Day 1 Eurowinter 2008

In Nuremberg’s station cyber cafe waiting for bus to prague… didnt get enough sleep but I ate well I met a French girl who couldn’t speak english really well so we had conversation in mixed english, german and a bit of french, and I found out she has a thing for Heroes and Prison Break… she was a good company when Yani left me

7 hour journey by van, 3 trains, 2 flights and one coming bus to prague…. it’s gonna be soooo tiring! ergh!~

Yani went somewhere with her boyfriend. From early morning in airport till arrival in Nuremberg, she was a good company (for gossips especially)…. okay, gotta go toilet, pray and catch the bus to prague…

Eurotravel Winter 2008 and hatred for Moscow

Today me is so excitatory; I’m traveling Europe for 2 damn weeks starting 31st Jan 2008, taking break from boring Nizhniy to do some boring stuffs in Europe. And I will be missing 2 practical classes of Internal Medicine with the angry stern teacher who looks a lot like Sidney Herron of Grey’s Anatomy, except that her name is something like Maria Lvovna and she’s blonde.

My plan: Moscow – Nuremberg – Prague (Hradec Kralove included) – Zurich (Basel included)-Nuremberg (Rosenheim, Munich, Füssen, Salzburg are included in Hatimi’s plan) – Moscow.

So, from Nizhniy-Moscow I will be taking chartered Marshroot (van) service from hostel compound to airport. It’s not cheap because they kinda charge 1200 rubles (RM 160) per head compared to train which is like three times cheaper. But, it’s safer (hope so) and more reliable. I never liked traveling by train for security reasons… and many of you know how much I despise Moscow, so I have to minimize my time traveling within Moscow to reach from one place to another.

And from Moscow-Nizhniy on my way back to this damn med school I will be taking S7 airlines from Domodedovo airport to Nizhniy airport. Just right after AirBerlin flight lands in Domodedovo, I will catch a connecting flight S7 Airlines to Nizhniy, a connecting flight which is not available had I choose Aeroflot which services its flights in sucky Sheremetyevo. Yep, when I am happy from my 2 weeks holiday, I want to be in my room as soon as possible. Minimize my time being in Moscow, and minimize encounters with potential Moscow criminals (and police). And FYI: MOSCOW SUUUUCCCCCCKKS!!! Wahahaha… Let’s review why I despise Moscow so much:

1st year: a day before my trip to Munich, I got robbed in one of Moscow’s metro station (credit card, camera, passport), ending up in cancellation of my whole trip. At that time there were 4 of us. Yep, that’s right, FOUR. I was robbed and 2 of my friends had to give 3000 rubles to the cops for no good reason.

2nd year: Holiday in Europe was perfect. But on the way back to Nizhniy, we had to take stupid train. There were 6 (SIX) of us. Hilmi’s MP3 was taken away by hooligans in the trains, and he almost end up in another town had not we shout his name to get off the train on arrival. And then stupid police interrogated us. Urgh! Why did I ever choose Aeroflot???

3rd year: Thank God no problem. But I feared every nanosecond in Moscow train station and in the stupid train tho… it effects my psychological and emotional stability.

One day in Moscow ruining my 2 weeks holiday in Europe is definitely not what I want. So, AirBerlin it is this year (but expensive!!)

I have to start packing stuffs becoz my van is at 9 pm tonight… and finish my infectious disease study TODAY!!! Wait a minute… Why infectious disease??? hihihihihihi… As I said, today me is so excitatory, I might do so many inappropriate stuffs… including studying for infectious disease

Working as doctors in Singapore

Singapore, despite being a very crowded country, is the best place to do business in the world. Being the gold mine for business, how about the doctors there? Yes, they also face the doctor-shortage crisis…

But for junior physicians to work in Singapore, here are the lists of recognised medical schools by Singapore Medical Council (SMC). Apparently, Russian medical schools are not recognized, so no chance for Russian medical graduates to work there. And the only medical colleges in Malaysia which are recognized by SMC are Faculties of Medicines of UM and UKM, in which any medical twinning programs provided by UM and UKM will not be recognized. WoW! Singapore is really maintaining its high standard, huh?

No worries, if you still want to work in Singapore but your med schools aren’t recognized, you can try working there as specialists. But, jeng jeng, the Specialist Accreditation Board of Singapore is even tougher. To register as specialists in Singapore, here is a list of medical qualifications eligible for specialist accreditation. Wahahaha! Now, how tough is it to work in Singapore?

