Exam is Over

Assalammualaikum.

I had my exam 4 days ago; on 14th Dec 2019 at Monash Clinical School JB.
The exam started at 10am, and we were seated by 9.30am.
There were 30 of us, all from Johor / Melaka. Dr. Omar was the chief invigilator.
I am writing this in detail so that in a few year's time when I reread this post, I can relive the moment and perhaps, felt gleeful about it.

I studied really hard for the exam, took a 4-day leave prior to the exam.
I dreamt of physiological and pharmacological facts.
Words like pKa, potent, baroreceptors kept appearing in my dreams - for real.

I find the exam considerably okay - I could answer most of the questions. There were no "Wow, I've never heard of this" kind-of question.
But still, when people ask - I dare not sound as confident lest I do not pass this exam.
And I don't even admit to people that I studied hard, in case I do not pass.
And the markings system is really a disadvantage.
The negative markings mean I will get fewer marks than I expect to and it might not be sufficient to reach the passing mark.

There were 60 questions, to be answered within 90 minutes.
That means we can spend only 90 seconds per question.
Each question (stem) has 5 true or false statements.
That effectively means I have 300 true or false statements to answer.
As time passes, I noticed I took roughly 1-minute per question ie when I look up to see the clock, it was roughly 10.15am when I was at question no 15 and so on. That meant I finished answering the paper with 30 minutes left to check my answers.

I managed to check my answers only up to question no 52 if I remember correctly.
I only managed to check if I shaded the correct answer from then on - making sure I transferred the right answer onto my answer sheet.
And I erased many of my answers from the answer sheet the second time I read them. I chickened out.
I'd rather leave the answer blank than put a wrong answer and got my marks deducted.

One of the free-marks questions was "The intubating dose of Atracurium is 0.2mg/kg" - I was so glad reading this statement.
Atracurium is such a common drug in Anaesthesia that even our housemen are expected to know the correct dose at the back of their hands.

A flatlay Sharmine and I created during our study sesh in Amerin Hotel during the intensive course

OK, anyway the results will only be released in April next year.
Only then will I know whether I pass this entrance exam and if I am accepted into MMed Anes and if I am, which university will I be enrolled in.
Now is the time for me to be tawakkal.
Ingat, tawakkal itu di penghujung usaha manusia.
Tawakkal only comes after all the possible efforts.

For now, let's pray hard and also play hard. 😆😆

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

MMed Anaes Entrance Exam

Assalammualaikum.
A short update today.

The exam is coming up in less than a week.
This is my entrance exam; ie the RM250 exam that will determine whether or not I get accepted into the MMed Anaes Masters Programme.

Last week we had an intensive course - one whole week in Hospital Permai.
The intensive course combined the entrance exam candidates as well as the first-year masters students - they will be having their exam in April next year.

I met many of my INTEC and IMU mates who are already in the Masters programme - sometimes I feel left behind but then, we should never compare other people's timeline with ours 💪

During the course, someone asked Dr Omar - what are the syllabus for the masters entrance exam, to which he replied - "There is no syllabus. Anything can come out - from primary to final year questions"
😫

And worse, the exam incorporates a negative marking system.
I have never had negative marking exams before.
Negative marking means your marks will be deducted for every wrong answer - that means if you don't know the answer, better leave the question blank!

As an example:

A highly ionised drug:
A. Is well absorbed from the intestine
B. Is excreted mainly in the kidney
C. pKa is close to physiological pH
D. Is reabsorbed into the renal tubule
E. is highly protein bound

The true answers are: A False | B True | C False | D False | False

So if I answered all correctly, I will get 5 marks.
But if I answered 3 corrects, but 2 wrongs - I get only 1 mark (3 minus 2).
And if I answered 2 corrects, but 3 wrongs - I get 0 mark (2 minus 3).
If I was certain of 3 answers, I should answer the 3 I know, and leave the other 2 unanswered, at least I get 3 marks.

Getit getit?

Anyway, that's it for today.



-Because life is a test-
-AkMaR-
http://nur-akmar.blogspot.com

First Screening for Masters Programme

Assalammualaikum.

Alhamdulillah, I passed the first screening of the Masters programme for MMed Anaes.
The registration for the programme was in July this year.

The screening is just a formality to screen and filter out applicants who do not fulfill the requirements eg those that are not yet 3 years in service, or those with insufficient LNPT marks.
So as (almost) expected, it was smooth for me. Alhamdulillah.

eHLP - Permohonan Berjaya

I am not sure about last year, but this year the exam board created a blog / website for us applicants to register for the Entrance Exam.
The Entrance Exam fee is RM250. Initially, the closing date for the exam registration was 1st November but that doesn't make sense because the release of eHLP result of the first screening has not been announced. Thank God they postponed it to the 10th November 2019.

So today, I paid the RM250 and registered myself for the entrance exam which will be held in mid Dec this year.
Let's start studying again :)


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Applying For Masters Programme

Assalammualaikum.

Hadiah Latihan Persekutuan (HLP)
For those who don't know, HLP is the name of the program by MOH for staff to apply for further studies be it doctors applying for masters, pharmacists or nutritionists applying for masters, radiographers applying for a degree or perhaps masters and so on.

Every year, the HLP offer will open at around July for a month.
And this is my first year of applying.

Last year and the years before, one of the many conditions set includes the average for the 3-consecutive-years mark of SKT must be 85% or more. That means if u start working in 2014 ie first SKT is in 2014, hence to apply for Masters in 2017, you will need the average of your 2014, 2015 and 2016 marks to be 85% or more.
If you get 89% for 2014, but somehow got 74% for your 2015 and then 89% for 2016, your average for past 3-consecutive-years will not be >85% and you will not be eligible. That was what happened to me last year 😞

This year, they changed the ruling.
You need an average of 3 years' marks within the past 5 years to be more than 85%.
That means the rule above still apply but in case you start work in 2014, and you have SKT of 2014, 2015, 2016, 2017 and 2018 - you only need any of these 3 years average to be more than 85%. So it doesn't matter if you scored really badly in 2015, as long as you excel in other years. They removed the "consecutive" condition. And it doesn't matter if you are not yet 5 years in service.

The Entrance Exam
For each programme, the entrance requirement will be different. Radiology (Hubs, Akmal is applying for Radiology) for example, the applicants will need to go for an exam as well as an interview.
For Anaesthesiology (me me me!), on the other hand, there will only be ONE SUPER-DIFFICULT entrance exam which will be somewhere in December this year.

And I have not studied enough, yet.
Urgh I really should start studying.
Very very few people get in on their first attempt, but Hui Fong did it!
Yeah, that girl did it. I am not sure how had she studied for the exam, but knowing her, she must have slept, ate and vomit books and notes.

And we have to pay for that exam!
And next year onwards, they will start conducting exam through Medex (I might talk about it in a different post in the future) and it will cost RM800!
Crazy.
They are making the exam equivalent to a Royal College exam.

Anyway, it looks like I have to start burying myself in books like I did mine during medical school years.
To adiks2, yes. There is no short-cut.
You just gotta study hard and smart.

