Saturday, October 4, 2014

ESBL - Extremely Sedative/Seductive/Sexy Boy's Love ?

OK. Fine, I am probably fed up with studying microbiology and their pharmacology counterpart. I wonder how can one make to remember all the odd names of microorganism and the worst part the therapeutic name of chemotherapy drug for infectious disease. Salute to ID physicians. Not to mention lots of laboratory characteristics, clinical pictures and therapeutic regime to remember. Phiew! Now I am doubting whether I can continue with Med.

ESBL - Extended Spectrum Beta-Lactamase producing organisms, usually referred to Gram Negative Enterobacteriaceae. The un-ending war between human and pathogens had started since the early beginning of human species in the written or unwritten history. Well, pathogens simply way older than us, photogenically speaking. Human and pathogen stories also made up of great part of history of medicine. We can say we are co-evolved with them. Somehow, there are quite novel suggestion that we, human are made of viruses? see video:


The first antibiotic being discovered is Penicillin, by Dr. Alexander Fleming on 28 September 1928. It had marked the start of the an era of modern medicine where people try to come out with various biologic missiles and bombs to fight against human pathogen in this un-ending war. It seems like, we are winning the war initially, but halt! Don't mess up with ancestors or our human seniors, they are master in adaptation. It has not even been a century from where human first discovered these seemingly effective "weapon" until now where resistant strains of microbes, the titans are flaring out to bash human critically.

Eradication of microbial disease is a will-o'-the-wisp; pursuing it leads into a morass of hazy biological concepts and half truths.——Rene Dubos
If the world fails to mount a more serious effort to fight infectious diseases, antimicrobial resistance will increasingly threaten to send the world back to a pre-antibiotic age. ——Gro Harlem Brundtland,
Lesser and lesser effective antimicrobial been discovered, while more and more resistance strains of pathogens are emerging, we are almost left with no option eventually. Perhaps aggressive fight is not the solution? This let us to ponder how human can live peacefully with pathogens.

Well, back to the post title, ESBL - Extremely Sedative/Seductive/Sexy Boy's Love. It is a good example of how human behaviors are closely related to human health and infectious disease. Well, I am not trying to stigmatized people of any sexual orientation, but using gay/man homosexuality as an example would yield great impact because most people have the stigma towards this group of people.

When we think of gay, what comes in our mind? SEX! I am not sure why people made this association, but yeah, GAY-SEX-HIV-SATANIC are kind of synonymous? No for me while YES for those who not concern enough.

Ok, let me illustrate how human behaviors shaped our health and affects the human-pathogen relationships. To start off, I would illustrate that there are microbes all around us and all over our body, which is known as normal flora. The relative distribution and abundance of normal flora would depends on the local factors, such as humidity, pH, temperature and so on. Well,normal floras are "normal", most of the time, but if they went left astray to some odd parts of the body where they not usually belong to they are not so "normal" after all. Speaking of sex, let me mention that the warm and humid condition of anogenital region of human being serve as a good paradise or vocation spots for many microbes, they are simply having party there.

While they longing a  bacchanal, human too are having parties, where a lots of bodily interaction can occurs to satisfy our bodily lustful desire and will sometimes end up with the intimacy of sex-homosexually or heterosexually. Phallic-vaginally, Phallic-cephalic, Phallic-anally. Choices are there. Don't assume anal sex is the privilege of gay people, man and woman can have such mode of sexual activity. OK, now, sexual activity can be viewed as the grand migration of microbes having party. Two human being at sexual intimacy, be it same sex or opposite sex, we are exchanging microbes all over with our partner, be it temporary or permanent. Well, I would like to add on that love is blind, we tends to accept everything and every bits of our lovers, then should we welcome also all the bacteria and viruses into our body with each thrust and stroke, each moans and groans. Penis, Anus, Vagina, Mouth are heavily housed by enormous microbes.

