Posted in Uncategorized on December 31, 2012 | 34 Comments »
The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.
Here’s an excerpt:
About 55,000 tourists visit Liechtenstein every year. This blog was viewed about 520,000 times in 2012. If it were Liechtenstein, it would take about 9 years for that many people to see it. Your blog had more visits than a small country in Europe!
Posted in Uncategorized, tagged vacation on September 17, 2012 | 11 Comments »
Since it was a public holiday today, I decided to bring my family to Legoland, Johor Bahru which just opened on 15/09/2012. I bought the annual pass quite some time ago when they were having the promotion,much cheaper then. So, I thought of giving some review over here.
First and foremost, I could not last more than 4 hours in the park due to the weather. Even thou there was no hot sunlight but it was freaking hot. Most of the trees are newly planted and do not give you any shade or shelter. It will take at least another 2 years for the tress to grow enough height to give shade. I feel the management should provide more shelters and air conditioned environment. Most “Q” waiting areas got no fan, including the ticket as well as main entrance.
The park is mainly for children age 2-12 years old, thus can be called as a “family theme park”. Those with no children may not enjoy the park as much as a family. Most of the rides are catered for children except for the 3 rollercoasters which even adults can enjoy. I could not get into 2 of them as the Q was just too long ( at least 1 hour). Your children below 15 will enjoy Legoland.
The Miniland is one of its kind in this region. Almost all of the Asia’s landmark are built with legos and brilliantly crafted. The interesting part is when you see the miniature structures like LRT, KTM Komuter, bus, cars and even the airplanes moving! I must say it really catches your eyes.
I will go back there to complete all the rides with my family since I can enter unlimited number of times till December 2013. My personal opinion is that Legoland is more of a family theme park (family with young children) where else Universal Studio, Singapore is more for youngsters and adults. The water them park will be ready next year and for those outside Johor, the Lego Hotel should be ready by 2014, which is just in front of the ticket counter.
Posted in Uncategorized on March 10, 2012 | 77 Comments »
Two days ago, someone by the name of ThiruKCS wrote a letter to at least 3 medias, namely theStar http://thestar.com.my/news/story.asp?file=%2F2012%2F3%2F8%2Ffocus%2F10874444&sec=focus, Malaysiakini http://www.malaysiakini.com/letters/191405 and FreeMalaysiaToday http://www.freemalaysiatoday.com/2012/03/08/the-darker-shades-of-a-houseman%e2%80%99s-life/. I got no idea what he is trying to say and what is his intention but he sounds desperate!
I will say this again that if you want good, nonstressfull life, then go and find another job! Being a doctor needs a lot of commitment and stress management as life’s are at stake. If you can’t handle that, you can always quit and find another less stressful job. The last I can remember, housemen are doing shift duties now! so, if even shift duties are still stressful, then what does this guy wants? Does he really think that other jobs are less stressful and have better life? No doubt that the others may not be dealing with life but do you know how many hours an accountant spends doing accounts, a lawyer spends in preparing a case etc etc? Every job has it’s stress but medicine is different in the sense that it deals with life and since you chose this job voluntarily (hopefully by knowing all these before), you just have to go with it and learn how to cope.
There is no such thing as “office hour” job for a doctor. You need to make sure that every of your patient is well and properly managed before you leave the ward! That what makes you a good doctor. Of course, I am not saying that you should work 36 hours straight but working shift hours does not mean your responsibility is less! The stress of doctors only increases as you go higher in hierarchy as the responsibility increases. And don’t forget the litigation rate and lawyers ever waiting to sue you. BTW, where did he get the figure that 60% of housemen are having psychiatry disorder? That means 6 out of 10 housemen are mentally ill!! That’s scary. Are these the people who are going to treat us/public in the future?
