The Road to MO-ship

Almost there. Sauce

Or should I say, 'well-beaten yet overgrown dirt path'?

I cannot find good resources on how people filled out the forms required for MO-ship.

Where I'm concerned, the process I'm currently undergoing (because I still have yet to receive my MMC number and would say I'm not really qualified to say anything of it) is rather easy so far. As I have documented earlier during my early HO days, my hospital's administration staff are highly helpful and efficient. I just ask and they will provide.

Just makes our jobs a lot easier; I can't begin to imagine how much of a headache the staff in charge of us feels, now that there are over 100 HOs in the hospital (I kid you not)! But she's always very pleasant and eager to help.

Anyways, once I have more details I will update this space.

For now, all I can say is:

1) Send your logbook from your 5th posting EARLY. Try at least 2 weeks before ending, so your admin staff's work is easier.

2) Prepare RM150 for the full registration fee (which could be reimbursed later LOL) and this will have to be done by wang pos, mostly.

3) Think (and pray) hard about what you want to do later and where.

4) Don't get hung up on a specific place/department to practice for now, unless you're married or have strong cables (yaknowwhat'msayin') OR have passed the first part of the paper, if applicable (i.e. MRCS, MRCP and the ilk).

5) Don't panic and freak out.
Which is exactly what I'm doing.

And perhaps,what I should be doing better,
6) PREPARE MONEY FOR THE UPCOMING UPROOTING TO UNCHARTED TERRITORY.
Movers and house rental deposits? Not cheap y'all, not cheap.

7) Get credit cards
Seriously, don't panic and freak out. Just keep revising man. It's all on you in a few months, man. All that responsibility and life-altering decisions.
All you.
So, you know, don't freak out or anything. It's chill.

The Curse of Time Awareness

When we were younger and carefree,

keyword here being 'carefree',

we are less aware of time.

We progress through our days as our parents and teachers dictate.

Wake up in the morning from our mothers' not-so-gentle calls.

Shower and brush our teeth because we are supposed to.

Go to school because that's what our parents tell us to do.

Attend classes as our teachers change, lesson by lesson.

Go out into the field and run because it's part of normal school activity.

Have fun with friends because we are supposed to.

For most of the Malays, school doesn't end in the afternoon.

"Sekolah Agama" beckons until later in the evening.

After that, come home and shower.

Then tuition, or Qur'an classes, until night time.

Then an hour or two to spare for homework, and maybe some TV, before we are forced into bed.

Weekends are largely dependent on how free our parents are (or how financially-constrained, but we rarely realize that until much later).

I don't know how different it is compared to the days of children now, but I rarely count my moments as a child, and well into my teens. I wasn't trying to deduce how many hours of me-time I have left. 

I left it all to the authorities, the 'rentals.

I was devoid of care. 

Entirely carefree.

Where time is concerned, all I want to do is grow up.

Now, every hour is calculated, every effort a pending reward.

I am too aware of the time I spend.

I couldn't recall, during my childhood, there being a time when I'm thinking, 'Aw man, only three hours before I have to sleep!' or 'What, only two days left to school holidays?!'

My days went by as planned by those older than me, and I willingly accepted whatever routine or non-routine activities mostly planned out for me.

I never questioned much of my time. Even in high school, when work began to pile on me and my many younger siblings meant that I have to dedicate most of my free time to helping around the house, I still barely thought about all the free time I'm missing.

Is it because, back then, I had close to nothing to do?

I didn't have free reign to the only PC in the house, nor do I play the old PS2 all that much. 

I didn't own a great deal of books. Most of my reading material were from the school library (and even then I wasn't as picky about what I read, I just devoured what books I could get voraciously).

My goal was to do medicine in a university in the UK, and for that I studied very frequently, mostly without prompting. The dream was only half-fulfilled- and I wouldn't have it any other way.

I often turned down invites to people's parties, and by my geeky nature, it was only a matter of time before invites trickled down to the closest of friends.

Let's not even get into the fact that I did not get into a relationship until I was in my twenties.

So, yeah. 

