Housemanship : The Sweetest Nightmare

 I believe this is one of the hottest topic in town for the past one week after a new houseman "fell" to his death in Hospital Pulau Pinang. Following the incident, many (not-so-) dark secrets of our fraternity surfaced. Many had shared their experience being bullied during their training, and there are a number of public pages exposing the "malignant" medical officers/ senior house officer/ specialists/ consultants. (so we called, the fierce and scary ones, as this term simply means cancer - something bad and aggressive)

I am currently a medical officer. I have gone through my housemanship training.

In Malaysia, a 2-years housemanship training is compulsory for all medical graduate. We would be practising under provisional registration with the medical council. Upon completion of the training, we will get our full registration to practice as a medical officer, embarking on the future of more uncertainties, especially in the era of contract healthcare workers. (Only fully registered personnels can practice in private sectors)

How is Housemanship like? On paper; 

Introduction :

We will serve in one of the training hospitals (of our choice) for 2 year. We will rotate in 6 different postings/ departments, namely Internal Medicine, General Surgery, Obstetric and Gynaecology, Paediatrics, Orthopaedic Surgery, and lastly an elective posting depending on availability at your training hospital, but the selection consists of Anaesthesiology, Emergency Medicine, Psychiatry or Primary Care. Each posting will last for 4 months by default, however if deemed incompetent/ attitude issues, the houseman may be extended/retained in the posting for another 1 or 2 months. If one had not passed the posting after 8months, the HO will then be transferred to another hospital for training continuation.

For each posting, we are given a logbook as part of the assessment. Specific topics and procedures for each posting are listed in the logbook. As a houseman, (especially one in the current era), there are many procedures in the logbook that we are not allowed to perform, due to medicolegal issues. Most of the time we were only assisting our medical officers.

At the end of third month of each posting, the houseman will have to approach the specialist in charged/ assigned for end of posting assessments. These assessments are tailored and differs among hospitals and departments. Nonetheless, the aim is to assess the houseman's competency (basic, of course) in the particular department, before the houseman is allowed to move on to the next posting.

Working hour :

During my time, most hospitals had already adapted to the shift system for housemanship training. In general, we would have 3 different shifts -

AM/ normal day shift, 7am to 5pm

PM/ Extended hours, 7am to 9pm

Night shift, 8pm to 8am/ 10am/ 12am

(Every week, we have to do at least 2 PM and 1 Night shift, depending on the availability of housemen in the department.)

Of course again, all these working hours differs slightly among hospitals. On paper,  the housemen shall get one off day per week, which may or may not be on weekend. During housemanship, there isn't a Public Holiday. and we don't get replacement off/ extra claim for working on PH.

On paper (again), a houseman shall not work more than 65hours/week. But 90% of the time, this is not the case. A houseman will usually come at 5am (some busy hospital they come at 3am), finished up their work at 11pm, or even 1am. And our 1 off day per week is not guaranteed.

Salary:

"Overworked, underpaid" is not an understatement. As a fresh started houseman, our basic salary would be RM2947.00. Note i said "basic". Housemen are entitled to some prefixed allowances, meaning all HO are entitled for these without having to apply/ submit claim :- 

elaun perkhidmatan kritikal, Imbuhan tetap khidmat awam

elaun waktu bekerja fleksi - hence no overtime claim

elaun perumahan wilayah - depending on your state of origin and the state you are serving, the allowance may differs by about RM300

At the end of the day, after adding all the allowances and deducting for KWSP, SOCSO and Income tax, a houseman's monthly income will be about RM4500-5000/month. And while working for the government, we get a yearly increment of basic salary, by RM225/year.

You'd think, 4.5k for a fresh grad, sounds good what.

Think again, after 6-7yrs of tertiary education and the working hours/week, does it really pay okay??

===============================

That's all about the concepts of being a junior doctor in Malaysia.

Next I'd like to share my journey of being a houseman back then.

Medic Diary: starter

Hey, it’s been a while since I wrote anything regarding medicine. I checked, and the last post related was during my 4th year as a medical student. Fast forward, I’m now into second year of my housemanship.

