Thursday, November 23, 2017

a revelation made easy

2 years ago I remembered myself being asked to become a tour guide for a few Japanese students who are studying at my faculty. and i reminded myself to keep a safe distance between them, to avoid being overly attached. and here i am, after a 5 weeks of the similar activity. being too attached.

(medical students from japan :)

before starting this program i asked myself will i ever be able to deliver what is needed to be done. i had no proper education with excellent english, no prior mentoring experience. in fact, the story of how i got recruited for this job was also a bit messed up : i was the last one to be recruited ( a day before the program started ). the trainers tried to call me many times but i was always busy doing something else. sorry Puan Khadijah. but as Puan khadijah said ' youre here, lets just move on forward! '

on the first day of  the program i honestly still could not keep up with the names of the friends / buddies , and it took me the whole week to remember each and everyone of them. things was a bit confusing at first. we needed time to adjust on to the work environment and of course, focusing on you lovely japanese people :) few things that i noticed at that time. first was that most of the students were very shy, or maybe nervous. and without the students know, we also felt the same. some of us never spoke to any foreigners, some of us never actually see japanese people, face to face. As for me what i see is that they really want to speak but what they need at that time, is the necessary push to turn the switch on. and as the weeks follows, i can assure that nervous, and confidence was not an issue anymore. and we achieved so much more after this barrier has been eliminated.

weeks follows, and from my point of view, the studying part was a hectic session. everyday from 8 to 5 they will be having classes straight on with only 3 meals break, and no rest. not to mention the homeworks they have to do. sometimes i feel pity for them knowing the fact that there is not much we, as buddies can do. but nevertheless, we tried as much as possible, to make the stay a memorable one. and because of this. we tried as much has we can to entertain them after classes and on weekends. honestly speaking, at times, it felt tedious, but surely i dont think non of us mind. we do everything, i guess its for the moments and memories rather than the financial benefits. and THIS, was the highlights of the entire stay.

after-class activities were the moments that are usually anticipated. its where we are free to do what we want, without the stresses of class and we are able to experience malaysia. so many places to visit, so many foods to try, and so many cheap items to buy i guess? what amazes me was the fact that some of them were able to go on their own to the places without us guiding. despite all the various of activities that were done, the best moments for me were simply the moments spent together, just talking. i like to get to know with people, and probably from their experiences and their habits, we could learn alot and reflect on ourselves on what we can do to improve ourselves in the future. here are some of the highlighted moments that i considered worth mentioning;

1. ever since i was little my mother keeps on reminding me to always help people in need, and that includes making other people's job easier. i remembered once ( i think many of them actually), my friend asked me after i finished a meal at McDonald; " why would you clean your tray of garbage after eating it? let the restaurant staff clean it. its their job " and i was left without an objectively right answer. i thought it was common courtesy. but i guess i was wrong. Until i meet these japanese people. everyday after breakfast or lunch i would see them take a turn to clean the tables they used for their meal. and by cleaning means that they also wipe each table with their own wet wipes. never have i seen a malaysian do that before. just the example needed to allow me to follow what my mother said. and hence another thing to add into my long lists of  `things i dont need approval from local society '

2. after talking to them, some of them actually lives far from tokyo. making them having to stay in tokyo by themselves, and some of them even lives alone. its quite hard to imagine for us malaysian, right after finishing high school, to go and study far, and lives alone. to add to this fact, most of them are actually working part time to make sure they are able to pay for their living costs in tokyo. let it be at a restaurant, shops in the mall, or even a sushi rider ( keep it up ashun! :D ) they do it as part of their daily live and it is a norm to do this type of lifestyle over there. and for some of them, the money of the part time jobs are the financial source for them to come to Malaysia. and the rough estimation of the cost is more than 10k! i salute you all, hats off, and i hope that in the future i have the same determination to be functional at this level so that i can earn money to go to japan to see all of you :) on the reflection side, i should be able to find some strength to normalize myself in the future medical field

3. this one is dedicated to one of the students, Oikawa Natsuko ( as shown in the picture :) it was during week 4 of the program, and during the afternoon buddy session, we were needed to discuss on a topic called, ambition. so everyone needs to give a brief speech on what they want to talk with regards to ambition or dream generally. all of them would normally write the speech before giving the speech knowing that it is actually quite hard to speak without a proper script. plus, with the script, it allows us to correct any grammatical error for the sake of improvement. Some students would like to give a funny speech just to entertain us. some have a more serious thought that should make us ponder upon their words. A particular one written this one below,