I didn't have much to do, and I wasn't aware of those times I might have missed out.

My parents didn't realize until way later, when my siblings have all grown up, that I was the easiest child they ever had to care for.

I despise how time-aware I have become.

Now, by the evening of my day off I'm already dreading the next working day; already thinking of worst scenarios to happen, already cursing myself for things I did not do in my free time. 

I spend nearly a quarter of my free time worrying about what's to happen during my working time.

It's a curse.

I have no idea how to get rid of it. How do I return to those days when I take each day as it is; without overt worrying, without putting undue stress on myself? Did I develop an anxiety disorder as I grew older, or is this simply the normal course of an ageing mind?

I am not a young adult anymore. 

I am a full-fledged adult. I can do everything; age restrictions don't apply to me, until such a time when I have to look forward to discounts for being in my 'golden years'.

Where I wanted to fast-forward time, now most of the time all I want to do is slow it down.

I need a Dr Who in my life.

Emergency Medicine

I'm loving this way more than I thought I would.

There are some seriously bad days, but 99.9% of the MOs are very nice (and even the 0.1% is nice in his/her own way).

NO AM ROUNDS WOOHOO!

Short attention span is fine.

Clerking is short.

ADRENALINE RUSH IS REAL.

YOU give the diagnosis.


I dunno man, it feels pretty real up here.

No ragrets.


Except, I do feel stupid a lot here haha!

Staging the Malignant Tumour & The Norm.

I'm lucky now that I'm in such a positive environment.

This is probably the department with the most relaxed, least angry bosses in the hospital.

Also the department which people from other departments are always condemning, but whatever.
Condemning other departments is normal, no?
At least in any hospital with departments to condemn.

And although that is the norm, it is rather toxic.

I rarely- RARELY- hear my bosses in any department defend their colleagues in other departments.
It's weird.

Why?
Because it's the norm.
That's how their seniors worked, and that's how they work now, and that will be us in a few months.

In fact, I know of some people who take pride in being known as 'The Malignant Senior HO'.
They take pride in the fact that fellow malignant bosses also approve of how scary and intimidating they are to their junior colleagues, their fellow staff, and patients. Apparently, being 'malignant' is encouraged- and a sign of aptitude!

And hey, take a gander at how they will run their future department soon!

Mocking other people.
Mocking other departments.
Mocking other hospitals.
Especially those that are considered 'beneath' them.


Repeatedly, I have called up certain departments to request- kindly- for a process to be expedited, or an investigation that requires expertise not available in my current facility, only to be shot left, right and centre even before I could even begin to tell my story. Simply from the introduction which indicates my HO status, the previously semi-warm greeting plunges into icy tundra, and all hell breaks loose.

Telling my seniors or bosses (with amusement, because that's how you're supposed to wave it off) only results in further remarks on how that is expected and usual, and that it somehow builds character.


I was quite surprised to find that there are decent people out there, who, when faced with the fact that we simply do not know how to properly present relevant details, will actually teach instead of scolding or slamming the phone down.
They realize that we are not experts in the field as they are, and accept it with patience.
They persevere in teaching us, so that we may do better next time.
Besides, it will definitely benefit them in the future.

Just as it benefits our health, mentally and physically, to encounter such positivity in our working environment.

These are the types of people that should be the norm in this field- this career that demands so much time and energy devoted into the caring of others--

--and yet 

they are 

the minority!

I don't even have to ask why.

It's because we accepted that things should be tough for us.

We accept that
those supposedly higher in rank have the right to scold us unnecessarily;
that despite how wrong they are, we should strive to accept their words and not defy them.

We accept the hierarchy that has been established, blindly, and do not strive to improve our own fraternity because 'it's working'.

The hospitals are running, people are coming, so it's working.


In the journey after medical school going to fully-licensed medical practitioner, we lose our humanity and accept this so-called 'norm'. Come MO-ship, almost all of us are same ol', same ol'.
Those who don't accept this status quo are shunned by the fraternity, then ultimately leave for greener pastures (private practice or leaving the medical field entirely).