Oh, some might ask. What's in it if I get into and graduated from this Masters programme?
Well, Masters graduates are basically Specialists!
So once I am a specialist, 1) Higher pay 2)Bigger responsibility 3)Becomes a bigger boss 4)Can be malignant 😈😆


-Because life is a test-




-AkMaR-
http://nur-akmar.blogspot.com

Year 5 Exempting Exam; Univ of Manchester

Assalammualaikum.
My exempting exam is Day 2, in South.

I tried to remember as much of the wordings of the questions as I could.
I know it is easier to practice when we know the question structure.
To maintain confidentiality, where possible I will not disclose the patient's gender as well.

Station 1

Please examine this patient's cardiovascular system.
You may need to tailor your examination according to your findings.
Please tell the examiner what you are looking for and what are your findings.

The patient's blood pressure is normal.
An ECG taken last week is provided for you to refer to.


Ok, this was apparently an AF station.
When I felt the pulse, at first I thought it was irregular.
But when I tried to tap the rhythm with my head, it became regular. Haih~
So the chest was clear, I could not find any other signs.

When I was given the ECG, it was clearly AF.
But the examiner challenged me saying I did not pick up the AF while examining the patient.
But he wasn't mean. He asked why wasn't I able to get the irregularity of the rhythm.
So I mentioned the patient might be having paroxysmal AF and when the bell goes off, I managed to say "because he has been rhythm controlled!!" literally while walking out of the station.


Station 2

This patient had a cerebrovascular accident (CVA) affecting one or both arms.
Please examine the patient's arms.
Please tell the examiner what you are looking for and what are your findings.

At the end of the station, the examiner will ask the nerve and muscle groups that are affected.

OK.
So this is quite a straightforward upper limb neurological examination.
I performed only the motor bit, I did not do sensory or coordination.
It was UMN signs on the left arm.

For the muscle groups and nerve, I managed to say deltoid, biceps, triceps, anterior compartment of the forearm, posterior compartment of the forearm, and lumbricals for shoulder abduction, elbow flexion and extension, wrist flexion and extension and fingers abduction and adduction respectively.

The examiner did not prompt me of the nerve supplies. I am not sure if that means she is satisfied with my examination/answers but to be fair, I only had like 30secs left.

My friend said he would have done the coordination and some sensation as well.

But I did offer saying I would to do sensory of the upper limb and full neuro of lower limb to see if the CVA has affected the legs as well.

Station 3

You are the Foundation Year doctor in the general practice.
This is Natasha XXXX, a 28 year-old woman who has recently given birth and is now breast-feeding.
She is here for oral contraceptive pill.

Please discuss the options available for her.

It was an SP.
Since the question specifically mentioned ORAL PILL, it became a lot easier.
Pt is breast-feeding so we cant give the oestrogen bit, and I don't have to explain all the implants and coils. Only PILL.

Pt asked about:
1) Side effects - irregular bleeding.
2) Immediate protection - yes if taken on day 1 menses.
3) What happens if she vomits aft the pill - if within 5 hours, u may need to take another dose. Check the leaflet in the box.
4) Does it protect against STI? - No. (I cant understand why she ask this. She's married! Ok, being judgmental here. Anyway...)
5) Why can't she go back to her microgynon (a COCP) - bcos oestrogen affect breast milk production.


Station 4

This is XXXXX. She was admitted 4 days ago for severe iron deficiency anaemia.
She was given blood transfusion and an upper GI endoscopy was normal.

She is going to be discharged today.
A colonoscopy has been arranged for her as an out-patient next week and she has been given sachets for bowel prep.

Please discuss with her about the discharge issues and the colonoscopy.

Woohooo...
New type of Q from the university!
Discharge planning has never came out before.
When I knew it came out in Day 1, I was so surprised and luckily I read about it.
Or else I would not know what to say.

Well basically just ask how she is feeling, is she ready to go home..
Who is at home with her - husband.
It was all okay until I asked, "Is your husband well?"
Then only the drama begins...
"Oh..my husband has severe Parkinsons......."

She asked about:
1) I am the patient, but I don't need carer. My husband will need carer. Can the ward arrange carer for my husband? - I dont know the exact ans for this.
2) What will the social services do? - plan care package, tailored to individual needs.
3) What does OT do? - come to ur house and see how they can help with the condition of the house to make it easier to live in.
4) What is the bowel prep? - STRONG LAXATIVES to empty your bowel.

I FORGOT TO ASK ABOUT MEDS! Haih~
DC planning will always include meds changed in hospital stay.


Station 5

This patient has pain in the right hip.
Please examine the patient's hip.
Please tell the examiner what you are looking for and what are your findings.

Again, a straight forward ortho exam.
My patient was a medical student I think.
He understood all my instructions. So nice~

Was asked by the examiner what is the diff with true and apparent leg length.


Station 6

This patient have difficulty passing urine.
Please take history to find out how it was diagnosed, include discussion about complications and any plans for definitive treatment.

This was a REAL patient, without scripts.
I don't think I can divulge the case here, since it's supposed to be confidential.

Enough said that I think UoM is trying to test us on how we communicate with actual patients.
All this while we are tested on our ability to EXAMINE real patients, but never actually TALK to them.
So I really felt like those days where I spend a very long time talking to patients in the ward, that most of the time they didn't understand what you asked and went completely off-tangent.
Sometimes you can't even understand what the patient said.
It was exactly that same feeling just now - the difference is there is someone watching you from behind and ticking the boxes.

My pt knew quite a lot of things - it was almost just a case of me sitting there listening to his story.

Station 7

This patient has pain in his/her legs while walking.
Please examine the arterial circulation of the patient's leg.
Please tell the examiner what you are looking for and what are your findings.

There is an Duplex provided. You need to use the probe.

At the end of the examination, the examiner will ask what your diagnosis is and next management plan.

Again, a straight forward PAD exam.
This was a real patient.
I cant feel pt's pulses - all the way till popliteal.
But apparently no one couldn't.
But the arterial flow via Duplex was very clear.

Examiner asked Dx: PAD
What to do now: Straight leg raising, as it is one of my differentials. ABPI. Fasting glucose and lipids.


Station 8

Please examine this patient's hands.
Please tell the examiner what you are looking for and what are your findings.

At the end of the examination, the examiner will ask your diagnosis and the conditions associated with this findings.

When I was outside the station, I was very happy thinking it is going to be a RA hand. I hummed pulmonary nodules, pulm fibrosis, vasculitis etc to myself.

But when I got in and started inspecting - turns out it wasn't RA.
At first I thought it was trigger finger but then I realised this is Dupuytren's!

So I did the hand exam just like I would for RA. But it was very hard because patient's hands were in severe fixed flexion deformity.

Qs: What is this? - Dupuytrens
Where can u find this? - idiopathic, cirrhosis bla bla bla
How would u say the severity of this contracture? - moderate
Rx? - reconstructive fasciotomy


Station 9

You are the FY in A&E.
This patient has blurred vision last week, but it has resolved since.

