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, 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.

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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 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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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:

Friday, 10 December 2021

AFHEA and FHEA Submission Samples

While working as a Teaching Fellow at Newcastle University Medicine Malaysia (NUMed), I gained the Associate Fellow of the Higher Education Academy (AFHEA) qualification in June 2021 and the Fellow of the Higher Education Academy (FHEA) qualification in December 2021.

Here, I am sharing my AFHEA and FHEA submissions. You may use them as a guide if you are applying for the AFHEA or FHEA. However, please note that plagiarism is strictly prohibited.


Associate Fellow of the Higher Education Academy (AFHEA)

Account of Professional Practice:
Summary of Evidence:


Fellow of the Higher Education Academy (FHEA)

Saturday, 27 November 2021

My FHEA qualification

I have just received my Fellow of the Higher Education Academy (FHEA) postgraduate qualification! When I was working as a Teaching Fellow at NUMed, I had the opportunity to apply for Associate Fellow of the Higher Education Academy (AFHEA) and Fellow of the Higher Education Academy (FHEA). FHEA is of higher level than AFHEA, but the requirements for getting FHEA are more difficult to fulfil. Initially, I decided to just go for AFHEA as I didn't want to risk failing my FHEA application and getting nothing. But after I applied for AFHEA in April 2021, I was thinking, why not give FHEA a try? I submitted my FHEA application in July 2021 just before my Teaching Fellow post ended. And now, I have finally succeeded.

You can view my AFHEA and FHEA submissions here:

Friday, 15 October 2021

Why didn't I continue working as a Teaching Fellow?

I worked as a Teaching Fellow at NUMed from October 2020 to June 2021. Subsequently, I started working as a House Officer in August 2021. You may be wondering, why didn't I just keep working as a Teaching Fellow instead of becoming a House Officer?

Actually, I too wish that I could continue working as a Teaching Fellow at NUMed. After all, the Teaching Fellow job is so much easier and more interesting and it's monthly salary is just slightly lower compared to that of a House Officer. However, there are several reasons why that's not a viable option for me.

The main reason is that my Teaching Fellow contract ended in June 2021. There was no provision for an extension of the contract as NUMed offers Teaching Fellow contracts on a one-off basis only. One of the Teaching Fellows in the previous year tried to get a long-term contract after his contact ended, but he was unsuccessful in that. One of my Teaching Fellow colleagues on the 3-month contract also tried to extend his contract without success. Therefore, I didn't attempt to seek an extension of my Teaching Fellow contract.

An alternative to extending the contract would be to reapply for the Teaching Fellow post for the 2021/2022 academic year. With the teaching experience and the AFHEA qualification I gained through working as a Teaching Fellow, I would have an advantage in the application. However, the post is mainly meant for graduates from the 2016-2021 batch. The 2016-2021 batch had been quite unfortunate and I really sympathise with them.

Due to the Covid-19 pandemic, they missed out on the opportunity to do their Student Selected Components and Electives in UK and there were a lot of disruptions and uncertainties during their Stage 5 of MBBS. I definitely want them to have the opportunity to be a Teaching Fellow. If I reapplied for the Teaching Fellow post, I would be denying someone from that batch the opportunity. Considering how competitive the application is, every single place counts. Therefore, I decided not to reapply.

Even if I could somehow get an extension of my Teaching Fellow contract, there's the fact that Teaching Fellows aren't full-fledged Medical Lecturers. NUMed Teaching Fellows are mostly involved in teaching parts of the Year 1 and 2 curriculum, with limited opportunities to teach Year 3 to 5. While the Teaching Fellow job had been very interesting and rewarding for me, it's not my plan to be a Teaching Fellow permanently. Instead, I view it as a stepping stone to gain valuable teaching experience in order to achieve greater heights in my teaching career.

My aim is to become a full-fledged Medical Lecturer who will have more teaching responsibilities. Unfortunately, there's no direct upgrade path from a Teaching Fellow to a full-fledged Medical Lecturer. To become a full-fledged Medical Lecturer in Malaysia, one must have Full Registration with the Malaysian Medical Council, which requires the completion of 2 years of housemanship. Like it or not, I have to work as a House Officer for now.

My transition from being a Teaching Fellow to being a House Officer is like going from heaven to hell. The House Officer job is really stressful with long working hours. However, my Medical Education dream motivates me to persevere with my housemanship. I must survive the hell before I can get to the higher levels of heaven.

Sunday, 26 September 2021

My Covid-19 vaccination

The first batch of Covid-19 vaccines arrived in Malaysia on 21 February 2021. Soon afterwards, the Malaysian government opened the registration for Covid-19 vaccination to the public. I registered through MySejahtera on 23 February 2021. In the following months, I was waiting for a vaccination appointment. At that time, I was working as a Teaching Fellow at NUMed in Johor Bahru.

In April 2021, following reports of rare thromboembolic events caused by the Oxford-AstraZeneca Covid-19 vaccine, the Malaysian government decided to offer it only on an opt-in basis. Data shows that thromboembolic events occur in around 1 out of 100,000 cases. I consider that to be a very low risk and I decided that I would take the AstraZeneca vaccine if given the opportunity.

The 1st round of opt-in registration for the AstraZeneca vaccine was open on 2 May 2021 for those living in Selangor and Kuala Lumpur. I couldn't register as I was in Johor Bahru. Subsequently on 26 May 2021, the 2nd round of the opt-in registration was open to those staying in Johor, Penang and Sarawak in addition to Selangor and Kuala Lumpur. I surely wanted to take that opportunity to register.

The registration was supposed to open at 12 noon, but it got delayed until 12:15PM. Then, there were major issues with the registration website due to a large number of people wanting to register. I was able to key in my personal information, but I couldn't select the state no matter how many times I clicked on it. I refreshed the page a countless number of times and I tried using my laptop, tablet and phone, but the same issue persisted.

There were a few times where I managed to select the state, but when I proceed to selecting a vaccination centre and date, a message appeared stating that the slot was full, even though it was still available in reality. I tried registering for about an hour, without success. After that, the website announced that the opt-in registration had closed as all slots had been taken up. I felt quite upset and disappointed.