I’d love to share a little bit something here, when I’ve got more time.

Currently, the hottest topic in town would be COVID-19. Malaysia is one of the most severely affected countries in Asia. Being in the field now did not make life easier, especially being away from home.

We are now under restricted movement order. If your country is also having a (partial) lockdown, make sure you guys adhere to the authorities’ rules. By doing this, you are helping yourself and the mankind.

Till then, take care and stay home guys.

Zoe,

07042020

Deep Sea Baby: Miri 1.0

Been here for 5+ months and it's my first dive in Miri.

Have always wanted to spend my offday underwater since I started but guess I just couldn't really coped with the busy surgical posting. Currently I'm in my second rotation, Orthopaedic surgery. It is a rather chillax rotation here, where you get to eat and drink like normal ~50% of the days. And this week my schedule is arranged in a way that I get a postnight off and off day together, (thanks leader).

SO, IF NOT NOW, WHEN??

Booked my dives with Borneo Dive Network as recommended by my colleague in the hospital.

Day trips (3 dives)
RM418 including transport from accomm, gears and lunch

I joined their member in order to get them to quote me a cheaper price. However, memberships are for Mirians and those with working permit in Miri only. And they will need the members to dive at least once every 3 months.

Members price:
RM260 for 3 dives
RM20 gear rental
transportation not included
+RM50 membership registration fee

It's a nice sunny day today. Boat departed from Marina Bay Jetty at 8.40am. The Marina Bay in Miri, not the one in Singapore. keke

I don't have an underwater camera or gopro with me, and it's a big regret that I still havent invested in one, because THE UNDERWATER SIGHTINGS HERE ARE PRETTY AMAZING

Dive 33:
Kenyalang Wreck, Miri
Bottom time 40mins; Max depth 21.2m
>> An old oil well with plenty of fishes and a fun playground
## Porcupinefish- I've never seen them swimming in a group. Like everytime there'll be at least 3 swimming pass you together.
## Seasnake- I myself saw three, and they remind me of an epic patient I met recently

Dive 34:
North Siwa, Miri
Bottom time 47mins; Max depth 15.5m
>> Biggest reed in Miri
## A rather chill dive with many nudibranch sightings

Dive 35:
Anemone Garden, Miri
Bottom time 55mins; Max depth 11.3m
>> Highlight of the day (man!)
## Giant Barracuda (single) swam side by side with me!! Before we entered, dive guide told us there's this barracuda that'll always come and follow BDN's dive group. And we saw it today, it, was, huge, really giant okay. Initially it just stayed in the middle and all of us surrounded him (divers from BDN and Coco), all snapping pictures or taking videos. It's probably the star in Barracuda hahah. Then when we were swimming towards our boat, I was following the guide. As usual the guide would routinely turn back and check on us. This one time, he turned back, and he stunned for like 5s. Then he instructed me to wait, look, and pointed to my left. I turned to my left and i literally said DAFUQ with the regulator in my mouth. The barracuda was beside me. I mean. NEXT TO ME. WTF IT's DAMN HUGE about 1m in length kot. I almost shit in my pants. But it was a good exposure to me. Saw it's teeth, its scary but ugly la, is there animal dentist kah?? hahahha
## My first sightings on cuttlefish (x3), octopus (x2)
## Also found a shrimp trying to crawl out from the sandhole while a fish was spying on it. Then the fish went into the hole and attack. And then I don't know what happened underneath the sand anymore.
## Lion fish

A random selfie featuring my new hairstyle by the wind

Well, overall a great (and eye opening) experience diving here in Miri. I foresee myself to be diving more often here since I've already paid for the membership, kan.... hehe.

Note:

Lunch was not served on board but after we get back to Marina jetty. Meaning- 3 dives back to back without main meal. They do have some biscuits onboard. I hoarded on it cause I was damnnn hungry after the second dive.

After eating the lunch provided, I went to get another bowl of kolo mee from hawker stall nearby. HAHAHA that's how hungry I was.