Back to gay. people having stigmas with these group of people because historically, the they are first group of people who were documented to be suffered from AIDS, well, sometimes being the first is not so good after all. But now, of 3 millions of people who had infected with HIV, most are people who practice heterosexuality. 

In my opinion, human behaviors and stigmas will continue to worsen infection diseases spread, not only HIV but also others Sexually Transmitted Disease. Also, the openness and attitude of physicians and a country to notify the world about an ongoing or emerging infections is important to break the chain of transmission of communicable disease. The worst sometimes go to health care workers that is not concern with the hygiene in clinical practice. Poor hygiene is related to prolonged hospital stay, secondary infection with hospital bugs, poor clinical outcomes and increase hospital burdens. With many evidences to illustrate the effectiveness of hand hygiene, the compliance rate of this practice is not 100%. Well, we should start to think twice when we complaining that patients are not compliant, as we too are stubborn, this is perhaps the reality of human being. Health care workers, are we given the power to kill or to heal? 

There had been one occasion where I attended a talk entitled "no more option" that discuss about the emergence of multi-drug resistant pathogen as human succumb our strategies of infection control to use of various antimicrobial drugs. The over-emphasized of treatment rather than prevention had it place for this problem. The awareness on prevention is not deep where a doctor actually ask the panel about the effectiveness and evidence of hand hygiene in controlling health care acquired infection. How ignorance, well, historically, Dr. Ignaz Semmelweis had shown us how tragedic and arrogant people can be. Read the evidence here .The ignorance among Dr.s also shown in the talk when everyone who were at least a clinical specialist or specialist-to-be tried to run off when the main speaker suggest that everyone stayed back for 5 minutes at the end of the session to learn proper hand washing techniques with the nurses. Well, Dr. I know you're Dr, but do you know you're Dr. ?

Going back to stigma, if we keep stigmatized those who are HIV positive, chances are they will find their own way to hide themselves out. It is a good thing, you would think. However, what if, one day, when you're in the same party as they are, and at that time your heightening urging libidos that drives you almost crazy, lead you to have sexual intimacy with one of them? Of course, they won't admit they are HIV positive if you're going to judge them. Also, at the emergency and burst of sexual urge, how many of us would bother to wear a condom as a protective barrier? At the end, the stigmas hurts everyone. Those who stigmatize get the disease, those who being stigmatized being torture psychologically. What for?

Well, this essay is written ad lib in a sleepless night, so you might not find any continuity, I do hope some of you might get some of the main idea. Well, ESBL - Extremely Seductive Boy's Love I would say(in my opinion). Still, I am not sure why gay is being depicted in an exotic sexual way, even most of the gay people "communicate" solely with each other in a bodily way. If it is a true love (haha, again, love is blind, we have to accept every part of our lovers?), there should have a emotional and spiritual aspects that we can go for. I know social pressure had led LGBT community being peripherized from the norm and development of the society, but I do hope one day, we can be more open-minded to these group of people. I am not encouraging people to be homosexual, but asking yourselves/pondering about it, can sexual orientation be encouraged? How many straights out there would volunteered or be encouraged to be "bent" ? LoL. We are simply born this way. Perhaps social stigmas towards LGBT society can be liken the antimicrobial selection pressure on microorganisms, eventually resistance and highly virulence strains emerged and neither human and pathogen can live with ease. Peace is the way, not the destination or result of assimilation. Things that make sense and created by straights are not necessary meant the same to LGBT, not to mention there is always some discrepancies among same group of people too. This is life, embrace the variations and celebrate the diversity, this is make what we are human.

Well, what ESBL meant to you? If I am gay, would you date me? hahaha. Don't judge! I am just a bit hyper, sleepless and imbalance for my friends are having holiday and vacation and I stuck in university, alone, wondering where's my next meal.


Well, girls don't emo, most hot, good looking guys in the market are gay? a weird phenomenon to me, or maybe it is just meant for creating the dramatic effect in gay film industries? I am confused, while people are celebrating LGBT in straights' films(do we need to categories strictly? aren't they should be just films to entertain us and to spend our past time with our love ones?), like depicting and make fun of sissies in movie scene, why when discussing about LGBT issue in society, they turn their eyes like the are not even involved/be responsible of !?