(this is shuka's speech. i really like reading their speech, but this one is taken from syafiqah's instagram :)

this shows that some of them are actually taking this topic to a serious level and hopefully it is fulfilled in the nearest future. then comes this cute girl, natsuko, giving her speech. Initially i was about to just dismiss that speech. but as the speech progresses, i knew that this was not a normal speech. she started her speech by saying why she wants to learn english. Im very sorry natsuko, but i could not recall all of your speech, but this is what i remembered . sorry if it is wrong. few years back when the tsunami hit asia, her family was one of the victims of the disaster. when that happens, help came from many different countries. however none of them spoke japanese. and mostly were able to speak english. at that time none of them could speak english. the utter frustration of having such communication barrier is a whole lot to bear, especially during the hard times of desperate moments. and such pain is a great motivation to keep her focus on what she is doing now; which is learning english so that she can teach children from her hometown english so that they wont go through what she has gone through. she had difficulities in delivering that speech, but she was also holding back tears, for the sake of delivering the message. But she cried afterwards and at that point i understand her motivation. and its a strong one. im pretty sure a lot of other students have their own story, of which i was unfortunate to unable to listen to them all. sigh.


and so, a question is raised. why ? why are you so concern with all of these things? why are all the moments are mentioned? why would such things matter to that extend?

( Ms Hancock's class in Plascrugs school)

so lets start here, as i once said, i never had a proper background of learning english with the right way. and as far as i can remember i was really dumb and disliked english ever since i was in kindergarten. to a point i always copied my english homework(ONLY ENGLISH. other homeworks i did it with passion and interest. haha) in kindergarten because i could not understand it at all. until i was 6 years old and we had to go to UK because my father was studying there. in the effort of making me learning english, my mother bought me a story book and she would force me to read it everytime before going to sleep. so i was frustrated with that because i had to read something i dont understand, and also i could not really pronounce the words,it lasted for about a month before we move to aberystwith, wales,. and over there, i went to a school where obviously everyone is either speaking english, or welsh. and i remembered that the 1st day was a day where i cried all day long because i cant speak to anyone and i cannot even go to the toilet because of that. it took me 2 days to learn the 1st word in english, and that was *yes*. my mother said that if anyone asks you anything just say that word. and i still couldnt go to the toilet. until i actually memorise the phrase on how the words actually sounds like, instead of learning what the word really was. funny times. haha

and to top up to that problem, the class was full so i had to sit at the table where all the smartypants were sitting. so they were usually given more homeworks and exercises to do. plus if we are doing diary session, we needed to do longer essays in comparison to other. i did not like the situation that i was put in. but as time goes by, i just go with the flow, and manage to cope with the problems. and of course, a must to mention, thanks to my mother for forcing me to learn, and also the teachers and friends who sat down and was there throughout my stupidity period. i guess the endurance to sit and be patience is something i needed to highlight and make it a part of me.

another story that i think is worth mentioning was when i was 16, i went to egypt to learn arabic language. of course i had been learning that language since primary and junior high school. but since that i dont live in an environment where that language is practiced daily, its hard to use it to communicate. plus, the words written in the books are not the common words use during communicating. writing and reading wasnt the main problem. but listening and speaking was. and again with the help of friends, and self perseverance, i manage to grab that language and use it for basic understanding of that language. but i guess something went wrong somewhere where i could not score A in this subject in my high school. haha. but the least that i could say is that after school, i can understand what the arabs are speaking in the restaurant where i previously worked, or in the hospital when i was talking to an arab patient. this is a more satisfying achievement in comparison to the exam i took during school.

From these 2 experiences of me learning 2 languages, i realize that the key to understanding another language is the environment. by environment, i meant by the people around you who are actually using the same language to communicate, as well as many supports as possible to encourage you, to push you. Im not a noble man of wealth, nor am i a man with the prowess to do great thing. but i am a firm believer of one thing that my mother always reminds me of :