Zoe,

22082019

Heck, I climbed Mount Fuji!

Few years back, never had I thought that one day, I would climb up to the summit of Mount Fuji (Fuji-san).

January 2012:

It was the first time I saw Fuji-san. I was on my flight back to Osaka, where I'd catch my connecting flight back to KL. Looking out of the aircraft's on my window seat, the Japanese lady seated in front of me said, "え〜これわ。。富士山。。" (Eh.. this is Mount Fuji!), aloud. And this attracted almost everyone from the other side of the plane to come over our side and look out of the windows, "すごいね〜" Some were taking photos, I did too. Though at that time I thought, to be honest, the mountain looks pretty ordinary lah, except that the peak of the mountain reached beyond the clouds and covered with snow.

Then I told my sister about that. She replied, "Oh wow! That means you'll be coming back to Japan again! There has been a saying- If you see Fuji-san on your return journey, you'll definitely come back to Japan for sure!"

And I guess there it set, my unwindable fate with Japan.

- On my first visit to Japan: Hokkaido, Osaka, Tokyo -

January 2015:

My second time seeing Fujisan during my third visit to Japan. This time I made a trip to Fujikawaguchiko in the Yamanashi Prefecture, one of the best rated destination for viewing Mount Fuji together with some other tourist spots including Oshino Hakkai etc. I was there for 2 days and thankfully, I was blessed with perfect weather and clear skies in the winter days. The view of the mountain from the sea level was simply amazing and magnificent, and it left me speechless. I secretly promised myself that I will come back one day and to be submerged in this breathtaking view again. Little did I know that, people can actually climb up the active volcano.

- On my third visit to Japan: Osaka, Kyoto, Tokyo, Yamanashi -

One day, I was enlightened by my sister's attempt to climb the volcano, also the highest mountain in Japan. The kiasu me can't let this happen right, so I knew, I too, have to do this one day. 

You probably know that I love sports, and I always think that sports are a good way to connect with other people. As much as I love how hiking helps us to reconnect with the nature which is often neglected, I am not a bigggg fan of hiking, though. If you ever ask me to go for a hike, I will likely say yes. But to rate this activity, on a scale of 1-10, I will give a 6.

Then I completed my medical school in February 2018. There would be a long wait before my housemanship placement, therefore I was doing some rough plans on several trips/bucket list items. Then it hits me that I have not visited Japan for more than 2 years now, and my first opportunity to visit Japan out of it's winter season. I have been to Japan for 4 times, all during winter. Can't say that I dislike their winter season, but I'd like to experience another. While I was considering to visit in spring for the Sakura season, something strikes me again: Mount Fuji is open for climbing in summer. There it is.

It was not until three weeks before the departure date that I booked my flight tickets to Tokyo, when my father kept pushing me. hahahhahaha. Well, after some researches regarding the climb, I decided to climb the mountain on my own, without taking part in a tour or following a guide. Then my family thought that it is crazy enough for me to climb the mountain without anyone I know, let alone without a guide. So okay, I asked my sister to help me book a local Japanese tour with guide, that costs me JPY13,800. The price for a local tour is about JPY10,000 (~RM360) cheaper than a tour that is catered for foreigners.

We started our ascend from the 5th Station at around 1pm, following an hour of rest & getting used the the altitude. Because we were ascending in a group of 16 people, with an Obasan & 2 kids, it took us 5 hours to reach the place we were supposed to get some rest. It is a small rest station where you can get some nap & meals before continuing the journey to the summit.

We arrived at our designated mountain hut or 'hotel' Haku-unso (白雲荘) when it was close to 6pm. After a simple dinner served, we were asked to take some power nap and we'll continue to ascend at 12am midnight. The sunrise was expected at 4.40am.

Well, I did not sleep at all. And this is bad. And I only had 2hours sleep the night before. I was so scared that I'll die actually because I wasn't feeling so well, with my quick heartbeat + lightheadedness.