However on 29 May 2021, I received an SMS which stated that my registration for the AstraZeneca vaccine was being processed. On the next day, I got my 1st dose appointment through MySejahtera, which would be at Persada Johor Bahru International Convention Centre on 22 July. While I was glad to get the appointment, the issue was that my Teaching Fellow job would end on 30 June and I would be returning to my hometown after that.

After giving some thoughts, I decided to stay in Johor Bahru until the end of July so that I could receive the 1st dose of the vaccine. I didn't want to decline the appointment as that would lead to further delays in getting the 1st dose. However, I wouldn't be in Johor Bahru for the 2nd dose. As the interval between doses of the AstraZeneca vaccine is 9 weeks, it wouldn't be feasible for me to continue staying in Johor Bahru till then.

On 22 July 2021, I received my 1st dose of Oxford-AstraZeneca Covid-19 vaccine at Persada Johor Bahru as planned. I arrived a bit late as the main road leading to Persada Johor Bahru was closed which required me to take a detour, but that wasn't an issue. The process was quite smooth and well organised, although I had to wait for a while as there were a lot of people. As a matter of fact, I had been to Persada Johor Bahru in July 2019 to attend the NUMed Congregation.

In the morning on 23 July 2021, I started feeling quite lethargic which likely was an adverse effect of the vaccine. I didn't experience any other side effects. On that night, I was feeling a bit better and I could watch the opening ceremony of the Tokyo 2020 Summer Olympics online. By 24 July 2021, I had recovered from the lethargy.

I soon received my 2nd dose appointment which would be at Persada Johor Bahru on 23 September. Based on my plans at that time, I would be in Kulim in late September so it would be quite troublesome for me to travel to Johor Bahru. Therefore, I declined the 2nd dose appointment and changed my address on MySejahtera to Kulim, in hopes of getting an appointment in Kulim.

I returned to Subang Jaya on 1 August 2021. On 4 August 2021, I unexpectedly got the news that the start date of my housemanship would be brought forward from October to late August. I decided to do my housemanship at Kluang hospital. Once again, I had to change my address on MySejahtera to Kluang. However, I never got another 2nd dose appointment on MySejahtera.

During the orientation for housemanship, I was told that house officers who hadn't completed their Covid-19 vaccination could get the vaccine at Kluang hospital. However, the AstraZeneca vaccine isn't available in Kluang and the only vaccination centre in Johor with the AstraZeneca vaccine is Persada Johor Bahru. I regretted declining the 2nd dose appointment at Persada Johor Bahru, but I couldn't reinstate it. Consequently, my 2nd dose of vaccine was in limbo.

I contacted MySejahtera helpdesk and the Johor state health department to seek help regarding the issue, and they both told me that I could just walk in to Persada Johor Bahru for my 2nd dose of AstraZeneca vaccine on my original appointment date. Despite that, I was still a little worried as I didn't have an active appointment on MySejahtera. 

On 23 September 2021, I went to Persada Johor Bahru to get my 2nd dose of Oxford-AstraZeneca Covid-19 vaccine. Johor Bahru is about 1 hour and 20 minutes drive from Kluang. As it turned out, the staffs at Persada Johor Bahru are very helpful and friendly. They allowed me to walk in after I explained my situation, and the process completed smoothly. I was happy to go back to Johor Bahru, as I had the opportunity to taste some of the food there which I miss so much.

With that, I have finally completed 2 doses of Covid-19 vaccination, 7 months after I first registered for it. On the following day, I once again felt quite lethargic. The lethargy lasted until 25 September 2021, requiring me to take 2 days of sick leave. Still, that was a relatively minor adverse effect which is totally worth it considering the protection against Covid-19 given by the AstraZeneca vaccine.

In late 2021, the Omicron variant of Covid-19 emerged. Its symptoms are significantly less severe, but it spreads significantly faster. 2 doses of Covid-19 vaccine is no longer sufficient to protect against it, a booster dose is needed. The Malaysian government started offering booster doses of Covid-19 vaccination to the public. Initially, the booster dose was given at 6 months after the 2nd dose, which meant that I would be getting my booster dose in March 2022.

Later, the policy was changed such that the booster dose can be given at least 3 months after the 2nd dose. Many vaccination centres in Malaysia were also allowing walk-ins for the booster dose. Despite that, I wanted to wait until March 2022 before getting my booster dose, as I had read that the efficacy of the booster dose is greatest if given at 6 months after the 2nd dose.

In late January, the number of new Covid-19 cases daily in Malaysia was increasing very rapidly due to the spread of the Omicron variant. Therefore, I considered getting my booster dose earlier. After some reading on the internet, I concluded that getting the booster dose at 3 to 6 months after the 2nd dose will not significantly decrease its effectiveness. I decided to get my booster dose as soon as possible.

At that time, Kluang hospital asked all staff members who would like to receive the booster dose of Covid-19 vaccine to fill up a registration form, and I promptly did so. On 7 February 2022, I received my booster dose at Kluang hospital. This time, I was given the Pfizer-BioNTech Covid-19 vaccine. Once again, I experienced lethargy after getting the vaccine, which required me to take 1 day of sick leave.

In June 2022, Kluang hospital opened the registration for the 2nd booster dose of Covid-19 vaccine to all staff members. I promptly submitted the registration. The 2nd booster dose was to be given at least 6 months after the 1st booster dose, which meant that I would be getting it after 7 August 2022. However on 2 August 2022, I unexpectedly got called for my 2nd booster dose.

As it was just a few days short of 6 months after my 1st booster dose, the effectiveness will not be significantly affected. Therefore, I went ahead with receiving my 2nd booster dose on that day. Once again, I got the Pfizer-BioNTech Covid-19 vaccine. After the vaccination, I experienced lethargy which was worse compared to the last 2 doses, so I had to take 1 day of sick leave.

I am glad to have completed 4 doses of Covid-19 vaccination. The AstraZeneca + AstraZeneca + Pfizer + Pfizer combination provides good protection against Covid-19, including the Omicron variant. While the number of new Covid-19 cases daily in Malaysia is still high, vaccinations have greatly reduced the severity of Covid-19 infections and allowed us to return to our normal lives just like before the Covid-19 pandemic. I hope everyone will receive their booster doses of Covid-19 vaccine as soon as possible.

