graduation. As it turned out, 58% of the students voted July, which wasn't that great of a majority I had expected. The second meeting about the exams was held on 11 May. Newcastle University UK reiterated what NUMed had mentioned in the previous meeting. They clarified it wasn't true that the WriSkE would be incorporated into the End of Stage MOSLER for UK students. They also said that the End of Stage MOSLER would have 6 stations, down from 8 in the previous years. At that point, most students in my batch accepted the decisions NUMed had made and there were no more calls to have online exams.

On 13 May, it was the formative in-course MOSLER assessment for Surgery, held online. I got a case of Acute Appendicitis. I performed quite well and got a pass for all 5 domains. I had another formative in-course MOSLER on 18 May. The case was Colorectal Cancer. The examiner was quite strict and she pointed out a few areas which I could improve on. Still, she gave me a pass for all 5 domains. Due to the Covid-19 situation, the summative in-course MOSLER assessment for Surgery was not held. The last WriSkE practice session was on 21 May. That was the end of both the Surgery rotation and HBP. Occasionally, I would message my close friends in the new batch to keep in touch with them. On 27 May, the Ministry of Higher Education announced that final year medical, dental and pharmacy students would be allowed to return to campus for face-to-face sessions on 1 July, subject to the ending of the CMCO.

June 2020:

Around that time, I learnt how to solve a 4x4x4 Rubik's cube through online. It's just a little more difficult than solving a 3x3x3 Rubik's cube. The only part that's difficult is solving OLL parity. I then bought a 4x4x4 Rubik's cube through Lazada. The quality of the cube was excellent. On 10 June, the CMCO ended and was replaced with the Recovery MCO (RMCO). Under the RMCO, travel between states was allowed and schools and universities would be allowed the reopen gradually. On 11 June, NUMed announced the definite dates of the final exams, which would be from 13 July to 28 July. There would be 2 weeks of online and campus teaching sessions in early July before the final exams. Students who hadn't completed the sign-off of all competencies in the logbook would be given the opportunity to do so at the NUMed campus before or after the final exams. 

At that time, I was busy preparing for the final exams. I mostly revised the textbooks and WriSkE notes. I didn't do a lot of SBA practice questions on PassMedicine as I felt that they were quite different in style from the questions in the previous year's SBA exam. I didn't feel too stressed as I had been studying consistently since March. On 14 June, my close friend who had graduated came to Johor Bahru and I had dinner with him. On 16 June, the group list for the July sessions was released. I would be in the same group with TL but not with PG and IL, which was really unfortunate. I tried switching to PG and IL's group, but I couldn't find someone to swap groups with me. I then switched to NB and CL's group by swapping with one of my friends. TL phoned me twice at that time, most probably to ask about my group switch, but I refused to answer his call. A rep was needed for each group to set up the Zoom meetings for the online sessions, and I volunteered to be the rep for my group. 

On 18 June, the Graduation Ball committee announced that the NUMed Graduation Ball 2020 had been cancelled due to the Covid-19 situation. They would be refunding the fees and giving a souvenir to everyone. They were still planning to have a smaller scale celebration. While I felt quite disappointed about that, I understood that they had done their best. I decided to take the souvenir but not the refund as I found it meaningless. On 19 June, my group had an online session for Orthopaedics. PG's birthday is on 21 June. I bought a birthday card for her, but I couldn't pass it to her as she was back in her hometown. On 29 June, there was a briefing where NUMed explained about the Standard Operating Procedures at the campus which would reopen on 1 July. The library and IT cluster would be open every day, and students who wished to use them had to making an online booking on the day before. On 30 June, there was a talk on House Officer training and MMC & GMC registration.