Please examine the patient's visual field and perform fundoscopy.
You are not required to examine the visual acuity and pupillary reflexes.

Please tell the examiner what you are looking for and what are your findings.
At the end of the examination, the examiner will ask for your findings, and diagnosis.

Again, straightforward eye exam.
Examiner very nice~~~

All normal, I can't visualise the optic disc.
Was asked:
1) Present ur findings
2) If the Hx is blurred vision for one week and has resolved since, what do you think is happening? - Optic neuritis.
3) Cause? - MS
4) Ok, if it is MS, what findings will u expect? - Central scotoma, pain on eye movement and I just simply said blurred optic disc. Truth is, I dont know! What is the findings on fundoscopy in optic neuritis? I forgot. You better check.


Station 10

You are the FY in A&E.
This patient has come in with acute chest pain.
Please take a focussed history and perform a focussed examination on the patient.

Please tell the examiner what you are looking for and what are your findings.
At the end of the examination, you are required to present your findings, diagnosis and management plan.


Acute chest pain.
Pt had this a few times for the past 2 weeks - all on exertion.
Usually it goes away with resting. Today the pain persist even after 2 hrs.

Obs given were all normal. I cant remember if they gave respi rate - sorry.

Examiner was mean.
Didn't even respond to me, I asked if I can get the observations and he pointed his CHIN to the wall. I didn't understand at first.
Then only I realised that the set of observation is pasted on the wall!!

Station 11

You are the FY in general practice.
This is Mrs XXXXXX.


Please take a history from her to find out the problem.
In the last 2 minutes the examiner will ask for your diagnosis and management plan.

I knowww....the question was so unhelpful..
I sat outside banging my head on the wall. Nothing to prepare.

Anyway, this pt kept saying she was very embarrassed to talk about this matter.
I thought she has dyspareunia or PCB or something.
Turns out she has heavy menses bleed.
Well to be honest, by this stage of med school, I am no more embarrassed about heavy menses bleed.

Remember ICE ICE!
Pt's concern was cancer - as usual...
I mentioned that cancer of the womb usually happens to older women, it is not the first thing that came to my mind for a woman of her age. But we will still do all the necessary investigations. She seemed very happy for that.

Examiner asked:
1) What pt has - menorrhagia
2) Possible causes - DUB, bleeding disorder.
3) Mx - bloods: FBC, U&E, TFT, Prolactin. What else did I say jz now? Forgot adi. USS to check endometrial thickness.


Oh...I'm getting more tired of typing now..

Station 12

You are the FY in general practice.
This is Mrs XXXXXX.

She has come today because she is feeling very anxious.
Please take a history from her.

In the last 2 minutes, the examiner will ask your diagnosis and the reasons.

Generalised Anxiety Disorder with secondary panic attacks.
Did some MSE but not risk assessment.
I wanted to explain the possible Mx but pt cut me off and jz said she wants leaflet. Weird..

Station 13

You are the FY in general practice.
This is Mrs XXXXXX.

She is a regular patient in the practice.
She usually sees Dr Rayburn.
Dr Rayburn is on leave today hence she has booked in to see you.

Please talk to her and discuss the reason of her attendance today.

Jz by reading, I know this is ethics adi...
Pt said she has STD, she doesnt want me to put this on her note bcos Dr Rayburn will know about it. Dr Rayburn is a close family friend and she doesnt want her husband to know.

I said I need to write about our consultation, it is a legal requirement.
And Dr Rayburn and I are duty-bound to keep the confidentiality. She wasn't convinced.

I asked how did she know she has STD - she said because she vaginal discharge.
I said she can go to GUM clinic to get treatment, everything there will be confidential. No letter will be sent to us. She said can I then not write anything about today, because she wants to go GUM. I said cannot, I have to write it down.
She said then no point she go GUM, I will write anyway.
I told her I don't know if she has STD. I have not tested her yet. So I cant write she has STD, I can only write that she suspects its STD.

Anyway at the end pt agreed to go GUM and did not make any trouble anymore. I managed to advise safe sex until complete treatment. She said it's gonna be very uncomfortable anyway with the discharge. Lululz~

Station 14

You are the FY doctor in the ward.
You are required to administer the first dose of IV medication for this patient that has been prescribed by a senior member of the team.

This medication is usually given as a slow infusion but for the purpose of this examination, you are to give it in a bolus injection.

You will all learn this in OSS block.. So lazy to write. Anyway, got Px chart but no BNF or product leaflet. Confirm with the examiner to mix the med with saline or water for injection and how much to mix it with.


Station 15

You are the FY in A&E.
This is a patient who came in because he vomited blood.
He is very upset.

Please take a focussed history and discuss the need of admission with this patient.
You do not need to examine him.

Weird Hx. At first I didn't know what was it at all. It didn't sound like ruptured varices (but pt is a heavy drinker) because pt shd not be able to talk to me if it is varices.
Didn't sound like Mallory-Weiss tear either. He vomited a pint of fresh red blood this morning! No stomach content. No assc pain, just some dizziness.

Vomitted once 7-10days ago, but small amount.

Halfway through I found out that he regularly takes Nurofen 2tabs 3x a day, every day.

So at last I can say we suspect you are bleeding from your gut. We may need to keep you in. And he was unhappy because his vry busy at work. But it didn't take him long to agree - because I said we need to pass scope in to see what actually is happening.


Station 16 AAAhhhh.. last one~

You will be given a case history of a patient together with blood results, ECG and CXR.
You have minutes to look at the information provided.

You should then tell the examiner what was going on and your next management plan.

Bloods: all normal apart from 8.5kPa pO2 on ABG.
ECG: AF
CXR: some say collapse, some say pneumothorax. Whatever...

I dont think I did well in this station.
Thank God it was my last one. I would have felt very stupid otherwise, while doing the other stations.

With that, I bid goodnight~

Hope this helps!


-Because life is a test-
-AkMaR-
http://nur-akmar.blogspot.com

9 hours post-OSCE

Assalammualaikum!

My exam is finally over.
I am now officially a free bird! Until next Thursday, Jan 23rd; the day my results will be released.
I am not sure if I will post about my results. I might, if I pass.
If I don't......

I woke up very early this morning, I set my alarm at 5.45am but I was awake well before that. I didn't even want to look at the clock too see the time, I tried to sleep until my alarm rang.
The undergraduate department has kindly provided a shuttle bus from Preston Hospital to the hospitals in Manchester, where our exams will be in. We will not have our OSCEs in the same hospital that we studied in, this is to avoid bias from the examiners, seeing a student that may have been working with him for so long. Hence all students will be allocated randomly within the 4 UoM teaching hospitals.
My exam was in University Hospital South Manchester (UHSM) or better known as Wythenshawe Hospital or even better know among student as South.

The day started off hectic.
I was walking out with Ibrizah towards the Education Centre where the shuttle was waiting for us and half way there, I realised I did not bring my phone! I can't imagine going without my phone, I am sure I want to scream to someone when the exam is over so I ran back home to take my phone.
Imagine running within a hospital compound, without anyone around, at 6.50 in the morning with full smart formal wear, and smartie shoes. The ktak ktak ktak ktak ktak sound of my shoes was so embarassing.

