Thursday, November 6, 2008

The final Med1022 written examination is over. Attended the exam debrief yesterday and thank god everything went smoothly as I expected. Now, all I have to do is just stay focus and strive for excellence in the upcoming OSCE (Objective Simulated Clinical Examination).

Enjoyed a cup of freshly brewed hot cafe latte in starbucks right after the written exam. I was glad. At least my hard work paid off. Was sipping on the coffe while talking about random stuffs with my collegues. I was amazed how fast time flies. One more exam and I will be officially an 20% doctor. After all the time and effort that I have put in, making sacrifices along the journey, studying throughout the night, It arouses me whenever I know that I am one step closer in achieving my dreams.

Looking at the stems for OSCE in this wonderful Saturday morning with lots of thoughts in my mind. I wonder whether I am competent to call myself a 20% doctor. Well, I make sure that I am fairly good with my anatomy, pharmacology, physiology that would probably come in handy in the future. But am I competent mentally? In terms of facing uncertainties? Facing grief? Somehow deep inside me I want to be a doctor that can be entrusted when you just look at him. The way he talks, indirectly tell you that everything is gonna be fine. But with the 20% knowledge I am having right now, I know the journey is still long.

Medicine is practically an art of science. You deal with people. You need to improvise. You need to know what you are doing. Memorising the steps of clinical examination blindly just merely to pass the exam is shallow. For me, I need to know all the basis of doing all those examination. The 6 steps of: Ask Look Feel Move Specific Tests should not be something that restrict what you can do. Modify it, do those that suits the patient the most. After all, what doctors do is to find out what is wrong and at the mean time please the patient.

I am pretty sure I am gonna do just allright on Monday. Fingers crossed and hopefully I can show the examiners how competent I am in dealing with patients. Dr Kelvin once told me although I am an undergraduate, never restrict yourself on what you can learn. Being a year one doesnt mean what I know should only be for year 1. I want to achieve more than 20% perhaps.

Below are the scenarios that I might be having on monday.

Truck Driver’s Pain
Time allowed: 8 mins
Mr. Christopher Ram, a 42 year old truck driver, has come to the GP complaining of lower back pain after loading his truck with a consignment of computers for a new college. He had felt a sharp pain in his lower back which had gradually become much worse and spread to his right buttock. He also had a burning/tingling sensation down the outer side of his right leg which extended to the top of his right foot. A diagnosis of a prolapsed intervertebral disc affecting the L5 spinal segment was made.

Task: Neurological Examination In response to the L5 spinal segment

Life Style
You are a doctor in a GP clinic. Arif Asri, a 36 year old sales manager, has come to your clinic because he is very concerned about his health and wants to know what he can do to improve it. He has recently been diagnosed as having diabetes mellitus. Apart from this, he has gained a lot of weight in the past two years, and also smokes about 20 cigarettes a day. On examination his BP is 130/90 mm Hg and his BMI is 30.

Task: Assess his understandings on his current condition and see whether I could talk him into changing his life style.

Time allowed: 8 mins
You have entered the room to find Jennifer is unconscious on the floor.

Task: Save Jennifer, save the world.

Examination of Shoulder
Time allowed: 8 mins
Joe Peters, aged 23, comes to see the doctor because he is worried about his left shoulder.
Joe has noticed that sometimes throwing a baseball is painful. There has been no recent injury. He plays baseball every weekend and has recently increased his training. You are a medical student at your General Practice placement, you have been sitting in with the GP. The GP has asked you to examine Joe’s shoulder.

Task: Examine the shoulder and look for abnormalities.

Time allowed: 8 mins
You are a medical student attached to a GP’s surgery (clinic).You have been asked by the GP to take a history from patient Jane Henry. You have never met her, and she is coming for a new problem which is a headache.

Task: I am gonna play detective here. Where does headache leads me to?

Eye Examination
Time allowed: 8 mins
Patient Name: Joey Binder
Age: 25
Occupation: Teacher
Joey, aged twenty five, has come into the GP to get his/her eyes checked. You are a medical student on a site visit, and the GP asks you to examine Joey’s eyes while he/she supervises you.

Task: Look into her eyes

Time allowed: 8 mins
Jess is a 22-year-old student who has come to see you, her/his GP, because (s)he is quite unwell and has a productive cough. You diagnose pneumonia, and decide that the most appropriate treatment would be procaine penicillin injected intramuscularly. This is a very thick suspension, which causes pain on injecting.

Task: POKE!

Guess It will be fun afterall with all the adrenaline rushing inside you. Trying your @ss off just to impress the examiners. Wish me luck folks. Till then.

Best wishes