Well, good night and I hope I am sleepy, while in fact, I am not.

Friday, October 3, 2014

我的医学系第一年 :疯狂+ 那为别人生活的日子?

傻乎乎、呆头呆脑挤进医学系。那不知天高地厚的我不知道在得到什么勇气下选择了这个少有的决定——回顾小时候,我的第一个志愿是当个厨师,接下来就是就是迷上了交响乐团,想当个指挥家抑或演奏家。即将中学毕业是,觉得临床心理学家还不错,工程师也不赖。就怎么也都不想选择读医的这条路。

大学报考截止日期前几天,我把全部科系空档都填满了医学系。老实说,我以前是那种有理想不过不敢去追的青年,医学系的选择完全是因为一向来成绩不错,所以认为成绩好的人不选医学系有点浪费的心态而选下来的。结果我现在就必须为我的选择,为我种下的因,承受医学系的种种。

我的医学系第一个星期,现在回想起来我真的不知道讲师在讲些什么。我上课打盹,基本上是完全不懂为什么我需要学这个学那个。读书方法也是背的,超级辛苦!记忆力 根本不及人家。生物学又不是自己怎么喜欢的科目。再加上 自己是不明原因进来的,而且又有活在哥哥昔日辉煌成就的影子下。可以说是挺压力的。

医学系里的第一次考试,是最容易也是最困难的人生考试——我是有“背”而来的。基本上我花了两个星期去把笔记的资料完全复印进去脑子里。每天 像僵尸活着,抑或是存在,没晒到一个星期的太阳。还在考试前一天失眠加心跳急促。考试我是没有原因不会做的,因为,我都说我是有背而来的。我拿到医学系里第一个A不过我并不为此感到开心。如果要我那么压力地度过 医学系生活倒不如,走人吧!

如果你是没有愿因进来的, 那么 你最好是有留下来的原因。当年我也像其他人,都想在科系里当高材生,那高材生的骄傲光环无法抵挡。不过我很庆幸我在适当的时候遇到邱学长。他可是影响我医学系生涯 最大的学长。他让我知道第一年怎么过。医学系怎么读。没有他的帮忙,也许我现在只是一直在烦恼书怎么读的中下等学生。身为最后一年学长,我真的很感谢邱学长,不曾嫌弃那个呆头呆脑的我去问些无聊的问题。每每有想不通的问题,我都会去登门造访,一星期定时几次。

学长的指引与自身的努力是成功的踏脚石。学长可以在不同的角度上帮助 我们,教会我们生活的学长要比教会我们课业的来得更重要。只有在把大学课业融入到现实中,我们才能够学以致用。

表演——说实在,在我大学里的医学系学生可说是全职表演者,兼职学生。太多活动,来自各方的压力,让自己理所当然地也要有这个责任与大家忙了起来。别让人们发现你的表演技能,除非你乐意演出,并懂得适当拒绝。当年,傻傻的,我说了,我懂演戏。样子长得抱歉些,说要演戏只有丑角的戏份,愚弄自己,取悦他人。

卖过直男同志都吃不下的“叉烧包”,演过不可一世的Uncle Roger, 当过龌龊的“妓男”相声演员,最气愤的应该说是在大学里所谓被誉为最大的华人活动里,当了侮蔑传统的“疯癫道士”荼毒了人们对道士的印象。没关系,纵横这几年的表演,我们都倾向于扭曲传统的美妙。我可是看过至少10届的表演纪录,听过哥哥当年诉说的故事。自以为是的人们。

你会想一年里,演那么多角色,不必读书吗?时间是自己安排的,挤牙膏般地腾出时间温习功课,所幸一路上有贵人相助。不过,基本上,半年后,我可说是虚脱了。

表演——图得到的名气,将会是你往后孤寂空虚的筹码。各个角色都深入人们的印象,在人家眼中,他很会演戏哦,也许就只有这样,完了。很少人看得清傻里傻气背后的认真?就如鲜少人能够体会,成功背后的付出。没关系,自己懂。

半年后,大家开始忙了。大考的大考,结业的结业,实习的实习——大一的小弟小妹们这才真正体验到全职学生的趣味。这不然,平静的日子才不久,第二年的学长这又物色交棒人选,希望能够把那责任传承下去。这下可好,又要开始忙了!