I never thought of eyeing Singapore (too crowded and kiasu), but, WTH right? People can change… if I ever work there (haha I wish!) and I miss home, I can simply drive up north

Russian style diplomas

While I was browsing thru the net to find a meaning of red diploma (issue was brought up by Amani), which is like the yummiest academic award for Russian-trained undergraduates, I got this from Russian wikipedia:

Требования к обладателю диплома с отличием каждый вуз вправе устанавливать самостоятельно, однако: квалификационная работа должна быть защищена на «отлично», количество оценок «хорошо» не может превышать 25 % (в исключительных случаев допускается одна оценка «удовлетворительно»).

Translation: Each tertiary education establishment has the right to establish requirements for honours degree (red diploma), however, qualifying works should always be on the level of excellent grades (5), the quantity of good grades (4) cannot exceed 25 % (in unusual cases one satisfactory grade (3) is excusable).

For those who aren’t used to the Russian system of examination, the scale of gradings used are 1-5. Excellent grade is 5 (translated into A grade), 4 is good (B grade), 3 is satisfactory (C grade). Grade of 2 and below= fail.

I tried browsing the meaning of red diploma elsewhere, but unfortunately, in my opinion red diploma only has its meaning in Russia. That doesn’t mean anyone should stop from getting all fives in exams because red diploma has no meaning in our home countries, but if you manage to get a red diploma, good for you! Meaning you are up to Russian standard of education. As a very-fast-growing country, you really want to get that red diploma in Russian Federation! Seriously!~

And those who don’t have any chance to get the red diploma will get blue diploma (it’s me, it’s me!) and start working as mediocre doctors in Malaysia… or not! We’ll see…

But hey, look what I found when I googled up красный диплом:

Diplomas can be bought? Wow! Now everyone can easily obtain a diploma!

Easier for MOs in rural areas to further studies

When I was browsing Malaysian Medicine (in my link), I read an old news dated June 2006: 

Medical officers serving in rural areas would find it easier to go for post-graduate studies under incentives being considered by the government for officers posted to rural areas, the Dewan Rakyat was told Wednesday.
“We may give additional merit points for medical officers serving in rural areas who wish to further their studies,” said Deputy Minister of Health Datuk Dr Abdul Latiff Ahmad.
Replying to Raime Unggi (BN-Tenom), he said medical officers should discard the perception that it was difficult to live in the rural areas because the facilities there were being upgraded to match those in the urban areas.
Dr Abdul Latiff said the government was targeting a 1:600 ratio of medical officers to patients by 2015.

Fine. Good enough, it’s in the news. But how can we be sure these people keep their words when there are so many more promises they didn’t realize? If you are really an ambitious doctor, unless you’ve got a signed black and white that you’ll be posted rural only for a 2-3 years, don’t fall for the offer.

The officer in some health admin office who promised you that you’ll be posted rural for only 2 years prior to postgraduate studies should have signed black and white. Verbal promise is not usually well kept. The officer maybe promoted elsewhere when you try to reach him/her after you finished 2 years of rural posting and you’ll be staying rural forever…. or they’re just messing with your minds and end up saying after your 2 years: “Saya tak pernah cakap macam tu pun!”

Well, my opinion sounds like a very emotional negative one. I advise you to get a second opinion from MOs who are posted rural; ask them how long have they been there. Of course, some people find rural posting very rewarding and satisfying, and there’s absolutely nothing wrong with that.

On another news:

 Malaysian doctors take longer to become specialists than their counterparts in Britain and other western countries.
A local doctor said it would take at least eight years for a fresh medical graduate working in hospitals here to become a specialist and earn a U48 pay under the Public Services Department salary scheme.
“Doctors serving in Britain or elsewhere can qualify as specialists in two-third the time.”
He said that under local requirements, doctors have to wait at least three years after completing their one-year housemanship before they could take up the specialist course.
“They would take at least four years to complete the course. However, the doctor will have to wait for his qualification to be gazetted by the local medical authorities before he can enjoy the specialist pay.”

The news dated May 2006. Now I think it’s gonna be 9 years since housemanship has been extended to 2 years. Meaning almost 10 years before a medical graduate can enjoy specialist pay (9 years training + x months of gazettement). Hmm…

Teenage Russian Radiologist

Old story about a teenage girl from Saransk, Russia who can see internal structures of body thru her eyes. She claimed to have a “psychic X-ray” power and earns much more than a certified russian radiologist; which is $2600 a month, charging $13 per reading. A regular Russian physician only earns $150-400 a month (that’s why many students take advantage of a comparatively cheaper and less competitive medical education than in their home countries).