Anyway, due to the heavy traffic, we reached South at 8.30am!
1.5 hours in the shuttle, I slept in countless postures and positions.
I think everyone was sleeping and it was also very dark so I dont think anyone actually saw me sleeping.

I will write the stations in the next post. I think it is very beneficial to actually have a set of questions from seniors to refer to.
So I hope this will be beneficial for the next generation, cewah.

Today also is the day my brother, Amran will be flying to Jordan.
He enrolled in the Ana Arabiy program, which is a reality TV show covering Malaysian students in Jordan trying to learn Arabic and the Quran.
Apparently it is going to be aired in April 2014.
Whoa.. But I feel good for him. He has always wanted to learn Arabic.

His flight was at 2200 Malaysian time so when I called him, it was only 10 minutes before the boarding gate opens.
So I quickly all the XOXO I can give on phone.
When I said I am so afraid of the results, he laughed it off.
I can't believe he laughed it off. He said it has never occurred to him that I can fail any examination.
He believes strongly that I can pass.
I was so touched with the trust. I didn't know that was the impression I gave him.
What if I really fail? There is always the possibility.
He must be very surprised, and perhaps disappointed too.

Anyway, right when I reached home, I cooked lunch and went to Kiew's room to debrief her.
I told everything about the stations today and how did I tackle the Qs.
And after that I went straight and practice with Akmal. Both Kiew and Akmal are going to have their exams tomorrow.
Akmal's in the morning while Kiew's in the afternoon. But they will not meet each other because Akmal will be quarantined after he finished his exam while waiting for Kiew to be quarantined. And after Kiew is quarantined, Akmal will be released. If that makes sense?

Anyhow, today I felt like eating big but I didn't defrost any chicken so I went Amonbagh and buy some dinner.
Lamb Rogan Josh, which cost me £5.45.
It's not that good. I won't buy it again.
I forgot what did I order before, that was very tasty.

I watched Running Man happily, without any guilt.
And I laughed and laughed and laughed with Ibrizah and Syahidah; my 2 housemates who have finished exam.
Poor Kiew, she is the only who have not finished her exam in this house. The 3 of us are free, she must be so stressed now. As stressed as I was yesterday.

Now, I am writing this. In a gooooood moooood~
Plans for today and tomorrow:

1) Write some love letters (haha)
2) Pack for my trip with housemates (I'm keeping the destination secret for now)
3) Pack for Malaysia (8 days till home!!)
4) Start reading again. I have left non-medical books for such a looong time. I keep buying books (bcos they are cheap) and just putting it on my shelves make me feel good. Now I have to start touching them again.
5) Running Man. I have about 5 episodes left.
6) Perhaps I will finish off Gye Baek; the Korean drama that I left halfway.
7) Online shopping. I wanna buy stuff and get them sent to my house in Malaysia so that I can wear them in time for CNY!

Wah, it seems there are a lot of things that I have to do!

With that, byeeee~


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

1 Day Before OSCE

Assalammualaikum.

At last, that day has come.
For my medical school final exam, I have to sit for 2 written papers and 1 clinical (OSCE) examination.
I have done the two written papers and my last ever exam is tomorrow.
I hope this is my last ever exam in medical school; I don't want to sit for the May exam. I can only be exempted for the May exam if I pass this one.

Today, I was calm until a friend of mine posted the list of stations that came out today (There are altogether 3 days of OSCE, and mine is on Day 2. They do change the questions!)
I was calmly practicing the stations with Akmal, trying to drill the examinations into me so that it became ingrained in me. Reading, again and again, the management of chest pain, breathlessness, how to examine a patient with neurofibromatosis, hip pain, knee pain, etc.
It was all calm, albeit nervous.

But when I find out the questions of Day 1, I panicked.
The horrible thought of "TOMORROW IS EXAMM!! TOMORROW IS EXAMMM!!" came rushing into my mind, ruthlessly sweeping my composure away.
And I thought, "Have I studied enough?" "Am I prepared enough?" "Can I pass this exam?" "What happens if I don't?"

From then on, I flipped through my OSCE for Finals book like a mad Asian girl, googling every single thing that I forgot or unsure of; non-invasive ventilation, osteoporosis scores, driving and heart attack, and even the sizes of cannula!

Now, I'm tired.
So I start writing.
Next, I have to continue reading.
May Allah ease~

14.01.2014
6.19pm
Preston

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Down with Flu

Assalammualaikum wrt wbt.

18 more days. 18 more days for my final exam, the exam that is gonna test the knowledge I accumulated (and kept in an unknown area of my brain) throughout these 5 (5.5actually!) years of medical school.
I hate this kind of exam. Why can't they give us exam after each posting? Like a lot other med schools, the exams will be held after the posting hence we need to gobble up all the topics in that block only.
In this exam of mine, I need to revise every little thing from acute asthmatic attack to myocardial infarction (heart attacks), to premature birth, to soiling in children, to menopause, to intrapartum care (care of the pregnant lady in labour), to taking cervical smears and swabs to administering oxygen, performing ECG and prescribing medications!
Such a wholeee lot of things to revise! Thank God they won't be many questions of the basic biochemistry; Kreb's Cycle and all. I cant even remember them properly now.

And I've been down with flu since like, 3-4 days ago.
It started with simple sore throat which progressed to blocked nose, some sort of sinusitis and headache and stomach "dizziness" today.
Most of the people in my house are walking around with rhinorrhoea (read: running nose, and we have to catch them). One of them asked me, "Could it be because we did not take the flu jab this year? Did you take yours? I didn't"
And I can't help but to doubt that could be the contributing factor.
As someone who works in a hospital, my friends and I are always offered free flu jab as part of the occupational health "requirement". I've never taken one, for the past 3 years. I can't remember if I was down with flu as well last year. But another of my housemate, the only one who took the flu jab this year, is not walking around with nasal voice and blocked nose. She's studying happily comfortably. And I had to drink litressss of water to "flush everything out" of my system and of course, run to the toilet several times during the day.

I've been reading a lot of headlines on vaccines these days, with one of my teachers being one of the most influential anti-vaccine person in my life. Hence, I always doubt vaccine that's why I did not take them for the past 3 years. And to be honest, I haven't read in detail about how vaccines are dangerous to us, but I can understand the fact that they may not be that beneficial to us, the pharmaceutical company may be just making money out of us.
I did read however about the autism and MMR vaccine, and that the link was apparently made by a doctor who published a fraudulent paper in The Lancet. I had to read that article because I need to convince mothers that vaccines are very good for their children. It came out in my mock OSCE that day! I can imagine how much my teacher is gonna hate this kind of station; brainwashing future doctors to brainwash future parents and damaging future children.