And what a shame. What a bloody waste of talent and resources.


I notice that the department in which house officers thrive- stay happy, and excited to work- are those in which the Head of Departments have zero tolerance for HO bullying.

They do not condone harsh teaching of their HOs by the MOs or other specialists or healthcare staff.
They tell their staff to treat the HOs like their younger siblings; to respect them as human beings and junior colleagues.
They actually will tell their MOs NOT to do something right in front of everyone, when they think it's wrong.

These thriving departments are not the departments which justify their MOs' legendary repute for yelling, screaming and borderline physical abuse because 'conditions are stressful'.
Sure, they say, your MOs will shout at you at first, but it's okay because they will be better to you once they know you're able to do work. And you will learn either way, if you're a tough HO, because remember, only tough HOs make it through!

And this attitude is exactly what needs to be corrected.


But who am I?
Just a HO, green from the pastures, with nary a ring to put to my career span.

Going Back

There are many ways in which people gauge the status of a houseman.

Competency, that is a no-brainer. Are you able to manage the common emergencies or cases? Perform the basic procedures without much difficulty? Diagnose a life-threatening complication of your patients in ward? A competent houseman is, more often than not, a good houseman.

Then there's knowledge. This contributes to competency. Safe to say, most of us have knowledge, because let's not forget that the journey to becoming a medical student wasn't easy- at all. More often than not, it's just a matter of doing proper revision, and more frequently. Otherwise, everything our specialist taught us during the rounds just fly out our memories within the span of a week (or less).

But attitude... Now that's something to contend with.
How would you gauge attitude?
What defines a houseman with a good attitude?

It's easy to speak about it theoretically, I'm sure. But this is probably the facet that is hardest to evaluate objectively.

A houseman may seem very competent and knowledgeable to her bosses, and hardworking too, but shunned by her colleagues. Turns out, the houseman shirks from work during all times except when her bosses are around.

Another houseman who seems likable and hardworking, but avoided and talked about by nurses. Competent enough, but lacking in communication skills and the tact to deal with people who are seemingly under him.

And on and on.

It's very hard to judge a person when you only see them for a total of less than 6 hours in a 70-hour work week. In those few hours, that person may be having the most difficult time, and have done some major blunders that do not define the person at all. After all, to be human is to err.

But that is what happens.
Because, like it or not, first impressions do matter.
And second impressions.
And maybe third ones too.

So how to define attitude more objectively?
Therein come the logbooks with the attendance records and multisource feedbacks, and other things associated with them.

**********

Attendance is a very fickle thing.
For the most part, it is believed that the longer hours a houseman works, the more positive his attitude is, and thus a better houseman he will be. However, in those supposed punched-in, punched-out hours recorded, how did the houseman fill his time?

There are housemen who diligently come and go on-time. And these are scoffed at, because they do not put in extra hours, and must thus be less hardworking.... Right?

Those housemen who leave late on record, now those are the hardworkers! ... Right?

Anyone who's been a houseman these days know that this is not entirely the case.

I know of people who punch in on-time, and punch out extremely late almost each shift.
These are the same people who disappear while they're supposedly on-shift, doing God-knows-what and leaving the abundance of their other co-workers- because yes, nowadays there are more of us working and the days of single-person shift are fast coming to an end- to deal with the work.
These people will unfailingly be there when bosses come and act like they've done all the work.

These people will disappear again afterwards.
And well after their working hours are over, they come back to the hospital to punch out.

Whereas those who come and leave right on time aren't necessarily lazy. They spend the required hours doing all that is required of them and maybe more, and by the end of the day they deserve to punch out on time. After all, some of them have families to come home to; work is not their entire lives.

And yet we define the attitude so easily based on some scraps of paper that supposedly record our hours.

**********

So, I've been in this leave early (aka on time) or late dilemma too.
But then I realize, it's all so simple- if I don't come to work merely with the intent of pleasing only my bosses or other authorities watching over me. I come to work for myself, and for something larger than me and my bosses.

And there is an omnipotent being monitoring all my moves.