" do good, and be good. always help people where ever you can. and see how kindness and good deeds will give you more satisfaction than money will ever give. Or atleast you'll feel better seeing people wont have to go through what you've been through "

seeing all the japanese students struggle, i could not help but to try my best to attend to all of their difficulties to  learn english. and ofcourse listening and speaking was the hardest part. i could say that all the buddies were sooooo attentive in allowing them to take their time to try and speak in english. its not about the amount of the english words spoken. but we actually just want to turn on the switch for them to become more confident in the knowledge that they already have. from day 1 i could actually see that they can , they just need that necessary amount of push to keep rolling on to speak english. sometimes that necessary push comes from outside of the class session. maybe making them feel comfortable staying here in Malaysia would ease up the process of their learning. and at the end of the day, im just a human being with the same limitation. I feel really bad as i was unable to entertain the needs of all of them. some of them that are even dear to me. and I truly am, sorry. gomennasai :(

and during the times where i was stressed up with all the problems that came up during the program, i would try to remind myself of all the motivations i needed to keep on doing what i do. that includes my mother's word, and most of them, are the efforts shown by the students. japanese people are hardworking people i could say. i would always say to myself, if they can be that hardworking, maybe i should too. again, we are all humans with the same capabilities and not handicapped right? and of course, i find pleasure knowing that they are happy. to seek for pleasure is a man's goal right? :)

And suddenly i remembered what my mother once said to me out of the blue:

' in life we dont just make money, we create memories '

5 weeks spent of what i thought was for the payment that we will get. but along the way i noticed that was not possible. instead, along the way we created something more valuable. we were more than just buddies, but brothers instead. and these valuable moments that makes you realize, it was all worth it, and im willing to do it again. thankyou everyone. i love you all, and i will miss you all.

Here is a little parting video from me. enjoy :)

Friday, August 25, 2017

The hurdles of an undergrad’s medical school; PRO EXAM(s)

After all these years im still here writing, and you're still here, reading. Thankyou for your time :)

Degree life was no walk in the park regardless of the course. And the amount of posts here should justify this statement as time really, really, REALLLY is at the essence. Regardless of any course, we all needed to strive at one point right? And so often people keep asking how does the medical course really takes place. I've KIV-ed this post ever since and thought its only appropriate if I post it after I myself, have gone through it A to Z, especially the exams.

 So a lot of things happened, of which maybe when the time comes I will bring it up. But as how my previous exams prior to medical school that I shared, id like to share this in particular. In the effort of trying to make the medical exams understandable for those who asked, and for those who wondered, especially those unrelated or unfamiliar to the system. Ofcourse, some medical school may have a little different approach of the exams. But the main goal is always the same; to ensure all the graduates are safe and competent doctors. And fair enough to be said, it is one of the most unfair exams. But what to do, it’s the only way to assess and these methods of assessments have been around for ages.

So, medical school typically has a total of 5 years of study. And its divided into 2, pre clinical( 2 years)  and clinical years ( remaining 3 years). The first 2 years is reserved for theory and lecture hall based teachings where learning is emphasized on the non practical exams. And the other 3 years are more emphasizing on clinical skills, and the knowledge on management in the hospitals. So after 4 semester, at the end of the 2ndyear, exams are in the lab ( OSCE; for specimens and samples related ) and in the exam halls, either written or objective questions. Written exams emphasized on 2 type of questions. And all of the subjects ( at least 6 of them if im not mistaken) so the easiest example that I can provide is, its like taking all the PMR / SPM papers at once and they ask questions in the paper 1 (objective), paper 2 ( subjective) and paper 3 (essay). An addition to that, the objective questions requires you to answer all the choices and state either the statement A, B, C, D, E is true or false. Each correct answer gives you 1 mark, each wrong answer will deduct you a 0.5 mark. So if you do the maths, getting 1 wrong answer will only get you 3.5/5 and so on. So its better to leave the answers you’re not sure rather than ‘ bantai ‘.

So, students need to pass the 2nd year’s pro exam (the term used for the major exam) in order to proceed to the clinical years. If they did not pass, under certain circumstances some of them may be eligible for a viva voce session with external examiners from other universities in order to pass. If they did not pass that session , they will have an extension of 2 months of study, and retake the exam( while other students, mostly are enjoying the holidays). Theres a few points that I think makes this pro exam easier than the year 5 proexam which are; 1. Its all on paper exams which means you wont have problems of having a thought block. Worst case scenario is that if it’s a written exam, just fill in the blanks and just fill in the true or false statement in the objective section. Atleast you still have something to write 2. Its all in the books and slides. So if you read it, youre sure to pass. Although the thickness of the books and hundreds of slides usually makes this statement arguable. ha ha ha

So moving on beyond the theory part, for 3rd to 5th year, we’d be required to apply all those theory to clinical settings in the hospital. If before, we would be learning of a certain disease and knowing it’s symptoms and all the necessary things there is to it, clinical years would require you to do the opposite. Catching the symptoms and knowing what disease that may relate to that symptom. In other words; giving diagnosis to the symptoms. 

