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.

Monday 5 December 2022

A weird dream (Jul 2022)

I had a weird dream on 31 July 2022.

In my dream, Kluang hospital organised a holiday trip to Penang. I and several of my House Officer colleagues joined the trip. We stayed at the top floor of a hotel in Penang.

At one point, the building of the hotel started swaying. I wasn't too concerned about that, as I had known that tall buildings are designed to sway during strong winds to help prevent damage.

Suddenly, the Medical Officer in charge of the trip told us to evacuate the building as it had suffered structural damage from excessive swaying. She scolded the House Officer leader for not relaying the evacuation order to us earlier.

When walking down the emergency stairs, my colleagues were quite slow and I was far ahead of them. I kept rushing them, saying that although I didn't think the building would collapse, we shouldn't risk our lives.

Influenced by me, they started speeding up. Eventually, all of us reached the ground floor. As soon as we walked out of the hotel, I saw its upper floors falling down. Luckily, it fell on another side, otherwise we would be crushed!

My colleagues then said that if they were just a bit slower in evacuating the building, they wouldn't have made it. They thanked me a lot for saving their lives by rushing them during the evacuation.

Later, we went to a restaurant and they treated me with a huge meal. I felt so honoured and I was over the moon. Then, I woke up from the dream.

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Tuesday 29 November 2022

Instagram Close Friends list

Instagram has a Close Friends feature in which you can choose to share your Instagram stories only to those of your followers that you have added to your Close Friends list. Now, I use the Close Friends feature a lot, where vast majority of my Instagram stories are only shared to my Close Friends list.

When Instagram first introduced the Close Friends feature in 2018, I wasn't interested in the feature at all, as I wanted as many people as possible to see my Instagram stories. I always shared my stories to all of my Instagram followers. At that time, majority of my Instagram followers were my friends from the 2014-2019 batch of NUMed and my Taylor's College friends. I only shared Instagram stories occasionally, when I had interesting events.

In February and March 2019, I went through a crisis with my group mates in 5th year of MBBS. While I undeniably made mistakes in that crisis, the fact was that my group mates had their mistakes as well. However, they refused to acknowledge any of their mistakes, instead they kept exaggerating my mistakes and sabotaging me. Many others in the 2014-2019 batch simply believed the narratives of my group mates without bothering to get my side of the story, and they disliked and looked down on me. It made me realise I had many fake friends in the 2014-2019 batch, and I no longer valued them.

The crisis contributed to my failure in 5th year of MBBS, which required me to repeat the year by joining the 2015-2020 batch. In my repeat year, I wanted to move on from the crisis and the 2014-2019 batch. I started making many new friends in the 2015-2020 batch. While I didn't know them well in the beginning, I got closer and closer to them as time went on. They gave me a great experience for my repeat year and I liked and valued them a lot.

In December 2019, a guy TL, who was originally from the 2014-2019 batch and was repeating the year as well, started becoming a real annoyance to me. As I was quite nice to him, he kept taking advantage of me. I didn't like being close to him as he didn't have any sincerity in friendship. I preferred mixing with my new friends in the 2015-2020 batch so much more compared to him. I tried to stay away from TL, but he kept trying to stick to me.

In January 2020, TL developed a new habit. Whenever I shared an Instagram story, he would open it using his phone right in front of me and my friends and mock it. He also often spammed my Instagram stories with irrelevant reactions and replies. Those were his desperate attempts to seek my attention as I increasingly avoided him, and I really hated that. To put a stop to that, I could just remove him from my Instagram followers list or even block him from my Instagram, but I didn't want to go to that extent.

At that time, I realised that the Instagram Close Friends feature would be the solution. By sharing my Instagram stories to my Close Friends list, which most definitely wouldn’t include TL, he wouldn't be able to see my stories anymore. I added all my new friends from the 2015-2020 batch and those few of my true friends from the 2014-2019 batch to my Close Friends list. Initially, I shared some of my Instagram stories to my Close Friends list and some to all of my Instagram followers. As time went on, I increasingly used the Close Friends feature, as I felt more comfortable to be in control of who could see my stories.

In March 2020, the Covid-19 pandemic started and the Movement Control Order (MCO) was soon implemented. NUMed had to suspend all face-to-face classes and clinical placements. Consequently, I couldn't meet my friends in the 2015-2020 batch. I was very sad about that and at that point, I realised they were the ones that mattered most to me among all my friends. My fake friends in the 2014-2019 batch as well as TL were absolutely of no match to them. 

The Covid-19 pandemic brought huge disruptions to our daily lives, giving everyone a difficult time. Almost everything posted on the social media was about the Covid-19, and seeing them just made us feel even more stressful. Whenever we came across rare posts and stories that weren't talking about the Covid-19, we would feel better.

To keep in touch with my friends, I decided to update my Instagram story every day. My stories were mostly about my daily life, such as the food I ate, how I kept myself entertained when I was bored and my preparation for the final exams, as well as interesting things I came across on the Internet. I never mentioned anything about the Covid-19 in my stories. I was hoping that my stories would give a sense of normalcy amid the Covid-19 pandemic, which would make my friends feel a bit better.

I also decided that moving forwards, vast majority of my stories would only be shared to my Close Friends list. Having known who are my most valuable friends, I felt that only they should see my stories. I always had the habit of checking who has seen my Instagram stories after I shared them. I would love to see the viewer list comprising entirely of those friends that matter a lot to me. It's the quality that matters, not quantity.

Sharing to my Close Friends list would also make my Instagram stories look more special, as they would show up with a distinctive green circle instead of the usual red circle. Since not many people use the Instagram Close Friends feature, my friends would notice my Instagram stories better. When they see that they are in my Close Friends list, they would know that I value them a lot.

Due to the MCO, the MBBS final exams originally scheduled for May 2020 had to be postponed. A few students from the 2015-2020 batch together with a few who were repeating the year came up with a proposal to have the final exams online, so that there wouldn't be delays to the exams and thus our graduation. However, I strongly believed that having the exams online would bring more harm than good, due to unfamiliarity with online exams and the strong possibility of internet connection issues, so I voiced out against their proposal.