Since I have not read any further about any other vaccine (because...I have so much other things to readddddd~ *facepalm*), I cant really say much. If vaccine is not that beneficial, why bother injecting something that is potentially dangerous in the kids' bodies? But why have they been telling us that the incidence of certain diseases have remarkably reduced after the introduction of vaccines? Haemophilus influenza B, the causative agent of acute epiglottitis being the most "sold" to us. Acute epiglottitis is a very dangerous condition where the child can lose his/her airway at any time but thanks to the Hib vaccine, we don't have them that much anymore now. Paediatricians sell that stories to us. "I've been working for 10-15yrs, I've only seen 1-2 cases of it"

Anyway, I gotta get back to my notes (and water) now.
Enough of rantings.
Bye!

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Two Weeks in Renal Medicine

Assalammualaikum.

Let me start with a bit of introduction on how year 5 in U.o.Manchester is structured.
First of all, we have 8 blocks altogether - each block is 4 weeks.
Blocks 1-4 is before the exempting exam while blocks 5-8 is obviously, after the exempting exam but before the final exam.

What's with these two exams?
Well, an exempting exam is in January and the final is in June.
If you pass the exempting exam in January, then as the name implies, you are exempted from sitting for the finals in June.
That means, if you pass the January exam, you are pretty much in your honeymoon months from Febuary onwards. If you don't, you bury yourself in books and stethoscope, sometimes with a tendon hammer or fundoscope and try to put everything into your brain, revengefully while the bulk of your friends enjoy their blocks 5-8.
Clear on the exam bit?

Now let's get to the blocks per se.
Blocks 1 - 4 are the blocks in which you will do ONE community block; that means you are gonna travel to a GP surgery (basically klinik kesihatan in Malaysia) and see patients on your own and try to make these poorly people well. The other two blocks are in the hospital and one more block is an OSS (and I can't remember what it stands for). Anyway, OSS block is the block where you revisit all the skills you've learnt for the past 5 years (wow) such as poking needles into patients, sticking a catheter up their urethras (that's where people pee from), perform blood cultures etc etc. On top of that, the OSS block is also your Oncology block (that is what the "O" in the OSS mean).
So juniors (if any of you ever read this), you'll know roughly what to expect.

After block 4, is the winter break (read: crazy last two weeks b4 finals). And then the Jan exam.

Blocks 5-8 are hopefully, my honeymoon months. I really hope I can pass this exempting exam (which will be in 58days time!)
So out of these 4 blocks, 2 will be elective blocks ie you can go anywhere in the world to help doctors save ppl or, you can do what I will be doing, go back to Malaysia and enjoy life as a medical student in a Malaysian hospital before coming back to work as a junior doctor.

One more block is a Student Assistantship, which basically mean you are gonna shadow a FY1 (the most junior doctor in the hospital) and help him/her with everything so that you can do his/her job when you start working. It doesn't really apply to me since I am not going to work here in the UK but I think it'll be a good exposure to know the system in and out. The other block could be another hospital or a community block, just like in blocks 1-4.

So for my fifth year, my blocks allocation are:
Block 1: Endocrinology (Hospital block) in Royal Blackburn Hospital
Block 2: Community (in Accrington. The bus fare cost me £51 per month and two hrs of journey everyday)
Block 3: Renal Medicine (which is the block I am in now)
Block 4: OSS

EXEMPTING EXAM!!!!

Block 5&6: Electives in Malaysia woohoooo!!
Block 7: Student Assistantship
Block 8: Hospital (cant remember what exactly)

Blocks 1-4 can be switched around, you may start with OSS and end with Community etc.
Same goes with blocks 5-8. That means you will nvr do electives before the exempting exam in January.

As I've said earlier, I am in block 3 (already third week now!) and I am doing Renal Medicine.
Guess what, my first day in this block was in a Renal Clinic.
And within that one morning, I know for sure I do not want to do Renal Medicine for the rest of my life. It is definitely one specialty I am going to avoid specialising into. Last year, we were asked to rank the blocks we'd like to do for fifth year and I think I put Renal Medicine as my second choice. That was because my mother has diabetes and I know it inavariably affects the kidney so it WAS always the specialty I consider. But after that first clinic, the interest and consideration went down the line. There is nothing wrong with my supervisor, NO.
It is just the fact that a Renal Medicine specialist could not do much for the patients. Kidney is just so important that when it goes, we cant really do much anymore. But because our kidneys are very good, we can lose about 60% of the function before they pack up.

You see, chronic renal failure (that is the failure of the kidney that happens over a long period of time, most commonly caused by diabetes and hypertension) is divided into 5 stages according to the severity.

Stages 1 to 3 can be managed in the community, means any doctor can deal with it with the patient coming over yearly or 6-monthly for health review. But at the same time, optimise diabetic or blood pressure control to slow down the damage to the kidney. Most of the patients will not progress further.

When it reaches stage 4, the guideline in UK recommends referral to a Renal specialist. I don't know at what stage do the doctors in Malaysia refer a patient with chronic renal failure (CRF) to the specialist.
And what will the specialist do? Not much, apart from keeping the diabetes and the blood pressure in tighter check. Well, most commonly CRF is caused by these two culprits. If it caused by any other diseases, then it will be a diff story.
Since the patient is now in the specialist's renal patient list, any deterioration of the patient's condition can be acted upon faster. Ultimately, when the kidney fails, we will be looking at either dialysis or renal transplant.


Hence in the clinic, patients will come in with a creatinine level of 280 (the normal level is less than 100), and the doctor will not be surprised, because the patient has been having a creatinine level of 260 and 270 all these years (remember the renal failure is already stage 4 when the patient is referred). Hence, the doctor is going to do the usual examination of the abdomen and BP la and everything and really2 monitor the medications the patient is taking (since so many meds can effect the kidney) and stop/slow the kidney damage. Hence a specialist might see the same patient for many many many years monitoring his/her renal function all the way, without actually treating it because we can't cure diabetes or hypertension.

That idea of seeing the same patient for 10 years but not being able to actively do something for him/her apart from keeping an eye on his/her renal function two or three times a year does not appeal to me, at all.

As a dramatic and active person, I would love to see my patient get better and not just monitoring them waiting for the kidneys to pack up, on one bad day in the future.

They say Orthopaedic Surgeons are very proud of themselves because their patients come into the hospital having broken their bones in an car accident or something and under their care, the patients can then literally walk out of the hospital. So I think literally, the patients of an Orthopaedic Surgeon will have the greatest improvement in their physical appearance, from a bent, bleeding almost crushed leg to an almost perfect leg (in a lot of the cases).
But no, I am not going into Surgery :)

'til then,

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Helping in Year 3 OSCE

Assalammualaikum!

A year ago, I had my end of year 3 OSCE and it was in my opinion, very terribly done. But I passed, Alhamdulillah.
I'm not sure if I wrote abt it here, let's check.

CHECKING......

CHECKING......

CHECKING......

CHECKING......

CHECKING......

Err, no.
I did not write about the exam itself. I wrote on how I felt before the exam.

Anyway, I splashed a good amount of IV fluids onto my (simulated) patient.