( a picture with one of the inspiring pediatrician. calm and collectively said that we all can really do it

Of course, for those who have been to a hospital with medical students attaching to it, you’d notice how students would spend a longer time to ask you specific questions in comparison to the practicing doctors in the ward where some of thr questions may not seem related to the disease, and some questions may offend the patient in a certain way (minta maaf zahir dan batin). This is because as students you cant take shortcuts and our lecturers / specialist doctors would want us to know all the details about the patient, including the social aspects.’ Treat the patient as a whole’ is the oath we took. Sometimes the patient comes with a broken bone, but we keep asking on whats the income of the patient and where does the patient lives. Its important to know so the doctors may provide the cost effective treatment and if required, to seek for funds and how to allow her to have the easiest access to further medical treatment. In addition to that, further lifestyle modification may be needed and the doctors / other hospital staffs ( nurses, occupational therapist and physiotherapist ) may adjust and aid accordingly. On the contrary, practicing doctors usually wont spend that much time because they only have 24 hours a day and so much to do, hence they only take what is necessary at that certain time, and if required they will ask from time to time.

Learning includes in the ward and also sessions in the class for a hands-on on the current practice of a certain disease and clinical procedures. So the flow goes like this: take history from the patient and do necessary examination to confirm your diagnosis. Know the required investigations to be sent to the labs and the management of the patient. Of course we need a solid knowledge of the theory behind all of this during year 1 and 2, and addition to this, the current practice at the hospital. For example, the book may say that the dosage of a certain medication but in practice the dosage may be different and this must be referred to the guidelines provided either by the world health organization (WHO) or ministry of health. And as how we all know, there are a lot of departments ( of which called ‘postings’) ; such as surgery, medical, paediatrics, obstetrics & gynaecology. These are the cores that we must learn throughout the clinical years. But the list goes on as there are also other subspecialties. In my medical school, they arrange the postings in year 3 and year 4. The final year (year5) is reserved for reincorporating the 3rd and 4th year and knowing the managements, and the treatment modalities of each disease. Of course, good students may have done all of this in the 3rdyear already. Hiew hiew. Good for them

Moving on to the exams, there are 4 types of exams in the clinical years. End of posting, end of semester, ethics in medical jurisprudence, and the final hurdle; PRO3 exam. So the end of posting exam is a clinical examination where our knowledges and skills are tested with regards to a certain disease in the ward. The mainstay of the exams are ’ longcases’ and ‘shortcases’. Longcases are exams where we are needed to ask the patient specific questions together with relevant examinations and all of this must be presented to the doctors as we are needed to come up with a diagnosis and relevant discussion shall follow after that. And the short cases are a relatively short duration of exam where within 10 minutes, you are not allowed to ask anything from the patient, but we need to come up with a certain diagnosis solely based on the examinations done during that short duration. A potentially biased and unfair exam as the doctors will usually see if there is any available cases in the ward, sometimes out of sheer bad luck, we may end up with a never been seen case and thus fail to pass the exams. After several postings, the end of semester exam will commence and the theory behind every postings and the format is still the same as there is subjective questions and negative markings-objective questions. Of course, after each exams we all, would want to score(read: pass with flying colours) it. Some may need it as to the cumulative pointer. But in our medical school, its part of the requirement to enable us to take the final exam. 

So, In order to graduate the medical school, students are required to pass the PRO3 exam. But before hand, they must be eligible to ‘ sit ‘ for the exam first. So the requirements are as follows;
1.       Must not fail the end of semester exams more than 2 postings out of a total of 17 of them. If so, they may need to repeat the year, not the semester. 
2.       Attendance of (maybe) 95%. It’s a super rare occasion where they must also repeat, even though they pass the end of semester exams.
3.       They must pass the ethics exams. This exam is usually taken prior to the pro3 exam, and this essay questions is solely to see if our thinking process is ethical enough to practice as a doctor, failing this, also requires the student to repeat the final year, despite having no problems with no.1 and no.2

And as all of this settles, then only the student may sit for the exam. This last hurdle, As I quote, from my previous dean ‘this is the most unfair exam that you will ever encounter’ and theres nothing much we can do about it other than to get through it , and pray for the best.
So for the last exams, they still retain the same format, but having the total number of questions increase. From 30 objective questions, to 60, and theres 2 sets of it tallying it up to 120 questions. Other subjective questions also doubled. They now divide the questions by surgical based ( such as obstetric, orthopaedic and surgery) and medical ( those discipline that does not require surgical intervention for the main treatment such as, psychiatry, paediatrics, and medicine). My theory exams was a bit catastrophic, maybe ill share later, and students need to pass both the theory and practical part.

