Graduation presents

December 21, 2014

After lunch at Wagaya, our families came back to our house to visit – a first time for my family from Perth!

In addition, our families took that opportunity to give us amazing, generous, graduation gifts – thank you so very much!

My mom gave us our gifts from my grandparents first – as they are the oldest and couldn’t attend in person – thank you Ong Ba Ngoai! We will put the money towards our future and wedding planning!

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I received a nice watch and card from Ong Ba Ba

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Thank you to Ong Ba Ut for their generous gifts – we will put it towards our relocation and setting up a new life in Rockhampton!

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A very special gift to Michael from his parents, a laminated card that his mom has kept safely for many years

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My mom is the best, as always!

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With the best card 😛

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She gave us each a Pilot retractable fountain pen

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Michael also got a beautiful dark purple DKNY tie from my mom, and I received 2 Pandora beads – thank you mom!

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Thank you to Di Loan for your lottery tickets! We were really hoping to win, but alas!

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Also a very special thank you to Ong Ba Hai (Ong Ba Ut’s best friends) and Nghiem for sending me cards and gifts!

Some family photos

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I also want to share the graduation gifts from Michael’s family! We received them on December 11, 2014, during our beach getaway at Noosa with his family 🙂

Aunt Patsy and Uncle Dan gave us a generous gift to treat ourselves out to a celebratory graduation dinner – thank you! It was really too bad that our graduation date was changed to a week later this year compared to previous years. Unfortunately, they couldn’t attend but I’m sure they had a great time on their cruise!

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Uncle Rick and Aunt Wendy gave us the cutest Christmas ornaments. They definitely went on our tree and will be on our tree every year!

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Uncle Jim and Aunt Brenda gave us the novel “Breathless” written by Dr Todd – a thoracic surgeon who performed many of Canada’s early lung transplant operations.

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Thank you so much to everyone for all your love, gifts, and kind words! Treasured forever!

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!

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!

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!

Back in Brisbane for the start of last rotation

We landed in Gold Coast at 8am on September 21st, Mike’s birthday!

Happy 35th birthday to Michael! We had a lot of fun celebrating in Canada and during our trip back in Hong Kong and Singapore so we didn’t have any special plans for once we were back in Brisbane.

No special plans didn’t mean we wouldn’t have appreciated not being held up at the airport for nearly 2 hours after landing though.

Let me tell you the story of how we almost ended up on Border Security. Actually, I’m lying, the show is never filmed out of Gold Coast Airport, but if we had been in Sydney or Melbourne, cameras might’ve been rolling. We got through immigration without any difficulties, picked up our luggage and headed to the customs declaration and exit line. While in line, a lady customs officer went up to Michael and asked him to see his incoming passenger card. He had nothing to declare (only me with homemade kimchi) and was given back the card with a simple thank you. I thought it was odd that she had solely singled him out of a big line and watched her go… straight to the customs officer at the front of the line and whisper something in his ear while pointing to Mike.

Great. Here comes trouble.

In the past, we have cleared customs through one of 3 lines:

  1. Straight out the door.
  2. Dog sniff. You lay all your bags on the ground and stand beside them while a cute beagle sniffs through all your stuff. If you’re clear, you’re free to go. This usually takes less then 10 minutes.
  3. Bag search and/or x-ray. We often end up in this line when we have things to declare and while slightly more tedious, still goes pretty quickly. The officer normally asks you to clarify what exactly it is you’ve declared, and if they deem necessary, they can ask you to open up your bags and show them the items or put your bags through a scanner. We have been in this line when we’ve declared bringing back wooden souvenirs from Vietnam and bringing back Frentel butter from Canada. Both times, we’ve simply opened our bags, showed them the items, which they were happy to let through and we were on our way.

This time, without any obvious reason or being told specifically why, both Michael and I were directed to a fourth line. One we didn’t know existed but immediately referred to it as the Border Security line. We were told to sit down on the benches and that an officer would be with us ‘shortly’. This area is completely blocked off from public view and actually depicts some scenes very similar to Border Security. Ie. An Asian man getting every nook of his baggage searched while he sits in a chair looking weary and worried. In another line, a ‘tough’ guy looks annoyed as his bags are being searched and he’s being questioned.

After letting us sit and stew for what seemed to be forever. The initial lady customs officer came over and said to Mike she wanted to talk about his “travel patterns.” Funny, because we both have the exact same travel pattern. We immediately figured it was because Mike was a guy and traveled too often and looked suspicious, especially when we frequented SE Asian countries. We explained to her that we were both medical students, have a 1 week break after every 2 month rotation and took the opportunity to travel cheap.

You could see her realise it… she was barking up the wrong tree. But that wasn’t enough and we had to sit there and answer more questions, including how we were even able to afford studying in Australia and travel at the same time. She was getting nothing and decided to let us go, after scanning our bags. One last jab from her as my bag was going through the scanner, “Are those cigarettes?” No, those are KitKat bars (and they look nothing like cigarettes, but nice try).

Anyway, we finally made our way out the airport. And miraculously, we were able to lug home 3 large pieces of luggage and 2 wheeled carry-ons back to Brisbane – via the bus, then the train. Pros or what?

Jet lag hit us pretty quickly but no time to diddle daddle as we had school the next day! The start of our last rotation – Surgical Specialties!

I was starting with 2 weeks of ENT, then 2 weeks of Opthalmology and finally finishing my medical degree with 4 weeks of orthopaedics. So close! Have to keep pushing to the end!

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. 🙂