A highly questionable poll showed that majority of the batch supported online exams. Unfazed by that, I continued opposing online exams by giving compelling arguments against it, and a few students criticised me for that. I got a bit worried that it might lead to me getting disliked by the 2015-2020 batch, much like what the 2014-2019 batch did to me in the previous year. However, I was confident that I was fighting for the best outcome for the 2015-2020 batch.

One of my close friends then messaged me to state that she and her friends appreciated my efforts in opposing online exams. Some others in the 2015-2020 batch also felt that my opinions were valid. Soon, many in the 2015-2020 batch realised that having online exams was a bad idea and they too were against it. My courage in speaking up against online exams earned their respect. Eventually, NUMed maintained its decision to postpone the final exams rather than having it online.

This incident made it obvious that the 2015-2020 batch is different from the 2014-2019 batch. Most of the 2015-2020 batch are capable of thinking rationally rather than simply making baseless conclusions and disliking someone. It made me love the 2015-2020 batch even more, and I decided to expand my Instagram Close Friends list by adding in all of my followers from the 2015-2020 batch.

The MCO gradually eased starting from June 2020. NUMed was able to resume face-to-face teaching and conduct the final exams in July 2020. I could meet my friends in the 2015-2020 batch once again and I was overjoyed about that. At that time, it had become a habit for me to share Instagram stories to my Close Friends list almost every day, so I continued doing so.

After I completed my MBBS degree, I started working as a Teaching Fellow at NUMed in October 2020. While I didn't know my Teaching Fellow colleagues well in the beginning, I soon became very close to them. Of course, I added them to my Instagram Close Friends list. They were from the 2015-2020 batch as well.

In March 2021, many of my students in NUMed started following me on Instagram. I then decided to add all of them to my Instagram Close Friends list. I really enjoyed my Teaching Fellow job and I had a lot of great memories with my students, so they surely deserved to be in my Close Friends list. That greatly expanded my Close Friends list.

In August 2021, I started working as a House Officer. In the beginning, I struggled to adapt to the House Officer job and I had very few friends in the hospital. Later, as I gained more skills and experience, the situation improved a lot. I became good friends with many of my House Officer colleagues and I added them to my Instagram Close Friends list.

Basically, I only add those of my friends who have meaningful good memories with me or have contributed positively to my personal development to my Instagram Close Friends list. Some may think that I simply add a lot of people to my Close Friends list without second thoughts, but that's not the case in reality.

For the foreseeable future, I will keep sharing vast majority of my Instagram stories only to my Close Friends list.

Tuesday 25 October 2022

The Dvorak keyboard layout

Anyone who has ever borrowed my phone would have noticed something strange: The touch screen keyboard of my phone appears to be all jumbled up!

Everyone who had used my phone had found it very difficult to type using the keyboard, and what I would do every time is to change the keyboard to the standard QWERTY layout so that they could type normally.

So, why does my phone have such a jumbled up keyboard? You may think that it's due to some kind of a software error. In reality though, I intentionally set up my phone's keyboard like that, and that's what I use every day.

It's known as the Dvorak keyboard layout. The arrangement of the keys in this layout is very different from the standard QWERTY layout which everyone is familiar with. While far less popular than the QWERTY layout, the Dvorak layout is actually better.

Have you ever wondered why the keys on a keyboard are not arranged in alphabetical order from A to Z?

Before computers were invented, keyboards were first used on typewriters. In the beginning, the keys on keyboards were indeed arranged from A to Z, and such a layout enabled users to type very fast. While that might seem to be a good thing, the issue was that back in those days, the keys on typewriters would easily get jammed when typing was done too fast. Jammed keys was a huge annoyance as it would disrupt typing.

To help prevent the keys from getting jammed, the typing speed had to be reduced. To achieve that, the QWERTY keyboard layout was invented. In the QWERTY layout, commonly used letters are placed away from the centre of the keyboard and common combinations of letters are placed further apart from each other. That made typing significantly slower.

The QWERTY layout increased the efficiency of typing on typewriters, because although the typing speed was reduced, the occurrence of jammed keys was also greatly decreased. The QWERTY layout quickly gained popularity across the world, and nearly all typewriters adopted it.

When computers were later invented, the manufacturers simply used the QWERTY keyboard layout because of its popularity. However, unlike typewriters, jammed keys doesn't occur on computer keyboards. On computers, the faster the typing, the better it is. Therefore, the QWERTY layout actually confers no advantage on computers.

Because of that, the Dvorak keyboard layout was invented. In the Dvorak layout, most commonly used letters are placed in the middle row and all vowels are placed on the left side of the keyboard. This layout aims to reduce the movement of fingers and maximise the successive use of both hands when typing.

The end result is that the Dvorak layout not only speeds up typing, but also makes it less tiring for the fingers. Studies have shown that for someone who is new to typing, it's easier to train typing with the Dvorak layout.

While the Dvorak keyboard layout has advantages over the QWERTY layout, the Dvorak layout failed to gain widespread adoption. As a matter of fact, most people have gotten used to the QWERTY layout and are not keen on changing. Consequently, computer manufacturers continue to make keyboards with the QWERTY layout.

Very few people use the Dvorak layout nowadays. However, most computer operating systems do support the Dvorak keyboard layout.

I first came to know about the Dvorak keyboard layout in 2009. Since then, I have been interested to use it. It doesn't matter to me that the Dvorak layout has very few users. Instead, the most important thing is the fact that the Dvorak layout makes typing faster and less tiring. Although I could type very well using the QWERTY layout, I still wanted something better.

However, I didn't have a keyboard with Dvorak layout and it's very difficult to get one. There were suggestions on the Internet to manually remove the keys on a keyboard and rearrange them in the Dvorak layout. However, the keys on my laptop's keyboard are not designed to be removable, attempts to remove them would damage the keyboard.

It's possible to use stickers to relabel the keys on a keyboard. However, I didn't want to do that as it would make my keyboard look really weird. Another alternative would be to memorise the Dvorak layout, but that was too challenging for me. Consequently, I gave up on the idea of using the Dvorak layout.