Wednesday, 18 August 2021

My Teaching Fellowship at NUMed

I worked as a Teaching Fellow at Newcastle University Medicine Malaysia (NUMed) for 9 months from 1 October 2020 to 30 June 2021. During my Teaching Fellowship, I lived at EcoNest which is located quite close to NUMed. Here, I am sharing my experience working as a NUMed Teaching Fellow. In this post, I will be using a two-letter pseudonym to refer to each particular person.

September 2020:

I received the offer for the Teaching Fellow post on 25 September. There were 7 Teaching Fellows for the 2020/2021 academic year, me, LG, GC, NR, TM, AL and KT. TM was on the 3-month contract while the rest of us were on the 9-month contract. Unlike the previous years, the Teaching Fellows this year wouldn't be offered the Postgraduate Certificate of Medical Education (PGCertMedEd) as the programme was suspended due to the Covid-19 pandemic. On 30 September, I met a lecturer for Year 3 EoCP induction.

October 2020:

I started the Teaching Fellow job officially on 1 October. The 1st week was mainly induction sessions. On 2 October, I went to Hospital Sultan Ismail to help coordinate the first hospital visit of the Year 3 students. I began delivering teaching on 5 October. At that time, I was adapting well to my Teaching Fellow post. From 5 to 22 October, I delivered only the spirometry skills session and orthopaedics skills session. Both were Year 3 EoCP sessions taught in small groups at the NUMed campus. Every day, I delivered the same session 3 times to different groups of students.

At that time, I wasn't close to my colleagues as I didn't know them well. Still, I would talk to them whenever we met on campus, and occasionally we would have lunch together at the NUMed Garden Café. On 14 October, my NUMed staff email was activated. The delay was due to a cyber attack that Newcastle University was suffering from at that time. On 16 October, the office for Teaching Fellows was ready. I was in the same office room as LG, GC, NR and TM. I didn't quite like the office as it's a bit old. Instead, I preferred to go to the NUMed library.

On 19 October, NUMed informed that Teaching Fellows could apply for Associate Fellow of the Higher Education Academy (AFHEA) or Fellow of the Higher Education Academy (FHEA). I and my colleagues were interested to apply, as it would be a good alternative to the PGCertMedEd which we couldn't get. To get the AFHEA or FHEA, we had to complete a written assignment. The FHEA is of higher level than the AFHEA, but is significantly more difficult.

On 22 October, I submitted my UK Foundation Programme (UKFP) application. On 25 October, my friend IL passed me my MBBS certificate which she helped me to collect previously. From 26 to 28 October, I delivered the EoCP acute care simulation session and orthopaedics skills session. During a session on 28 October, one of the students kept laughing while the other students weren't engaging well, which made me feel a bit annoyed.

I received my first salary from NUMed on 28 October, which felt so good. On 29 October, I submitted my application for Foundation Priority Programme (FPP) of UKFP. On 30 October, I, LG, GC, NR and TM filmed a tutorial video for an upcoming Year 1 session. After we were done, they invited me to join them for lunch at The Tribus @ Puteri Harbour and I agreed. That was my first time going out with my colleagues, and it brought me closer to them. 

November 2020:

The start of November marked some significant changes to my Teaching Fellowship experience. Year 3 EoCP had just ended, which would be followed by MACS. Only LG, GC, NR and TM were involved in the teaching for MACS, while I would be teaching Year 1 and Year 2 moving forward. The Year 1 and Year 2 sessions were supposed to be a mix of online and face-to-face sessions. However, Johor Bahru became a Covid-19 red zone at that time. As a result, face-to-face sessions at NUMed were no longer allowed and all sessions had to be moved online.

For the first 2 days, I delivered the virtual hospital visit debriefing sessions. The sessions were quite boring and I didn't have much to talk about. From 4 to 10 November, I delivered several sessions on hearing loss. Although those sessions were interesting, I very much preferred to deliver them face-to-face. I and my colleagues had planned to deliver Written Skills Examination (WriSkE) practice sessions for the Year 3 and Year 4 students, but we had to scrap the plan due to suspension of face-to-face teaching. Instead, I shared a compilation of WriSkE resources with the students.

I chose to deliver many of the online sessions from my office as the internet connection there is very stable. At that time, I began to like my office a lot and I went there quite often. There was a focus group discussion on 6 November where I and my colleagues gave our feedback about the NUMed MBBS programme based on our experiences. On 7 November, I and colleagues had a dinner with a senior lecturer at Alam Seafood Restaurant. SF, a Teaching Fellow from the previous year, joined us as well. 

On 8 November, Johor Bahru ceased to be a red zone. However, the government had decided to implement the Conditional MCO (CMCO) in Johor. Under CMCO, no face-to-face sessions were allowed and students also weren't allowed to use the NUMed library, but staff members could still enter the NUMed campus. On 11 November, I delivered a Malay language support session for the international students. On the week from 16 to 20 November, I had no sessions at all. I felt quite bored and I really wished I could teach Year 3 MACS.

On 21 November, the CMCO in Johor ended and the number of active Covid-19 cases in Johor Bahru was close to 0. With that, face-to-face sessions at NUMed could resume on 23 November and I was so delighted. Unfortunately, the number of new Covid-19 cases in Johor Bahru increased rapidly right after that. Just a few days later, Johor Bahru was a red zone again and face-to-face sessions once again had to stop. I didn't have the opportunity to deliver any face-to-face sessions during that period of time, as I was only involved in 2 online sessions on 23 and 24 November.

Around that time, several Clinical Teaching Fellows (CTFs) from UK started working at NUMed. Between November and December, I delivered 2 online revision sessions for the Year 3 students. On 26 November, I attended a support session for AFHEA and FHEA. I decided to apply for AFHEA during the April 2021 submission period. Starting from 30 November, I was quite busy again as I had online teaching sessions on several days every week. As a Teaching Fellow, I like being busy. I had become quite close to my colleagues at that time and we often went out for lunch or dinner together.