And as stated in the article: Natasha protested during the test that appendixes can grow back after an appendectomy. When told this isn’t possible, she insisted that they do grow back in Russia. LOL! ROFLMAO! =))

 Read more about the story here.

Shortening route to Medical Specialization

Here is an old news from NST:

More than 200 Malaysians who studied medicine and practised abroad had returned to serve since 2005. Some of these practitioners, who held government scholarships, have been working up to 20 years abroad. Overseas Umno Club chairman Datuk Shafie Apdal said the country was facing a shortage of medical specialists.

“It was through visits and dialogue sessions initiated by the club that we were able to convince some about the opportunities here, especially since the government has built many hospitals equipped with modern facilities. Some are reluctant to come home because of concerns about promotion prospects and work-culture differences. They also worry about political instability, local facilities and training here.”

Shafie, who is domestic trade and consumer affairs minister, said this after officiating the United Kingdom and Ireland Pre-Departure Briefing 2007 yesterday. The briefing was held for 170 students who will pursue various courses in the two countries and six students who will leave for Cairo next month.

Hmm… currently local universities are churning out 1200 medical graduates annually. Medical schools from UK, Ireland, Australia, NZ, Eastern Europe, Middle East, South Asia add thousands more. Meaning there are more than enough housemen to do little works @ scutwork.

If we are really short of medical specialists, why not shorten medical specialization? Use the UK system for example; 8 years from graduation to consultancy. In the US, it takes only 5-7 years from graduation to be a consultant plastic surgeon. In Malaysia, 10+ years, or maybe longer.

With the shortening period, senior physicians can dedicate to train and teach junior physicians, and junior physicians will be trained much better and faster. This is a win-win-win-win-win situation for everyone involved in the healthcare system.

Gaining only 200 brains since 2005 does not impress me. There is this one Malaysian-born US-trained internal medicine specialist who was willing to return to Malaysia for his medical practice only to find himself working as a medical officer (MO) and posted in anesthesia department (not his specialty). He refused, and now he’s working in Canada and get paid 10 times higher than what home is paying him.

See, the issue here is not the money. The specialist already knew what crappy salary will he receive when he returns home, still he is willing to serve. The issue here is misuse of talent; to demote him to MO and post him at a department which is not his specialty. Clearly that is the biggest mistake.

Earlier, Shafie advised the students to focus on their studies and ignore the postings about the country in blogs.
“Those who want to excel in their studies should be reading books and not blogs.”

Wahaha you people shouldn’t be reading my blog!~ WTF??? Why are these people feel so damned threatened? Instead of stopping bloggers from blogging, why not they do the blogging to stand up for themselves and their own kinds’ sakes? Or are they too dumb to blog…?

What is the diagnosis… (1)?

This is a funny clinical encounter when I did my elective in IJN in Adult Cardiology department.

 Female, 56, complained of tight chest pain, pain in the eye, inability to talk. She has been consulting many specialists of different medical fields (gynecologist, gastroenterologist, neurologist etc). Her previous visit to a physician was chaotic since she demanded answer to what was really wrong with her and ended by her refusing to pay for the consultation fees. Clinical investigations showed no risk factor of any cardiac disease (normal cholesterol level, BP 120/70, no DM, not smoking, not alcoholic). Previous tests were normal (ECG, Echo, CXR, blood tests, OGDS, Stress Test). Other tests also showed no abnormalities in her. The previous physician concluded that she has anxiety disorder and begged the current physican in IJN to refer the lady to psychiatry. When the physician in IJN told her that nothing was physically wrong with her, she kept complaining again and again about her problems.

What is your diagnosis? I think the lady had Somatization Disorder since she complained of multiple organ systems problems with no identifiable underlying physical findings.

Hehe. Talking about IJN, I wanna bring an old news about Dr. Mahathir having a heart operation called Coronary Artery Bypass Graft (CABG @ Cabbage @ Bypass) in IJN. FYI, CABG is the largest number of adult cardiac surgeries (70-80%) and the success rate in IJN is 97%. All the consultant surgeons in IJN have mastered the surgery pretty excellent already, and guess what?

Dr. M flew out a chief cardiac surgeon of one of the best hospitals in US, the Mayo Clinic, Rochester to assist in CABG operation along with the already excellent and best cardiac surgeons in Malaysia to conduct a relatively not-so-complicated operation on him. Being a harsh critic of the US, it’s very ironic that Dr. M trusts Americans with his heart on a personal level.