July 2020:

At that time, I opted out of receiving the free food provided by NUMed every day. The NUMed campus reopened on 1 July and I went there for the first time after more than 3 months. My group had an online session for Mental Health on that day. In the evening, my close friend who had graduated came to Johor Bahru and we had dinner. He just got a House Officer post at Penang Hospital and would be starting it soon. On 2 July, my group had sessions on Surgery, Acute Care Simulation and Medicine at the NUMed campus. I got a case of Peritonitis for the acute care simulation. I was so happy to see my friends again as I hadn't seen them for a long time and we had a lot to talk about. I passed the birthday card to PG on that day and she was happy to receive it. IL who was part of the Graduation Ball committee insisted that I take the refund. For the souvenir, there was a choice between blue and pink cups and I chose the pink cup.

I wanted to join extra sessions at the NUMed campus with another group, but NUMed wouldn't allow it due to social distancing requirements. On 3 July, there was a briefing for the End of Stage MOSLER. We were told that we had to wear apron, surgical mask and visor during the MOSLER. Unlike the previous years, we had to be quarantined before and after the MOSLER each day to ensure security of the exam content. As only simulated patients would be used, the clinical signs would be provided verbally after we completed a physical examination. Starting from 4 July, I went to the NUMed IT cluster to study almost every day. NB was also there every day. Occasionally, she would offer me some snacks or ask me some questions on certain subject areas. On 5 July, I used the swimming pool at EcoNest. That was my first time using it after staying at EcoNest for close to 2 years.

Around that time, my PassMedicine subscription expired. They agreed to extend my subscription for free after I told them that my final exams were postponed. On 6 July, my group had sessions on Mental Health and Child Health at the NUMed campus. There was a case of self-harm and I had to perform a risk assessment. On that afternoon, there was a communication skills session held online. I volunteered to do a case about explaining the diagnosis of Asthma to a patient. We had an online session for Child Health on 7 July. On 8 July, we had several online sessions on Women's Health in the morning, followed by an online session on Surgery in the afternoon. That was the last day of teaching sessions. My group was very satisfied with my performance as the rep. Close to the final exams, I did some SBA practice questions on PassMedicine. In total, I completed about 500 questions.

The Written Skills Examination (WriSkE) was on 13 July, while the Single Best Answer (SBA) exams were on 15 and 16 July. The WriSkE wasn't difficult, but the questions were quite time consuming so I had to rush to finish them on time. The SBA was a bit easier compared to the previous year as the questions were more direct and had less focus on clinical reasoning. I was very confident of passing both the WriSkE and SBA. After the SBA, there was a walkthrough for the End of Stage MOSLER. On the following days, I practised the MOSLER with PS and AF. I was really serious when practising, unlike in the previous year. The End of Stage MOSLER assessments were on 22, 23, 27 and 28 July. On the 1st day, I got cases of Cauda Equina Syndrome secondary to Prolapsed Intervertebral Disc and Contraception counselling. On the 2nd day, I got cases of Severe Depression and Haemophilia A. On the 3rd day, I got a case of Sheehan's Syndrome. On the 4th day, I got a case of Ruptured Abdominal Aortic Aneurysm (AAA). The quarantine for the MOSLER reminded me of the quarantine for the science practical exams back in A Level. During the quarantine, I talked to my friends.

I performed quite well in the first 3 days. However, I found the Ruptured AAA case really difficult. It was an acute care simulation. The patient initially presented with pain in the left flank and was diagnosed with renal colic. The pain then worsened and progressed into generalised abdominal pain. Together with the MOSLER instruction sheet, there were 2 pages of patient notes which mentioned "renal colic" several times, as well an ECG showing sinus tachycardia. The blood pressure of the patient was 89/59 while the temperature was normal. There was generalised tenderness on palpation of the abdomen. No blood was visible in the urine output. I thought of the diagnosis of urinary tract infection or obstruction which are complications of renal colic, but they didn't fit in with the patient's presentation. In the end, I just couldn't make the diagnosis of Ruptured AAA, although I managed to perform ABCDE and prescribe IV Morphine for the pain. Consequently, I was a bit worried about the End of Stage MOSLER. Most of my friends couldn't diagnose the Ruptured AAA as well.