So people may think I go back early (aka on time). So what, if I know I've done all that is required of me?
I have also gone back late because I was helping others with their work.

No matter what happens or what the people monitoring my time card may think, I know that I've earned my keep. I know what I have done and what I would have shirked. And God certainly knows more.

And if I'm doing right by Him, then nothing can truly throw me off my course.


Not that I have ever had attendance issues.
Nor has this been a raised issue for me.

I am on both ends of the spectrum.
I have clocked in some rather long hours too in the past years of my life.
And I have clocked in some punctual hours, too- more so now that I have matured enough to care less about what other people may think.

It's just an interesting issue because I heard of a colleague bragging about how he/she is always around within 30 minutes after the supposed end of shift, and this colleague has a habit of disappearing within working hours and subtly leaving work for other people to settle.

Longer working hours are not entirely impressive, people.
Get over it.

So if no one in the ward needs your immediate help, and your work has truly been done (or any appropriate work passed over), then go home.

But God help you if your friends are dying for help and you hightail out of the ward like a convict on the run.


P.S.: Housemen in Malaysia get the same pay no matter their working hours. It varies slightly depending on where you work in relation to where you live, and your seniority. Other than that, we do not earn extra for the extra hours we put in, or which public holidays we work in.

I'm in awe~

Perhaps I was too afraid to jinx my experience so far, but this has got to be the most relaxing posting I've ever gone through.

Ever.

I'm just in awe.

Well, in awe at how superstitious I've become, but also at how amazingly nice this posting has been on my mental status.

Bosses are way nice.
Workload, most days, is negligible.

And not to mention, generally this department has a really quick turnover rate. Results are easily seen. And people get happy with their after results.

Not that there weren't unhappy people (they ruined some of my days, I tell ya) but that's a given.

Except I haven't been doing the bulk of what this posting even says- SURGERY.

Most of my work is in the ward!
Or in the emergency department!
Or in an ambulance!


Man, good stuff!

Where you lead, I will follow

Re-watching Gilmore Girls.

This time around, I'm closer to Lorelai's age than I am to Rory's.

SO weird.




END OF POSTING WOOHOO!

SO MANY THOUGHTS

1.

DEY. Control your short forms lah dey.

Watpe tew?

Ittew nk gi shopink skrunk

lanje ley?

cntk bju tew.

rege rape?

Rape?

RAPE???@

WHAT THE HECK IS WRONG WITH YOU PEOPLE?!??!?!?!!!



2.

ME IN WARD B: *Running around* AKAK, SAYA SANGAT LAPA--

SN WARD A 1: Dr, tak makan lagi ke? Tu ada nasi lemak Kak S bawak, makan meh--
SN WARD A 2: Dr, jemput makan kek akak buat~
SN WARD B 1: Dr, meh akak ada buat kerepek sikit buat kudap2--
SN WARD B 2: Dr, nak rendang dengan lemang?
SN WARD C: Dr, nah rasa kuih akak buat hari tu!
SN WARD D: Dr, ward kami ada buat makan2 sikit, meh la datang!

ME: -- *CRIES TEARS OF JOY WHILE STUFFING SELF SILLY*



3.

*Stares at logbook*

*Stares at schedule of bosses on leave*

*Stares at unsigned pages*

*Stares at unapproved leave forms*

I cri everytiem. ;___;



4.

Me: I'm so bloody tired.

Also me: Let's watch this 'Shape of You' parody for the 293848945893475934th time since it's 1 am and I'm on-call tomorrow!



5.

People: Dude.

Me: Whut.

People: You're like, almost an MO.

Me: *Fifty feet underwater*
*Gurgling air bubbles*
SRUUUR WUURRRR

How to NOT Die When 'Informing Bosses'

One of the less fine moments in life as a house officer- or any profession, really- is the need to inform certain matters to your boss knowing, most probably, that you will be berated for the information.

Deteriorating or collapsed patients are not included- those require immediate attention and only irresponsible bosses will refuse to heed your call. I'm talking about things in the grey area of urgency, which- unfortunately- make up the bulk of our time. Additionally, these gray-area issues contribute to a major portion of our bosses' source of anger.