BTW, this guy has just come up with a new theory for a cause of Cushing’s syndrome: Housemanship. So, medical students can now put this as a differential diagnosis. “Medical studies have determined that stress causes our bodies to produce more Cortisol. This “stress hormone” is normally only released into our bloodstreams in emergency situations. When we become scared or excited, Cortisol is flooded into our bodies to help us deal efficiently with the situation. Too much of this hormone in our bloodstreams can and does cause adverse health conditions. These conditions can include, but are not limited to, cardiac problems, strokes, obesity, a lower immunity system, and insomnia” WTH!!
So, for those who intend to do medicine and expect a good job, good life, good future and good money, please think again. It is people who have this perception who end up writing these sort of articles to newspaper and making a fool out of themselves. This was one of the purpose of this blog, to educate the youngsters about medicine and being a doctor.
THis was one of the comment that I just received in my blog yesterday, by a housemen: ”I realize that quality of doctor are dropping. Compare to senior 2-3 year older than me, i can see huge different between us. For example, during their HO time, maybe just 2 HO allocated in one 30- 40 patient ward,during my time it is 15 HO per ward. So, training is lacking.
Then, we also realize that our future was really unpredictable. After you complete your housemanship, where will you choice to go? I also find out that majority of the doctor will choose field which had relax life, they don’t mind to be a chronic MO, such as at KK, district hospital, or some posting with no active call like ENT, radiology, pathology, opthalmology, psychiatry. So, these posting become hot posting when it come to the time to apply as a medical officer there. When these posting are full of the chronic MO, then, it was a bit unfair for those who really had interest in the field and plan to be specialist there, because when a department is full, you will had to go to other department which you don’t really like.”
Asta Levista babe……………………………
–>March 8, 2012
FMT LETTER: From Thiru KCS, via e-mail
Lately, there has been a lot of discussion on the plight of medical house officers in our country who are compelled to work long hours uninterruptedly. The most important asset of a country is not its natural resources, but rather its human resources. This is especially true in a knowledge-based economy, which, of course, will be the trend in the future if not already the trend in most of the Western countries. When noble professions are ever discussed, the first that comes to mind is none other than medical doctors. The big unsolved question is that are we giving enough importance to this profession?
Stress and burnout are concepts that have sustained the interest of house officers and researchers for several decades. These concepts are highly relevant to the workforce in general and house officers in particular. Despite this interest and relevance, the effect of stress and burnout on patient outcomes, patient safety, and quality care is still at the tip of the iceberg when it comes to solutions and action plans.
The Employment Act 1955 (EA) mandates that overtime pay at double the normal wage-rate and triple the normal wage-rate must be paid when employees work on rest days and public holidays, respectively. I’m aware that civil servants do not come under the purview of the EA; and doctors, housemen and the medical fraternity in government service are specifically excluded due to “work, the performance of which is essential to the life of the community” [EA Section 60A (2)(b)]. It’s almost absurd when authorities are convinced that they have looked into the matter by comparing the improvements introduced from a decade back. The issue that crucially awaits justice is what could be done to further improve the lifestyles of these house officers.
The utmost important issue to be addressed over here, apart from the payments and incentives which has always been debated despite the rise in the cost of living is the quality of life that these house officers lead in their daily lives. As the flow of life force energy moves through the physical and emotional bodies, it can become imbalanced or blocked. Although the hazards associated with the prolonged hours worked by resident physicians and house officers have been documented in numerous studies, limited attention has been paid from the administrative point of view on how to curb this issue. It’s distressing looking at the rates of house officers that seeks for psychiatry consultation at an alarming 60% in total at year 2008. Is this the kind of situation that we anticipate being healthy for these group of professionals? I can safely call this a crisis that screams for immediate remedy!
The development of trust in the physician leads to a proper patient-doctor relationship and is part of the healing process. A major element necessary for patient trust is with an individual whom is able to respond to the patient with focus and diligently gather information from the slightest reactions exhibited by the patients; and this in no doubt is only possible when your mind and body is in synch. How would you even try to develop this professional relationship with your patients with these factors; red, puffy eyes and a haggard appearance, lack of mental clarity not mentioning your aching physical body!