December 2020:

As the number of new Covid-19 cases in Johor Bahru kept increasing, I had to accept the reality that face-to-face sessions at NUMed wouldn't be allowed anytime soon. I decided to embrace online sessions and I aimed to deliver them as best as I could. On 7 December, the CMCO was reimplemented in Johor Bahru. Unlike the previous CMCO, both students and staff members were allowed to enter the NUMed campus to use the facilities. Strangely enough, interstate travel was allowed for the whole country except for areas under Enhanced MCO. 

On 5 December, I and my colleagues had a dinner with the CTFs at The Spice Kitchen. Despite being in Johor Bahru for more than 6 years, that was my first time going to The Spice Kitchen. Throughout November and December, most of the sessions I delivered were history taking and clinical reasoning sessions for Year 1 and Year 2. I also delivered a few advanced communication sessions for Stage 5 P4P. I really enjoyed delivering all those sessions. Based on the teaching evaluation I received, most of my students liked my teaching as well.

On 11 December, AL missed out on a session he was scheduled to deliver due to some issues with the timetable. As I was delivering the same session with another group of students, I told his group of students to join my session. On that afternoon, there was a support session for Teaching Fellows on Teaching and Learning in Classroom. I and KT voted to have the session face-to-face, GC and NR voted to have it online, while LG, TM and AL didn't vote, resulting in a 2 vs 2 tie. Later, KT defected and voted for online instead, breaking the tie. In the end, the session was carried out online.

On 17 December, I took the Situational Judgement Test (SJT) for UKFP. The SJT was held online through remote proctoring and I used a computer at the NUMed campus. On 18 December, I marked the online Year 1 oral presentation. That was the last day of the 1st semester and TM's Teaching Fellow post came to an end. There was 2 weeks of winter break from 19 December to 3 January, during which the NUMed campus was closed. I returned to my hometown for the break.

January 2021:

The 2nd semester of my Teaching Fellowship began on 4 January. In January, the Year 1 and Year 2 students were having exams so there weren't any teaching sessions for them. On the 1st week, I delivered 2 Prescribing Safety Assessment sessions for Stage 5. On the 2nd week, I conducted online interviews for a few students who were applying to study MBBS at NUMed. On 15 January, I helped perform a test run of the online surgical bad-day-on-call session planned by the CTFs for Stage 5. The CTFs gave me valuable feedback on my performance during the session.

The MCO 2.0 was implemented on 13 January due to the worsening Covid-19 situation in Malaysia. Under MCO 2.0, face-to-face sessions were allowed for medical students undergoing clinical training. Students were also allowed to use the NUMed library, but staff members had to request for permission in order to enter campus. NUMed allowed me to deliver online sessions from my office after I explained that the internet connection at EcoNest wasn't very stable.

On 19 and 20 January, I was involved in the Stage 5 surgery acute care simulation session as a simulated patient. That was my first face-to-face session since 28 October. On 21 January, I delivered an online session on History of Medicine for the Foundation students. On the following week, I marked the Year 1 and Year 2 Short Answer Paper (SAP) exams. The exams and the marking were both done online.

February 2021:

On 2 February, I started delivering teaching sessions for Year 1 and Year 2. Clinical skills sessions were conducted face-to-face while clinical reasoning and history taking sessions were conducted online. There were several replacement sessions for the clinical skills sessions that couldn't be held face-to-face in the previous semester. I was so glad to meet my Year 1 and Year 2 students in person for the first time after having taught them entirely online in the previous semester. On 4 February, I marked the online oral presentation for the Foundation students.

The Chinese New Year was on 12 February. I couldn't return to my hometown as interstate travel wasn't allowed under the MCO 2.0 . Dining in at restaurants was allowed at that time, so I celebrated the Chinese New Year by going to several restaurants for my lunch and dinner. As I didn't have any red shirts, I went to AEON Bukit Indah to buy one. I bought Chinese New Year cards and gave them to my colleagues. On 15 February, I attended the OSCE examiner training session.

A few of my batch mates created the Come Together (CT) programme to help the Stage 5 students in their preparation for final exams and I decided to join it. Under the CT programme, I would be mentoring 2 students. Around that time, replacement sessions for Year 3 MACS were scheduled. I and my colleagues were supposed to deliver those sessions, but NUMed later decided to let the CTFs take over the sessions. As a result, we were no longer involved in teaching Year 3.

On 19 February, I marked the online Year 2 oral presentation. On 23 February, I, LG and GC had lunch together for the first time since December and we had a long chat. On 27 February, I and my colleagues had dinner at Rosmarino Italian Restaurant. At that time, we had become very close. Between February and March, I delivered a total of 5 online lectures for Year 1, which were Understanding Asthma, Drugs Used in the Respiratory System, Treatment of Asthma & COPD, Antibiotic Resistance and Skin & Systemic Diseases.

March 2021:

I took over the eye examination session from NR on 4 March as I really wished to teach eye examination. On 5 March, the MCO 2.0 ended and was replaced with the CMCO. With that, staff members were no longer required to seek permission to enter the NUMed campus, while face-to-face sessions were still allowed at NUMed. Around that time, I, LG, GC and NR chose to participate in a research project led by our senior lecturer. Our role would be to perform data analysis. I, LG and GC went for lunch at 安记酿豆腐 in Taman Ungku Tun Aminah on 11 March.

On 11 March, the UKFP allocation was out. I got allocated to Northern Foundation School which was my 1st choice. However, my application for the FPP was unsuccessful. My SJT score was 35.5 out of 50. Coincidentally, I was told to do the hospital selection for the Malaysian house officer training programme through the e-Housemen system on the next day. As I wanted to complete my Teaching Fellowship first, I chose to defer the start of my house officer training by 6 months.

On 13 March, I and my colleagues jointly conducted an online MOSLER practice session for our mentees in the CT programme. On that night, we had dinner at Carabao Restaurant, where we jointly celebrated me, LG and AL's birthdays. GC offered to let me take over her mental health seminar on 18 March as she would be delivering a webinar on Orthopaedics for the NUMed Medical Education Society, which I gladly accepted.