没有华丽堂皇的结局,只有待续的期待——我的医学系第一年 :疯狂+ 那为别人生活的日子!

逝去的21……

若有一天,你知道你只剩下1年寿命,你会怎么办?
若有一天,你知道你只剩下1个月的寿命,你会怎么办?
若有一天,你知道你只剩下1天的寿命,你会怎么办?
若有一天,你知道你只剩下1小时的寿命,你会怎么办?
若有一天,你知道你只剩下1分钟的寿命,你会怎么办?

你是否还会在意自己长得不美?你是否还会在意自己的事业不够成功?你是否还会在意人们的是是非非?你是否还会在意他人亏欠你的种种?你是否会在意前些日子所贪得的小便宜?你是否会在意曾经拥有的享受?那澎湃的欲望,膨胀了,淹没了自己。人,本来都是纯洁的。待无知的人们被幻影蒙蔽后,选受苦的抉择,我们都是罪人!或深或浅,我们都必须接受我们的罪行——祈求圣人的救赎……

那天,医生手里拿着报告,很严肃的告诉我,那是急性肝脏衰竭。器官衰竭,不自然的结合品,被加冕在我身上的感觉,打翻了所有情绪罐子。那柠檬黄的眼睛,纤瘦的身子,看着医生的身影慢慢加大,那阴森的影子简直就快要把我给覆盖了。“一个月”,行刑令一下,手无缚鸡之力的囚犯,只得素手就擒,伸长脖子," 咔喳" 一下,人头落地。身首异处的躯体,慢慢的黑红色的血液渗透了每个毛孔,躺在血泊中,眼睛张着看着那无助的躯体,废掉的。灵魂破碎的时刻,侩子手骄傲地挥舞着血刀——有朝一日他也会受刑的,孤零零的头颅想。碎掉的,还是自己?还来不不及得到答案,蛆虫已经长满,入侵每个我曾引以为傲的身子。不!停!请别带走我的躯体!我哭求着。

灰黄色的骷髅,零零散散地,给这大地,添增一个黑色幽默。每个看到那未来的自己,都害怕得颤抖,我飘在风中,嘲笑无知的曾经……傻笑,狂笑,歇斯底里,谁会在无声的世界,感受到这绝望的求救?

我是实实在在的瞠着,被这突如其来的消息吓坏了。我根本不懂死是那么接近自己,毫无防备。在死神面前,我是渺小的。心情是糟透了,慢慢腐烂的心灵,快让它瓦解吧!倘若要用一种颜色来描绘那种情况,这将会是阴森的黑色。

面对着无知的,未知的世界,那死后的世界。其实,自己以往一直吹嘘,自己对死亡是多么的看得开,不过我是实实在在地感受到那个“怕”。心沉下去,刺骨的寒冷在身体传送了一遍。

那无助,真希望在临走前能抓些什么的,显然什么都带不走。越是挣扎,自己越是深陷黑色的泥泞,毫无翻身的机会。我还很年轻,我不可以这么就去了。这时的世界,光速般地离开我,我还没留下我曾经存在的印记,我就快要去了。21年的时光里,旧黄影带的重播,我看到了来龙去脉,太迟了,赤裸裸地我来到这世界,自以为是的,战战兢兢的;兴致勃勃地我走了这趟奇特的旅程,落魄的我被白色死神判下绝刑,离开了,毫无预告,一切就是那么的毫无选择。不舍不甘,我想重来,这是过多的奢望。左看看,右望望;大家何尝不是来去唐突?