For this exam, I was the simulated patient for an Arterial Blood Gas station.

That means, I sit there and pretend to be a lady who's suffering from pneumonia and needs ABG.
The students have to talk to me, explain the procedure, gain my consent and then proceed to take blood from a dummy wrist next to me.

There were 8 students altogether. Generally, they did well.

But there was one who did not know what he was doing! I felt so bad for him.
He looked like a nice boy, who studies a lot. But looks can be deceiving, can't it?

And an exam is always nerve-wracking anyway.

He did not clean his equipment, neither did he wash his hands with the alcohol gel.
He took a pair of gloves and then throw one away. He tore a packet of alcohol swab and left it there next to me. He really looked as if he did not what he was doing. And I felt so much for him. Haish...

Too bad, but not surprisingly though, the examiner failed him :(

In conclusion, the experience of becoming a volunteer in an exam gave me a whole new perspective. Being in an exam but on the side of it. Not as a student taking the examination but someone backstage. I saw how the skills centre staff busily set up the place for examination. How they gathered the simulated patients and what briefing they give.

After this I won't be afraid and scared of the patients anymore :D

They're just students like me. Haha

Apart from some who are real patients with real findings, the rest are normal people :)

-Because life is a test-
-AkMaR-

http://nur-akmar.blogspot.com

Post GE-13, Pre Exam.

Assalammualaikum wrt wbt.

Oh well, the GE 13 has passed.
LOADS of things are in my mind re the GE, but let's keep it in there for now.

I've changed my layout again. This is not the end result.
I've just decided to republish previous posts because I feel bad for keeping my blog "Under Construction" for too long.

I have my Progress Test next Monday, I will continue working on this blog after that.

Dh la, jom study!
:D

-Because life is a test-




-AkMaR- http://nur-akmar.blogspot.com

Pruritic Fingers and Absent Mind

Because the exam is coming near.
Because I am stuck on my desk for most of the time, mugging up the notes.
Because there are too many things to revise, I do not know where to start from.

And I feel like scrolling down ebay or amazon and buying stuffs.

Anyway, I watched these two videos lately,

1) Yusuf Estes answering a Christian's question on what changed his mind from a Bible preacher to a Muslim preacher.
It's a bit long (32mins), yes. But the first 20-25mins was well worth it and interesting :) The end is a bit dramatic but hey, it's genuine! You can skip the last 10mins if you want to.




2) A totally different video, a sweet and entertaining wedding speech by a groom.




Ugh, I so want more time to revise but I also want this exam to be over, fast.

And anyone knows how to get rid of that annoying ads on this blog? The ads that come out either on the top left corner or the bottom right corner? The one that comes out on the top left corner can be closed (there's a small, almost invisible [close] below the ad that you can click) but the one that appears on right bottom corner is the more annoying, I can't close it.
They are ads about interesting videos.
I've no idea what I did that they turned up.
I did not put in any html on my blog, I might have put my url in some other websites allowing ads so that I can use their feature (and I cant remember what now).

Btw, pruritus is the posh (read: medical) word for itch so, pruritic means itchy.

p/s: At least I'm writing nonsense here in my blog, writing my disorganised thoughts than posting it as a status on facebook where everyone is forced to read it in their newsfeed. You're reading this bcos you chose to. The fact that you got this far down prove it.

Ok.bye.

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

When the Exam is NEAR

I've always written my yearly summary (at least for 2010 and 2011), I wonder if I should wrap up my 2012 this time?

When the exam comes, I start to feel the burning desire to write.

-Because life is a test-

Akmar

F&C OSCE Nov 2012 (part 1 of 2)

Assalammualaikum!

Instead of talking about my personal life, I'll write out the questions I got for my latest Family & Children (F&C) module OSCE.
With this, any juniors or medical students can refer to this post. I've had a hard time looking for past years!

In Univ of Manchester, we get 1 minute to prepare outside the station after reading the question and 8 minutes to complete the station. 2 minutes before the station ends, there will be an announcement.

Day 1 (Paediatrics)

1. You are a medical student in Community placement. This is a mother whose 10 y.o son has been complaining of headaches for the past 6 months. His son is not with her. Take appropriate history from her and present your differential diagnoses and investigations you would like to do to the examiner.

      - Son headache for 6 months, worse past 2 weeks.
      - Start to vomit
      - No photophobia but complains eyes hurt (should ask about vision)
      - Son becoming more clumsy (either unsteady on his feet or cant see properly, need to differentiate these)
      - Headache worse early morning
      - The mother was quite cross, and anxious about her son
      - Mother was afraid it's brain tumour

2. You are a medical student in Community placement. This is a 10 y.o boy complaining of abdominal pain. Perform an abdominal examination and give your differential diagnoses to the examiner. Do not take extensive history from this patient.

       - Normal abdo exam. Causes of acute abdo pain in children.

3. You are a medical student in Community placement. This is a mother who came in to get her son's blood test result. Her son complained of tiredness and have been found to eat soil. Explain to her the results and address any concerns she might have.

      - Result given was FBC. All normal except for MCV, Hb and ferritin. Diagnosis: Iron deficiency anaemia.
      - Mother was worried it is leukaemia because she read from magazine.
      - Mother wants to know why son eats soil. It has been reported as a manifestation of IDA in children (weird eh?)
      - Mother wants to know what treatment. Tablet / diet modification / dietitian referral.

4. You are a medical student in Neonatal placement. This is a young lady who have just had a premature labour. Explain to her the complication of premature labour and address any concerns she might have.

      - Gave birth yesterday. Spontaneous labour, no history of trauma
      - Be sympathetic (haha)
      - Worried because doctor and nurse took the baby away right after delivery
      - Wants to know what is happening to baby
      - Wants to see the baby. Yes, nurse can arrange.
      - Explain lung isn't mature yet. Need special equipments to help baby to breath.
      - Mum asked whether can breastfeed baby. Ans is can and if baby is on ventilator then can give expressed milk.
      - Mum asked if baby will get cerebral palsy (shocked me. For a while I thought we were supposed to explain cerebral palsy, not lung prematurity. But then mum directed me towards other stuff)

5. You are medical student in Community placement. This is a boy who had murmur few months ago (cant remember exactly). He came for a follow up. Examine him and look specifically if the murmur is still present.

      - Normal cardiology exam.
      - Boy very shy lah. Didn't want to take off his clothes.

6. You are a medical student in Community placement. The parents of a school girl are worried about her growth. Measure her height, weight and head circumference and calculate her mid-parental height using the formula (they'll give the formula). Plot these information on the given chart. She is unaccompanied by her parents. Do not take extensive history from this patient.

      - This is one crazy station. The measuring was easy but I've never seen the chart. Didn't know where to plot her mid parental height. They didn't use the WHO chart so....

7. You are a medical student in Community placement. A father came because his son has been very breathless and feverish. Take focussed history and prescribe paracetamol for his son.