For the practical part, theres one long case, and 3 long cases that must be faced. And these 4 practical session should be able to compensate each other in order to overall pass the practical part. So the theory and long cases are done in week one, and the second week is reserved for the short cases only. By the time they are doing the short cases, they have already summed up all of the marks from week 1 and by the end of the short  case session, the cumulated marks are calculated and the lecturers should already know either students passed their PRO exam or not. If the theory part is so poor ( which is a rare event) theres nothing much that can be done. But if theres a borderline fail due to lack of marks on the practical part, theres a special session after the short case session called modified short / long case (depending on the lacking component ) to compensate the marks. 

So the flow goes something like this, after the short cases session, students are required to be quarantined and await the names for those who needed the extra marks sessions. It’s a really stressing moments as of at this time everyone would be wondering on how the little flaws they did may affect the overall marks. And half of the time those who ‘kantoi’ during the practical sessions would expect to be having this session. For those whose names were called, if they are able to perform well at that current exam, they should know either they pass or vice versa without having to wait for the resultsto be announced. As for those whose names weren’t called, they would be either a pass, or worst, clear fail, especially those who didn’t do well and their names was not announced. And these thoughts will haunt them until the names of all those who has passed will be announced on the next day. 

On the next day they will have all of the students and lecturers to come into the lecture hall and they will announce the name, one by one, those who have passed and those whose names have not been called, will know that they have not passed, and will need an extension of 6 months. It’s an emotional moment as millions of thoughts were on the line and the moment you see ewither all the bloods, sweat, tears shed in the past 5 years were enough, or you needed to do more beyond what you've done. after the names were announced, then the hyppocratic oath / declaration of Geneva is taken. 

(pic was taken an hourafter results were announced, not the same expression an hour before for sure)

Its a quite lenghty post, probably might make you read a line or two twice or trice. But i hope the message is conveyed and see how the flow is not like the typical pointer system. i hope this post does not oofend anyone. Sorry if i did. And next time ill proceed with, my hurdles. Thankyou (for sticking till the end! :D )

(p/s: if you're wondering why there isnt much pictures of hospital setting, well that's because its actually unethical to take pictures in the wards/ hospitals as the privacy of the patient is one of the things we took oath to protect .. cheers! )

Thursday, February 23, 2017

The permanent, everlasting reminder.

To the one and only person, who would surely ponder upon these words, regardless of how exaggerated they are, or how excruciatingly long they may be.

in the times of where you start to lose sense, in what is right and what is wrong,
the rights will always be with those who had the best common courtesy.

As you lose sight in those who are right and those who are wrong,
Religion will always be with who are right, and surely the wrongs, when they take advantage on what religion has to offer.

As time flies and you look at the road you're on so far,
you are where you are not just because of your effort, but the support you have from everyone, the prayers from your parents. In sickness, In health, in the hectic life you have, you are still a son, with the responsibilities to be accomplished and will surely be asked infront of God later on.

In times of disbelieves, and when man's wrath and their way of life part you from your path, 
Remember, there is the right example for you to follow, and the wrong example for you to refrain. you are stronger and wiser, as you can still differ the rights and remain with it.

In times of where you see everyone in every walk of society,
Appreciate, be kind to them as the kindest among them are the ones people will usually overlook. 
the ones from the low society often been recited in history as those who paved an easier route to heaven.

Of all the hardship you've been through, you've always said to yourself to be strong as there will always be a harder obstacle ahead. So raise your chin and move forward, there's always a silver lining in everything.

When the world gave everything it has to offer, be humble, and remember your roots.
Allah will always have better plans for you and trust Him, and dont lose faith in Him. Surely He'll provide you with the strength to move on and reach Him in all the right medium you're using.

To the one and only person, who would surely ponder upon these words, 
to the future me, always remember, hopefully when you remember, you will be better.