Many years later in 2016, I discovered by chance that the touch screen keyboard powered by Gboard on my Android phone does support the Dvorak keyboard layout. That rekindled my interest in the Dvorak layout. I started using the Dvorak layout on my phone at that time.

Using the Dvorak layout was quite challenging for me initially. Being used to the QWERTY layout, I had to relearn the Dvorak layout from scratch. I struggled to find the locations of each key and that slowed down my typing a lot. I also made typing errors quite often. Sometimes, I had to switch back to the QWERTY layout when I needed to type fast.

Apart from my phone, I wanted to use the Dvorak keyboard layout on my iPad as well. Unfortunately, the touch screen keyboard in iOS and iPadOS didn't natively support the Dvorak layout. Still, it's possible to install a 3rd party keyboard app that supports the Dvorak layout on an iPad.

However, all the 3rd party keyboard apps I found had poor design where the keys were either too big or too small and they were quite laggy, which made typing quite inconvenient. None of them could offer the intuitive typing experience of my iPad's default keyboard. Therefore, I soon gave up on using the Dvorak layout on my iPad.

I had use the QWERTY layout on my iPad and on my laptop. Therefore, I had to master both the QWERTY and Dvorak layouts. Despite the challenges, I persevered with using the Dvorak layout on my phone. As time went on, I became more familiar with the layout and I got better at typing with it.

By 2018, I could type using the Dvorak layout at almost the same speed as I could with the QWERTY layout, although I still made typing errors occasionally. That year, Gboard added support for the Dvorak layout on iPhones and iPads. While Gboard on iPad had a much better design compared to other 3rd party keyboard apps, it's still awkward to use compared to the iPad's default keyboard, so I didn't want to use it.

By 2020, I have mastered the Dvorak keyboard layout on my phone. I use it all the time and I prefer it over the QWERTY layout. Meanwhile, I still maintained my proficiency at typing with the QWERTY layout. I was a bit disappointed about not being able to use the Dvorak layout without compromises on my iPad. I always hoped that Apple will add native support for the Dvorak layout on iPhones and iPads.

Now, my wish has finally been granted. The newly released iOS 16 and iPadOS 16 have added native support for the Dvorak keyboard layout. I can now type using the Dvorak layout with the great default keyboard on my iPad. This is surely one of my most favourite features in iPadOS 16.

Monday 19 September 2022

24 reasons why Dr Strange in the Multiverse of Madness and Thor: Love and Thunder are the same movie

1. MCU Phase 4 movie after Avengers: Endgame

2. Got banned in several countries

3. The protagonist has superpowers but isn't happy in his life

4. The protagonist's girlfriend left him many years ago but he still misses her every moment

5. The protagonist's girlfriend is now a scientist

6. The villain lost their children and wants to get them back at all costs

7. The villain's mind got corrupted by an object that gives them dark powers

8. The villain attacks the good guy's headquarters

9. Many heroes join forces at the headquarters, but the villain still defeated them

10. The protagonist and his ex-girlfriend fight the villain together

11. The villain managed to kidnap children with superpowers

12. The good guys pursue the villain across different worlds

13. The good guys try to seek help from a council of powerful people, but the council refuses to believe or help them

14. The council arrests the good guys, but the good guys successfully break free

15. The good guys realise that the villain seems too powerful for them and got really scared as the villain approaches

16. The final fight occurs at the place where the villain is the most powerful

17. A good fight took place, but in the end the good guys are unable to defeat the villain

18. The good guys admit defeat and allow the villain to have what they want

19. The villain realises their mistake and does the right thing in the end

20. The protagonist finally gets to confess his feelings to his ex-girlfriend, and she accepts it

21. The protagonist still doesn't get to be with his ex-girlfriend in the end, but he accepts the reality

22. The villain got the reassurance that their children will be loved

23. The villain dies in the end

24. The protagonist eventually goes on a new adventure with a new girl

Wednesday 24 August 2022

KSSM Form 4 and Form 5 Dual Language Programme (DLP) E-books

If you are looking for e-books for the KSSM Form 4 and Form 5 Dual Language Programme (DLP) subjects, you can download them from the links below.

These e-books are based on the latest KSSM syllabus, intended for Form 4 and Form 5 students taking the SPM.

Mathematics Form 4:

Mathematics Form 5:

Additional Mathematics Form 4:

Additional Mathematics Form 5:

Chemistry Form 4:

Chemistry Form 5:

Physics Form 4:

Physics Form 5:

Biology Form 4:

Biology Form 5:

Science Form 4:

Science Form 5:

Additional Science Form 4:

Additional Science Form 5:

To download, open the download link above. After that, click the Download button at the top of the page to start the download. The downloaded file is in PDF format.

E-books for Chinese Language and Chinese Literature are available here:

Wednesday 27 July 2022

The critical phase

I have just entered the critical phase of my housemanship.

Since the first day of my housemanship, I had UK Foundation Programme (UKFP) 2022 as a backup option in case something goes wrong.

After I complete the 3rd posting of my housemanship, I will gain full registration with the UK General Medical Council (GMC). That will enable me to apply for the Foundation Year 2 (F2) Stand-alone and Widening Access to Specialty Training (WAST) programmes in UK, which will be my backup options in case something goes wrong.

However, my UKFP 2022 job offer only remained valid until July 2022, after which it expired, and I will only complete the 3rd posting of my housemanship in November 2022 at the earliest. During the 4 month gap between July and November, I have neither a UKFP job offer nor GMC full registration.

The 4 months is the critical phase of my housemanship, as I don't have any backup options if something bad happens that makes it untenable for me to continue with my housemanship. In such a situation, I will have to say goodbye to my Medical Education dream forever.

Almost the entirety of my 3rd posting of housemanship is within the critical phase. I definitely need to be extra careful and to put in real efforts in gaining skills and experience so that I can maximise my chances of getting through the critical phase.

Once I pass this hurdle, I won't have much to worry again, as I will always have a backup option available.

Tuesday 28 June 2022

My most bizarre night shift

Throughout my housemanship so far, my most bizarre night shift has to be on 16 June 2022. It was during my Obstetrics and Gynaecology posting.

