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Assalamualaikum and hi yalls,
Again, it's been a long time. Trying so hard to keep this blog alive so here I am, again. I am now finally a 3rd year medical student, and we finally starting to get a feel of clinical years (I'm also in India, if you don't already know). To be completely honest, it was definitely overwhelming to face the fact that I will be facing actual human beings, and talk to them, as healthcare workers. I felt very undeserving and not competent to talk to the patients but we'll get more into that later. This might be a long one so you can scroll to whichever part interests you.
Brief insight on semester 5
Definition of OBG
My first posting for Semester 5 is OBG which is short for Obstetrics and Gynecology, or in Malay pakar sakit puan. The department basically handles women's health problems- where obstetrics handles anything related to pregnancy and gynecology handles other women related issues. Obstetrics is an interesting department because it basically deals with healthy women (who are obviously pregnant) that undergoes a normal life event, however proper care (antenatal care) should be given to these amazing women to detect and avoid any complications during and after pregnancy.
Although me and my group mates were so excited to go to the hospital for our first posting, unfortunately we couldn't because one of our batch mates was tested positive for Covid. So we had to have online classes for a week due to quarantine, which sucks a bit because we're finally in India, but it is all for the sake of our safety so, it's fine.
Doctors advice in hospital
As it is our first time in the hospital, the doctors gave us a lot of advice especially on how to present ourselves in different of the patient. We are basically babies among the healthcare workers but we still bring the image of a doctor in the hospital. So, we should maintain a decent attitude and be mindful of what people would think about us. We should also wear proper and clean attire to make a good impression on the patients. However, we should not wear a strong perfume to the hospital because it might aggravate some of the patient's symptoms, especially preggo mamas.
OBG doctors are such a blessing. They were very nice, knowledgeable, and very motherly. It was such a great start for my clinical years. *hugs to all of them*
Seeing first surgery with tips
Seeing first surgery with tips
I went to see a surgery the very first day we were posted in the hospitals. We changed into scrubs and it was so exciting. The first surgery that we witnessed was a abdominal hysterectomy (removal of the uterus through the abdominal wall) and I loved it, but then the lecturer said there was another caesarean section (delivery of a baby through an incision on the abdomen and uterine wall) happening in another room, and we went and watched that. I was shocked, it was not normal delivery, but I was still so shocked at what the mother had to go through just to deliver the baby out. Well technically the doctors pulled the baby out, but the sound of the baby crying was such a relief even to me a mere bystander. I imagine it must be the happiest moment for the mother. My other batch mates did have a chance to witness a normal labor, but unfortunately I couldn't due to some health issues. I really felt a bit missed out, but I am grateful for whatever I saw. Maybe it wasn't the right time for me to witness that.
My last surgery was another hysterectomy, supposedly to be a vaginal hysterectomy (removal of the uterus through the vagina) of a prolapsed uterus. Well, at the beginning it was, but because the fibroid in the uterus was too big, the doctor shifted to abdominal hysterectomy. And during that day, we stood watching the surgery for more than 3 hours, an eventually had to excuse ourselves before the surgery was over because we had another class. But I loved it so much.
Meeting patients
Okay, so we are in India right, in Udupi to be exact, so most locals here can converse in a little bit of English but for most of the times it's really hard to decipher what they're saying. Locals in Udupi mostly speak Kannada, and we in fact, have had a few classes on Kannada, but, the most I could say in Kannada is either good morning, have you eaten? and count from 1 to 3. So it's a bit hard communicating with them. However, we tried our best, and we learned a lot from patients, both in terms of communication and knowledge in the medical profession.