We then departed again at 12am. I just popped 2 panadol before our departure and prayed for the best. It was coldddd and my lousy down jacket is so old and it feels like it is not doing anything to keep me warm LOL

The view of the climbers' headlights

When you ascend at night, and your altitude was way above the clouds, you see a blanket of stars. That was miraculous. And at one resting point, one of the girls in my group actually saw a shooting star. SAD. TOO LATE WHEN I LOOKED UP. but I still made a wish. I DON'T CARE. AHAHAHHAHAHA

Ok then we arrived at the summit, FINALLY, at about 3.45am. Because we were following the tour, we were allowed to rest in one of the house/restaurant. There I got a bowl of hot curry udon slurppp. Sorry lah, really needed alot of fuel ma to climb the mountain. hahahahahah.

Then our guide brought us to show us the volcanic crater of Mount Fuji. 

 Hahahahhaa I guess you're thinking like, uhm, the top of the mountain is not up to your expectation? Well yeah me too. but IT'S OKAY, it's the VIEW FROM THIS SUMMIT. We did not walk around the crater as according to the guide, this will take another 1.5hours. And this is not included in our package. ahahah 大丈夫ですね~

 A lot of people had already booked their spots before our arrival haha but our guide brought us to another viewing point. #insiders

And this is how shitty I look following the climb + no sleep + cold + my contact lenses were falling out from time to time + forgot to take out my retainer (smart).

Our guide, Kuro-san

My new friends, Mr Ogano & Ms Akiko, who were so excited to talk to me eventhough I can't speak Japanese and they can't understand English. But we still managed to talk for 3 hours.

Over beer.

Ice cream is irresistable

And, I have to say, bringing a portable oxygen tank with you IS SO IMPORTANT. As I said I was having quick heartbeat and lightheadedness earlier, but I had not recognised that these were all caused by altitude sickness. As a medical graduate I feel ashamed. Then when we reached the peak and while we were resting, I decided to open and breath in some oxygen lah, since I already bought it, might as well I use right. Because I've seen many people kept using it. Minutes after 3 breaths my lightheadedness was gone. *MAGIC*

Moral of the story: Do not hesitate to use your oxygen.

Still can't believe it. I was actually standing at an altitude of 3,776m above sea level. Earlier this year I started scuba diving, which had brought me to 18m below the sea level.

Because life is all about ups and downs, right?

keke.

Travel Diary : Pulau Lang Tengah

Hi all (or maybe just the future me), finally a holiday/mid-semester break since semester 7 started. In Malaysia's education system- there is no such thing as summer/winter break. What we are having right now is a super precious one-week-long Raya break. (Which, is going to end in 72 hours ermargadddd)

Starting from next Monday I'll be going to the last rotation in this semester : Psychiatry posting. I'm not looking forward to that though. But let's see. And perhaps we will talk about it later. (hopefully hehehe)

So, it had been a kinda hectic 4.5months without any break. *cries* And I told myself I deserved a break/getaway. Did not plan anything ahead until two weeks before this break. At first I wanted to visit Hong Kong again but the airfare was crazyyyyy obviously i can't afford ittttt because im not workinggggg. T^T I then decided to hang around in Malaysia. So I've got my yolo-est buddy K to go with me.

We were contemplating whether to go to Pulau Redang or Pulau Lang Tengah. K chose Lang Tengah and we booked a package at D'Coconut Resort through cuti.my.

The package we got : RM1007.00 for 3D2N, including 2 breakfast, 2 lunch, 2 dinner, 2 snorkeling trip and return boat transfer from jetty in Kuala Terengganu (this is the price for 2 pax). CHEAP OR NOTTTT. if it wasn't raya holidays it'll be cheaper. HELLOOOOO.

However the flight to Kuala Terengganu will cost us another RM500 each so err we drove up to Terengganu. because my parents are paranoia about highway busses. We left KL at 4.45am and arrived at the jetty around 3-4 hours later.

at Jeti Merang. boat transfer is at 10am. I was damn hungry but it the town was so quiet. Probably because it's still Ramadhan. oh well. STARVE LOH.

Oh yeah, they have a sheltered parking area. Need to pay of cz, RM45 for 2 nights.

