Graduation – Family Photos

December 21, 2014

With no other graduation ceremonies taking place, the University of Queensland campus was beautifully quiet for our family to take photos at a leisurely pace.

Campus is beautiful with sandstone and green back drops. For just one camera, a tripod and me running back and forth in heels to set up – I think the pictures turned out pretty good! What do you think?

Some of my favourites 🙂

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My pretty mom!

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Who knew this day would come?

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And always take the opportunities for pretty photos! That’s my rule 😉

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Everyone was ready for lunch by the time we were done taking photos – off to Wagaya for Japanese food!

We had a made a reservation and had our private room, which was nice!

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Sake for everyone, right mom? 😛

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Very happy everyone loved their food! It’s one of our favourite places and we were really happy to share with our families

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After lunch, we came back to our place… more about that in the next post!

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MBBS Graduation – we’re doctors!

December 20, 2014

After a long journey, MIchael and I officially became doctors – yay!

Our graduation ceremony took place at the University of Queensland campus and attended by Michael’s parents, my mom, Ong Ba Ba, and Di Loan.

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Micheal receiving his “diploma” and being congratulated by the Chancellor. You actually receive an empty cylinder on stage and receive a packet of documents, including your diploma/testamur once you leave stage 🙂

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My turn 🙂 I didn’t faceplant on stage, success!

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As with every university graduation ceremony I’ve attended, the graduates are asked to turn around, face the audience, and give our family and friends a standing ovation. To thank them for their never ending love and support, for helping us achieve our dreams, and celebrating with us. This is a moment of happiness for many students, but a bittersweet moment for me. Happy to have succeeded but with tears stinging my eyes, remembering my father who’s no longer on this earth to see his daughter graduate. I know he would’ve been extremely happy and proud 🙂

My Ong Ba was quite exhausted after the long ceremony

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With a class of over 400 people, you can imagine how crowded the campus was!

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Family photo!

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My biggest support

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My other half, my meant to be!

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We decided not to hang around for long as it was quite crowded and hot, plus everyone was tired, but we were able to grab a few photos with our friends on the way out!

With the lovely Sarah 🙂

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Josiah and his family are amazing people – so warm and gracious – will never forget their hospitality!

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Will be working with Chuan in Rockhampton in 2015! Woo hoo for getting jobs!

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Can’t forget these 2, Fiona & Smiley, PBL 25 represent from Day 1. Missing Christine (elsewhere), James (on his honeymoon) and Kristen (with her baby girl)!

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And of course, Tom!

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While getting our diplomas framed, we ran into Lauren!

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Woo, we did it!

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Part of the reason why we were eager to leave was because we had already made plans. My Ong Ba Ut couldn’t attend our graduation (not enough tickets) so we had decided to come back the following day (Sunday) to take some family photos together. We would dress up again and come back to campus to take photos at our own leisure. It would work out perfectly because our graduation was the last ceremony of the year so campus would be completely empty.

So with that plan in mind, we went back to my family’s apartment to celebrate!

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Lots of toasts!

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Lots of “1-2-3-Voooooo!” (1-2-3 cheers!)

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Michael and I had wanted to take our families out to dinner to thank them. But everyone was tired and we decided to get McDonald’s takeaway instead. With wine. Ended the day super classy!

Thank you again to all my family and friends for your love and support! Couldn’t have made it to today without all of you!

Final exams of medical school – 4th year OSCEs

November 22-23, 2014

As you may recall from my last post, we had our Surgical Specialties (orthopaedics and ophthalmology) exam on Nov 13. Following that, we had a week to prepare for our final exams of medical school – the dreaded OSCEs!

These are a set of clinical exams that test all the skills we’ve learned and honed throughout medical school. A variety of skills may be tested, including history taking and examination, clinical reasoning, basic/advanced life saving, investigation interpretation and response, procedural skills (venepuncture, blood gases, etc) and more.

We were told ahead of time that we would be rotation through 8 stations, each with 2 minutes perusal (to read your stem and collect your thoughts). 6 of the stations were 8 minutes long and the other 2 stations were broken down to 2×4 minute stations with related tasks.

Needless to say, we were stressed. We were incredibly stressed! The entirety of our medical school could be tested in 1.5 hours. Not only was there so much to know, but 2 of the most important rotations (paediatrics and obstetrics & gynaecology) we had completed first in the year, which seemed like so long ago.

My OSCEs took place on the morning of Saturday, November 22nd. The group of us sat in nervous anticipation waiting to start, trying to pass the time by chatting with our colleagues or doing some last minute reading.

I was allocated to the green team with 7 other students and we were soon escorted to our first stations. Facing away from the wall, the buzzers soon went off, signaling the start of our OSCEs. Everyone turned to the walls to read the stem (taped to the wall) of our first station.

Once the OSCEs started, they passed by in a whirl. Time flew and you were in and out of each station in what felt to be a blink of an eye. There was no time to rehash or even think about how you did in the last station because you were too busy giving it your all in the next. In less than 1.5 hours, it was over. The wonderful ladies coordinating the exam for my green team gave us big smiles and congratulated us before ushering us out to join up with the rest of the group.