This reminds me of a very rude post-op VVIP patient who demanded that no medical student (me) should be in his room, only chief of cardiac surgery department operate on him, and demanded too much from the nurses… prepare the milk like I instruct you to, clean me like I instruct you to, do this la, do that la… He is a political secretary of a current Malaysian minister.

 Hmm… guess when those people on higher ground fall, they really feel the pinch, huh? Now, now, instead of importing surgeons or demanding super VVIP services, why not just improve the currently suck healthcare system? Better government hospitals, better pays, better equipments and amenities, better working hours, better training and education for doctors and nurses… With this, even the unluckiest can benefit something out of it.

Why medical dramas are fake

 

1. A neurosurgeon looking like McDreamy
2. A presenting complaint of skin rash elicites a differential diagnosis that includes acute pulmonary embolism (the scriptwriter for House MD really should consult a real doctor)
3. All the doctors and nurses are hot
4. The same doctor admits the patient, wheels them to MRI and operates the damn machine AND reads the images, hangs the IV fluids, assists with surgery, and if the patient dies, performs the autopsy.
5. The docs are humping like jackrabbits on Viagra Extra Strength
6. The surgeons scrub in BEFORE they put their masks on. Dooh.
7. The chest never rises during CPR (or maybe the docs weren’t ventilating adequately)
8. Dr. House able to make a diagnosis of pheochromocytoma on the basis of a patient’s extreme rage and superhuman strength
9. Residents still look pretty and have make-up on post-call
10. The hospital cafeteria food actually looks good
11. Interns have a social life
12. Doctors put their stethoscopes on backwards (earpieces pointed backwards instead of forward)

Med School Nerd scale

The following scale has been developed in close cooperation
with the UVA psychiatry services (Well at least I was thinking
of some of their characteristics and used some of their class
time to compose it). It is designed to test if you have spent
too much time in medical school and whether you are having
adverse side effects due to prolonged exposure.
Score one point for each statement that applies to you.

1 You have ever said "Netter is good".
2 You can discuss autopsy/ anatomy over a meal
3 You own a 4 color pen
4 -it just isn't enough colors for you
5 You use more than one color to take notes
6 You have use up more than 6 highlighters in the past 6 months
7 you have ever highlighted something YOU wrote
8 you retype handouts given in class
9 you haven't had a date in 3 months
10 you haven't had a date since entering med school
11 you have not been able to remember the normal term for
something because you were thinking of the medical term (ie
reflux for heartburn)
12 You get more sleep in lecture than at home
13 You know the correct spelling for pruritus
14 - you also know what it means
15 You have ever asked a question in class
16 - The prof. didn't understand the question
17 - you didn't believe the answer the prof. gave
18 - you went to look it up to see if they were right
19 You can't hold a conversation on anything other than med
school
20 You skip class to study
21 You've said you didn't do well on a test on which you beat the mean
22 You spend more than 15 hrs a week on e-mail
23 You have a callous on you finger from writing
24 More than one professor knows you by name
25 When you ask a question, a new professor has said "Oh, I've
heard of you"
26 You can name more amino acids than past prime ministers
27 You use more than 5 acronyms an hour when talking
28 you actually know what PERRLA stands for
29 You know all the steps of the TCA cycle
30 You do not read PTA as parent teachers association
31 You can remember the muscles in the forearm
32 You know the strucures in the urea cycle
33 You know the dermatome distribution
34 You can't remember what you had for breakfast
35 You can't spell world, much less backwards
36 You've ever been sexually aroused by the breast shadow on an
X ray
37 You equate "morning stiffness" with Rhematoid Artheritis
38 You actually know normal values for plasma Na
39 -K
40 Missing class causes you extreme stress
41 You have seriously asked someone "So how does that make you
feel?"
42 You have asked will this be on the exam
43 -Just after the prof. said it wouldn't
44 You identify with Deb on E.R.
45 You have made a medical joke
46 -no one laughed
47 -You figure they just weren't that far in their studying
48 You wear your stethescope around your neck on the bus
49 - you don't even know which way the thing goes in your ears
50 "SOB" means short of breath to you
51 You have gone to student health with suspicion of a disease
you have studied
52 -within 3 days of the lecture
53 You have answered a question in class
54 -asked by the professor
55 -it was a rhetorical question
56 You can quote lines from the movie "Malice"
57 -you believe them
58 You can flip your pen over your thumb
59 - with both hands
60 - you do so throughout class
61 You have corrected a professor in class
62 -the rest of the class didn't understand the lecture to
begin with
63 You know how to claculate specificity
64 -positive predictive value
65 - anion gap
66 -you can't balance your checkbook
67 You don't know what the weather was like for the past week
68 You don't know what the weather is like right now
69 You actually talk in open ended questions
70 DIC isn't a slang term for the penis in your book
71 You think B- is a bad grade
72 you have stressed about a pass/fail class
73 You study during most of your meals
74 You saw nothing abnormal about the Obsessive-Compulsive
Disorder
75 You draw all of the slides not already provided in the
handouts
76 -including the cartoons (humourous type)
77 Anatomy makes you hungry
78 You would even consider saying "Ease back on my finger at
your own pace"
79 You know the size of a RBC
80 - you don't know the size of a football field 81 Your eyesight has worsened by 10 pts or more in the last year
82 You have the library hours memorized
83 Hou have your own seat in the library
84 You score more than 95 on the Epidemiology final
85 You own more than one white coat
86 You have debated between giving up sleep or eating in order
to find more time to study
87 You started studying for boards more than 2 months in
advance
88 You have never received a personal invitation to discuss
your grades with the dean
89 A tie is the only addition necessary to what you normally
wear when you go to see patients
90 You wear scrubs to tests
91 You have made plans to study on a beach during vacation
92 - you actually did
93 You have a designated seat in lecture
94 - You have ever asked someone to move from "your seat"
95 You sleep less than 4 hrs a night
96 -you think that is plenty
97 -you have thought about cutting back
98 You study more than 35 hrs outsid of class
99 -you think you are a slackard
100 You think everyone answers yes to most of these questions