On that night, I was supposed to be in charge of the labour room & patient assessment centre (PAC), while one of my colleague was in charge of the ward. However, my colleague took an emergency leave just before the shift started at 7PM. As a result, I alone had to look after both the ward and the labour room & PAC. That was a very tough challenge, considering the large amount of work in both places.

At 8:30PM after clerking a new patient and doing a postnatal review, there was no pending work at the labour room & PAC, so I quickly went up to the ward. There were 13 postnatal discharges and I started writing them. I expected that before long, there would be new patients at the PAC and I would have to go back down to clerk them.

As it turned out, no patients came to the PAC at all from 8PM until the morning shift House Officers arrived at 7AM on the next day. This is a very rare occurrence. Throughout the night, there was only one patient in the labour room, who was sent down from the ward by me.

I managed to complete all the 13 postnatal discharges and take all of the morning bloods by 6AM. I then proceeded with doing the postnatal examinations and baby updates. In the end, I completed all my work and went home at 9:45AM.

Thursday 26 May 2022

第一站 The First Stop

Moving forward along the track,
Bergerak ke hadapan atas landasan ini,
moving, moving,
bergerak, bergerak,
where am I going to?
ke mana akan kupergi?
I am a heavy train,
Aku keretapi berat,
moving forward carrying my dream?
bergerak ke hadapan dengan misiku?

Nobody knows the outcome of this dream,
Tiada sesiapapun yang tahu kesudahan misi ini,
除非是 头上的青天和湖里的水。 
apart from, the sky above me and the water in the lake.
kecuali, langit atasku dan air dalam tasik.
I know, the end of this track is the sea,
Kutahu, penghujung landasan ini ialah lautan,
but how about the end of the sea?
bagaimana pula dengan penghujung lautan?

Moving forward along the track,
Bergerak ke hadapan atas landasan ini,
moving, moving,
bergerak, bergerak,
where am I going to?
ke mana akan kupergi?
The sea is the home to all rivers,
Lautan ialah rumah segala sungai,
let it be the first stop of this train.
biarkanlahnya menjadi perhentian pertama keretapi ini.

Saturday 23 April 2022

Why I chose to do Medicine?

I had my first ambition when I was 4 years old. I wanted to become an architect, simply because my father is an architect and I thought it was natural for me to follow the footsteps of my father. However, I had absolutely no idea how the job of an architect is like.

When I was a child, I would fall sick every few months, where my grandparents would bring me to see our family GP. As time went on, I began to get fascinated with the job of a doctor, particularly on how a doctor could just ask some questions and do some examination and then determine the diagnosis and prescribe the medications. I was also curious to know how sicknesses arise and how medications treat sicknesses. I often read the labels of medications to learn more about them. Unlike many other children, I generally wasn't afraid of taking medications, in fact I loved the taste of some medications. 

With that, I started having some interest in Medicine. Over time, I began thinking, perhaps I should become a doctor. From my observation of our family GP, his job was quite relaxing, as he just had to sit in an air-conditioned room, wait for patients to come to him and he would make a lot of money every month.

Meanwhile, as I began to know about how the job of an architect is like, I wasn't impressed with it. An architect has to visit construction sites a lot. On a few occasions, I followed my father to his construction sites and I felt quite uncomfortable being there. Just like Anakin Skywalker in Star Wars, I don't like sand because it's coarse, rough, irritating and it gets everywhere. Construction sites certainly have a lot of sand and other sand-like materials. I also observed that my father's job of an architect is very stressful. He had to work very long hours everyday and he looked so tired every time he returned home from work. His mood was often bad because of his stress from work. I could tell his job wasn't enjoyable at all.

Architects need to be creative and good at designing. I was very poor at the Arts subject in school. There were so many things I didn't know how to draw and I had essentially zero interest in learning it. That being said, architects generally do technical drawings which is quite different from the Arts we learnt in school. As a matter of fact, I wasn't bad at technical drawings and I even had some interest in it. Sometimes when I had free time, I would draw maps of roads and plans of buildings. My father was quite impressed with my work. Once, I drew a map of a major road interchange in Subang Jaya, which my father said was so accurate that even many of the architects in his office couldn't have drawn it so well. Despite that, I was well aware that being an architect involves so much more than just drawing maps and building plans.

The perceived stress of the job as well as the need to routinely visit construction sites made me stay away from becoming an architect. Instead, I felt that a doctor is a much better job. In school, I had been learning that doctors are there to save people's lives which makes them so noble. I could appreciate that this is what makes the job of a doctor so great, rather than how much money a doctor earns. Meanwhile, architects were almost never mentioned in the school books, and most of my classmates didn't even know what it is.

My family had also been saying that to be a successful architect, I would have to work in a big city like Kuala Lumpur. Having lived in Kulim for so many years, I really didn't want to leave the place. But if I were to become a doctor, I could just stay in Kulim and open up a clinic there. That made the job of a doctor even more attractive for me. When I was 10 years old, I decided to change my ambition from becoming an architect to becoming a doctor. When I told my friends in school that I wanted to be a doctor, some gave me their encouragement, while others questioned whether I could be a good doctor.

In the following years, I watched several drama series from Taiwan and Hong Kong. While those drama series weren't primarily about doctors, they did occasionally feature scenes in hospitals. That gave me some insights on the job of doctors working at hospitals, especially when I had never visited a hospital up to that point in life. From what I observed, a hospital is a nice work environment with air-conditioning and nice furnishings, and doctors are constantly going around saving the lives of their patients which seemed so interesting. In contrast, working in construction sites felt so terrible compared to working in hospitals.

2009 was a pivotal year for me, as three significant events happened that year. The first was the global economic recession known as the Great Recession. So many people all over the world lost their jobs because of that, and some even committed suicide. While my family wasn't affected, I felt bad for all those people affected, especially when many of them hadn't done anything wrong in their jobs. The Great Recession started all because the United States government failed to manage their country's economy properly, and the whole world had to live with the consequences of that.