On 29 and 30 July, there were clinical skills sessions at the NUMed campus for students who hadn't completed the sign-offs of all competencies in the logbook. NUMed needed two students to help out with the coordination of the sessions, I and one of my friends volunteered for that. There was still no news about the NUMed teaching fellow post application at that time. We asked a lecturer about it, and he told us that NUMed was still planning to recruit teaching fellows, just that they were waiting for the approval from Newcastle University UK. I attended the suturing session, where I practised performing sutures on a banana and got the wound closure competency signed off. With that, I had completed all sign-offs in my logbook. I met DD and SD who attended one of the sessions and took photos with them.

The Graduation Ball committee distributed a free pizza to everyone in my batch to celebrate our completion of the final exams on the afternoon of 29 July. The distribution was done at Garden Cafe of NUMed and it was quite fun. Although I wasn't part of the committee, I stayed with them till the end of the event. I had conversations with them and I had the opportunity to meet almost everyone in my batch. On the afternoon of 30 July, a logbook review session was held at the NUMed campus. SC made batik cake and she gave me a box of it at that time. I met NB and CL during the session and took photos with them. After the session, I had lunch with PG and IL at Tang Ren, EcoBotanic. We had a great catch-up on what happened in the past few months. I also took photos with them.

August 2020:

I watched Fast and Furious: Hobbs and Shaw on 3 August. On 4 August, I went swimming at the EcoNest swimming pool for the second time. On that evening, I had dinner with SC, SM and EM at K Fry, Holiday Villa. We had some interesting conversations and we took photos. Around that time, TL blocked me on all social media. On 6 August, the final results for Stage 5 was released and I passed all of the final exams successfully. For the WriSkE, I scored 90.8% while the pass mark was 64.8%. For the SBA, I scored 75.5% while the pass mark was 62.8%. For the End of Stage MOSLER, I scored 14/18, 11/18, 12/18, 11/18 and 13/18 for the 5 domains while the pass mark was 10/18 for each domain. The MOSLER was still my weak point as I was just 2 marks away from failing 2 of the domains. After 6 years, I finally graduated from the MBBS course at NUMed and I was so happy about that. While most of my close friends passed the final exams, unfortunately a few of them failed. A total of 14 students failed Stage 5.


Stage 5 2019/2020 had definitely been a very great year for me. This year is surely much better than my previous year of Stage 5, and it is my most favourite year in NUMed. I can say that I have no regrets repeating Stage 5. The course content of this year is really interesting and intellectually stimulating. I did make the most out of the learning opportunities I had throughout the year and I put in my efforts to improve on my weaknesses. My efforts paid off in the end. I am really happy with my PSA and WriSkE results, while I feel that I could have done better in the SBA and End of Stage MOSLER. I didn't find this year very stressful as I was just relearning what I had learnt in the previous year. I often taught my friends in the new batch using the knowledge I gained from the previous year. Not only I enjoyed doing that, it also helped enhance my own knowledge and gave me valuable teaching experience for my NUMed teaching fellow post application.

My friends in the new batch are very nice and they gave me a great experience throughout the year. I mixed with them more than the repeat students. I have a lot of good memories with them, which I will keep remembering for a very long time to come. Although I have only known them for about a year, the memories I have with them is surely comparable to the memories with those in my original batch. I really hope we will continue to keep in touch moving forward. On the other hand, TL is a real annoyance, and I made the right choice to stop mixing with him. The imperfection of this year was the disruptions caused by the Covid-19 to clinical placements and campus teaching. However, it made me cherish the time with my friends in the new batch even more. Thankfully, we could still return to the NUMed campus for teaching sessions and final exams in July 2020. I am so glad that I didn't graduate early without sitting for any final exams, as that would be an anticlimactic and unsatisfying ending to my MBBS course at NUMed.

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