Medical studies have determined that stress causes our bodies to produce more Cortisol. This “stress hormone” is normally only released into our bloodstreams in emergency situations. When we become scared or excited, Cortisol is flooded into our bodies to help us deal efficiently with the situation. Too much of this hormone in our bloodstreams can and does cause adverse health conditions. These conditions can include, but are not limited to, cardiac problems, strokes, obesity, a lower immunity system, and insomnia. An overworked house officer is prone to make unavoidable mistakes that would simply cause the lives of their patient not forgetting a huge blow to their career.
Based on current empirical evidence on stress and burnout in house officers, it is highly recommended that these issues are looked into precisely to enhance patient safety. May the relevant authority ensure that these public service doctors are happy and capable of providing the best service to the nation. So to the powers that be, wake up and smell the coffee.
Posted in Uncategorized on January 25, 2012 | 7 Comments »
Finally, I manage to get a locum cover for Chinese New Year 2012. It was the best time to cross the causeway without any traffic. Thus, I decided to bring my family for a short entertainment across the causeway on the first day of CNY.
For those who can’t remember, Universal Studio was supposed to be in Nusajaya, Malaysia initially. Way back in the year 2000, Universal studio was already in talks with Malaysian authority to build a theme park in Nusajaya. I personally saw the MBJB master plan in the year 2000. However, some how it did not get throu’ and I am not sure why. We have a bigger and cheaper land than Singapore. I feel it must be the bureaucracy, rules and regulation that put them off. Finally we had to turn to Legoland which will open its door in June 2012 in Nusajaya.
Unfortunately, it was Singapore who benefitted. Surprisingly, Universal Studio Singapore belongs to Genting Berhad which is a Malaysian company!! How ironic!
The best ride was this:
I must say it lives up to its name as the world’s first Transformers ride. A virtual 3D action where you feel like you are in the movie! I would recommend this to anyone who visit Universal Studio Singapore.
The rest of the rides were awesome as well. The cyclone roller coaster was really scary. Lucky I do not have any cardiac disease yet. Felt like I was flying 14 storeys high
It was exhausting I must say. I spend almost the whole day from 10am to 7.30pm walking and taking rides with my kids/wife etc.
Despite that, I could not finish all the attractions in the park. The Mummy indoor roller coaster with visual effects was also excellent.
After all these tiring rides, the best part was when I could drive back to my house in JB in less than an hour !! NO JAM at all…………………………….
Looking forward for another visit in a year’s time.
Posted in Uncategorized on January 1, 2012 | Leave a Comment »
The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.
Here’s an excerpt:
London Olympic Stadium holds 80,000 people. This blog was viewed about 300,000 times in 2011. If it were competing at London Olympic Stadium, it would take about 4 sold-out events for that many people to see it.
Posted in Uncategorized on December 31, 2011 | 18 Comments »
It has been almost 2 weeks since I last posted. It has been quite a busy 2 weeks with a lot of things to settle before the new year. Year 2011 has been a relatively good year for me, being my first full year in private practise. So far everything seem to be going on well.
Same can’t be said about the future of medical education and practise in Malaysia. The mushrooming of medical schools is a big screw-up. Unemployed doctors are going to become a reality. The ministry has already started to give housemanship on contract basis indicating that the system is bursting. I can only say that the situation will get worst soon.
I had given enough advise to many budding doctors to decide on their fate. It is all up to them to analyse and decide on their future. Being a doctor is no more prestigious, money-making or easy life. The salary in government sector after the recent introduction of the new salary scheme (SBPA) is fairly good but getting a job in civil service is going to be the major problem in near future. On the other hand, the income of doctors in private sector is gradually dropping and unethical practises are increasing as a mode of survival. I will write more about this soon.
Well, whatever said, I hope 2012 will be a better year for everyone. I hope it will not turn out to be like the 2012 movie.
Happy New Year 2012 to everyone………………………
Posted in Uncategorized on January 2, 2011 | 1 Comment »
The stats helper monkeys at WordPress.com mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health:
The Blog-Health-o-Meter™ reads Wow.
