Hello and welcome to a little segment where I just write about things I have learnt during my clinical years. Some of these little notes are very important to me and some have helped inspire me. These are the scribbles i've written down taking home the messages of heroes, lecturers, and doctors over the years. Take care and enjoy :).
#1
Dealing with a Difficult Patient. (NURSE)
N = Name the emotion. [anger? sadness?] [worry? anxiety?]
U = Understanding the emotion of the patinent
R = always Respect the patient
S = Support [by listening, setting up appointments]
E = Explore/Empathize
#2
Pregnancy
HTN --> do not give ARB, ACEi, statins [teratogenic]. Safest bet is labetolol & methyldopa
DM --> Safe OHA are metformin & gibleclamide. Should also start folic acid.
IUCD --> Safe for DM patients if glucose controlled. Unlikely to get infection.
Theraputic Lifestyle changes --> exercise 20mins/day, total 150/week. But can cause hypo if on insulin therapy.
#3
Ward Round With hero 2
LBBB is always pathological
Unilateral tender leg swelling --> Top 3 diffrential = 1. DVT 2.DVT 3.DVT.
Lymphatic edema is a diffrential (non-pitting edema)
Should do Well's Score when suspect DVT.
Doppler and D-dimer should be done. [high sensitivity]
In patient with gout/RA develop calf swell and pain ---> Ruptured Branchial Cyst
Pruritus
Local = fungal, scabies, lichen planus
Systemic = Liver, obstructive jaundice, CKD, DM, hyperthyroid, drugs, CHF. Pregnancy in young ladies.
CKD
Normally ARB should reduce proteinuria but can be bad for kidney. Thats why must do baseline RP and compare 3 weeks later. If increase 30% then must stop.
Renal Artery stenosis can be fibromuscular dysplasia (young ladies) or atherosclerosis
Monday, April 20, 2015
Thursday, April 9, 2015
Guide on applying for Housemanship in Malaysia
A simple guide applying for housemanship after graduation in
Malaysia.
Hello there. Congratulations on graduating and receiving
your medical degree. Now begins the real tough job of applying for the
housemanship job! I’m gonna combine what I’ve experienced the past few months
along with what my batchmates kindly helped out with.
Here’s a breakdown of the documents that you will need for
the entire application. I would suggest that you make multiple copies of the
documents and get them certified.
Ok first of, These are the documents you have to prepare for
the interview with the Suruhanjaya Pekerja Awam (SPA). You first have to apply
for an interview with SPA. I would suggest calling them and asking about
arranging an interview. IMU arranged this for us thankfully so I’m not too sure
on how to arrange it myself.
Documents: [credits to lolo]
1. Resume 1 to 2 pages with recent photograph
2. Identification card (original and photocopied)
3. Birth certificate (original and photocopied)
4. SPM certificate (original and photocopied)
5. Consent letter final year student (Provided by Your Uni)
6. TRANSCRIPTS PHASE 1 (collect from Bukit Jalil during your
hols)
7. Other certificates (original only)
For help with certifying documents, here’s a sample on how
you can do so. Basically any government officer with higher ranking than UD 41
is able to certify. You can do so at a school where you can ask the pengetua or
PK to help sign them.
http://mmc.gov.my/v1/docs/form/4B.%20APC%20-%20Amendment%20-%20updated27062013(drnadya).pdf?hc_location=ufi [Credits to Kuding]
Next, you would have to register online at the SPA website.
Here are the instructions I borrowed from SPA to IMU students. [It’s in BM,
keep in mind that you have to have SPM BM pass in order to go for the interview]
PERMOHONAN
01. Permohonan adalah secara online
melalui laman web Suruhanjaya Perkhidmatan Awam Malaysia (SPA) – http://www.spa.gov.my
02. Klik pada BORANG PENDAFTARAN PEKERJAAN DI SEKTOR AWAM (SPA8i). Daftar Akaun
Baru.
03. Gunakan borang IJAZAH/SARJANA/PHD. Menu pilihan adalah pada No.3 (Jawatan-jawatan
yang dipohon).
04. Isikan semua maklumat yang diperlukan. Beberapa perkara penting untuk
perhatian adalah seperti di bawah:
Maklumat Peribadi Pemohon
(a) Jawatan-jawatan yang dipohon : PEGAWAI
PERUBATAN GRED UD41
(1 jawatan sahaja)
(b) Pusat temu duga : ****Depends on where you want to have your
interview.
Maklumat Akademik Pemohon
(a) Keputusan
SPM :
Isikan keputusan SPM (10
mata pelajaran maksimum)
** sekiranya calon tidak mengambil
SPM, kosongkan ruangan ini.
(b) Kelulusan
Pengajian Tinggi
1 (a) tahun graduasi :
***Graduation year
(b) PNGK/CGPA : kosongkan
(c) Peringkat Kelulusan : PLJR THN AKHIR (SAR.MUDA/SAR.)