      - Not really sure what this station wants us to do.
      - Father talked a lot so I didn't have much time to prescribe the PCM.
      - Essentially son is having acute asthmatic attack secondary to chest infection. Father didn't think it's an asthmatic attack because son is coughing out phlegm. Usually son has asthmatic attack wout the phlegm

8. You are a medical student in Paediatrics placement. This is a parent whose son has
just been diagnosed with diabetes type 1. Explain to him the diagnosis and the management plan and address any concerns he might have.

      - Boy is 10 y.o
      - History of tiredness, weight loss and vomitting
      - Wants to know if boy can continue football
      - His own brother (boy's uncle) has DM type 1 as well. Some of my friends said his brother died of DM, but he didn't tell me that. Maybe I didn't ask but he didn't look distressed or worried. So diff patient might tell diff thing.
      - Father wants to know if son cannot go into any specific career due to the DM. I said I'm not really sure but you cant be a pilot if you have diabetes. And father said boy wanted to be a pilot. Explain about hypoglycemia and the danger.

I'm tired now.
I'll write about Day 2 (Obs and Gynae) tomorrow insyaAllah.

Diclaimer: The sentences used are not the exact sentences in the exam. I can't rmember the sentences exactly (who can under such tension?!). And anyway, patients will usually direct you towards the diagnosis. If you did not ask him/her, he/she might ask you.

All the best!

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Emergency Demo For Gaza

Gaza, Gaza, Don't You Cry. We Will Never Let You Die

But can we really not let them die?

What can we do to prevent them from being shelled?
It's not like we have an army to deploy to their rescue.
We have no white knights with shining armors.
We are not the world order.
We do not have the UN under our command.

Gaza is Under Attack

Yesterday, the world sees Gaza being attacked, again.
The last huge massacre was 4 yrs ago in December 2008, for 22 days Gaza was shelled and bombed, children and babies die in their own homes. They were made orphans if not deformed.
That was the time I started being active in the blogging world.

Last night, I saw an event in Facebook, an emergency demonstration for Gaza in Piccadilly Garden!
I see that as a very good opportunity for me to show my solidarity.

The Palestinians will not directly feel the effect of me being there, but being there with abt 100 ppl, will raise some awareness amongst the Mancunian (it's what u call Manchester people).

The press might not be there, but restaurants around have customers. Customers are people. People get nosy. Add that with curiosity and the internet, you get news. Soon enough, really nosy and curious people know more about Palestine and the inhumane attack. The more people know, the better.

Why?

The more money can be collected and channeled for the Palestinian cause.
More volunteers will be produced for the Palestinian cause.
More flotillas, aids, and convoys can be deployed.
More healthy politicians and lawmakers can be trained.
If, more people know.

Anyway, today I got up feeling really motivated.
The exam is next week (see the ticker up there?), today was supposed to be my rest + study-to-the-max day.
But since I want to go to the demo at 5, in Manchester, I need to set off from home at 3pm. I need to finish revising by 2.30pm.

I've called my brother, Wasil to come to the demo as well.
I've been feeling very steadfast the whole, determined to go.
But guess what, once I got onto the bus from home, to go to Preston bus station, I started to waver; I started thinking why am I putting myself in such a difficult situation, spending 2 hours journey to go Manchester, when my exam is in 5 days time?

Why can't I just call Wasil and tell him how much I want to donate, and let him pay on my behalf first?

I kept telling myself, "Ni setan ni...ni setan yang make you feel this way ni...."

After much thoughts and reflections, I came to the conclusion that I am going there because of I:

1. Think I have been very "dormant" and "distracted" for the past year.
2. Want to experience a Gaza demonstration in the UK.
3. In Malaysia, you'd see mostly Malays. I want to see if I'll see only Indian / Pakistani here or can I also see the whites and the black together with the browns and yellows.
4. Regarded myself almost like a journalist, so I am there with a mission and am going to write about it in my blog so that people who can't be here today can read how it was like.

The Demo Itself

I reached Piccadilly Garden at about 5.15pm.
By then, there were about 100 people there, with their Palestine scarves and flags, and banners and hailers.

And it felt lively. A lady was giving a speech in front, I do not know who she was.
She went to Gaza before and she was telling what she saw there, what was happening and all.
And one thing I remember she said, "Remember those (Israelis) nuclear weapons...."

Her speech was then followed by a speech by Dr. Thariq. I really can't hear neither understand much what he was saying, he had a very thick Arabic accent in his English that some times I almost convinced myself that he was speaking Arabic. But he is a Palestinian.
The next speaker was a school teacher. I think he is English.

I think he said he did not pay much attention to the conflicts in Gaza but after seeing horrible pictures of children and babies bombed to pieces, he was outraged.

And I think that was what brought him here. I liked his speech, it sounded so genuine.

He mentioned that he can't bear the thoughts of people bombing and shelling babies and he was also embarrassed by being the citizen of a country, Great Britain who apologised for and supported the atrocities of Israel.

According to him too, Facebook brought down some of the heartbreaking pictures of babies and children being bombed, under the excuse that those pictures are not suitable to be displayed. And I liked what he said about that. He said if Palestinian children are forced to see those deaths, we have to see those images as well. And I second that. Why must we protect our minds from these images?

I went for my Maghrib and Isya after some time in Muslim Youth Foundation (MYF), a place I recently discovered :)



By the time I got back, they left the site they gathered previously and have started parading around Piccadilly Garden.

They were behind RICE Restaurant.
From there on, we walked around Piccadilly Garden cheering for the Palestinians. It's different from the cheers in Malaysia.

There were:

"1, 2, 3, 4 ..... Occupation no more!"
"5, 6, 7, 8 ..... Israel is a terrorist state!"
" .......(smthing smthing I can't catch) .... minions, We are all Palestinians!"

At about 6.45, the parade stopped and the organisers thanked everyone for coming and for their supports. The same gathering will be held tomorrow as well, at about 5pm too. I don't think I can come tomorrow :(
At about 7pm, the crowd started to disperse.



And after that, the 3 of us went for our dinner :)

I think this is the only picture of me tonight.

The Police

Unlike in Malaysia, the police were not there anticipating violence.
I saw only two policemen tonight. In Malaysia, a demonstration like this will require at least 10 policemen.
I think this is something our country needs to learn; facilitate the demo and prevent violence rather than anticipate violence and act at the slightest hint of wildness.


And oh, we can HELP by:

1. Donating
2. Boycotting
3. Spreading the words and create awareness
4. Prayer. I like one of the sentences I found today on FB; "Tembak doa kita". Literally, that meant "Shoot them with our prayer"
5. Study hard, be a useful person in the future.

Goodnight!

-Because life is a test-




-AkMaR-
http://nur-akmar.blogspot.com

Pre-Exam Syndrome

My final clinical exam is coming this Thursday 14th June 2012. That is exactly a month from my final theory exam on the 14th of last month.
And after this clinical exam, I will have a 4 week SSC project and then, Malaysia I come!

I am not sure how should I be feeling now. I've had two weeks of study break to prepare for this clinical exam and I've used the two weeks to study, shop in Manchester twice, sleep, and watch at least 2 and a half series of Korean and Japanese dramas.

