Archive for September, 2007

Mistrusting the GP – DM screening

[warning – long entry]

Prior to studying medicine, J. had an incredible respect for General Practitioners (GPs). It was partly this respect he felt that physicians had that led him to do medicine. However, during this course, while rotating among the various subspecialties, he realised that many GPs were masking their inadequancies and/or were simply not up to date. It is refreshing, however, to meet that occasional family physician who admits candidly for the sake of the patient.

Take for instance, J.’s recent trip to the University Health & Wellness Centre (UHWC) for a skin condition. The doctor said, “How’s final year? Okay let’s see… Hmmm, looks like classical [skin condition]. What causes it? We see together ah…” He opens a cupboard, pulls outa dermatology text and flips to [skin condition]. It was sufficient that he could recognise it and respect J. enough to admit that he didn’t know everything like the back of his hand. After all, family physicians have a huge scope of knowledge to know, and it is hardly expected of them to be able to know everything.

Remember: he who knows not, and knows not he knows not, is a fool – shun him. Pithy quote, eh?

J. is disappointed about two recent issues with GPs – DM screening and antibiotic regimes. Let’s talk about one of them.

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Surgery SIP at NUH: Upper GI

6 weeks after the Medicine Student Internship Programme (SIP) at SGH, J. went to National University Hospital (NUH) for one month of Surgery SIP with the Surgery Department, split into 2 chunks of two-weeks duration. The first two weeks he’s spending with the Upper GI (Gastrointestinal) team, the second two weeks will be with the Plastic Surgery team.

Other teams in the Surgery Department, which J. colleagues joined, include Breast & Trauma, Colorectal, Urology, Neurosurgery, Hepato-pancreatico-biliary (HPB) and Endocrine & Laparoscopic. Vascular surgery, unlike in SGH, is under the CTVS department (Cardiac, Thoracic and Vascular Surgery).

J. thinks it’s very fortunate for him to be on the Upper GI team. The consultant, an Associate Professor, and the registrar are both incredibly enthusiastic about teaching. It led to very stressful situations in the first few mornings, when J. and friends were bombarded with questions like, “What are the causes of post-op fever?”

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Coffee Culture at Coffee Bean (Guthrie House)

Having experienced Starbucks at Holland Village, J. thought he’d try a different place such as The Coffee Bean & Tea Leaf at Sixth Avenue, conveniently located next to Cold Storage and Venezia.

J. ordered a double shot espresso (S$4.00).
Coffee Bean Double Espresso

A single shot costs $3.20 and J. figured he shouldn’t fall asleep during a subsequent dance performance he was attending.

There’s a thing about espresso, where a skilled barista can time the pour to get a good extraction. Not so at Coffee Bean, where the timing of the extraction is pre-set. It seemed to turn out okay… barely, with a thin, thin layer of crema and being somewhat acidic. A bit blah. It also left a bitter taste at the back of J.’s throat, which might be partly due to his recovering from a URTI.

The place has both outdoor and indoor seating, as can be expected, and what struck J., in comparison to Starbucks, was the lack of people using laptops.

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Variant Medstudentitis re: Ergotrid Acne Vulgaris

Ergotrid – Area of skin between upper lip and nose

Acne vulgaris – commonly called “pimple”,

Medstudentitis – The mild hyponchondriasis of medical students who (with little to no grounds) believe they have signs/ symptoms of illness, usually whatever they happen to have just recently studied.

Variant medstudentitis – newly coined by J., and not accepted anywhere else except on this blog. The tendency for medical students to diagnose the more popular, severe, interesting (and rare) conditions.

Example: 36-year-old flight attendant presents at a GP clinic with first, single-day episode of URTI (cough, coryza, sore throat), mildly swollen tonsils with no oral candidiasis. The person with variant medstudentitis would diagnose (not just entertain a thought of) HIV. Why? Because he’s a 36-year-old flight attendant, and according to the pathology exams, they always have HIV, tuberculosis and/or pneumocystis carinii pneumonia.

Recently, J. developed a pimple just superior to his labium superioris (upper lip). It developed like any other pimple, a solitary area beginning with tenderness, redness, and went from a papule to a pustule.

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HCI Mid-Autumn Festival 2007 – A brief note

The institution formerly known as Hwa Chong Junior College held its annual Mid-Autumn Festival (MAF) celebration on the 15th September 2007. As an alumnus of the school, it’s a reason and an excuse for J. to return to his alma mater and visit the doctors.

Of course, being several years removed from the school, J. didn’t see many of his batchmates, much less classmates, and noted the absence of a couple of teachers who were either furthering their education or out of the country.

Here’s what’s [barely] noteworthy:

– The class benches have been reorganised. J.’s [previous] class bench is now in the middle of nowhere at the wing in a T-shape, and is colonised by both fresh-faced and kiampa-looking juniors

– New buildings, new extensions, in particular the CCA block and a new science lab next to the LTs

– The cruddy gym is undergoing renovation

– The bio teacher is in the US, the chem teacher is furthering studies, the physics teacher is about to go further studies.

– The math teacher is still the same. Exactly the same.

– J.’s old jersey, previously a ‘spare’ for the team, has seemingly disappeared

– Ever since J.’s batch released a CD of HCJC songs which had a mistake in singing, the future batches have failed to realise the mistake, and 5 years down, are still singing it wrongly.

– Nobody ever changes the mass dances

That’s that for MAF 2007.

Fourplay – Quadfac Bash

A tradition to hold a bash bringing together the three healthcare faculties – Medicine, Dentistry and Pharmacy – continues with the addition of a new faculty, the faculty of Nursing. This year’s bash named Fourplay (bringing to J.’s mind the Burn The Floor show Floorplay) was held at the Ministry of Sound (MOS) on the 8 September 2007 (Saturday) from 8.00pm to 10.30pm. Ticket prices were at $17 per ticket, where a normal MOS ticket for guys before 10.30pm on a weekend would cost $15.

The highlight of the event: a dance competition requiring each faculty to send at least one team.

And the winner is…

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Clinical Years – The Toughest Posting is NOT O&G

It is undoubtedly Paediatrics, the branch of medicine concerned with neonates (<1 month), infants (<1 year), children (pre-pubertal) and adolescents (post-pubertal to the age of 18).

There’s a prevalent rumour going around that Obstetrics & Gynaecology is the toughest posting – with its combination of multiple 7.30am Q&A sessions (each of which contribute to the final score), Neonatology lessons and quizzes, an MCQ test, an essay test, an OSSE test and an OSCEs (that counts towards the final MBBS score). Beware! Fear!

Well, it’s unwarranted.

J.’s O&G posting was the final one before the Pathology exam, another examination with a vicious reputation. The idea of such a devastating combination brings to the mind of many an M4 student an [/a particular orthopaedic surgeon’s] analogy involving dilators, reaming and anal laxity. Brutal.

Once again, unwarranted.

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