The Great Recession made me realise that a lot of jobs aren't secure, as employees can be laid off at anytime, but being a doctor is different. A doctor will never be jobless as they can always operate their own clinic and there will always be patients. If I become a doctor and I hear news about an economic recession, I would be thinking about how I could offer cheaper treatment to my patients who are affected by the recession, rather than worrying about whether I would lose my job and whether I could get food on my table. I liked the fact that doctors always have a stable income, which further strengthened my desire to become a doctor.

The second significant event in 2009 was the H1N1 pandemic. In August 2009, the H1N1 was spreading widely in Kulim. One day, I felt lethargic and feverish. My grandparents immediately brought me to see our family GP. I felt that my fever was just low grade, but the GP said I had a high fever of 39°C after measuring my temperature with a forehead strip. He said that my lungs were clear which meant that it was quite unlikely I had H1N1. I was so relieved to hear that. However, he then said he wanted me to be quarantined at home, emphasising that I mustn't visit my friends or let my friends visit me.

My grandfather was extremely worried after hearing that, as he felt that the GP was still suspecting I had H1N1 despite saying otherwise. All the time, my grandfather was worried that my condition could deteriorate. Whenever my grandmother told him not to worry so much, he would brush it off, insisting that we must prepare for the worst. My sickness was already giving me a hard time, and the excessive worrying by my grandfather made my experience even more miserable. Worse still, I was having a school examination at that time and my preparation for it was greatly affected. In the end, I performed poorly in that examination, and my ranking dropped from 2nd to 64th.

I blamed the family GP to be the cause of my grandfather's excessive worrying and thus my misery. He used a forehead strip which is known to be not very accurate, which might have overestimated my temperature. His statement that I was unlikely to have H1N1 seemed contradictory to his instruction for me to be quarantined, which he failed to properly explain the reason. I felt that the contradictory statements indicated only two possibilities, either the family GP was unsure whether I had H1N1, or he had poor communication skills. Either way, it meant the family GP wasn't a good doctor, and I was reluctant to consult him again if I fall sick in the future.

2 months later in October 2009, it was the third and most significant event in 2009. The H1N1 pandemic had ended at that time. One day, my grandfather had haematuria. He immediately went to consult our family GP. As it turned out, the GP just tried to keep quiet as far as he could, avoiding the questions asked by my grandfather about his sickness. It was very clear that he couldn't make a diagnosis at all, despite haematuria being a common presenting complaint. He didn't even attempt to refer my grandfather to a hospital or a specialist clinic. My grandfather then travelled to Bukit Mertajam to consult a specialist physician. He was a bit worried about how much the consultation would cost. I, being so naive, reassured him that I was sure it wouldn't be too expensive as doctors are there to help people rather than make money.

The specialist physician diagnosed him with urinary tract infection and prescribed him with antibiotics and paracetamol. Much to our surprise, the bill totalled up to almost RM1000! That was a financial burden for my family. My grandfather started taking the antibiotics after returning home. On that night, he started experiencing tachycardia. He telephoned the specialist clinic to ask about it, and he was told to go back to the clinic immediately. We had to rush to the clinic in Bukit Mertajam at night. The specialist physician then said my grandfather was allergic to the antibiotics and decided to switch to another type of antibiotics. Guess what? He charged another few hundred ringgits for that. My grandfather hadn't brought so much money with him as we left home in a hurry. However, the specialist physician insisted on the payment. We had to travel to the specialist clinic once again on the next morning to pay the few hundred ringgits, only then my grandfather was given the new antibiotics.

For quite some time after he started taking the new antibiotics, his symptoms still didn't improve. He was so worried that it could indicate something more serious. However, he chose not to see a doctor once more, knowing that the family GP wouldn't be able to diagnose him while the specialist physician would charge him a high price again. My grandfather certainly was going through a very difficult time and I felt so bad for him. I blamed it on our family GP who lacked the necessary knowledge to be a doctor, and even more so on the specialist physician who was too money-minded to the extent of completely disregarding the wellbeing of his patients. It took a few weeks for my grandfather's symptoms to resolve. The whole incident, as well as the previous incident, made me realise that there are so many bad doctors out there and they bring a lot of sufferings to their patients. I felt that this definitely had to change, and I wanted to bring about the change.

I told myself that I must become a good doctor, who will equip myself with the necessary knowledge for treating my patients and focus on helping people rather than earning money. If I become a specialist, I would still charge my patients the same price as that of an ordinary GP. I firmly believed that the decision to become a specialist should be motivated by the desire the explore further in an area of medicine that we have a particular interest in, not to make more money. I wouldn't hesitate to offer cheaper treatment or even free treatment to my patients who can't afford it. I was sure that the amount of money a doctor earns is way more than enough to live a good life, so there should be no excuses not to help patients in need with the excess money. With that, I firmly decided on doing Medicine.

In upper secondary school, I chose to take the subject of Biology. I knew very well that Biology is required for getting into medicine. In Biology, I could learn even more about the human body, and for the first time, I learnt a bit about some diseases. I found it really interesting and I wished I could explore further. I did find Biology a bit challenging as the examination questions weren't straightforward and often required long answers, but in terms of learning the subject, I really enjoyed it. At that point, I had another strong reason for doing Medicine, which was my interest in learning the subject.

I had always excelled in the Mathematics and Additional Mathematics subjects in school. However, I wasn't keen to study a degree in Mathematics as I didn't really have an interest in Mathematics and I was concerned about the job prospects of a Mathematics degree. I was quite interested in computers, which was why I chose to take ICT in upper secondary school. While I enjoyed the subject a lot initially, once I started learning about coding and programming, I began finding it a bit tedious. As a degree in Computer Science or IT would surely involve a lot of coding and programming, I decided that it isn't for me. Therefore, I set my mind on Medicine.

After completing secondary school, I studied A Level at Taylor's College. In A Level Biology, I had the opportunity to learn even more about various diseases, especially through the topics of Gaseous Exchange, Infectious Diseases and Immunity. Learning about human diseases fascinated me. I was so sure that there was no other course than Medicine that I would be more interested in studying. Knowing that I want to become a doctor, my Taylor's College friends kept telling me about the qualities that a good doctor should have, including good communication and practical skills. I was aware that I lacked communication and practical skills, but I was confident that I could improve on them through the training I would get in medical school.