On 21 March, I, LG and GC went to Mount Austin to meet up with our friend NB and we had dinner together. I had not seen NB for quite some time and I was happy to meet her. On 22 March, I and my colleagues filmed several tutorial videos for the upcoming Year 2 sessions. My birthday is on 23 March. Many of my friends wished me, including all of my colleagues, several of my 2015-2020 batch mates and several of my students. On 24 March, I met a few Year 1 students to do the sign-offs for their clinical skills.

On 26 March, LG was having dinner with a few Year 2 students at a restaurant near EcoNest and he invited me to join them. I had a great conversation with my students, enabling me to know them better. When walking back to EcoNest, we coincidentally met a few Year 1 students and they said hi to us. After that, I started getting a lot of followers on Instagram from my Year 1 and Year 2 students and I followed all of them back. There were 2 weeks of Easter break from 27 March to 11 April. I didn't return to my hometown as interstate travel was still not allowed. 

April 2021:

On 28 March and 3 April, I delivered online sessions on IV Fluid Management and Acute Red Eye for Stage 5 students under the CT programme. The NUMed library remained open throughout the break and I went there almost every day. I was busy writing my AFHEA assignment. I also did the statistical analysis for the research project I and my colleagues participated in, using R software which I learnt during my SSC1 in Stage 4. I let NR take over my Increased Intracranial Pressure and Brain Death lecture on 14 April as she was really interested in delivering it.

I delivered the Basic First Aid session for Year 1 on 14 and 15 April. On 16 April, I and my colleagues had a very long conversation at our office and we skipped lunch. I, LG and GC then went for a heavy dinner at Spiced Mala Hotpot on that evening. The AMSA Medical Myth Quiz was held on 17 April for the Year 1 and Year 2 students. I and LG contributed many questions for the quiz. After the quiz, we provided the explanation for each question to the participants. On 18 April, I finally completed and submitted my AFHEA assignment.

On 20 April, I and my colleagues jointly conducted the 2nd online MOSLER practice session for our mentees. On 22 April, I delivered a session on knee and foot examination. As foot examination wasn't actually in the Year 2 learning outcomes, the students were only required to feel for the bony structures in the feet. However, I felt there was no point in just learning that, so I decided to teach my students the foot examination in full. While they acknowledged that it's difficult, they still performed it quite well.

At that time, I decided to apply for FHEA during the next submission period. One of the CTFs had strongly encouraged me to go for it. Although I knew it's difficult, I wanted to give it a try. On 23 April, I delivered a session on sensory and motor examination. The session was supposed to last 2 hours, but as the examination is really long, it took me 2 hours 30 minutes to finish. Right after that, I had another online session which I had to delay the start by 30 minutes. Thankfully, it didn't clash with the students' timetables.

For the next sensory and motor examination session on 26 April, I tried to save time by telling my students to watch the tutorial video beforehand, but the session still went overtime by 15 minutes and the lab technician got quite annoyed about that. There was one more sensory and motor examination session on 27 April. This time, I used a different strategy and managed to finish the session within 2 hours. AL still hadn't finish the session when the 2 hours was up, so I took one of his students to help save time.

Around that time, my colleagues remarked that one of the shirts I wore had a few holes on it. They advised me to stop wearing it, but I told them that I really liked the shirt. They then decided to give me a makeover by getting me a new shirt. On 25 April, I and my colleagues went to Oriental Kopi in Johor Jaya for breakfast followed by JWC for lunch. We then went to Mid Valley Southkey where my colleagues chose 2 really nice shirts for me. On that evening, we had dinner at 豪享痴卤肉饭. It was a really interesting outing.

During the abdominal examination and cardiovascular examination sessions on 28 and 29 April, my students requested to take photos with me and I gladly agreed. On 28 April, I and LG conducted an acute care simulation practice session for our CT programme mentees. On 29 April, I took over the clinical reasoning in bowel disease session from AL and KT. On that night, I and my colleagues had dinner with a senior lecturer at Carabao Restaurant. I love my Teaching Fellow job so much and at that time, I made the firm decision to pursue Medical Education in the future.

May 2021:

I delivered an online lecture on Nutrition in Elderly for Year 2 on 4 May. I played badminton with LG, KT, AL and the CTFs at the EduCity Sports Complex on 5 May. On 6 May, I, LG and GC had dinner together at Oven & Fried Chicken. That was our last outing before the MCO 3.0 was implemented on 7 May. Under the MCO 3.0, dining in at restaurants wasn't allowed. Face-to-face sessions were still allowed for medical students undergoing clinical training, while staff members had to request for permission to enter the NUMed campus.

On 7 May, there was a face-to-face session on Falls in the Elderly, which I and my colleagues had been planning for weeks. The session provided the Year 2 students with MOSLER style practice. I chose to take over the clinical reasoning in genetic disorders session on 10 May, as I really liked genetics. I was an examiner for the Year 2 OSCE on 11 and 12 May. On 15 May, I, LG and GC conducted an online Q&A session for Stage 5 students under the CT programme, as they would be having their final exams soon. On 17 May, I was informed that my AFHEA application had been successful.

My last ever face-to-face session was on 18 May. Around that time, I received teaching evaluation from the Year 1, Year 2 and Stage 5 students, who gave me very positive feedback. On 20 May, I marked the Year 2 SAP exam. The exam was paper-based but the marking was done online. GC bought some pastries for me and LG on that day and it was really good. From 24 to 27 May, I delivered online sessions on Urine Dipstick for Year 2 TCBL. On 27 May, I marked the Year 1 SAP exam. Throughout May, I regularly conducted online MOSLER practice sessions for my CT programme mentees. 

June 2021:

On 1 June, the Full MCO was implemented. Under the Full MCO, entry into the NUMed campus by students and staff members was only allowed for exam purposes. Since then, I didn't have the opportunity to meet GC and NR in person again. On 2 June, I withdrew from the UKFP. I took over the online TCBL Mock Round session on 4 June from one of the CTFs. During the session, I conducted a case-based discussion on heart failure with my students. That was my last ever teaching session.

