#4 : Busy Department

Busy.... Busy.... Busy....

Do you know that in United Kingdom, they have rules & regulations saying that the maximum working hours for doctor is 48 hours per week, that includes junior doctors as well.
Which can be translated to, working more than 48 hours per week, is AGAINST THE LAW !!!

Developed country strongly believe that mistakes will only increase if doctors are overworked, thus they implemented such rules. Malaysia, the next promising developing country yet to be classified as developed country, is somehow....
doing the direct opposite. Didn't the West did what we are doing right now years ago and they failed ??? Why can't we learn from their mistakes, they tried everything before becoming a developed nation, isn't it ??

"Those who cannot remember the past, are condemned to repeat it "

Whatever lah, Malaysia Bull-eh, hehe...
Ok, to be successful in HO life, my advice is to choose your department wisely. Most of the HO who quit, are in the 1st & 2nd posting. Most of them can't even endure the 1st month in HO life, then they went missing.
The solution, don't even think of doing the busy department as your 1st posting if you are not well prepared !! Call your hospital admin before duty-reporting date, ask them to change, give them 999 reasons to help you !! 

It is generally known that, Medical department is the MOST BUSY of all, regardless of states, be it in KL or in Kelantan.
In my hospital, the ranking goes like this (from the most busy, to the less busy)... :-

1. medical
2. surgical / ortho
3. o & g
4. paeds

of course Emergency dept is busy as well, but it'll be your last or 5th posting only.
The word "Busy" here is directly proportional to number of patient, i am not talking about some annoying specialist who ask HO to do hourly vital signs monitoring for all patient making you "busy" as well (nurse will be jobless then). The ranking changes, but medical will always stay as the KING !!!

Tips : Find out the number of wards allocated to each department, you'll get a rough idea on which department has the most patient.
Example :-
If Medical has 8 wards altogether meanwhile o&g has 4 wards + labour room, doesn't that tell you something ???

#1 : Busy Hospital

Rule of Thumb #1

Busy hospital = busy for everyone, not only HO !!!

How busy do you expect HO life is?? You don't until you become one !!!
Thinking back, HO time is the only moment in my life where i write and walk THE MOST... and... eat, sleep, holiday, rest THE LESS !!!  zzZzzZzz...

Since all government hospitals are expected to be busy all year long, what you can do is, use your head.
Since the population in KL/Selangor is bigger compared to Perlis, it is only logic to say, HKL is more busy than HTF. Do some research, if you want to.

Example :
HKL has neurosurgical department, but Malacca Hospital don't. So Malacca will have to refer to HKL if they have neurosurgical patient. Which will result to more patient in HKL.

Although all government hospitals are expected to have all sort of specialist in various field, still they are lacking of sub-specialist in some department. Say Hepatobiliary Consultant, only a few in the whole south region of Malaysia !!!

Tips : Busy hospitals have advantages as well. Such as KKM will allocate more HO for busier hospital, you can learn a lot from different cases. Sabah/Sawarak hospital let HO do some procedures where in Peninsular, they prohibit HO to do so, like LSCS (Lower segment cesarian section)

THERE ALWAYS SUNSHINE AFTER THE RAIN !!

1st posting (department)

Almost a year since i last posted??? Walao !!

Then i'll just write what comes into my mind, because if i wait, this blog gonna be history.
Departments can be divided into 2 major categories, which are, surgical based and medical based.
By now, you all should already know which department belong to which category, right?

Based on my experience and my experience ONLY, the choice of department DO play a big role in your HO life. I'll tell you why...

Example :
You graduated from your university, went to the "Kursus Penempatan" or whatever they call it, now you know which hospital you're going to serve. Those coming from local universities have more advantage than those from the overseas (i graduated from indonesia, so chill laa, Malaysia Bull-eh). NOT in terms of level of knowledge (generally speaking) but in working environment.
Local grads, did their clinical years in local hospitals. Everyday they see how specialist do ward rounds, how things were done there, how HO get f***ed up & lots more. So its like ;

"well... i've been to Zimbabwe once with my family, next time, if i go alone also, i can survive one" said Ahmad with one eye closed.

Meanwhile, overseas grads, if they never do attachment in govt hospital during semester break, they will not have any idea on how govt hospital is being run. Its like,

"well... i'm a tip-top student in my university, how hard can housemanship be, sure can laa", said Bidil while sipping his favorite Starbucks' Cappuccino.

When i was a first poster (1st day in my 1st department), i was damn BLUR. I don't know what to do. Everyone is busy doing some work, i don't know what i am supposed to do. People told me to clerk the new patient. I don't even know what "clerk" really means !!! So i took one file, and... started READING for like 30mins, trying to understand what is written on the referral letter.

<<<< Referral Letter >>>
Dear doctor, kindly see this pt, 28/C/F, G2P1 @28w
p/w cont pain since 2am, no leaking, FM good, no show. Documented cont 2:10:15secs, CTG reactive, uFEME leu 2+
Imp : Threatened Preterm Labour d/t UTI
Kindly see her and do the needful. Tq
 ============================================================

I was like, WTF !! this is NOT a letter written by human being, this is some kind of alien telegraph intercepted by the CIA.
When they saw me NOT helping at all, they then gave me an easier job, which was, trace the all the blood investigation STAT. Since i went to the hospital orientation before, i knew where the lab is, but still, i don't know what blood to trace, whos blood to trace, bloody hell laa wei... lol
The next day, i became a senior HO's shadow, i switched to mode "watch & learn".

Since you have a lot to learn as a 1st poster, it is going to be a lot harder for you to start in a "busy department" than in a "less-busy department", right?
Medical department is well known to be the MOST busy department of all, applies to all hospitals at all time. So, it is more wise NOT to start in medical as your first posting.

For me, i started in O&G. Still a busy department, but compared to medical, O&G is less busy !!
I have to learn the short forms, how to clerk cases, set up IV line (branula), take vein blood, trace blood & vaginal examination. If i were in medical, i have to learn all these (except vaginal examination), plus how to take & analyze arterial blood, do rectal examination, neurological examination, take blood culture, ECG interpretation and many more. (during tagging time of course).
Learn "one by one" slowly is far much better than" all by one", common sense !!

Remember, less busy = less stress !!

Tips : some hospital "administration officers" understand  1st poster's problem, after getting your "duty-report" letter, try to call your respective hospital admin officer (normally at bahagian sumber manusia), introduce yourself and ask them if possible, not to put medical as your first posting. They are the one in-charge of new HO's department arrangement.

p/s : medical is a big posting, you'll learn alot there, try to do it as early as possible, or if you can, as your first posting. HO always say, if you finished medical, you be more confident in managing a patient yourself.