Snippets: Last Day in Orthopedic Department

Today is my last day as a 4th poster in Orthopedic department. Ortho in my hospital is known as the most chillaxing (chilled and relaxing) department for housemanship. No official tagging period, not so much workload, reviews are not complicated, rounds are fast and decisive, patients do not easily collapse, orthopedic emergencies are far less than medical or surgical emergencies, MOs are helpful, specialists are not as malignant as one could imagine, plus with the start of shift system and lessening of working hours – really made this a honeymoon posting. Everything’s heaven, but I just have no interest in bones and smelly feet.

I did however sort out many personal things in my abundance of free time to make up the loss of time for the previous one year (three postings) of my housemanship. I even went for my honeymoon.

Orthopedic is so full of characters and stuffs:-

1. Work, work, work – When I came to ortho there were 60+ houseman. Most of them became jobless by 11am. After one month, the number of houseman became halved. The numbers did not become better till my last day. I worked every weekend since then. While the workload increased, I still could have breakfast and lunch, I still could chitchat and gossip with my fellow houseman and nurses, I still could attend teachings and CMEs, and I managed to go home on time. In shift system, all houseman must work morning shift from 7am till 4pm, the latest I clocked out was 4.15pm.

2. Love, Hate and MIA – There are few houseman who make problems in any department, any hospital. These are the people nobody wanna work with. Sometimes they don’t show up to work, which already shows no team effort.  Sometimes they do work halfway, leaving everybody else to settle the rest, meaning patient care compromised. Sometimes they push the work to others, meaning they are just full of shit. There was one HO in my ward who always MIA (missing in action) was in relationship with a Staff Nurse in another ortho ward. At a night shift, he came to work drunk, he was miserably in trouble for punching his girlfriend the staff nurse. That night a whole team of gangsters came in to my ward, made a ruckus and kicked this houseman’s ass. He never showed up to work since then, like he didn’t show up to work before. I don’t mean to preach or be in a high horse, but please understand we don’t want to cover you anymore for missing shifts, it adds to our workload. You’re better off NOT being a doctor. Apparently MIA is a big issue among ortho houseman in my hospital.

3.  Seniors – MOs and Specialists have very different backgrounds and characters. Some of them are really teaching and helpful, some of them just don’t care, some of them are funnily malignant but incompetent at the same time, some of them don’t know what is the dose of aspirin, some of them cannot insert branula or take blood anymore, some of them really don’t know how to intubate or insert CVP line. Anyway, it’s true that once we specialize in one area, we  tend to forget the others…. Like this one consultant who forgot the rate of correction for sodium and potassium.

4. Office politics (Mentee pool vs General pool) – Since there are many houseman, our ortho department created the MENTEE SYSTEM. A mentee is a house officer tagged to a specialist or consultant. The specialists and consultants have their own team; namely spine team, sports injury team, joint replacement team, paediatric team, tumor team and hand team. A mentee is supposed to take care of their specialist’s patients. I was offered to be under paediatric ortho team but I declined, as I do not like kids and I want more exposure in general orthopedics. I have no problem with the mentee system to be honest. But some of them are really annoying they act like MOs already. The mentee pool come to see their boss’ patients and order for this and that. They don’t know that the general pool takes care of the ward clerking, morning reviews, performing exam on patients, we present cases during ward rounds, doing ward procedures, bloods and branulas, arranging radiology appointments, discharging patients, come for morning reviews on weekends. For me it’s ok because I take care of more than 10 patients a day so I can learn a lot. But I believe some mentees haven’t even perform a single examination on their boss’ patients. They usually read my notes and go off. I don’t mean to offend the mentees, but please understand that the general pool work MUCH MORE than you. So at least you can be nice to us 2-3 people taking care of the whole ward. Don’t act like a consultant (or CONSULTOID – as the specialists say it). Lucky the specialist in charge picked up this issue and addressed it. I feel a bit appreciated as a houseman in the general pool. Imagine a tumor specialist picked a second posting houseman among all the 4th, 5th and 6th posters to be her mentee, just because she used to teach him in med school. Did he perform an exam to the patient? NO. Did he get MRI for the tumor patients? NO. Did he know anything other than orthopedic tumor? That remains a big question. Nobody is allowed to subspecialize early in their career. But the specialist picked him up, because he think he is “good.” Ergh, what disgust!

5. Assessment – the most annoying part is that when you are ready to be assessed, the specialist postpones your scheduled assessment. I was really miserable for the past 2 weeks trying to sort out this assessment, but in the end I passed. I never believe in EOP (end of posting) leave. There are always some things not settled at the end of the posting.

So tomorrow is my new start 5th posting in Obstetric and Gynecology department. Have to tag from 7am till 10 pm everyday till New Year, I guess…

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