On 8 June, it was the Year 3 Exemption OSCE and I volunteered to be a simulated patient. On 16 June, I marked the online oral presentation for the Foundation students. That was my 4th time marking oral presentations. During the Year 4 MOSLER on 22 and 23 June, I once again was one of the simulated patients. That was officially my last session as a Teaching Fellow. Between June and July, I and my colleagues had several meetings through Zoom.

The final exam results for Stage 5 was released on 23 June. Both my CT programme mentees passed Stage 5 and I was so happy about that. However, before they could graduate, they had to replace the hospital assistantships they missed out previously due to the Covid-19 pandemic. I went to my office on that day and left a message for the future Teaching Fellows.

Around that time, I started writing my FHEA assignment. It turned out to be not as difficult as I had expected. On 25 June, I finally received my AFHEA certificate. On 26 June, I had an online discussion session with my CT programme mentees about the Teaching Fellowship application. My Teaching Fellowship contract ended on 30 June. I got the permission to enter the NUMed campus on that day to take out my personal belongings from my office. I definitely felt very emotional about that.

July 2021:

I continued staying at EcoNest until the end of July. On 6 July, the Teaching Fellowship application for the next academic year opened. Both my CT programme mentees were applying and I wrote a reference for them. On 13 July, I completed and submitted my FHEA assignment. The outcome of my FHEA application would only be known in November. On 22 July, I went to Persada Johor International Convention Centre to receive my first dose of Oxford-AstraZeneca Covid-19 vaccine. The only adverse effect I experienced was feeling lethargic.

August 2021:

On 1 August, I moved out of EcoNest and returned to my hometown. After staying at EcoNest for 3 years, I finally had to leave permanently, which made me feel very emotional. My NUMed staff email was disabled on 2 August, which marked the end of my Teaching Fellowship at NUMed. On 9 August, both my CT programme mentees were offered the Teaching Fellow post for the 2021/2022 academic year and I was so glad to know that. They started their Teaching Fellow job on 16 August.

Conclusions:

I definitely had a very great experience working as a Teaching Fellow at NUMed. It surely is my most favourite year out of my 7 years at NUMed. I thoroughly enjoyed the sessions I delivered as a Teaching Fellow, as I love interacting and sharing my knowledge with my students. My Teaching Fellow colleagues are truly sincere in friendship, and we spent a lot of good time together. I am extremely grateful to NUMed for giving me the opportunity to be a Teaching Fellow. The imperfection of my Teaching Fellowship was the disruptions caused by the Covid-19 pandemic to face-to-face teaching. However, the online sessions I delivered were still quite fun. I will always remember all the memories I had throughout my Teaching Fellowship. I hope that not too far in the future, I will be able to return to NUMed as a lecturer.

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For more information about the MBBS course at NUMed, go to this link:

Tuesday, 10 August 2021

A weird dream (June 2021)

On 10 June 2021, I had really weird dream.

In my dream, I was going for breakfast with 2 of my Teaching Fellow colleagues, LG and GC. We went to a restaurant at Taman Tasek, Johor Bahru. GC was driving while I and LG followed in her car. On the way to the restaurant, we stopped somewhere for ice-cream. LG and GC ordered the regular size of the ice-cream, while I ordered the large size as I really like ice-cream. The ice-cream was really good, so I took my time to enjoy it.

When we arrived at the restaurant, LG and GC had finished their ice-cream but I still haven't finished mine. The restaurant was located at the 1st floor and there were many customers. As many restaurants don't allow outside food, I didn't want to bring in my ice-cream. I suggested that LG and GC enter the restaurant first to get a table while I continue having the ice-cream in the car, and they agreed.

A few minutes later, I finished the ice-cream and went into the restaurant. I looked around the restaurant, but LG and GC were nowhere to be seen. I then went from one table to another and I still couldn't find them. I couldn't call or message them as I had forgotten to bring out my phone from home. I thought that LG and GC might be playing a prank on me. There was an empty table, so I sat there and waited for them to show up.

After waiting for some time, LG and GC still didn't appear. I was getting hungry, so I didn't continue to wait and I ordered my food. When I was about to finish my meal, I suddenly noticed that LG was sitting at a table not too far away from my table. I immediately approached him. LG told me that he had been sitting there and waiting for me all the while. Strangely, I didn't notice him at all before that and he too didn't notice me, even though our tables were at obvious locations.

I then asked LG where was GC. However, he said that GC didn't join us for the breakfast at all and that it was just the 2 of us right from the beginning. That sounded so unbelievable as I was so sure that GC was with us earlier and she was the one driving. For some reason, I was feeling very tired at that time, so I thought that I might be hallucinating things. I walked out of the restaurant to see if things were real, only to find that GC's car was no longer there.

I got so confused that I woke up from my dream.

P/S:

In reality, throughout my Teaching Fellowship at NUMed, I often go for lunch and dinner with my colleagues. However, that ended after the MCO 3.0 was implemented on 7 May 2021, where dining in at restaurants was no longer allowed. I really miss going out with my colleagues, which is probably why I had this dream.

Interestingly, I and my colleagues never had breakfast together. We also never went to Taman Tasek, although we passed by the place several times. The only restaurant I know at Taman Tasek is George & Dragon Café, which I tried only twice. George & Dragon Café is located at the ground floor rather than the 1st floor, and it doesn't look like the restaurant in my dream at all.

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Monday, 2 August 2021

EcoNest - A place I will never forget

The NUMed managed accommodation is located at EcoNest. I stayed at EcoNest for almost 3 years. I first moved into EcoNest on 26 August 2018 when I began Stage 5 of MBBS.

The NUMed managed accommodation was previously at Horizon Residences, but it got moved to EcoNest in 2018. My first impression of EcoNest was that it looks much nicer and has better facilities compared to Horizon Residences. My unit was at Tower C of EcoNest. I particularly liked the washer-dryer provided by NUMed in my unit, as it makes it very convenient to wash and dry my laundry.

Despite that, initially I didn't like EcoNest and I still preferred Horizon Residences. The area surrounding EcoNest was rather isolated which made me feel uncomfortable. There weren't many shops nearby, so I had to travel quite a distance to Bukit Indah for my meals which I found quite troublesome. Worse still, NUMed didn't provide a cleaning service for EcoNest, and instead wanted us to be responsible for the cleanliness of our unit.

