Tuesday: Turns out there is some admin issues and they need to split up our subcg :( I join our sister cg for a rather good respi tutorial with a respi doctor who goes into great detail about the percussion findings of pneumothorax and consolidation etc. The other two go for an abdomen tutorial, the details of which are sadly lost to me forever lol. We get a new tutor! Who is very pro and cool. C and me clerk some abdominal patients with hepatitis etc. Don't eat cockles, folks... We join the ranks of whitecoats clustering in the hallways over casenotes and shamelessly ask seniors for goodcases (me mostly ahah)
Wednesday: Ward rounds at 7am instead of 8.30am! With an onco doctor actually, thereby going a full circle from pre-med school days haha lovely bookending there. Good lesson on observational skillz. I then join the other two for trailing behind our other tutor for ward rounds, feeling like a blur duckling. Then we have a respi tutorial. Lesson learnt: Be nice to your patient. HAHA. Then sit in on department meeting which was interesting + now we know all the GI MOs so we can ask them to help us find cases ;p
Thursday: While doing a respi exam on a random dude our tutor chances upon us and gives us an unplanned (read: never read up) neuro tutorial. note to self: DO PRONATOR DRIFT!! After lunch, we have an interesting time ;p clerking cardio patients. Met a patient with SLE! The GI MO recommends us a really nice lady who we chat to for vv long and who has lots of signs + excellent history. And who really just basically wants some people to chat to. So it worked out awesome. :)
Friday: Have rather fruitful time clerking a variety of cardio patients cos our tutor asked us to prepare for a cardio tutorial. Including patients with heart attacks, pacemakers etc (eh this is so common there's no ethical issues in saying this right LOL). got rather owned anyway which is per normal cept actually i know this stuff i just didnt know it was required okay its not like anyone is gonna read this and hereby i redeem myself ahah nvm i'll just do it properly next time yo). note to self, never go first for stuff again. HAHA. not that im shy per se just that reduces chances of getting owned. HAI nevermind just that usually i get commended for presenting stuff (as opposed to say, solving mathematical equations) but its a learning curve so yeah will take criticism :) This actually bugged me for awhile but then I figured that this is the best time to make mistakes & never forget it so all's good. Had a abdo history taking tutorial too which was really ah, detailed on the causes of every single abdo symptom, even the classes of anaemia?!! lol. We heard some murmurs over these few days & I'm getting better at sorting out which type of murmur it is so it's good :) Did at least 1 cardio exam & history taking i think. BUT I ALWAYS LEAVE OUT SYSTEMIC REVIEW. and hobbies and pets. hahaha
yes lol we had to go back for tutorial. on cardio exam i think, err since we're not allowed to take notes actually all i remember is my tutor presents very impressively. oh and one must make exaggerated movements to check for scars.
Lots of thoughts but LACK OF SLEEP generally. Clinical medicine is so different, and so much more tiring. I can't really remember what I thought it was supposed to be like, but I'm really enjoying it! Also the getting to dress up bit. Heh. Nah, I'm kidding lah. I really like that I'm learning so much & I love the hospital environment (from the doctor's pov not the patient's of course). And the balance between sign hunting & just taking the time to chat to patients is really important I feel.
Like my cg mate is really so kind & concerned for the patient even though half the patients she interviews seem to distract her/ have atypical random symptoms but she still takes the time to talk to them coz she is genuinely genuinely interested & wants to chat to them... wow I just felt so humbled today.
PS I dont run away from patients or interrupt them, I usually read the casenotes beforehand to preselect patients ;p haha. its better if you want to see signs! So far I've seen all the usual stuff lah like ascites, shifting dullness, jaundice, purse-lipped breathing (emphysema), pitting edema, peripheral cyanosis. Also some random stuff like herpes zoster opthalmicus, tricuspid regurgitation, etc. And also sle signs. Sigh I really feel bad for that patient though ><
Anyways so yes I think the main point thus far is that: I may think I know alot coz I did the OSCE last time after yr2 but there is actually lots of other random stuff *cough pronator drift* & I need to brush up on the 94 page csfc guide! But ultimately, I'm just really happy to be doing a clinical posting. I come back everyday more tired than I've ever been, but also freaking happy like never before :D