It was as though the two weeks were too much and too long, given that the exam is only a day. But at the same time, these 2 weeks fled like wind, and suddenly I am left with only 2 days. I can't say I did not prepare at all, I did. But at this point of time, I found myself so saturated and desperate that I do not know what else to study on but I do not have the heart to do "other things" eg watching dramas, shopping or sleeping, or even reading novels! It was as if I am robbing myself of my study time if I start doing non-academic stuff.

As I logged into my blog to write this post, to pour all these emotional and mental saturation, an email reached my inbox. It was from Medscape Medical Student, and the subject was Suicide Among Medical Students. Oh! What a timing! No no, I've never thought of suicide. But since suicide is very highly associated with exhaustion and desperation; the two emotional states that can describe my current mental state, the email tickled me into laughter.

I think I've prepared enough. But I think I have not known everything (or most of the things).
There will be 16 stations in this OSCE exam, and I need to fail only 4 to fail the whole exam. Resit is on Aug 8th, but I am not supposed to be back in the UK until a week after Raya. Thus, failing will not only mean that I have to suffer the agony of preparing for the resit during my summer break but also an extra of at least £600 for my flight ticket here. So, a fail is definitely out of the question here.

After publishing this post, I do not know what to do.
Should I continue studying? If yes, what?
If no, then what should I do?

I can see my chocolate and Dorito's waving at me, asking me to have one, two or hundreds bites at them.
But then, I remembered that I've gained at least 3,4kg since I got here last year *tears*

I can see my novels waving at me, asking me to pick them up and flip them open.
But then, I see my OSCE books and notes.

I can see my purse and coin bag, asking me to get out of the house and take a bus to the town.
But then, I remembered then I have to save money and that exam is coming in two days.

I want these two days to pass as fast as they can so that I can get over this exam fast.
But I also am afraid that I am not fully prepared, thus more time will always help.

Oh, whatever~

-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

And Tomorrow is The DAY!

Tomorrow is my exam! Tomorrow is my exam!
Tomorrow is my EXAAAAMM!

Yes yes yes! OSCE exam tomorrow.
Testing my clinical skills.

Testing how competent I am with needles and syringes.
Testing how competent I am with stethoscope and a pen torch.
Testing how competent I am with communication skills and friendliness.
Testing how competent I am as a third-year medical student.

Praying that everything will run smoothly tomorrow, amin.

-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Study: Where Shd I Start From?

Didn't I say that this upcoming exam is just a formative test; that is it will not be counted for my final marks?
Guess what, I received an email few days ago saying that it is actually counted!
I'm not sure who to blame, or should I even blame anyone?
I am pretty sure during the assessment briefings they said this exam is just a formative, or did I understand it wrongly?

What difference does or should it bring to my level of study effort?
If it carries mark for my final, then should I be studying harder than when I thought it is not counted?
Then that means I have been studying for exams rather than preparing myself to be a good knowledgeable doctor in the future.
However I can't help but feel that since this exam affects my final marks, I should "fear" it more.

All UoM medical students from Year 1 to Year 5 will be sitting for this SAME PAPER on the SAME DAY at the SAME TIME but with different passing marks. That will mean this paper encompasses all the systems I've studied in IMU.
It has to include the basic sciences Year 1s are studying, to emergency managements Yr 5s are expected to know.
Thus I am supposed to be able to answer at least the questions targeted for Yr 1 to Yr 3 students.
Now, I do not know where to start studying.
2.5 years of syllabus, to be revised and prepared to be tested in a week?

People say, don't study hard but study smart.
Intelligence, seek me!

Ok, going to bury myself under the piles of books again.
'till then,


-Because life is a test-



-AkMaR-
http://nur-akmar.blogspot.com

And The Result is Out!

Assalammualaikum.

I did not sleep last night.
Not because I was too excited with the 901 revolution happening in Malaysia, but because I was afraid I won't be able to get up for sahur if I sleep.
But being awake enabled me to get real-time updates of what was happening in Malaysia.
A friend introduced me to a website where we can stream Malaysian TV channels and watch it online through our PC.
So I put on TV3 to the lowest volume, put on my iTunes volume a bit louder and study.
I can still hear what was going on on TV3 and planned to watch if there was any news.
So I heard MHI; Dr Harlina and Ally Iskandar were talking about the worrying increasing number of child abuse cases in Malaysia.

I did not realise when, some documentary program was being played.
I thought TV3 bought the documentary program and broadcasted it, like what TV1 did.
The documentary was about germs something2...I wasnt really paying attention.
But then I heard advertisements in English, like totally totally English.
And when I check the window (I had my ebook on the active window), it was really Discovery Channel. And after confirming the TV programmes on Utusan website, I realised the website was no longer streaming TV3, but Discovery Channel instead.
Arrrgghh! I don't mind watching a documentary, on GERMS but not when I desperately want to get real-time updates on Malaysia.
Anyway, my fb newsfeed then started to explode with joyous exclamation of Anwar being freed.

When I was a small girl, before I turned 8 I used to go to my neighbour's house to play.
She owned a board game called SAIDINA. It is the Malaysian version of Monopoly.
On my 8th birthday, my mother presented me a huge SAIDINA. I was so delighted and can't seem to stop playing it. I even brought the board game to the neighbour's house to play, and photocopied the money to make me richer, and I still have them at home till now.

Back then I didn't know that there were a lot of SAIDINA versions, but mine was Malaysian political states. We get to buy our own state/town and build houses/hotels in it.
Penang and Kuala Lumpur were the two most expensive states (RM1,300 each) while Kangar and Batu Pahat were the cheapest (RM400 each). And at one corner of the board, there was a jail.
If you get a "jail" card, unless u can pay the bail, u'll hv to go to the jail.

That year too, Anwar was jailed for his first sodomy case.
And Mahathir was the name most adults talked about.

So I imagined that Anwar and Mahathir were two players playing Monopoly, and Anwar got the "jail" card so he was jailed. And one day, he'll come out of it and continue the game.

True enough, he did.
But he was nearly jailed again today.

Politics

The thing about politics in Malaysia is, the politicians turned it into such a filthy field that the people do not know who to trust anymore (or at least I don't).
The normal people do not know these politicians personally, how will they know their true colours?
How will I know if these politicians are good men or good actors?

People can think, yes.
People can talk too, yes.
But people can think and talk, only based on what were presented to them.
And the things that were disclosed are not always true.
The mainstream media in Malaysia always report the good side of the government, hiding the bad ones and at the same time make the opposition looks almost like the worst coalition ever existed.
The opposition media will do exactly the same, the other way around.
The media makes u think what they want you to think.
And they'll tell you what they want you to know.

I think I sound rather pessimist here.
Let's stop talking about other people and continue studying.
Exam is just around the corner.
Ourgh! Exam is I believe one method of getting the attention of the youths away from current issues. Hahaha.. Beware, there are some truths in that.

p/s: This post was written retrospectively. I couldn't make it to post it on January 9th even though I started writing on the day itself.

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com