At that time, I heard for the first time from my friends and family that after completing medical school, all doctors will have to do housemanship for 2 years before they can practice Medicine independently. My initial reaction was highly supportive of it, thinking that housemanship would enable me to gain more experience to become a better doctor. Later, I began hearing some scary stories about housemanship, especially on how house officers are bullied by their superiors, being required to work very long hours and not being given time to eat.

However, I simply dismissed them as rare and isolated incidents. My thoughts was that doctors have a lot of knowledge and are highly respected by the society so they surely would be able to speak up and defend themselves against any bad working conditions. In April 2014, I joined a field trip to IMU. There, a lecturer said it was very likely that housemanship in Malaysia would be shortened to 1 year in the near future. I strongly believed what he said, and I thought, no matter how housemanship is like, 1 year is just a short time and I would get to do what I like thereafter.

I was primarily interested in opening up my own clinic, although I was also considering working at hospitals. I didn't want to make a decision on what I would like to specialise in at that point. I felt that every area of Medicine is great in its own way and I would like to explore them first before deciding which is best for me. I also didn't think specialisation is very important, as I would be content with being an ordinary GP.

Finally, I started studying MBBS at NUMed in September 2014. I really looked forward to becoming a good doctor, still oblivious about the challenges that I would be facing.

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Friday 25 March 2022

22 September 2021: An extremely stressful day

22 September 2021 has to be my most stressful day in 2021 and my most stressful day throughout my housemanship so far. It was during the 3rd week after I started working as a House Officer (HO).

A day earlier on 21 September, I had failed the off-tag assessment which made me very upset. Not only was that quite embarrassing for me, it also meant I had to continue working the tagging hours from 7AM to 10PM every day, which is significantly longer than the normal work hours.

On 22 September, I was in charge of the acute cubicle in the Medical ward. Patients in that cubicle were generally very ill and they required morning, afternoon and evening reviews every day. At that time, I was still really bad at blood taking, where more than 80% of my blood taking attempts failed. A specialist ordered a blood culture for a patient whose blood was very difficult to get, even though another specialist had decided that it wasn't necessary earlier.

Taking a blood culture is a complicated procedure as it requires a large amount of blood and has to be done in a sterile manner. I couldn't even get a single drop of blood from that patient, how could I possibly get the large amount of blood needed? My colleagues and the MOs couldn't help me as they were so busy, so I gave up on the blood culture entirely. Shortly afterwards, the patient had to be admitted to the ICU. As he was intubated, I was required to accompany him there.

After arriving the ICU, an MO there asked me several questions regarding the patient's history and I couldn't answer at all. The patient's notes was several hundreds of pages long and I didn't know how I should read them. The MO was very nice and didn't scold me, but he emphasised the need for me to know the full history of a patient before accompanying them to the ICU in the future. Right after that, I had to accompany another intubated patient for a CT scan. Accompanying the 2 patients used up 2 hours of my time, while I still had a lot of pending work in the ward.

When I returned to the ward, an MO was doing the afternoon review of my patients and I had to join her. Although the MO is very nice, she was really thorough in her reviews which took a very long time. Later, a nurse was chasing me to complete the domiciliary care form for a patient who had been discharged a few days ago. The form had to be filled up in 3 copies. Then, one of the patients had a fever and I had to review him. After that, I could finally start doing the work which had been pending for a long time. Before I was done with all the work, it was time for me to do the evening review of my patients.

Suddenly, an MO came and scolded me for not arranging a Covid RTK-Ag test for a patient's wife who would be coming to learn nursing care. I had no idea that the RTK-Ag test was required. Then, a nurse told me that a patient required an IV cannula. Soon afterwards, I had to join the evening ward rounds by the specialist which lasted more than an hour. Much to my dismay, the specialist ordered a blood culture for a patient. The night-shift HO had arrived at that time, but blood cultures cannot be passed over to night-shift HOs which meant that I had to take it.

Seeing that I was so stressed, a senior HO helped me prepare all the equipment for taking the blood culture. I tried taking the blood culture but I wasn't successful. Then, I tried inserting the IV cannula for the patient who required it but I failed in that as well. The senior HO agreed to help me take the blood culture and insert the IV cannula, while emphasising that I needed to practice more and improve. I still had quite some work pending and my colleagues gave me some help.

I managed to finish all the work only at 10:45PM. That was the first time where I had to work overtime and I was truly exhausted. Combined with my failure in the off-tag assessment just a day earlier, I surely was having a very difficult time. At that time, the only thoughts in my mind was that I wanted to quit housemanship. I had applied for UK Foundation Programme 2022 as a backup option, and I felt that I really should go for it.

On the next day 23 September, I travelled to Johor Bahru to receive my 2nd dose of AstraZeneca Covid vaccine. I used that opportunity to go to EcoBotanic to taste some of the food there which I missed so much. At EcoBotanic, I kept reminiscing the good times in the past when I was working as a Teaching Fellow, where I truly enjoyed work and had so little stress. I really wished I could just keep working as a Teaching Fellow for the rest of my life.

On that night after returning to Kluang, I started feeling very tired which was a side effect of the vaccine. I had to take 2 days of sick leave, which gave me a much needed break from work. Thankfully, on 26 September I was allowed to off-tag and start working the normal work hours, which was 2 days of 7AM to 5PM shifts, 2 days of 7AM to 9PM shifts and 1 day of night shift every week.

After working my first night shift, my blood taking skills improved by a lot. Since then, I have been coping well with my housemanship. I am glad that I persevered and didn't actually quit housemanship.

Sunday 27 February 2022

A weird dream (Feb 2022)

On 25 February 2022, I had a really weird and bizarre dream.

In my dream, I was with my parents when we saw some weird-looking clouds just above the surface of the ground. I thought, could it be a wormhole that can bring me back to the past? Hoping to get back to my 2 great years between August 2019 and July 2021, I tried walking into those clouds. My father who had read about wormholes wanted to give it a try as well.

After we walked into those clouds, we noted a sudden change in the surrounding environment, especially the buildings. It was an obvious sign that we had gone back many years into the past. I was disappointed that I didn't return to the 2 great years as wished, but much further back. Suddenly, the thought that we might have returned to the World War 2 era made me feel quite scared.