By bosses I mean MOs, obviously. You don't normally immediately inform your specialists of abnormalities, do you?

There is no getting around it, nevertheless.
Sure people tell you to be resilient, otherwise don't become doctor lor, but that  sentiment doesn't help much since you weren't born with the resilience of other people. Nor were you raised  the same way. Upbringing contributes to resilience too.

I am a rather sensitive person. Malays may call it the tissue heart syndrome, or 'hati tisu'. Getting a scolding will probably lower my mood for the entirety of the day- so getting scolded early in the day really affects my performance.

But I've learned some adaptive maneuvers, more or less. Mind you they're not miracle solutions, nor are they magic, but they seem to work on me a little.

Okay, a lot, since people think I barely get affected by scoldings some days it's ridiculous.
And at the end of the day, I'm still enjoying my time here which means I'm not too negatively affected.

I sincerely hope this helps others too.

• Preparing/Psyching
• During this time, you should really know your case; the patient's history and progress, and why what you are about to inform can significantly impact the patient's management and perhaps their life
• Convince YOURSELF that it is important 
• Tell yourself it is for the PATIENT- no one else is more important
• Before informing, make sure you have assessed the patient and done the basic steps of management accordingly. If you're not sure, try asking your seniors- yes, that includes your senior nurses who have seen the same management chain day in, day out for years. Bosses hate mere informants
• On the other hand, some bosses hate the idea of you giving your own prescription/management, so just tailor what you do based on what you know of this boss.
• Remember that your boss is not your God. And the moment of wrath, if it comes, will PASS soon enough (this is especially important with more malignant bosses)
• If the last point is not enough, believe that God is fair and those who are truly not well-meaning will get their due

• While informing
• Take deep breaths. Don't rush through it. Better to be a little slower and pace yourself rather than rushing irrelevant and potentially wrong information out of your troubled tongue
• Look ANYWHERE but your malignant boss's expression UNTIL YOU FINISH PRESENTING. Over the phone, this is made infinitely easier
• Remember to be unfailingly polite and humble no matter what. Not for the sake of the boss, but for your own and others in the vicinity
• Don't overthink your boss's reaction before it is received. Just keep your information- and the patient- in mind while you are informing
• If the boss starts asking questions in a scolding manner, just try your best to answer with what you know and bear in mind that any scolding you are about to receive is fine. It is totally fine. It is temporary.
• Remember your responsibility and your duty

• Aftermath 
• If you were scolded, with no positive criticism given- throw the wrathful aspects of the session into a mental wastebasket, and chuck it into the ocean- along with your anger and disappointment. No, seriously, it works, if only a little.
• Keep any positive scraps of the scolding session into your mental scrapbook of improvement (or, you know, jot the new knowledge down somewhere safe and more tangible, like a tiny notebook or your phone, where you can easily retrieve them)
• Remember, again, that you were just doing your duty and your intentions were right (see preparing/psyching, bullet number three
• Remind yourself that you are still learning- and as a house officer, that is your NUMBER ONE goal
• Look forward to your next pleasurable activity whenever you feel like stewing over the disappointing event, preferably one far away from the hospital walls
• Remember it's only a few months of your life until you're not directly under said malignant boss! 
• Remember moments when you were praised. If it's too wounded, your ego needs a boost to function. You're not entirely worthless, mmkay?

Dah.

Tomorrow is a new day!

One Fine Night in a Hospimart

I was wasting money in my favourite shopping place in this district (obviously Hospimart) when a lady came up to me.

"Dr baru habis kerja ye?" asked the middle-aged lady. She was wearing baju kurung, and being there so late at night I wondered if she was the relative of one of my patients. I barely recognise them, but I tried my best to be friendly nonetheless.

"Ha'ah mak cik. Biasalah, satu hari kerja, lapar malam-malam ni", I replied, grinning.

"Tak pe Dr, kerja macam Dr ni banyak pahala..." She told me. I just smiled and nodded, and said I hoped so.