About 3 million people visit the Taj Mahal every year. This blog was viewed about 54,000 times in 2010. If it were the Taj Mahal, it would take about 7 days for that many people to see it.
In 2010, there were 110 new posts, not bad for the first year! There were 63 pictures uploaded, taking up a total of 46mb. That’s about 1 pictures per week.
The busiest day of the year was September 10th with 2218 views. The most popular post that day was For Future Doctors: General Misconception of being a doctor Part 1.
The top referring sites in 2010 were facebook.com, medicine.com.my, zorro-zorro-unmasked.blogspot.com, google.com.my, and mail.yahoo.com.
Some visitors came searching, mostly for pagalavan, mariam mokhtar, columbia asia hospital nusajaya, pagalavan blog, and columbia asia nusajaya.
These are the posts and pages that got the most views in 2010.
For Future Doctors: General Misconception of being a doctor Part 1 September 2010
18 comments
For Future Doctors: General Misconception of being a doctor Part 2 September 2010
33 comments
About Me January 2010
For Future Doctors: General Misconception of being a doctor PART 1 September 2010
7 comments
For Future Doctors: Housemanship, Medical Officer and Postgraduate Training (Part 3) November 2010
101 comments
Posted in Uncategorized on November 8, 2010 | 41 Comments »
DR PAGALAVAN LETCHUMANAN
MBBS(Mal) MRCP(UK) FRCP(Edin) AM(Mal.)
Dr Pagalavan secured a place to do medicine in University of Malaya (UM) in 1992 after becoming the top STPM student for the state of Negeri Sembilan in 1991, scoring 5A’s. Upon graduating from UM, he underwent his Housemanship training at Ipoh Hospital after which he was transferred to Pontian District Hospital in 1998. After passing his MRCP Part 1 in 1999, he was transferred to Hospital Sultanah Aminah for further training. He underwent training in several specialities including Nephrology, Cardiology, Neurology and Respiratory medicine. He passed his MRCP Part 2 in 2001 and subsequently left to Edinburgh, UK to complete his MRCP Part 3 clinical exams. He obtained his MRCP (UK) in June 2002.
He worked as a Clinical Specialist at Hospital Sultanah Aminah from July 2002 till June 2005, during which he was put in-charge of ICU and HDU patients for almost 2 years. He also covered as a specialist in Nephrology, Respiratory medicine and Neurology during this period of time. He published a paper on “Melioidosis: The Johor Bahru Experience” in 2005 (MJM Dec 2005; 60(5): 599-605), the first data on Melioidosis from the Southern Region.
In July 2005, he left to continue his subspeciality training in Rheumatology at Selayang Hospital. He was the first to publish a paper on “ Systemic Sclerosis” (Demography, clinical and laboratory features of Systemic Sclerosis in a Malaysian Rheumatology centre. Medical Journal of Malaysia June 2007; 62(2): 117-121) from Malaysia, during his 18 months stay in Selayang Hospital. He resigned from government service in 2006 and joined Monash University Malaysia as a Lecturer. To complete his training in Rheumatology, he went to Singapore General Hospital under the guidance and supervision of A/Prof Julian Thumboo in March 2007 and completed in August 2008. During his stay in Singapore, he published 3 papers in high-ranking International Rheumatology Journals. He was subsequently promoted as Senior Lecturer in Monash University in 2009. He received his Fellowship of Royal College of Physicians of Edinburgh (FRCP) in May 2010. He left Monash University and joined Columbia Asia Hospital Nusajaya (CAHN) in July 2010 as Consultant Physician & Rheumatologist. He is also the Chief of Medical Services for CAHN
1) Dr Kumar Hari Rajah
MBBS (Manipal), M.Med Surgery (UM), MRCS (Ire)
2) Dr Zulkarnain Hasan
MD (USM) M.Med Surgery (USM) AFRCS (Ire)
Dr.Zulkarnain Hasan joined Columbia Asia Hospital Nusajaya since October 2010 as a fulltime Consultant General Surgeon. He has extensive experience in the field of surgery having performed more than 500 appendicectomies, more than 200 open inguinal hernia surgeries throughout this career as both trainee and surgeon.