My score is <22> yey! I am far from being nerd nyeh nyeh!

Ever Wonder what Anesthetists really do?

Lyric

Everybody wonders what anaesthetists do
While the patient is asleep
Everybody wonders what we do for three hours
While the machine goes beep
Everybody reckons we drink coffee and we gossip and we’re generally subversive
Everybody reckons we do crosswords and Sudoku and we chat up all the nurses

But do you really think that’s all we do
Well let me tell you now isn’t true…

‘Cause we sometimes check the screen
And every now and then we write stuff
And if we have to intervene
We inject a bit of white stuff [propofol]
And we offer to alter the lights
Or the height of the bed
Or fiddle with the radio, change the CD
We even check the patient occasionally…
And if they move, we turn up the vapor,
And then we go back to reading the paper

‘Cause when the patient’s asleep
We just sit and listen to the beep
We just sit and listen to the…

Once upon a time I took pride in my job
But now I think it’s time to depart
‘Cause I just sit here everyday
And listen to bleeps of the heart

Training Timeline for Malaysian doctors

Here is Pekeliling (a PDF file in Bahasa Malaysia) dated 2002 in planning of education for medical graduates in Malaysia. There is a timeline on which departments that a houseman has to be trained in, plus the postings.

Well, talking about postings, those who start housemanship in Hospital Kuala Lumpur (HKL) or other university hospitals (UM, UKM, USM etc) are luckier than those who start housemanship elsewhere. For those who started elsewhere; by the 2nd year of graduate medical training, the posting will be so rural and it’ll be much harder for you to settle in, get married, have sex with husband/wife, have kids and not to mention an ambitious doctor’s worst nightmare; not being able to specialize!!

I’m not saying those in HKL and University Hospitals won’t get rural postings, but those who started housemanship there, fight to death to stay as the Senior Medical Officer at the exact same hospital. At least you can settle down (if not get married) and you’re ahead of your peers (who got rural posting) by 2-3 years for Masters Specialization program. Seriously, once stuck rural, you have to stay rural forever until someone offers you for Masters program (that’s only what I heard – needs checking for information accuracy)

That’s only how I interpreted the Pekeliling. I might be wrong. By the way, that thing was in 2002. Housemanship has been extended to 2 years by our beloved scandalous ex-minister of health, remember? Apparently, health admins think that young doctors nowadays are very incompetent, thus extend housemanship. But they never wanted to admit that they’re short of specialists and the route for medical specialization is so damn long! HOMOs (House Officers, Medical Officers) doing scutwork? Yeah, so much fun!

Blame the housemen or blame the system?