Then she told me, "Sebenarnya anak mak cik dulu pun macam Dr juga. Dia jadi doktor pelatih. Tapi dia tak tahan dengan bebanan kerja... Jadi dia pun dah berhenti. Tak sanggup kerja lagi sebagai doktor. Puas mak cik pujuk dia, dia memang tak mahu dah. Rasa macam luruh hati mak cik... Berharap sangat nak ada doktor dalam keluarga. Nak buat macamana?"

I was taken aback.

"Bagus lah Dr tak putus semangat. Orang yang kuat sahaja boleh tahan kerja macam ni. Apa nak buat, anak mak cik tak boleh nak tahan..." She was getting tearful, and I was reaching my capacity too. How troubled the mother was. Her voice was breaking.

I put a hand on her shoulder and patted her, looking her in the eye.

"Mak cik, saya pasti semua yang berlaku ada hikmahnya. Rezeki anak mak cik di tempat lain. Mungkin dia yang akan boleh jaga mak cik nanti, walaupun dia bukan Dr.

"Saya sendiri, atuk sendiri sakit, ibu bapa sendiri sakit, jarang sangat dapat nak melawat. Sebab selalu jaga orang lain punya atuk, orang lain punya ibu bapa..." I felt my own tears threatening to fall, but I plowed on.

"Saya tahu mak cik sedih. Tetapi percayalah, mak cik langsung tak rugi kalau mak cik percaya pada perancangan Tuhan. Mestu ada hikmahnya, saya percaya. Mungkin tak nampak sekarang, tapi lambat laun mesti mak cik perasan." 

The lady nodded,wiping her tears. "Saya tahu, tapi kadang-kadang masih rasa menyesal."

I nodded sympathetically. We exchanged a few parting words, and I took my leave, my head abuzz with emotions and thoughts.



It's almost natural, it seems, for parents to want at least one of their offspring to become a doctor- except to parents who actually are/were doctors. At least it seems that way in this country. And it transcends racial boundaries.

I do not understand the fascination, not entirely, but then again I already am a doctor. I am well aware of our capabilities and our large limitations; I was, in fact, a product of such thoughts. My parents really wanted me to become a doctor. I was 'brainwashed' since my infancy, to the point that I actually thought I was here of my own volition.

But that's obviously not true.
No toddler would want to do this for the rest of her life.



And yet there is something so tangible, so rewarding, at the end of the day. The moment you leave the hospital, one of those rare moments where you are actively reaching beyond the walls of your wards or the hurtful words of your seniors, your own thoughts of inadequacy. These are the moments when you feel, 'Yes, I can do this for a lifetime. I can keep on doing this, just give me some breaks in between.'

And life as a house officer, I believe, is way more rewarding than medical student life.

Don't get me wrong, student years are very fun and there is no beating that 'no responsibilities' feeling. But now I get to own my hard-earned money. The hours can be crazy long, but we do get some rest in between. And in the end, I contribute. Despite my lack of experience, and sometimes my mistakes; despite the scoldings of being mere 'clerks' and the feeling of just having to follow orders. Despite these, I have contributed to the society in some way. I have helped save some lives.

I have, most importantly, played a part in alleviating other people's pain and suffering, and brought smiles to their faces.



Perhaps this can be the most rewarding job in the world. But for it to be that way, I must always look above and beyond my hospital walls.



And I pray, so that those parents- whose hopes seem shattered beyond repair when their children refuse to become a doctor- will find the truth and see the advantages of a child not working in the healthcare service. Most other jobs are rewarding, too, as long as one's intentions are right.



Anyway, it has not been the easiest past few weeks. And the story I just told happened in one of my previous postings. I feel like I lost so many insightful moments when I do not write them down somehow.

But at least this one will stick for a while :)

My Current Mission

I AM ON A MISSION

TO FINISH MY LOGBOOK.

And also to really truly decide if this is THE posting for me, because I have never enjoyed a posting as much as this one.

Seriously.
I'm thinking of taking MRCOG, this is how serious I am - and I haven't even REALLY truly conducted a delivery all on my lonesome, nor have I done a cesarean section!