DrZulkarnain’s special interest includes upper gastrointestinal (GI) surgery, endoscopic and laparoscopic procedure and surgery. He also has experience working in thoracic unit to handle non-cardiac thoracic conditions. Two (2) years in surgical training abroad allowed him an opportunity to work with experienced surgeons in upper GI surgery in Ireland. He is able to perform minor, major and laparoscopic surgery such as laparoscopic appendicectomy, laparoscopic cholecystectomy and laparoscopic hernia repair procedure.
Dr.Zulkarnain is well-trained and expert in performing diagnostic and therapeutic endoscopic procedure such as endoscopic ligation of esophageal varices, control of peptic ulcers, snare of polyp, PEG tube insertion and etc.
1) Dr Rajesh Mahendran Radha Krishnan
MBBS (India) M.Med O&G (UKM)
2) Dr Teh Jin Teik
MBBS (India) M.Med O&G (Mal)
Dr Yoga Raj
MBBS (Mal.) MS Ortho (Mal.) M.Med Sc (Otago) AO Fellow (Milan)
Fellowship in Arthroplasty (NZ)(M’sia), OHD (Niosh)
Dr. Muhammad Izzuddin Poo
MBBS(Mal.) M.Med Paeds (UM)
1) Dr Norezalee bin Ahmad
MBChB (Bristol) M.Med Anaes (UKM) AM (Mal.)
2) Dr Tan Kok Hui
MBBS(UM) M.Med Anaes (UM)
Dr Siti Suhaila Ismail
MBBS (USM) M.Med Rad (USM)
Posted in Uncategorized on November 3, 2010 | Leave a Comment »
After a very exhausting month of October, finally I am taking 2 days off to celebrate Deepavalli with my parents in Seremban. I must say that the month of October was a very busy month for me. Almost everyday I had patients in my ward and clinic. I even had a very ill patient with Severe Pneumonia who was finally ventilated in our ICU and transferred to Hospital Sultanah Aminah’s ICU. I heard the patient died 2 days later despite the best treatment. We are still loosing our battle to the brainless bacteria and viruses!!
I hardly had any time to blog or even reply to emails in October. Imagine almost everyday, going to the hospital at night to see ill patients!
The situation in my hospital seem to be cooling down over the last 2 days, probably due to the long weekend that is coming. I will be taking off from 6pm 4th November till 6pm 6th November for a short break with my parents. I thank Dr Chan for helping to cover for me during my absence. Thankfully my house kitchen renovation has been completed in time.
I would like to wish everyone a very Happy Deepavali 2010.
Posted in Uncategorized on September 18, 2010 | 3 Comments »
I have been very quiet since I posted the 2 most popular postings on the 7th and 8th of September 2010. My posting on “General Misconception of being a doctor Part 1 and 2” attracted almost 10 000 visitors! I also had many comments for the above 2 postings , almost all supporting what I have said. Interestingly, I also had some foreign doctors from US and UK commenting on my post. I also realised many medical students who commented on my post, agree that they have chosen the wrong field!
I have been reading all the comments and to answer some of the querries, I will be posting few more articles soon, especially on the housemanship and postgraduate training in Malaysia. I will not talk on the quality of doctors being produced nowadays as I have written enough about it in my MMA articles, some even way back in 2006! Yes, I did predict the current situation more than 5 years ago. I also believe that my prediction for the coming future will also come true someday, as I have written in my blog.
I have been quite busy lately and thus did not have enough time to write the continuation. However, I should be posting a new article within the next 2-3 days.
MBBS(Mal.) MRCP(UK) FRCP(Edin) AM(Mal)
Consultant Physician & Rheumatologist
Johor Bahru
Malaysia
Tel: 07-2339999