And and and, not to forget we also need to pay RM5 per person for marine park fee.

We're here! (omg, wasn't expecting it to be soooooo piao liang)

Disclaimers : all the pics were taken with iPhone6/5s/Sony waterproof camera

***NO FILTER***

Checked in. Our room was at the East Wing. D'Coconut has east and west wings; both sides have restaurant, swimming pool, the beach is longer at the west wing. Oh, there's a bar too at west wing.

We settled down in our room at about 11.15am. Lunch was not served until 12.30pm so we decided to take a nap. We pretty much went into coma until 2pm. hahahhahah thank god i woke up for lunch.

Snorkelling tour was at 2.30pm so there we go! right after makan.

The package price does not include snorkelling equipments. Of course you can rent it from the resort, it's RM10.00 per item per day. We took only the goggles because i think our density are not so great.

To the deeper part of the sea

First dive spot. (meh we dont dive, some people did)

I asked the guide how do i tighten the goggles in malay, then he was like WTF YOU SPEAK BM? i'm like uhm yeah because we are malaysian? After that whenever he said things in mandarin i just smiled. (things like 'Be careful' and 'can or not') Then he was like, EHH DO YOU SPEAK MANDARIN TOO? 

*rolled eyes* DUHH

but he's veli nice. he helped us take all the photos. HAHAHAH!! Thanks Raf! 

photobombed by the fishes 

The fishes bit me :(

Then photobombed by the bubbles Raf made

Some underwater view

Some camwhore session on the boat

and at the beach

Back at the beach at around 4.30pm

Then we went back to the room and comatose again until dinner time.

She made me wore a dress ahahahaha finally get to wear this dress i got from Bangkok after a year. lolol

Post dinner chill time at the beach with our own alcohol.

Had a bottle of somersby each followed by a few glasses of brandy under the sky. Such life. 

Day 2 :
Well, there are only 2 resorts on this island. D'coconut and the SummerBay Resort. You can walk to one another's beach. At D'coconut, it's very chilled and not many people la (idk about summer bay) hahaha.
And again on this island, you've got nothing much to do. Eat-sleep-swim-snorkel/dive-eat-sleep-eat... you can watch TV at the public area. Their Astro i think they subscribed most of the channels (except AOD) hahahahhaha

So we went to the west wing on the second day to sunbath after breakfast.
You can swim to west wing. Or you can walk through a trek for about 7minutes.

The view at west wing

I got a model and my model got a photographer.

At the pool. The pool water was salty as well an I couldnt dive. I still float. hahahhahaha (so much fat content mehhh)

Every meal's view

Dont have body to show so my selfies are more of me wrapped up. hahahahhahahhaha

Snorkelling trip on that day was postponed to 4pm so yeah we got our alcohol earlier.

At a spot near SummerBay resort. School of fishes dancing all over.

one last bikini shot of both of us. I guess i have spammed enough. hahahhah

I hate my ribcageee omg.

Same agenda at night :

Chill at the beach with brandy. but we went to the west wing.

Just sat there and talk and drink. at around 10pm some guy was walking and shining torchlight towards us. So we told him oh we're from East wing. Then he said, "It's low tide now! You guys should go out there and see!"

So we did. He walked with us both + the other 4 from Taiwan.

That blue snake-like pattern you see? it's a clam!!

So the guy, he was from Nepal. He explained alot of things in Malay so i just okay maybe I should translate for the Taiwanese. As I spoke,

"EHH? ARE YOU CHINESE?"

*heart breaks. abuden what do i look like?

Day 3:
Breakfast, check out and chill until boat came and get us at 12pm.
This trip is so short but I'm glad I came. Thanks Karen for making this happen!

Note :
1. The food here was okay. What i like about it is that they 'recycle' the left over. Eg too much scrambled egg in the morning, they stir-fry with cabbage for lunch.
2. Staffs are really helpful and friendly :D
3. No phone connection. Wifi worse than Seremban. But don't bother, try to live without fast wifi la! hahahah