However, those negative feelings didn't last long. Soon, I had gotten used to the area surrounding EcoNest and I was no longer uncomfortable with it. In fact, I realised that even though the area may seem isolated, it's actually good in the sense that it feels close to nature. As EcoNest is located quite near the NUMed campus, I don't have to wake up so early on the days where I have sessions at the campus.

A few weeks after moving into EcoNest, I had liked this place so much that I preferred it over Horizon Residences. Then in October 2018, in response to students' feedback, NUMed finally introduced the cleaning service for EcoNest. At that point, I felt that the NUMed accommodation at EcoNest just became perfect.

As time went on, more and more shops opened in the area surrounding EcoNest. With that, I no longer had to travel to Bukit Indah very often. In fact, almost all kinds of food is available near EcoNest now, including Chinese food, Malay food, Western food, Nyonya food, Indian food, Arabian food, Thai food, Japanese food and Korean food.

From September 2018 to December 2018, I had only one housemate in my unit. Although I wasn't close to him, I didn't have any issues with him. In December 2018, he moved out permanently as he would be doing his medical electives outside Johor Bahru for the following semester. Therefore, I could have the entire unit in EcoNest for myself, which is a privilege that not many students get.

In June 2019, with the end of Stage 5 of MBBS, I was supposed to leave EcoNest permanently which made me feel quite emotional. However, it turned out that I failed my Stage 5 final exam and had to repeat Stage 5. I definitely wanted to continue staying at EcoNest for my repeat year of Stage 5. NUMed offered me another unit at EcoNest and helped me move my personal belongings to the new unit.

My new unit was at Tower B. It's larger compared to the previous unit, but this also meant I had to live with more housemates. I really disliked one of my housemates because he often brought his girlfriend to the unit and they were quite noisy. In January 2020, it got worse as he started bringing a large group of friends and they liked to talk loudly even past midnight. I made a report to NUMed without hesitation and thankfully it put a stop to that.

In March 2020, the Movement Control Order (MCO) was implemented in Malaysia. My annoying housemate moved out permanently right before the MCO started and I was so glad about that. Throughout the MCO, I stayed in Johor Bahru instead of returning to my hometown. As I hardly went out, I spent most of the time at EcoNest. Thanks to the fact that EcoNest is a very nice place and has excellent facilities, it made the MCO much more bearable for me.

There are some cafes at the ground floor of EcoNest, but for a long time I didn't bother trying them. Since the MCO started, only one of the cafes remained open. In April 2020, for the first time I ordered takeaway from that cafe, and it's quite good. Since then, I had been ordering food from there regularly. After the MCO got replaced with the Conditional MCO, that was the first place I went to dine in.

EcoNest has a swimming pool. Between August 2018 and June 2020, I walked pass it several times but I never used it. In July 2020, I finally used the swimming pool for the first time. However, I found it a bit underwhelming. Although it looks quite nice, it somehow feels more like a fish pond than a swimming pool. The swimming pool is the one thing where EcoNest loses out to Horizon Residences.

My repeat year of Stage 5 was supposed to end in June 2020. However, the final exams got delayed due to the Covid-19 pandemic, so I stayed at EcoNest for another 2 months. It's a good thing that NUMed didn't charge me extra for that. When I completed my MBBS course in August 2020, I thought I would be leaving EcoNest permanently, which no doubt made me feel very emotional.

Later, I got offered the full-year Teaching Fellow post at NUMed, which meant that I would be in Johor Bahru for another year. Unlike students, Teaching Fellows are unable to apply for the NUMed managed accommodation. However, I could directly contact the agent that manages the student accommodation at EcoNest. One of the previous year's Teaching Fellows recommended a unit at Impiana for me.

I chose to stay at EcoNest again as it's cheaper and I really like the place after having stayed there for 2 years. I got a new unit at Tower A and it's of the same size as the previous unit. The facilities provided in this unit are almost as good as the units managed by NUMed. My new housemates were quite nice. Although I wasn't close to them, I never had any issues with them. In October 2020, a new cafe opened at the ground floor of EcoNest and I really like it. 

Just like the previous year, I had to experience periods of MCO, which once again was much more bearable thanks to EcoNest. I delivered several online teaching sessions from my room in EcoNest. Occasionally, my Teaching Fellow colleagues would come to my unit where we had lunch or dinner together. They really liked EcoNest as well, and one of them remarked that he regretted not staying at EcoNest.

Throughout my Teaching Fellowship year at NUMed, I used the EcoNest swimming pool several times. Although I didn't really like it previously, I began to appreciate it's uniqueness. I even recommended it to my colleagues. With the implementation of the MCO 3.0 in May 2021, the swimming pool had to be closed and I never had the opportunity to use it again.

My Teaching Fellowship came to an end in June 2021. However, my Covid-19 vaccine appointment would be in Johor Bahru on 22 July 2021. I didn't want to reject the appointment as that would cause further delays. Therefore, I decided to stay at EcoNest until the end of July. I had been treasuring every moment of my stay at EcoNest as I knew I would be moving out permanently before long. Despite that, time still passed so quickly.

On 1 August 2021, I finally have to leave EcoNest permanently for real. Needless to say, I feel very emotional about this. I definitely have a lot of great memories at EcoNest over the past 3 years. I won't be returning to EcoNest again anytime soon, as I am not doing my housemanship in Johor Bahru.

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Friday, 23 July 2021

Issues with my Google account

There have been some drama going on with my Google account.

I had always refused to enable 2-step verification for my Google account. I found it inconvenient and I was sure that my account would be safe as long as I don't give out my password to anyone. Most importantly, I was worried that if I were to lose my phone, 2-step verification would prevent me from using Find My Device to locate my phone, as I wouldn't have my phone for the sign-in process. Unlike Apple, Google doesn't allow you to bypass 2-step verification for Find My Device.

