1st posting in Surgery – I loved surgical procedures ever since medical school. I started off as a humble houseman in surgery department. The first time I introduced myself in ward rounds, I was laughed off by the MOs and Specialists. I went to work before sunrise and go home after sunset for the first few weeks. I was so depressed because I didn’t see daylight in a while. The surgical procedures were nowhere near cool as I’d hope it would be. Neither are the surgeons. The rounds were harsh. Getting blasted, belittled and constantly harassed is a norm. Although there are not so many work here, but if the surgeon asked you to stay late, say till 11pm, then you have no choice but to do as you’re told, even if you’re post-call! Else you will be threaten with another 3 months extension in this hell-ish department. As I went through this posting, my interest for surgery faded away. If you think the surgeons have a good life, and have more independence to operate once they become specialists, more time for themselves and family, much less workload compared to the houseman and MOs, you’re completely wrong. In A+E posting,I respect surgeons even less. They even take their own sweet time to assess an unstable patient with intra-abdominal injury. Due to some hierarchial bullshit, first the junior MO has to come and assess the patient and ordered some blood tests. Later on the registrar will come and order CT abdomen. Then only the real surgeon comes to assess. The whole process delays patient for 1.5 hours from the diagnosis of intraabdominal injury with hypovolemic shock to emergency laparotomy.
2nd posting in Pediatric – I like children, but I don’t like the sick ones. The rounds were very tedious and long (from 9am till 2pm, then pm rounds start at 3pm), taking history must be detailed, physical exam is quite difficult, management must be precise, even simple procedure like branula insertion will take a while. I always go home 2-3 hours later on paeds posting, just because there are lots of work to do (unlike surgery). I was very fortunate to be trained under a top consultant nephrologist. She does her grand ward rounds twice a week, and she is very particular when a houseman presents about a patient. She is very particular about some words that can and cannot be used. A houseman will be scolded for 30 minutes just because he/she said SOB instead of “rapid breathing”. But I am very grateful to have learned under her, because only in pediatric posting have I learnt how to present cases properly, make diagnosis based on clinical findings rather than depending on bloods or imaging. Neonates on the other hand are much cooler. The adrenaline rush of attending a baby born flat feels so good. The procedures are plenty. We are much less bothered about parents in neonatal department. But the other parts of general pediatrics – irritable children, irritating parents, very long rounds, very small veins in children, innocent sick children dying, are just not for me.
3rd posting in Medical – this is the department where patients come in and go out nonstop. Patient came in with many presentations. All unwanted patients, addicts, psychos, patients with social issues are dumped in medical department. That’s why there are over 20 medical wards in my hospital. And a ward which can cater for 60 patients, can be moved around and round to cater for 80! Medical Houseman in my hospital works everyday. Somehow in this very busy department, I still manage to go home on time!🙂 This is the only department I enjoy doing my on-call claims because they are a lot! The learning process in this department is quite fun. The bosses they are nice and they teach. But on calls are very busy with patients collapsing left and right. The adrenaline rush is still there, particularly when patients collapse. I become very interested in medical department towards the end of my posting.
4th posting in orthopedic – this department is very relaxed and laid back with not so much work (or thinking) to do. Whether there are many houseman or not so many, the ward works are usually finished before lunch time. Most houseman usually get engaged or married in orthopedic. The rounds are simple and fast. The specialists and MOs do the hard labor of operations, while the houseman taking care of the medical aspects of the patients in the ward. There are plenty of procedures for houseman as well. Although it’s the least stressful department, I am still not interested.
5th posting in O&G – obstetric is very straightforward but gynecology is not. I love the rush of labor room and emergency cesarean sections. It’s the only department where I started to like babies, only for their first 10 minutes of life. It’s the department where you work with bitchy self-proclaimed demi-goddesses (MOs and specialists) and their roller coaster hormones. I realized that women require quite the maintenance, so I am not interested in maintaining them medically. Suffice to say I have seen a lot of women in this department. Still, I have no deep medical interest in them. It’s just another posting that I have to go through.
6th posting in A&E – initially I was just stressed and depressed being in this department, not knowing almost anything. But as I went through with the guidance of seniors, I feel better. The green zone is like the GP zone, where patient comes with trivial complains, some just seeking MC, but there are some who are quite severe. The yellow zone is semi critical, for patients who are not fit to be in green zone waiting to be seen by doctors, and not good enough for resus as they have no life threatening medical emergencies. Yellow zone is a common dumping place, and I hate yellow zone. Resus or red zone is for patients who have life threatening medical emergencies. My hospital receives a lot of trauma cases. As I had some resus shifts, I love the actions, the adrenaline rush, seeing and managing patient in their most vulnerable time of life, saving lives and formulate definitive diagnosis and management. There are more teaching in resus than elsewhere. We depend on clinical history and examinations more than bloods and imagings, which is absolutely fine by me but apparently not to the some surgery MOs. Although the consultants are very fearsome, I learn things in details, and actually having a lot of fun. The specialists, especially the newly certified ones, are teaching a lot. It’s a department worth keeping my eye on.
Well, this experience of mine is of course would not be the same like other houseman. The story is about my housemanship in my hospital according to my own sequence of posting. I am simply just sharing my thoughts, especially for the newly graduated medical students from my alma mater.