(d) Institusi yang
mengeluarkan
sijil : ***insert your
university here
(e) Institusi francais luar
negara : TIDAK
(f) Bidang : PERUBATAN
(g) Pengkhususan : PERUBATAN DAN PEMBEDAHAN
Ok next, you would have to fill up the Borang Maklumat Diri
(BMD). Print it out. For me, I had to submit it to my university management.
The file is available here [https://www.facebook.com/download/780710815327327/BMD_-_P.Perubatan_%28latest%29_.pdf]
Then next you have to go for your interview. You can search
up a few blogs of doctors whom wrote about their experience preparing and going
through the interview. I would say its more of a formality however you still
have to read up on current issues regarding our country. I made a small file for
revision.
Following the interview you should then next get your
documents ready as per the breakdown above.
Next, after graduation.
You should receive your offer letter from SPA along with a
pile of documents you need to fill up. Yes, this is where shit gets real. Take
note of the offer letter reference number and date. You’ll need them for later.
Alright so inside the envelope from SPA there should be the following: offer
letter, 3 borang setuju jawatan, a surat perakuan, and medical check up forms.
(do correct me if I missed out on anything).
Ok, so the only thing you need to fill up is one of the borang
setuju jawatan and send it back to SPA as addressed on the borang. Here is
where the offer letter reference number and date should be filled up. Should be
block C in putrajaya. You can either poslaju it there or you can deliver by
hand up to putrajaya. The other documents you can slowly take your time to fill
up as we only have to submit them during the Program Transformasi Minda (PTM)
which is your induction.
 |
| Location of the SPA. BLOK C Putrajaya |
Ok, so SPA down, MMC next.
For MMC please bring along the documents as shown in the
first picture. The relevant documents can be downloaded here. Just print it
out, and fill up the forms. Follow the checklist included. Should be easy
peasy.
Once done, head on over to the Malaysian Medical council
Building at blok B Jalan Cenderasari, Kuala Lumpur. It should be the first
result on Google maps. Nearby landmarks include the KL KTM main building,
Methodist girls high school and a terowong. The entrance to the building is
right next to the terowong. Also, you can park inside the compound at the
visitors parking once you registered with the guards. #alexlovesfreeparking.
 |
| MMC building. Next to the terowong at Jalan Cenderasari |
Next, arrange your documents in this order. For IMU
students, our university sends our sem 6-10 transcripts along with the letter
from the dean. However, don’t forget to bring your sem 1-5 transcript. All
photocopied and certified of course =).
 |
| Credits to Jia Ern |
Follow this arrangement so the MMC can easily process your
documents. I was then kindly asked to sit and wait in the waiting room for
about 20 minutes. I then got a slip to collect my completed cert after 5
working days. After that, collect your cert complete with temporary MMC number.
[shit really got real] Fun fact, the Methodist Girls school nearby is only less
than 500 meters away. Furthermore, you can Photostat your MMC document there
and get it certified by the pengetua or PK there. Just head towards the office
building. I just walked in and did it in less than 15 minutes.
MMC down, next onwards to KKM!
So for our KKM application, we just have to submit our
Borang Maklumat Diri (BMD) and a certified photocopy of our MMC cert. My
university took the liberty of forwarding our BMD to KKM prior to this. However
if your uni did not do that, I don’t see why you can’t do it yourself. Just
head towards Blok E7 in putrajaya. Register at the counter and head towards the
9th floor towards the unit pengurusan & professional. Just hand
over the documents and they should be able to process your application.
 |
| Bock E7 near the Kementerian Pelajaran |
All the paperwork done! Time to wait for e-housemanship.
Following March 2015, Malaysia started using the
e-housemanship portal for junior doctors to choose the place for their
housemanship training.
And so here is where the date of the offer letter is of
importance. The way that it works is as follows:
1. Check the KKM website that for a post that says we can
log in to the e houseman system to choose our hospital (the next one most
likely in May)
2. People with Offer letters that are dates from March up
till the date of the system being available (probably in May) will be able to
login to the system.
3. Choose your hospital and see the waiting time.
4. If your hospital not available, you can defer until the
next time the e portal will be opened.
5. The portal will be closed after like 1 week.
6. Then the offer letters dated from May onwards until the
next time the e houseman portal is opened again (probably in August) are
allowed to login again during the August intake.
This is where I currently am up to right now. I hope you
guys the readers appreciate this simplified guide on how to apply for
housemanship in Malaysia. I apologize for any mistakes I might have made but
please do correct me. Would also like to acknowledge the help of my batchmates
lolo, fi, Carmen, jia ern, Kuding and others. All the best in becoming Housemen! Don't give up!
Regards,
Alex.
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