Problems started in mid-April 2021. At that time, I received an email stating that my Google Ads ID had been suspended due to suspicious activity, and another email stating that I had successfully set up a video ad on Google Ads. Google Ads is a service where users pay Google to do advertising for them. Since I definitely don't use Google Ads, I thought those emails were just spam. In the following days, I received several more emails with similar content. I then realised that the emails were sent from Google itself so they couldn't be fake.

I did some checking and found out that a total of 20 Google Ads IDs had been created under my Google account without my knowledge! Some of those Google Ads IDs had been suspended due to suspicious activity, but the rest were still active and had accumulated charges ranging from RM30 to RM150 for each account. Worse still, as I had added my debit card to Google Pay for my previous purchases on the Google Play Store, those Google Ads charges were ready to be charged to my debit card anytime!

Someone must have gained unauthorised access to my Google account and created those Google Ads IDs. Strangely enough, when I checked the login history for my Google account, there were no logins other than those from my own devices. All my devices have passcodes and I never let anyone use them. I really had no idea how it all happened. I immediately changed my Google account password and enabled 2-step verification.

I tried removing my debit card from Google Pay before it could be charged, but I couldn't as there were outstanding charges for Google Ads. I also couldn't disable the Google Ads IDs as the Google Ads user interface is really complicated. I had to report the whole issue through Google Ads help center. There was no live chat available and the only option was to fill up an online form. The form asked for the Google Ads ID, where I could only key in 1 ID, but I explained in the main text that there were 20 IDs in total.

The Google Ads support team replied me a few days later, but only for the 1 Google Ads ID where I filled up in the online form. They disabled that ID and stated that I would not be charged anything for it. I then asked about the other 19 Google Ads IDs. They promised to get back to me in a few days, but they didn't do so. Later, I managed to navigate through the Google Ads user interface and cancel all of the Google Ads IDs. After that, I was able to remove my debit card from Google Pay. I thought the whole issue was over.

Some of the cancelled Google Ads IDs still had outstanding balances, which were still showing up in Google Pay. I didn't bother about that since my debit card was no longer linked to Google Pay. However on 8 May, RM34 was charged to my debit card for 1 of the cancelled Google Ads IDs. That meant I surely would be charged for the other Google Ads IDs as well, which would be several hundred ringgits in total. I immediately called my bank to block my debit card and request a chargeback for the RM34.

After I got a new debit card, I did not add it to Google Pay as I was worried that the outstanding balances for Google Ads would be charged to my new card. Later, I wanted to buy a custom domain for this blog. Among the domain providers, I felt that Google Domains is the best as it is cheap, reliable and can be integrated with Blogger easily. However, I couldn't make the payment for Google Domains without adding my debit card to Google Pay.

I wanted to know whether I would be charged for those cancelled Google Ads IDs if I add my debit card to Google Pay, so I seek help through Google Pay help center. Live chat was available, but only for Google Play developers. Although I have an app on the Google Play Store, the system somehow couldn't recognise it and wouldn't let me access the live chat. I had to go to the live chat for Google Play Store help center and ask them to connect me to Google Pay help center, which they reluctantly did.

The Google Pay support team told me that since my issue is with Google Ads, I should contact Google Ads help center. I argued that since the outstanding balances were showing up in Google Pay, it should be their job to do something. They insisted that they couldn't help me with that, and they couldn't give me an answer on whether the balances would be charged to my new card if I add it to Google Pay. As the Google Ads help center doesn't have live chat, they couldn't connect me to it.

I had no choice but to go to Google Ads help center and fill up the online form. Once again, the form asked for the Google Ads ID and I keyed in 1 of the cancelled Google Ads IDs. A day later, the Google Ads support team replied me that the Google Ads ID I keyed in was invalid and asked me to provide a valid ID. I then sent them a screenshot proving the existence of the 20 Google Ads IDs. Despite that, they insisted that none of the IDs were valid and asked me to provide a valid Google Ads ID.

I reiterated that all those Google Ads IDs had been cancelled but still had outstanding balances. I told them that instead of arguing about the validity of the IDs, they should just answer my question on whether those balances would be charged if I add my new card to Google Pay. They claimed that for security reasons, they must verify the validity of the IDs before they could proceed. They suggested that I create a new Google account if I am concerned about the outstanding balances and told me to fill up the online form again if I had further questions.

Creating a new Google account is definitely not an option for me, as I am using my current account for so many online services. At that time, I found a number to phone Google Ads support. However, the person I spoke to said that her job is only to help users set up their Google Ads campaigns. She insisted that she couldn't help me with my case and that my only option was to fill up the online form on Google Ads help center. I complained to her about how unhelpful the help center is, but she replied that there was nothing she could do about it.

Outraged by that, I filled up the online form once more. This time, I stated clearly that all of the Google Ads IDs had been cancelled so they most probably would be invalid. I also attached several screenshots to the form to prove that all those IDs were linked to my Google account. The support team got back to me, repeating that the Google Ads IDs were invalid and that I had to provide a valid ID. They added that they would not accept screenshots for verification.

It's clear that the Google support team isn't going to help me no matter what, simply because they won't make money from that. The amount of money I would pay for Google Domains is simply too insignificant for Google. Google is only interested in earning big money from Google Ads and Youtube Premium. Google has been nagging me to subscribe for YouTube Premium at a ridiculous price of 12 USD per month! For users who don't pay for that, Google shows more and more disgusting ads and denies them the most basic feature of background music playback.

Later, I managed to close down my Google Pay profile, which erased all of the outstanding balances from Google Pay. However, it stated that I would still be responsible for those balances. The question is if I create a new Google Pay profile and add my debit card to it, will those outstanding balances be charged to my card? There's no point for me to ask Google Pay or Google Ads support about that. Instead, I have decided that I will never add my debit card to Google Pay or buy anything from Google again.

I decided to buy my blog domain from Namecheap. It is cheaper than Google Domains, and although it has to be linked to Blogger manually, it's user interface is quite user friendly. I am currently using a Google Pixel 2 phone, but I intend to get a new phone within the next year, and my next phone will definitely be an iPhone. After I get an iPhone, I will never have to use the Google Play Store again. I am also using AdBlock Plus when browsing the internet to get rid of all ads from Google.