Later, I and my father found out that we were actually in the year 1950 which was after World War 2 ended, giving me a sigh of relief. Then, I realised that my mother had also followed us through those clouds. We walked around and spoke to some of the people we met. Many of them were talking about a movie newly released at that time, titled Interstellar (1950).

We decided to go to a nearby cinema to watch Interstellar (1950). Its plot turned out to be quite similar to that of the real Interstellar movie, but they weren't the same movie. At the climax of Interstellar (1950), the main character jumped into a black hole to save humanity. Right at that time, the clouds that brought us to 1950 appeared in front of us.

Not wanting to miss out on the opportunity to return to the present, we reluctantly left the movie before finishing it. I was really curious about whether the main character succeeded in saving humanity. As it turned out, the clouds didn't bring us back to the present, but to some point in the future after September 2023.

I had already completed my housemanship at that time and was attending an important job interview for Medical Education. I was wearing formal wear for the interview, but I realised that I didn't have a tie. Unfortunately, I didn't have time to get a tie as the interview was starting very soon. It was actually the 2nd day of a 2-day interview.

Strangely, the interviewer wanted to show me a short documentary and ask me questions about it. However, just as the documentary was starting, it got cut off by an emergency broadcast. The broadcast was from someone filming live on a helicopter above the sea, who claimed that he wanted to give a commentary about the movie Interstellar (1950).

He showed a clip of the movie's ending, where the main character succeeded in saving humanity but was sacrificed in the black hole. Coincidentally, that was the part I missed out earlier. He stated that he felt very emotional about the ending and that he too wanted to sacrifice himself for humanity. He then jumped out of the helicopter into the sea, filming it live.

While falling down, he suddenly revealed his actual intentions. He wanted to wipe out half of the world's population to save humanity from overpopulation, much like Thanos. He had armed nuclear weapons in the sea which would activate when his body hits the sea. He claimed that unlike Thanos, he isn't evil as he made sure that he himself would be sacrificed in the process.

As soon as he hit the surface of the sea, those nuclear weapons started firing everywhere, unleashing a global catastrophe. I was so scared that I woke up from my dream!


In reality, Russia began its invasion of Ukraine just a day earlier on 24 February 2022. The fear that it could lead to a wider global war was probably the reason I dreamt about the global catastrophe caused by nuclear weapons. My worries about having returned to the World War 2 era in the dream could also be a representation of the fear.

My current job as a House Officer is very stressful. I can't wait to finish my housemanship and pursue Medical Education, which might be why I dreamt about having completed housemanship. I really miss the good days when I was in 6th year of MBBS and when I was a Teaching Fellow, which was the reason I tried to return to the period of time between August 2019 and July 2021 in the dream.

I enjoy watching movies a lot. Interstellar and Avengers: Infinity War are among my favourite movies, which was probably why there were references to these 2 movies in my dream. I dreamt about the cloud-like wormhole probably because I once read a comic about it.

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Monday 10 January 2022

Why I chose to do housemanship at Kluang hospital?

Since 23 August 2021, I have been working as a House Officer at Kluang hospital. So, why did I choose to do housemanship at Kluang hospital?

The UK General Medical Council (GMC) recognises 8 hospitals in Malaysia, which are University of Malaya Medical Centre (UMMC), Kluang hospital, Penang hospital, Hospital Sultan Ismail (HSI), Hospital Sultanah Aminah (HSA), Queen Elizabeth hospital, Kuching hospital and Sibu hospital. NUMed graduates who complete their housemanship at one of those hospitals will be able to gain Full Registration with the GMC. For a long time, I viewed GMC Full Registration as something nice to have, but I didn't think it's very important for me.

When I first started my MBBS course in 2014, Kulim hospital was my top choice for housemanship. While I was born in Subang Jaya, I grew up in Kulim and stayed there for 17 years. Kulim is a nice place and I had the feeling of attachment to it. I also heard that the work environment at Kulim hospital is rather relaxed. However, the issue was that none of my friends at NUMed were interested in doing their housemanship at Kulim hospital, which meant that I would be alone if I go there. Kulim hospital also doesn't have GMC recognition.

After I entered Stage 3 of MBBS, I became interested in doing housemanship at Batu Pahat hospital and Kluang hospital. When I was posted to Batu Pahat hospital and Kluang hospital, I could observe that the House Officers there seemed quite relaxed. Batu Pahat and Kluang are nice towns just like Kulim, although Kluang is a bit underdeveloped. I initially had the misconception that Batu Pahat hospital is recognised by GMC, but I later realised it's actually Kluang hospital that has GMC recognition. A few of my friends at NUMed were interested to do their housemanship in Batu Pahat or Kluang, which is a plus point over Kulim.

During Stage 4 of MBBS, I did my Student Selected Component in UK. From my observation, Foundation training in UK is well structured and Foundation doctors have a good work-life balance as there are safeguards against excessive workload, unlike housemanship in Malaysia. At that time, the UK Foundation Programme (UKFP) was open for NUMed graduates for the first time and I was interested in it. However, joining UKFP isn't an option for me for personal reasons.

During my initial year of Stage 5, I thought of doing my housemanship at Seremban hospital. One of my friend at that time was planning to go there and I wanted to be with her. I also briefly considered Queen Elizabeth hospital. It's a popular choice among the 2014-2019 batch for some reason, so I thought that I would have more friends with me by going there. However, a crisis with my group mates later put an end to my desires to go to Seremban hospital or Queen Elizabeth hospital.

During my repeat year of Stage 5, I became interested in Penang hospital as some of my friends in the 2015-2020 batch were considering it. I had previously heard that Penang hospital has a very stressful work environment, but one of my seniors working there told me that it isn't too bad. Later, my friend EL chose to do his housemanship at Penang hospital.

After having stayed in Johor Bahru for many years, I certainly like the place a lot and I have become quite attached to it. I wished I could have done my housemanship in Johor Bahru. However, HSA and HSI are the only hospitals available for housemanship in Johor Bahru. The work environment at HSA and HSI is very stressful, which I knew would be unbearable for me.