Life as a government doctor in Malaysia (part 2)

Its quite clear how hectic and busy a Malaysian Govt Doctor’s life is. May I add that in some M’sian govt Hospitals, doctors work 40Hrs in a stretch because those on call do not get their day off on the next. They are to continue till 5pm which eventually ends around 7pm. And these tired, worn out doctors are basically zombies after a very busy and hectic night. Mind u, doctors don’t work sitting on their a$$. Our night involves running like lemmings here and there to pursue cases, results, set lines, attend to dying patients, face an angry relative or merely to sign an MC at 4o’clock in the morning.

We sometimes run to obtain vital blood results, climb on beds to conduct CPR, sweat in thick gowns in 7 hour night long surgeries, prick our fingers while taking blood, get scolded by patients for not “smiling”, write case summaries, beg with the blood bank MOs to get blood bags, and the list goes on….. There are times that the body works on its own without the direct control of the mind. And falling asleep during procedures or interviewing is almost a normal thing. And knowing that when u go home to enjoy your 12hr rest, the 36 hr on call will begin again when u wake up (Every Other Day – EOD).

Govt doctors in Malaysia work 36 hours non stop!! That’s the main message to get acrross. There’s no glamour here, there’s no respect, there’s no glory. When u save a life, its just a pat on the back, and when u fail, it’s your mistakes and faults. We go home after on call only wishing to sleep and prepare for the body for the next one. Imagine doing this for one year or more!! Saturday Sunday included!! No life definitely!! And for what? A mere RM 2733 per month and RM 150 per call. Most of us don’t have the luxury to spend that money.

Keep in mind, govt Hospitals wish to seek ISO approvals. It makes u wonder, are they more concerned about facilities available or the service provided? If a tired doctor comes and sees u at 5am in the moring, ask them this very wonderful question, “Tak balik ke?”

[credits to docfiles and standup]

Life as a government doctor in Malaysia (part 1)

Criterias for becoming a Malaysian Govt Doctor. Theres no need for an aptitude test. Students should consider these requirements:

1. No life outside medicine; this includes dating, sports, clubbing, chores for your parents and visiting the toilet
2. Not to live with your parents. Move out ASAP as they will never understand the ludicrous working hours that u go through. Furthermore, chores are not suitable for u as to rule No. 1.
3. Not to be married until completion of all 4 years of Govt Compulsory service as u will be transferred left and right to some of the most remote Govt clinics in Malaysia. Having wife and kids to follow you to your new working area may increase high level of stress on all parties. Furthermore, if your spouse is a Govt Doctor, he/she will also be transferred away from u and no matter what appeal is made, KKM will put up a deaf ear (unless u have big cables)
4. If married, no to have children until u finish all 4 years of Govt Compulsory service, as to which u and your spouse will not have much time for your child/children or they end up not recognizing u and refer the Indonesian maid as their mother (change in language patterns commonly follow).
5. To obtain life insurance once your govt service begins as there is not many claims for accidents during work. Don’t be fooled, Doctoring in Malaysia is hazardous.
6. Able to withstand 36 hours of non stop work and stress without mistakenly labeling Left for Right or uvula for vulva (or Volvo S40)
7. To buy a car with complete safety features which includes multiple airbags, ABS, EBD, side-front-rear-top-parallel and diagonal impact bars and seat belts to ensure survivability if u are involved in an accident because your driving resembled a drunkard maniac after working in the hospital for 40 hrs non stop.
8. Constant supply of coffee
9. Nicotine Patch as u will have the urge to start smoking due to overwhelming stress
10. Interest in watching medical sitcoms such as House MD, Scrubs, ER, Grays Anatomy and Chicago Hope to inspire u to continue your life as a doctor as the exciting things u see on TV does not resemble the real life of a Malaysian govt doctor.
11. Not to have any pets or plants (not even cactuses) as u will have no time to feed or care for them and eventually all will end up in your mortuary.
12. Able to endure the stench of your own sweat as to when 36 hours “on call” does not permit u time to bathe or freshen up.
13. Able to carry on working without food or water over 15 hours. If during fasting month, able to break your fast with “water for injection” as u had no time to buy food.
14. Able to come to work with fever/cough/illness or physical disability (sprained ankle etc) as to which doctors do not deserve MCs. (My MO was on crutches during rounds)
15. Able to stand scolding, destructive criticism, kiss ass behaviors, racial bias, finger pointing, scape goating, and in competency from your superiors.
16. Able to withstand the jealousy when your friends call u up for some fun and ur stuck in the hospital during on call.

The list goes on. These requirements should be sent out to all doctor wannabes and for them to determine if their life coincides with the Malaysian Medical Health service of doctors under KKM.

[Credits to docfiles and standup]