Even during the most busy days I find myself enjoying it and that is just insane.

Also on a mission to

- Lose weight
- Be healthier
- Get married
- Be more patient
- Earn more money
- Be more disciplined
- Have more books

etc, etc.

Woo O&G!

My frequency of posting entries here is dropping at an alarming rate.

ALARMING!

I'm going to say one thing for now:

I am mostly enjoying this new posting. Heh heh.

Okay byeee

1 Year of Housemanship in the Bag

WHAT DO I FEEL?

Mostly tired and sleepy.
Hehe.

Okay, some self-fulfillment too.
Alhamdulillah.

And at last I see the light~

Resources one should have in Orthopaedics posting as a HO in Malaysia

I think this might be a little important. Unlike Paeds and Medicine, for which there are the Paeds Protocol and various CPGs, there aren't any official guidelines for Orthopaedic management in this country. Apart from the following, I would suggest a small notebook in which you can jot down the common management seen in your hospital.

Look through your HO logbook and aim to complete it quickly. Some procedures are hard to come by and may not come by at all by the time you finish your posting!

As always, the following is based on my personal but honest opinion.

Books/Printed Documents:

Print This - A highly useful PDF document made by a great team. Has all the important fracture classifications, some important angles (to accept check x-rays), common dressings, implants and in the final page some important ortho emergencies to watch out for, amongst others. Try to memorize this by the end of the posting. To be The Ultimate HO, memorize the entire thing before the beginning of the posting!

'UIA Ortho Book' - It's actually titled 'Basic Fracture Management for Students and Housemans [sic]'.I don't know where you can officially get this, but since UIA/IIUM grads are everywhere, try asking them. This book came highly recommended by one of my specialists and a few MOs. The book is usually found photocopied. It is concise and has almost everything you need to know regarding some of the most common management points in the posting. If anyone has a means to get the original form or a way to contribute to the authors, I'd greatly appreciate you dropping me a line.

Netter's Concise Orthopaedic Anatomy - A great book for a quick look through important anatomical points, and concise information on some important injuries. It even shows x-ray techniques. This book saved my life (okay, more like reputation) quite a few times. Small enough to carry around (and lose :( ) in the hospital.

Apley's Concise System of Orthopaedics & Fractures - Get the concise version if the big one is too costly. Mind you, your specialist might tell you it's 'not enough'. It's more than enough for a HO not very keen on furthering in Orthopaedics (or too broke to afford the bigger book).

Websites:

1. Orthobullets - Concise as the name, and highly useful for some accurate high-yield facts and management points.

2. Wheeless' Textbook of Orthopaedics - Another highly recommended site.

Both of the above are more than adequate, and best of all they're absolutely free. And amazing.
God bless the contributors.

If you're not keen on getting the books suggested in the previous list, access to internet and the above sites, as well as the PDF document in the previous list, is more than enough most of the time.

Tools

1. Measuring tape

2. Goniometer

3. Tendon hammer

4. Don't forget your stets! And other basic HO stuff. Just because it's Ortho doesn't mean you don't review the patient holistically ;)

Actually these can be found- most of the time, anyway- in your clinics and wards. But it's better to have them handy. The goniometer? I've survived without one, but I could distinctly remember some MOs running around like headless chickens trying to find one in the clinic.

Conclusion

Some Orthopaedic departments are known to be the most chill departments in the hospital.
Some are known to be the most malignant.

Either way, it is always better to equip yourself in this posting, same as other postings. It may not be a major posting like medical or surgery, but once you become an MO, you may - MAY- be thrown into this department, and have no say in it. Furthermore, some basic management of orthopaedics is still important when you're the frontliners in medicine, working in a health clinic or the emergency department. So don't take this posting for granted!

Important topics?
Kindly ask your bosses. I might go into it later, if I have the time and motivation.

Counting down to the end of this posting...

Dear Various Staff of my Current Department...

Dear Specialists,

you don't function as our guardians.

You think you do, but you fail miserably.

Dear MOs,

screw you too.

And for those to whom this applies, love you too. Like, 2 of you.