The room was a buzz with students discussing the stations and their performance. Lots of happy smiles to have one last hurdle behind our backs, however, not without some caution that our performance in one or more stations may have been lacking. The director of the MBBS program shook our hands on the way out and asked everyone how the OSCEs went for them, a nice comforting gesture!

And since I might forget what my stations were in a few months time, I am going to record them here.

In no particular order unless specified.

1) This was my first station, which was a 2×4 minutes. Was given an ECG to report, which was SVT. Then also given some bloods to interpret (hypochromic microcytic anemia, likely due to iron deficiency). After interpreting the bloods, we were given pathology forms to request the blood tests we thought appropriate. This was almost a ‘gimme’ station as it was very similar to previous years, however, I was so nervous it definitely took away from my performance!

2) My second station was an 8 minute one. A few weeks prior to our OSCEs, we were asked to submit a clinical & procedural skills log – a report of the things we accomplished and to what level. At this station, the examiner looked through my log and asked me questions seemingly to verify our stated level of competency. I was asked a number of questions, including, “Talk me through how to do an IV cannulation. What complications could arise? How do you do an ECG? What gets printed out on the tracing? What are leads V1-V6 called? If you walked into a room and someone was unconscious, what would you do? And how do you do chest compressions? How do you perform ophthalmoscopy?” Nothing the examiner asked was out of my comfort zone and I just continued to answer his questions until the bell rang.

3) A young male fainted while gardening. Tasks are to take a history, examine and manage. Was greeted by the examiner as I came into the room playing the role of a nurse, with an unwell patient on the bed. Turned out he was in anaphylactic shock and required acute resus and further management once he was stable.

4) An expected death in a patient with advanced bowel cancer. Had to do a death certification, talk to the spouse and write up the paperwork.

5) Preadmission talk to a patient for an anaesthestic assessment. The main finding in his history is a mechanical valve on warfarin therapy. Would need heparin bridging and antibiotics.

6) Giving a distraught lady the results of her hysteroscopy D&C, which was thankfully not cancerous but endometrial hyperplasia. Talk to her about the risks of endometrial cancer and treatment options for endometrial hyperplasia.

7) Taking a history and presenting a mental state exam of a patient experiencing acute psychosis, likely schizophrenia.

8) My last station, another 2×4 minutes. First task was to interpret a chest x-ray which demonstrated lobar pneumonia and then to write up the medication chart.

Overall, the OSCEs went well. At every station, I can still to this day, think about things I forgot to say, things I should’ve done and things I could’ve done better. I just hoped that the examiners felt I performed well enough to pass overall!

Last 4 weeks of medical school – Orthopaedic Surgery

October 20 – November 13, 2014

Ending medical school with a specialty I had been dreading… Orthopaedic surgery. Crazy hours, macho surgeons, and an intense knowledge of anatomy required were only some of the things I had been warned about.

Needless to say, I found none of the above true and in fact, extremely enjoyed my ortho term. There were 5 other students in my group and we were based at a smaller hospital especially known for elective hip and knee replacements. We were split into smaller groups of 1-2 students and assigned to an ortho surgery team. There were 3 doctors on my team, a consultant, a senior registrar and an intern – and I was very appreciative of each person, in particular, our consultant.

He started every face to face encounter throughout the day (even after coming back from lunch) with a smile on his face and the words, “So, did you do any reading? What did you learn? Why don’t you tell me all about it?” In response to our answers, he would ask us questions and provide us with more teaching. He was always kind and non judgmental, even if you didn’t know the easiest answers. His continuous interest and support in our learning was the push students (like myself) sometimes needed to really become interested in what we learning. Although the registrar had a different style of teaching, he was the same. There was never any time we spent with our team, whether that be in clinic, in theatre, or even on coffee break, that we didn’t gain more knowledge.

Even though I am not interested in pursuing surgery, for the first time in a long time, I felt useful and wanted in theatre. The team would encourage us to come to theatre and rather than leave us to watch silently and awkwardly in a corner (the bane of medical students’ existence sometimes), we were always asked to scrub in and assist. Even if we weren’t assisting, the team would continuously ask questions and teach during the surgeries, which was great.

I really thought Orthopaedic surgery would be my least favourite rotation, especially with less interest in surgery and my subpar anatomy – but I have to say, these last 4 weeks of medical school have only bettered the two. I’m looking forward to my surgical terms next year when I’m finally working and I have to say my anatomy is heaps better now!

My last rotation ended with 2 MCQ exams on Nov 13 (a day earlier due to the G20 public holiday) – one 50 question ophthalmology exam and another 50 question Orthopaedic exam. Despite walking out of the exam with the trembling thought of, “Oh my god, that was so much harder than I anticipated,” I’m happy to say that our results have seen been released and I got an excellent mark – so stoked!