So some of tips from my side is:
- prepare a format for case sheet before talking to the patient so you know exactly what you want to ask
- just build up your courage and go talk to the patient
- if the patient cannot understand you or don't want to talk to you, don't be disappointed or sad and just move on to the next patient
- be very mindful of you patient's well being. yes you have a job to take the patient's history, but please do not disturb them if they are in a lot of pain, or busy with other stuff. try to read the room
OPD experience
The outpatient department (OPD) or in simpler terms, the hospital clinincs, is where patient from outside, can meet and consult with the doctors. So each of our lecturers have their own respective cabins/ rooms and at most 2 students can enter and 'shadow' the lecturers mainly to observe how the lecturers take patients history, carry out examination of the patients- palpation on the abdomen, measuring fundal height, per vaginal examination to view the cervix, pap smear. All the theories for basic examination is taught by the lecturers during class, so it is very important to see how the examinations are carried out by the doctors so we would have a greater understanding.
also one of our lecturers reminded us to always wear our stethoscopes and be proud that we managed to reach the clinical years sobs
My tips for getting the best in OPD is:
- head to the OPDs in the morning because there would be a lot of patients during that time, they would hardly be any patient in the afternoon so you won't be able to see much
- try shadowing all the lecturers and observe the differences in each of the doctors (lecturers) aproach to the patients. don't get too comfortable with one lecturer and neglect the others tehee
- the doctors would mostly speak in Kannada and most of the times you wouldn't be able to understand a thing, but what you can do is observe what the doctors are writing down (because they'll note down everything in English) and just pay full attention to all the examination carried by the doctors.
- if you have any questions, don't interrupt the lecturers when they're busy talking with the patient, wait for the right moment, or you can always just jot down your doubts and ask the lecturer in class
The ultrasound room is basically the same as the OPD room- the fact where you just shadow the lecturers, and look at the scan, I was so surprised that we could clearly see the baby faces and little fingers. It's just too cute. Apart from observing the fetus at different stages in the womb, we also took this time to practice calculating the due date of the mother as the last menstrual period date is clearly stated in the monitor.
One thing that took me by surprise was that, in India, the gender of the baby is never observed during the ultrasound because it is illegal. So we never got the chance to learn how to find out the gender of the baby in the ultrasound room.
End Posting Test
For the every posting, we will have an 'End Posting Test' (EPT) on the last day, on for OBG department, they decided to do a viva as an EPT. Viva voce is an oral examination, instead of a written exam, the lecturers would directly ask us questions and ask us to perform whatever examination on a mannequin. During the entire posting, I really didn't study as much because I was running here and there between the OT, OPD and wards and died once I reached my room. However, Alhamdulillah, I did manage to get a decent mark (which I am not very proud of) but I really do think I need to read a lot more and need to manage my time better.
What did they ask?
- It is a must to memorize all terminologies taught in class as they would probably bombard you with 10 terminologies for you to define.
- DO NOT skip antenatal and postnatal care. I did and got that question, I fried my answers real hard it burnt.
- Study the maternal pelvis and fetal head thoroughly, they would definitely ask, BOTH.
- By heart all the steps in a gynecological and obstetric examination. They will ask you to demonstrate.
- Familiarize yourself with presenting a history, they will ask you to present a case, they will ask questions based on your case. Prepare at least one complete case history of gynecology, ante partum, and post partum case each.
What I wished I could improve
- The first thing I wished I could do, is to practice more on the mannequin regarding all the physical examinations because we never really actually practiced on the mannequin because we did not know that we could
- To not neglect antenatal and postnatal care. (big mistake)
- Be more systematic in organizing my notes and utilize my time better.
- Talk to more patients and took more history
- Tried presenting cases more in classes, because it really helps a lot when the lecturer listens ti your case and correct whatever you did wrong.
- Another note is, do not rush to buy the textbooks, yeah India's textbooks are so much more cheaper than in Malaysia, but you will definitely regret if you hardly use the textbook, so what you can do is, go to the library and go through some of the books, or download some eBook versions of your textbooks and start from there. Only buy textbooks that for you is the most helpful.
- For me the textbook that I use the most is Dutta's Textbook of Obstetrics and Dutta's Textbook of Gynecology. It is much more detailed and easily understandable. Another textbook that is recommended is, Obstetrics by Ten Teachers and Gynecology by Ten Teachers, these books are much more brief and gives you the whole idea of the topic without diving much too deep.
Thank you all who reached the end of this post. I appreciate your time reading through all my writings and hope helped you at least a lil bit. If you have any other ideas for a blog post, feel free to DM me and I would love to hear from you. I am making a promise to myself to post more after this InsyaAllah so please pray for me too.
Again, tqsmily !
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Written on : Early December
Edited on : -
Edited on : -
Posted on : 19 December 2021
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