Dear Nurses,

thank you for being our gossip partners.

Sorry for semi-snapping at you when things don't get done.

Thanks for the CODs.

Dear PPKs,

I know you are underpaid, but so am I.

Please stop taking so many breaks if your work isn't done.

Stop making me do your job.

Dear HOs,

... hang in there.

This too shall pass.

Sincerely,

(And I am not liable for what I say when I'm so emotionally disturbed),

A Highly Upset Cockroach aka HO.

.

Frustrated.

So frustrated.


I actually want to cuss and swear while crying, if such a thing were possible on such a public blog.

I have never felt so stressed in my HO life.


Whatever.

Be back soon with better-sounding posts.

Some Days

Some days,

it's enough for a fellow colleague to thank you and say they trust you.

That you can be relied upon.

That when you're in their shift, they feel less burdened.

Bosses aside,

we know each other (HOs) most.

We are the ones who have to cope with one another, we are our own support system.

So what if your bosses constantly pick on you?

If their advice is useful, then improve on that which you're lacking in.

If not, keep your chin high. Don't be rude, and if it's too horrendous, vent to the proper channels.

Your colleagues, your friends, will be there for you as long as you're not entirely useless.

Entirely useless pun colleagues mostly takkan abandon kan...

Sebab tak nak kerja diorang pun susah.

Rojak sikit.

Love yourself, reward yourself.

And sometimes, be a little more proud of your effort. But not too cocky, mind. It's a thin line to tread. What's important is that you realize there is no way on Earth or in this life in which you can please everyone. The majority is enough.

Your intentions, your niat- set them right. God willing, everything else will follow through splendidly.

And study lah homework2 yang diberi MO/Boss, kalau tak saja cari nahas hahaha!

2017 and I'm Still Fightin'

So when a boss from a former department says "Ah, the most famous *Insert your full name here*~", do you:

A) Assume that you're loved
B) Assume that you're notorious
C) Assume that you're weird
D) Assume that you're reliable
E) Do not assume anything and just think of the boss as being friendly

???

Answers please, I need answers!

Thanks, boss. You're also most famous for being super cute (and moody, but when you're not super busy you're mostly cute) :)

**********

Also, doing periphery is making me feel quite some weird feelings.
Tired, and easily walking over 10000 steps per day now as I walk up and down stairs and around the hospital multiple times at least until noon.
But good thing I'm leaving my main ward a lot, because man, it's getting a little too stifling.

But then I also binge eat like mad almost every opportunity I get. Not necessarily because of periphery work, but because of the stress this posting is inducing on me.

THIS IS NOT A RELAXING POSTING.
ALL SENIORS WHO SAID THIS HAVE LIED.

We are critically low on HOs and the ward is constantly almost full and it is so stressful when your bosses do not understand and are constantly undermining your work for the silliest things, the tiniest mistakes. Even if it's not directly your fault, you feel the heat; the blame is directed, inadvertently, on all HOs for being so darned incompetent or whatever (even if those constantly receiving the complaints are usually the same one or two people).

Because, you know, we don't have people who are above us and supposed to supervise us, presumably.
We're just supposed to supervise one another. Crabs teaching their crablings to walk straight lah.
NOOOOOOOOTT.

Step 1: Do not supervise your underlings
Step 2: Underlings make mistakes
Step 3: Complain that underlings are rookies and unreliable
Step 4: ????????
Step 5: PROFIT

*Laughs* Sorry, sorry.
I'll stop stabbing at my bosses now.


Bosses, I love you.
It's just, you know,
hard to love you guys when you keep picking on tiny mistakes
and dramatizing
and not praising us when we do work properly *pffffrrtt*
because like you said,
we're all manja
unreliable
not like you guys when you were HOs, definitely.
Because you guys were simply excellent and perfect.


Haha I just stabbed my bosses again.

You see why I'm anonymous? Geez.
*Laughs maniacally again*



.........

I NEED A LONG HOLIDAY

Sincerely,
the least reliable HO ever.
(Who's probably notorious and doesn't know it herself)