After completing my MBBS course, I started working as a Teaching Fellow at NUMed in October 2020. In November 2020, I heard from a senior lecturer about UMMC. According to him, the housemanship programme at UMMC is similar to UKFP, being well structured which ensures good work-life balance for House Officers. The uniqueness is due to UMMC being under the Ministry of Higher Education. I quickly became interested in UMMC. However, it's difficult to get a place at UMMC due to it being a very popular choice for housemanship.

In March 2021, the hospital selection for housemanship through e-Housemen was open for NUMed 2020 graduates. I chose to defer the start of my housemanship for 6 months as I wanted to complete my Teaching Fellow post first. A few of my friends decided to do their housemanship at Penang hospital. My love towards the 2015-2020 batch made me want to go to Penang hospital as well. EL advised me against that, giving the reason that the work environment at Penang hospital is very stressful. However, I had also been hearing that housemanship is going to be stressful regardless of the hospital, so I thought I might as well go to Penang hospital and be with my friends.

However in early May 2021, I made the firm decision to pursue Medical Education. For that, I have to complete housemanship and gain Full Registration with the Malaysian Medical Council (MMC). With a long-term goal in mind, I felt that it's important to maximise my chances of completing housemanship successfully. Therefore, I decided that I must not go to hospitals with stressful work environment such as Penang hospital, instead I would choose UMMC or Kulim hospital.

In early June 2021, I met up with a senior lecturer for career advice. I was hoping that he might know an alternative pathway to pursuing Medical Education that wouldn't require completing housemanship. However, instead of getting good news from him, he told me some very bad news:

  • The MMC has decided such that starting from 2023, only doctors who are on the National Specialist Register (NSR) can practise as Medical Specialists or Medical Lecturers.
  • Having the full MRCP(UK) or equivalent qualifications isn't sufficient for a doctor to be on the NSR. The doctor will still have to complete gazettement process which would take years.
  • Only permanent MOs will be able to complete the gazettement process. Contract MOs don't get the opportunity.
  • Only about 10% of House Officers will eventually be offered permanent MO posts. The remaining will only get contract MO posts.

By implication, this means I would have no more than 10% chance of achieving my dream! The news definitely came as a bombshell to me and I was devastated. Worse still, that was right after I rejected my UKFP 2021 offer.

After giving some thoughts about it, I decided that I must do housemanship at a hospital that is recognised by GMC. This is so that in the very likely event where I don't get a permanent MO post, I will be able to do my specialty training in UK. I will eventually return to Malaysia as a specialist where I will get to enter the NSR. GMC Full Registration is no longer just something nice to have, but an absolute necessity for me, without which I will have a bleak future ahead.

Among the 8 hospitals recognised by GMC, I felt that I won't be able to survive housemanship at HSI, HSA, Penang hospital, Queen Elizabeth hospital, Kuching hospital and Sibu hospital due to their very stressful work environment. Therefore, UMMC and Kluang hospital are the only viable options for me.

However, Kluang hospital had been designated a Covid-19 hospital since March 2020, so it probably hadn't been taking in new House Officers. Meanwhile, the Covid-19 situation in Klang Valley was getting very bad at that time, so it was quite likely that UMMC wouldn't be recruiting new House Officers either. I was clueless on what my next steps should be and I felt quite depressed.

Then one day, my friend and Teaching Fellow colleague LG told me that he intended to do his housemanship at Kluang hospital. He clarified that Kluang hospital was actually still taking in new House Officers despite it being a Covid-19 hospital. I gave Kluang hospital a serious consideration and concluded that there would be many advantages doing my housemanship there:

  • Kluang hospital is recognised by the UK GMC.
  • The work environment at Kluang hospital is relatively relaxing.
  • Kluang hospital looks quite nice and I am rather familiar with it, having been posted there previously.
  • I will have LG and possibly other friends from NUMed as company.
  • Kluang has a lot of nice people.
  • The living cost in Kluang is quite low.
  • Unlike Klang Valley, Kluang doesn't have major water supply issues and the Covid-19 situation in Kluang isn't too bad.
  • Kluang isn't too far away from Johor Bahru so I can return to Johor Bahru regularly. 
  • As Kluang hospital is a teaching hospital for NUMed and IMU, I will have the opportunity to deliver some teaching, enabling me to gain further teaching experience.

The drawback of doing housemanship at Kluang hospital is that Kluang is quite far away from my hometown. Being a bit underdeveloped, it may also be a bit difficult for me to adapt to living in Kluang, after living in Johor Bahru for 7 years. I felt that the pros of choosing Kluang hospital greatly outweigh the cons.

In mid July 2021, e-Housemen hospital selection was open for LG and he chose Kluang hospital as planned. According to him, there were no vacancies at any of the Klang Valley hospitals including UMMC due to the Covid-19 situation. I expected that it would be the same for the next e-Housemen as well, so Kluang hospital would be the one and only option for me. 

The e-Housemen hospital selection was supposed to be open for me in late September 2021. However, it unexpectedly got brought forward to 5 August 2021. As I had already deferred once, there was no option to defer once more if I fail to get a place at Kluang hospital, making me really nervous. I nearly got a panic attack when I saw that there were only 5 vacancies at Kluang hospital. Thankfully though, I successfully chose Kluang hospital.

After that, I found out from one of my friend that there were actually more than 140 vacancies at UMMC, which was totally unexpected. I hadn't bothered to check if UMMC had vacancies available as I didn't expect there to be any. Despite that, I didn't regret choosing Kluang hospital, as it still has certain advantages over UMMC.

Now, I can say that I made the right decision to choose Kluang hospital. While I had to face quite a lot of challenges with housemanship especially in the beginning, the situation has become much better as I gain more clinical experience and skills over time.

In October 2023, MMC decided to abolish the requirement that only doctors who are on the NSR can practise as Medical Lecturers. This means I will be able to pursue Medical Education without having to complete specialty training or gazettement. In spite of that, it's still advantageous for me to have GMC Full Registration, as it gives me a backup plan if things don't go as planned.

You can read about my experience with housemanship at Kluang hospital here: