Introduction

Hi! I am Daniel Lim Jhao Jian. Since the inception of this blog in June 2009, I have been sharing a lot of my experience, knowledge and ideas here. I hope you will find this blog useful. Thank you for visiting my blog.

Saturday, 29 April 2023

Why I chose the Google Pixel 6A over the iPhone?

In April 2023, I got my new phone, the Google Pixel 6A. I can say that I am very impressed with this phone. It has a Google Tensor processor, 128GB of storage and 6GB of RAM. It runs very fast and it's battery lasts quite long, and the quality of its camera is excellent.

Google Pixel phones have never been officially sold in Malaysia. I had to buy the Google Pixel 6A online through Lazada. It costs a total of RM1400 including delivery, mobile protection service, screen protector, phone case and some free gifts, and the phone is a brand new set. I certainly think it's a very good value for money. Just like the latest iPhones and Samsung phones, it doesn't come with a charger, but I can use my old phone's charger.

My previous phone was the Google Pixel 2. I had used it for more than 5 years since December 2017, and it had been functioning well. However, its camera stopped working in April 2023. Since the camera is an important feature which I use a lot, I had to get a new phone.

In 2021, someone hacked my Google account and used it to create several Google Ads accounts, trying to make me pay for that. When I seeked help from Google, they were extremely unhelpful. They stated that they could only help me after I provided them with the IDs of those Google Ads accounts, but when I gave them the IDs, they insisted those IDs were invalid and refused to proceed with helping me resolve the issue. I was really upset with Google over that.

Google Pixel phones didn't support VoLTE in Malaysia, as they are not officially sold here. Worse still, 3G networks in Malaysia were shut down in late 2021. Consequently, Google Pixel phones could only use 2G for making and receiving phone calls. If I received a phone call while browsing the internet, the phone would automatically switch the network to 2G, and the low speed of 2G would interrupt the internet connection. The aging infrastructure of 2G networks also resulted in a subpar call quality.

Consequently, I decided in 2021 that I would never get another Google Pixel phone again and my next phone would be an iPhone. However, the circumstances changed over the course of 2022 and 2023.

Apple introduced iPadOS 13 in 2019. It introduced a lot of new features which brought the iPad much closer to being a laptop replacement. That contributed heavily to my decision to buy the iPad Air 3 in August 2019. I was hopeful that future versions of iPadOS would make the iPad even more useful, eventually becoming a true laptop replacement. Unfortunately, that wasn't the case. iPadOS 14 didn't bring any significant new features apart from Universal Search which is just a glorified Spotlight search. iPadOS 15 introduced a much needed new multitasking interface, but didn't go far enough.

iPadOS 16 in 2022 finally introduced Stage Manager which gives a multi-window interface similar to those in desktop operating systems. Unfortunately though, Stage Manager was only available for the iPad Air 5 and iPad Pro 3 and later. My iPad Air 3 will never get the Stage Manager, neither will the iPad Air 4 or iPad Mini 6. I was deeply disappointed with Apple about that. It wasn't even the first time something like this happened. Previously in 2015, Apple introduced the Split View feature with iOS 9, but only made it available for the iPad Air 2, leaving out my iPad Air 1.

In August 2022, the power button of my iPad Air 3 stopped functioning, while issues with its Lightning connector port made changing more and more difficult. This was despite the fact that I always took good care of my iPad. Knowing that an official Apple service centre would charge a hefty price for repairing due to my iPad being out of warranty, I got my iPad Air 3 repaired at a third-party repair shop.

While the repair went well, just a few months later in April 2023, my iPad Air 3 started having another major issue. Every few minutes, it will display a purple screen and then restart on its own. I had tried resetting the iPad, upgrading to the latest iPadOS version and even erasing all data on the iPad, but the issue persisted. My iPad Air 3 is less than 4 years old and it's already having so much issues. In contrast, my Google Pixel 2 lasted more than 5 years without significant issues. This indicates that the quality of Apple products is going down the drain. How can I be confident that an iPhone will last long if I buy one?

Apple has insisted on using the Lightning connector port on iPhones, even though iPads, Macbooks and most Android phones have switched to USB-C ports. The Lightning connector port is an outdated technology. It only supplies a very small amount of power to connected accessories which is often insufficient for them to function properly. The data transfer speed of Lightning cables is also significantly lower compared to USB-C cables.

iPhones are very expensive. Even the most basic iPhone 14 costs RM4200. I bought my Google Pixel 2 phone for RM4000, which was very expensive as well. However, Google later introduced the cheaper A series of Pixel phones, starting with the Google Pixel 3A in 2019. The A series of Pixel phones are often available for sale on Lazada at a price less than RM2000.

I have considered Android phones other than Google Pixel. Samsung is the most popular brand of Android phones. However, I don't like the fact that Samsung heavily modifies the interface of Android and adds a lot of bloatware in its phones. I used a HTC phone before and I really liked it, but HTC hasn't produced a flagship phone in quite a while. While Huawei phones are great, they are banned from Google apps and services which are essential for me. Nokia was initially doing well after it started producing Android phones, but it has been struggling to keep up with Android updates for some time. Meanwhile, I have little interest in Asus, LG, Lenovo, Motorola, Sony, Oppo, Vivo and Xiaomi.

There are 3 things I have always liked about Google Pixel phones. First, Pixel phones, including the cheaper A series, have excellent hardware specifications. Second, they receive Android version updates and security updates as soon as they are available. Third, they offer the pure Android experience, without any user interface modifications or addition of bloatwares. 

In late 2022, in response to popular demand, Google finally released an update which added support for VoLTE for Pixel 6, Pixel 6A and Pixel 7 in Malaysia. However, older Pixel phones including the Pixel 2 aren't supported. With that, I was once again interested in getting a new Google Pixel phone for my next phone. This eventually culminated in my decision to buy a Google Pixel 6A in April 2023.

Wednesday, 15 March 2023

Tips for UKMLA AKT and PLAB 1

Starting from the 2024/2025 academic year, all final year medical students in UK medical schools, including Newcastle University Medicine Malaysia (NUMed), have to take the UK Medical Licensing Assessment (UKMLA) as part of their medical degree before graduating. The UKMLA has 2 parts, the Applied Knowledge Test (AKT) and the Clinical and Professional Skills Assessment (CPSA).

All medical graduates from non-UK medical schools, with the exception of NUMed graduates and graduates with a relevant European qualification, have to take the Professional and Linguistic Assessment Board (PLAB) in order to apply for provisional or full registration with the UK General Medical Council (GMC) and practise Medicine in UK. The PLAB has 2 parts, PLAB 1 and PLAB 2. Starting from 2024, PLAB 1 is aligned with the UKMLA AKT while PLAB 2 is aligned with the UKMLA CPSA.

The UKMLA AKT and PLAB 1 are in the form of a Single Best Answer (SBA) examination. For each question, there are 5 answer choices and you have to choose the most appropriate answer. The questions may include images, such as clinical photos, inheritance trees, ECGs, X-rays and CT scans, and you have to interpret them.

I got a score of 75.5% for my final year SBA examination in July 2020. I completed my medical degree at Newcastle University Medicine Malaysia (NUMed) and subsequently worked as a Teaching Fellow there. Here, I would like to share some tips for passing the UKMLA AKT and PLAB 1. These tips may also be helpful for the Irish PRES Level 2, Australian AMC CAT MCQ and Malaysian EPR Theory Examination. I am writing the tips based on how I revised for the exam previously. However, different individuals may have different learning styles, so you should just take this as a guide.

You have to start your revision no less than 2 months before the UKMLA or PLAB. I recommend studying at least 5 hours per day on weekdays and 7 hours per day on weekends and holidays. If possible, you should revise every day. To pass the exam, you should aim for a score of at least 65%. If you do not understand any topic when doing revision, ask a lecturer or a friend for further clarification.

All specialties will be covered in the UKMLA AKT and PLAB 1, including:
- Internal Medicine
- Obstetrics and Gynaecology
- Paediatrics
- Psychiatry
- Surgery
- Trauma and Orthopaedics
- Ophthalmology
- Ear, Nose and Throat
- Dermatology

When revising, I recommend going specialty by specialty. Finish all topics in a particular specialty before moving on to the next specialty. Your focus when doing revision should be on risk factors, pathophysiology, diagnosis, investigations, management and complications. You should complete at least 4 full rounds of revision for all topics if possible.

Medicine should be studied mainly through understanding, not memorising. Basically, for every fact you come across in your revision, try to think "Why is this the case?" If there is an explanation, read it and make sure you understand what it says. If there is no explanation, try to come up with your own explanation based on your knowledge. Even if your explanation is wrong, it does not really matter as the exam questions will not ask for the explanation. You can also look up the internet for an explanation. The fact is that, when you actively seek an explanation for a fact, you will end up remembering the fact much better and your revision will also become more interesting. This is so much more effective than simply memorising the facts. However, do note that not everything can be studied this way. Certain facts have no possible explanation at all, so the only way to study them is by memorising.

You do not need to memorise the normal range of values for investigations as it will be provided in the questions during the UKMLA AKT or PLAB 1. You also need not memorise the doses of medications apart from very commonly used ones.

The most important revision resource for the UKMLA AKT and PLAB 1 is the textbooks. I recommend using the following textbooks for each specialty:
Internal Medicine - Oxford Handbook of Clinical Medicine (11th Edition)
Ophthalmology, ENT, Dermatology, Trauma and Orthopaedics - Oxford Handbook of Clinical Specialties (11th Edition)
Surgery - Oxford Handbook of Clinical Medicine (11th Edition) and Surgical Talk (3rd Edition) 
Psychiatry - Psychiatry by Ten Teachers (2nd Edition), Psychiatry - A Clinical Handbook and ICD-11
Obstetrics and Gynaecology - Obstetrics & Gynaecology by Lawrence Impey & Helen Jefferis (6th Edition)
Paediatrics - Illustrated Textbook of Paediatrics (6th Edition)

These textbooks are not essential for the UKMLA AKT and PLAB 1 but may be helpful to refer to if you are looking for some specific information:
Davidson's Principles and Practice of Medicine, Kumar and Clark's Clinical Medicine, Apley and Solomon's Concise System of Orthopaedics and Trauma, Robbins Basic Pathology, Underwood's Pathology, Rang and Dale's Pharmacology

You need to know the latest NICE guidelines. For Obstetrics and Gynaecology, you have to know the latest RCOG Green-top guidelines in addition to the NICE guidelines. Important guidelines are those covered in the textbooks, and you should look up the internet for the most up-to-date version of those guidelines. Take note of the publication date of each textbook and focus on guidelines released or updated after the textbook's publication date. However, do not spend too much time on the guidelines, as it is more important that you revise the textbooks and understand the facts.

You should do practice SBA exam questions. Start doing practice questions after you have completed at least 1 full round of revision of the textbooks. Go through all practice questions on the Medical Schools Council and PLAB websites and those provided by your lecturers. Apart from that, PassMedicine and Pastest have a large number of practice questions. They require paid subscription and I recommend that you subscribe to one of them. After finishing each practice question, check the correct answer and explanation and make sure you understand the reasoning behind every correct or wrong answer. Take note of question themes that appear commonly in the practice questions.

PassMedicine also has some revision materials. You should revise the high-yield revision notes in PassMedicine. It summarises the important information you need to know in a concise manner, and it also contains some extra information not found in the textbooks.

While Year 1 and Year 2 knowledge can be helpful at times, they are not essential for the UKMLA AKT or PLAB 1. There is no need for you to specifically revise any Year 1 or Year 2 topics.

During the UKMLA AKT and PLAB 1, you will have a limited amount of time to answer the questions. Therefore, you should be careful not to run out of time. Always time yourself when doing the practice questions. As you are reading the question, you should already be thinking of the diagnosis so that you can get to the answer faster. Even if you are unsure of the correct answer, you can try to eliminate the wrong answer choices one by one to help you reach the correct answer.

All the best in your revision! I hope you will do well in the exam.

Tips for the Newcastle University WriSkE can be found here:

Tips for the Prescribing Safety Assessment (PSA) can be found here:

Tips for the MRCP Part 1 and Part 2 can be found here:

Tips for the MRCPCH FOP (Part 1A) and DCH FOP can be found here:

Monday, 27 February 2023

The reality of clinical practice in hospitals

If you are thinking of doing Medicine, you should read the whole of this post first.

Perhaps you had been observing general practitioners (GPs) working in private clinics, that they just had to sit in an air-conditioned room, wait for patients to come to them, do some checking on the patients and prescribe some medications, then they could earn a lot of money every month. Perhaps you had been watching some movies or TV series, where you see doctors working in nice hospitals and going around to save lives, which looked so great and interesting. Perhaps you are thinking that being interested in Medicine and being caring to your patients and having good knowledge, communication and clinical skills is all it takes to be a good doctor.

Let me tell you this: The reality of clinical practice is very different from that, and there's so much more required to be a doctor. Here, I will be explaining in detail about how working as a doctor is actually like, based on my own actual experience. 

Just in case you don't already know this, you cannot work as a doctor in any private clinic or private hospital in Malaysia straight away after you graduated with the medical degree. You must first undergo 2 years of House Officer training in a public hospital. After successfully completing House Officer training, you must then work as a Medical Officer in a public hospital or public clinic for another 2 years to serve your compulsory service with the Ministry of Health. After completing your compulsory service, only you will be allowed to work as a doctor in a private clinic or private hospital. 

Even then, you will be facing tough competition from many other doctors who are also seeking to work in private clinics or private hospitals, which makes it challenging for you to operate your own private clinic or to get a job offer in a private hospital. To stand out, you will have to become a specialist. The process of becoming a registered specialist is very long and complicated. You will need to complete a recognised Master's or Parallel Pathway Programme, which involves working as a Specialist Registrar in a public hospital for several years. The fact is that, working as a House Officer, Medical Officer or Specialist Registrar at public hospitals in Malaysia is extremely stressful and challenging.

First, there's long working hours in public hospitals. Although the standard work hours for House Officers isn't too bad, you have to undergo 2 weeks of tagging at the start of each of the 6 postings in House Officer training. During the tagging period, your work hours is significantly longer, which is from 7AM to 10PM every day, for 6 days each week with only 1 off day. Such long work hours is extremely tiring. At the end of the 2 weeks, you have to take the off-tag assessment, which is often difficult as it demands a lot of knowledge and skills. The long work hours means that you won't have much time to study for the assessment. If you don't pass it, you will have to continue tagging. As for Medical Officers and Specialist Registrars, they have to routinely work on-call shifts, about 4-6 times every month. Each on-call shift is 33-hour long, continuously from 8AM until 5PM on the next day. Just imagine how tiring and stressful that is! The long working hours means that you have to make sacrifices on your meals, sleep, personal time and your time with family and friends. Yet, doctors are always expected to put their patients above everything else, even above their own wellbeing.  You can't even help yourself first, yet you have to help others.

Often, there's a lot of patients and insufficient doctors in public hospitals, which results in a very high workload for doctors. When that happens, doctors have to work fast which is very exhausting. Doctors are expected to prioritise the more urgent tasks. It's often the case that the more urgent tasks are also the more difficult tasks. Some people may find it more efficient to do the easier but less urgent tasks first, but that's not allowed. You absolutely don't have the freedom in work in your preferred style. Doctors are also expected to multitask, even though it greatly increases the risk of medical errors which may cause harm to patients. Routinely, you will be asked to stop whatever you are doing to perform another new task that's more urgent. If you are the kind of person who doesn't like leaving unfinished work hanging around, you will find that very annoying. Doctors may get called to see new patients at the Emergency Department at any time, no matter how busy they are in the wards. Doctors are expected to answer their phone promptly at any time of the day, even when they are in the middle of doing a surgery. At the end of the day, you still have to complete all tasks regardless of urgency. If you haven't completed them by the time your shift ends, you have to work overtime.

You may be thinking that doctors don't face bullying at work, because after all, a core aspect of Medicine is mutual respect and collaboration. I hate to tell you this, but doctors in public hospitals actually do face bullying quite routinely. Some superiors will scold you if something doesn't go right, even if you made no mistakes at all or it's something where you have no control over. In addition to scolding, they may even bring up your mistake in front of all your colleagues or issue you with a warning letter, which will make you feel really bad. Your superiors will almost always expect you to join them when they conduct ward rounds and to assist them when they perform clinical procedures or surgeries, even when you are busy with other tasks. It's not just joining ward rounds, you are also expected to engage proactively during ward rounds, failing which you can be penalised for poor attitude. Most ward rounds are very tedious, especially if they go on for a long time. Occasionally, your superior may tell you to do something that's outside the job scope of doctors, and you are expected to comply with their instructions no matter what.

As a doctor working in a hospital, you are expected to know and remember the cases of all patients under your care by heart. While information on every case is recorded in the patient notes, your superiors may expect you to present the cases to them without flipping through the notes. Not only you have to know the diagnosis, you also have to know the whole progress of each patient from the beginning of admission until now. That's a lot of information to memorise which makes it very challenging. All doctors come from a scientific background, which emphasises more on understanding rather than memorising. You may not like memorising things, yet you cannot avoid that. Sometimes, you may even be asked to recall information about a patient from a previous admission if you saw the patient previously, even if that was a long time ago. In addition, there are all sorts of guidelines and protocols which doctors are expected to memorise.

A major part of clinical practice is history taking, not just from patients but sometimes also from their family members. History taking may look fun and easy, but it can actually be a very tedious task. Different patients may have very different ways of communicating their illness, and you are expected to tailor your communication for each patient as well as to accurately interpret what they tell you. It's particularly challenging to get a full history from patients who have reduced consciousness, dementia or a mental disorder, often requiring you to get a further history from multiple sources including from their family members, which can take a lot of time. In addition, doctors routinely have to get technical information from patients as part of history taking, such as their previous medications, surgeries and investigations. Getting technical information from a non-technical person can be really challenging, as you have to translate technical terms into non-technical terms that they can understand and vice versa.

A lot of unexpected can happen in clinical practice in hospitals. Any patient in the ward may deteriorate quickly at any time. Whenever that happens, doctors have to attend to the patient immediately. You will then have to spend a long time managing the patient which can be very stressful. If your workload is already very high, that will worsen it. Moreover, doctors have to be able to perform all kinds of clinical procedures. There may be some procedures which you have never learnt before in medical school or in previous stages of your training or only have very little experience with, yet your superiors may expect you to be good at them from day 1 of your work. Not all of your superiors will be willing to properly teach you how to perform a procedure. Sometimes, you can only learn it through observation which may be inadequate for complex procedures. If you try to perform a procedure which you are not skilled at and end up not doing it right, you certainly will have to be responsible for that.

There's also complaints and medicolegal issues that doctors have to face. Some patients and their family members may make complaints for the tiniest issues which may or may not be the doctor's fault, yet doctors have to answer for every complaint made about them. Sometimes, a patient just won't survive or will develop a severe complication despite doctors having tried their best and not doing anything wrong. Yet, if you are unfortunate enough, the patient's family members may sue you in court for that. You may like to help others out of your goodwill. In actual clinical practice though, you cannot do things out of your goodwill, instead you are fully responsible for every single thing you do and you cannot avoid doing your job. If you do something for your patient with good intentions, but you unintentionally made a mistake in the process that causes harm to your patient, you still have to face all of the consequences for that. Nobody will bother about your intentions and efforts, everyone only cares about the outcome of the patient. The harsh reality is that clinical practice is not goodwill, it's an immense responsibility. That's what makes it so stressful.

Despite of all the stress and challenges of clinical practice, some doctors still enjoy their job a lot, while others don't. It really comes down to the individual. I have several friends who joined Medicine only to have to quit later because they realised that it's not for them.

If you are thinking about becoming a doctor, you most definitely should do comprehensive research on the job of doctors first. I hope you have read through and understood everything in this post. You should go a step further by doing a clinical attachment at a public hospital for at least a few weeks so that you can actually experience how doing clinical practice is like in reality. After that, ask yourself an honest question, are you ready to face all the challenges of clinical practice and is this really what you want to do for the rest of your life? If you can confidently say yes, then congratulations, you should go ahead with doing Medicine! Otherwise, please do yourself a favour by staying away from Medicine and exploring a different field instead.

Friday, 20 January 2023

International Recognition of MUET

The Malaysian University English Test (MUET) is an English language proficiency test in Malaysia, mainly used for university admissions. All public universities and vast majority of private universities in Malaysia accept the MUET.

Starting from 2021, there is a significant change in format of the MUET, and the band scores of the MUET are aligned to the Common European Framework of Reference for Languages (CEFR).

It is widely believed that the MUET is only recognised in Malaysia. In reality, the MUET does have international recognition as well, though that is quite limited for now. Here is a list of foreign universities that recognise and accept the MUET.

Branch of foreign universities in Malaysia:

Singapore:
Singapore Institute of Management
Singapore Management University

Hong Kong:
Hong Kong Academy for Performing Arts

United Kingdom:
University of East London
Manchester Metropolitan University
University of Plymouth

Australia:

United States of America:

China:

Japan:

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.

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

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.

Sunday, 25 September 2022

Teaching Fellow / Lecturer Personal Statement Sample

In September 2020, I applied for a Teaching Fellow post at Newcastle University Medicine Malaysia (NUMed) and I got offered the post successfully. As part of the application, I had to write a personal statement.

Here, I am sharing my personal statement for the NUMed Teaching Fellow post. You may use it as a guide if you are applying for a Teaching Fellow or Lecturer post at NUMed or any other university. However, please note that plagiarism is strictly prohibited.


Personal Statement / Application Letter:

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:

Past papers for the SPM examination 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

沿着铁轨向前走,
Moving forward along the track,
Bergerak ke hadapan atas landasan ini,
尽走,尽走,
moving, moving,
bergerak, bergerak,
究竟要走向哪儿去?
where am I going to?
ke mana akan kupergi?
我可是一辆负重的车,
I am a heavy train,
Aku keretapi berat,
满装了梦想而前进?
moving forward carrying my dream?
bergerak ke hadapan dengan misiku?

没有人知道这梦的货色,
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.
我知道,铁轨的尽处是大海,
I know, the end of this track is the sea,
Kutahu, penghujung landasan ini ialah lautan,
海的尽处又怎样呢?
but how about the end of the sea?
bagaimana pula dengan penghujung lautan?

沿着铁轨向前走,
Moving forward along the track,
Bergerak ke hadapan atas landasan ini,
尽走,尽走,
moving, moving,
bergerak, bergerak,
究竟要走向哪儿去?
where am I going to?
ke mana akan kupergi?
海是一切川流的家,
The sea is the home to all rivers,
Lautan ialah rumah segala sungai,
且作这货车的第一站吧。
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 to 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 or rest.

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 public clinics or public 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.

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

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 interview as part of my application for a Medical Lecturer post. 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!

P/S:

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 become a Medical Lecturer, 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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