We didn’t have time to lament awaiting our surg exam results though, as we had OSCEs to study for, which I will talk about in my next post 🙂

2 weeks on Opthalmology

October 6 – 17, 2014

My two weeks on ENT was immediately followed by two weeks on Ophthalmology. Without very little prior exposure to this specialty, you could say I was certainly a little stressed! However, my concerns were proven to be completely unwarranted. We were rostered to work in a variety of environments, each welcoming with its own learning objective.

The majority of my time was spent in the Eye Casualty Clinic seeing patients with acute illnesses like infections, foreign bodies in the eye, pain, etc. We also reviewed quite a number of follow up patients. Being in Eye Casualty allowed us to learn and hone some critical skills including how to take and document an opthalmology specific history, how to measure intraocular pressures, more practice using a slit lamp (with lenses) for indirect ophthalmoscopy and using a fundoscope for direct ophthalmoscopy. In addition, we also had the chance to see more specialised tests using machines such as optical coherence tomography and wide-field retinal imaging using Optos. Many thanks to the doctor in Eye Casualty for giving us much of your time teaching us!

We also had the opportunity to spend time in theatre, where I had the chance to see procedures such as an orbital decompression for Graves disease, ocular biopsy suspicious for cancer, and of course, cataract surgery. Although it may seem mundane after watching it more than 5 times, intravitreal injections are an important component for treatment of diseases that affect the retina, such as macular degeneration and diabetic retinopathy. As someone who is interested in General Practice, I especially appreciated learning how to identify and refer ocular emergencies.

And to end my brief blurb about my time on ophthalmology, here’s a photo of my (currently) healthy looking retina!

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2 weeks on ENT

Sept 22 – Oct 3, 2014

My two weeks with the Ears, Nose & Throat (ENT) team flew by very quickly. As part of my Surgical Specialties rotation, I chose to do my 2 weeks surgical elective in ENT for more exposure to a field that comprises a significant proportion of GP consults – particularly because I am interested in General Practice.

It wasn’t, however, exactly the experience I had anticipated. Fully expecting to see a lot of ‘bread and butter’ stuff (ear infections, sinus infections, etc), I had forgotten that as a tertiary hospital, we also saw all the rare and serious presentations. During the two weeks, I was lucky to have had the opportunity to meet and learn from many patients. From being on ward rounds, participating in clinics and attending theatre, I saw simple conditions from sinusitis, Meniere’s disease and ear infections to inverted papillomas, cholesteatomas, and serious cancers of different types and stages.

I worked alongside a great team who were keen to have students and willing to teach – so I learned a lot, and quickly! In addition, our team made it clear that they remembered what it was like to be a student. They were happy for us come and go as we please, to use our time as we saw fit. Thanks ENT team!

My Cardiology Elective experience in Halifax, NS

August 18 to September 12, 2014

After my Geriatric Medicine experience in Nanaimo, BC, I continued my medical elective adventure with 4 weeks of Cardiology in Halifax, Nova Scotia.

I will be forever grateful to Matt (Mike’s best friend) and his wife Laura for allowing me to stay with them and their daughter Isabelle during my 4 weeks in Halifax – thank you so much again guys!

I chose to do Cardiology because I wanted to become more confident as it has never been my forte and is so important within any medical specialty. I was lucky to be allocated to the Inpatient Cardiology Consult Service for my elective, which is a team who oversees all cardiology referrals for inpatients at the QEII and a number of other sites including Victoria General, Rehab, Veteran’s Memorial, and Abbie J Lane. It was a great opportunity to see lots of patient presentations, visit different hospital sites, and interact with numerous staff.

The consult service team consisted of a staff member (cardiology consultant) who rotated every 2 weeks and a resident (registrar). As you can imagine, it’s a pretty small team to take care of all inpatient cardiology referrals across numerous sites. There were some rare slow days, but most were extremely busy with continuous consults and follow ups.

I thoroughly enjoyed my experience on consult service! My responsibilities included: seeing new consults (full history and exam) and presenting them to the team including an impression and appropriate plans, communicating with treating teams and multidisciplinary team members, administrative work (writing notes, filling forms and orders), following up with investigations and plans, etc.

I had the opportunity to work alongside the same resident (4th yr anaesthesia) during the entirety of my 4 weeks, which was great. He was smart, friendly, and always willing to teach and provide guidance. I don’t think I would’ve enjoyed the experience nearly as much if not for him. I also had the chance to meet and work with 3 wonderful cardiology consultants – each with their own style and method of teaching and all of whom provided really positive feedback on my performance. They also offered to help me out in any way I needed (including being a reference), without me asking, thank you so much! 🙂 I worked as hard as I could, which was appreciated and validated, yay! Not to mention all the wonderful patients and other staff members I met and learned from throughout the 4 weeks. Heart failure, arrhythmias, myocardial infarctions, endocarditis, pericardial effusion/tamponade, etc.

Thank you to all the people I met and worked with, who were so patient with me and taught me so much! I hope to have the opportunity to see and work alongside you again. 🙂