前些日子,身体不适,总觉得那是小毛病。直到上个星期身体瘫痪了,罢工了,皮肤发黄,炽热的身体散发着难闻的异味,殊不知那是死亡的味道。太突然了,谁会预测灾难的来临,自己的末日。

那次被针孔扎着的意外,没想到是死神的邀请函。

我是没有什么理由不去赴约的。

一个月——想给21岁的自己为自己的生活做个总结,就好像小时后写作文,总结是必须的。我死后,我希望大家会记得我的笑容,那风中的莞尔也许能证明我曾经存在。我切切地为我曾经犯下的错误忏悔,我希望我的离去,留下的心灵能够释怀,不再为昔日的纠结而心烦。即将逝去的我,希望大家把恩怨寄予我那污秽的灵,让留下来的人继续前进,我也已经得到我的惩罚。爱我的人,请继续用给我的爱继续过活,我会好好的,希望你也是。至于许多未完成的梦,我是惋惜的,还留在世上的朋友,你们还等什么?去寻梦吧!

我多么希望当初我是时刻能感受到死亡的存在……至少现在我不是懵懂的。

今天你在风中伸出你的手,幼嫩的树叶在风中稚嫩的飘扬,

他日风中的那双手已成为幻影 ,枯黄的落叶迷茫地找寻在风中接待它的归宿。

21年的人生是场梦,惺忪朦胧中,傻笑这一切空无所实……





Wednesday, October 1, 2014

The Road to Professionalism: A Life Long Journey

http://www.youtube.com/watch?v=2R8m1jtAxVQ&index=5&list=PLF62512BCDB6EBAFD

Sunday, September 28, 2014

Ebola Essay


"If your friend who doesn't have medical knowledge asked you about The Ebola Outbreak, how would you explain it to them?" 


Friends, I wish to share with you a story:
I woke up in the morning, looking for my mother, wanting a pacifying warm hug, for I had a nightmare yesternight about an unknown, realising that she’s no longer there…
Just 2 weeks ago, she fell very sick; she became extremely exhausted never like this before.  Her body was very hot and she was in great pain! I cared for her like what she did when I was sick last time.
I remembered there was mystery men in horrifying white costume came to my house and brought my mother away to the hospital. They told us that she might have got “Ebola Viral Disease”. I think I’ve heard of it, many of my neighbours were brought away by the same white car with a bright red cross, but most of them never came back… I have seen a dying man abandoned by his family at the road side. I am so afraid!
Deadly, Killer Disease, Bleeding, Painful, No Cure, No Vaccine, Highly Infectious, Filovirus, Uncontrolled Outbreak... These big words are more than what a 10 year-old boy can handle. I pray to God that this is not real; there mustn’t be any disease…
Last week, my mother passed away. I was in grief. I couldn’t get closer and caress my mother for the last time during her funeral, like what I did for my grandmother few years back. Contact can spread the disease, they said. Will air, water and food do the same to me? Is it true that by simply washing my hands the deadly disease can be prevented? I was confused!
Again, the nurse came into my cubicle and replaced a new bag of fluid that hung on icy cold metal stand beside my bed. I can’t see her face, it was tightly covered, but I bet it was fill with fear, as most of them who seen me. I heard they said something about me; I am a positive case of Ebola Viral Disease.
Deadly, Killer Disease, Bleeding, Painful, No Cure, No Vaccine, Highly Infectious, Filovirus, Uncontrolled Outbreak... My mind was blank, and these words kept bugging me. I was lost and did not know if tomorrow’s bright sun and the future still belonged to me. I felt dizzy, my vision gone blurred and gradually everything became dull and black out.
If only Ebola remained known as the motherly river that flows peacefully, nurturing her children at the northern land of Democratic Republic of Congo... I prayed. ”


I hope that silent prayers of West Africa can be heard by my friends, knowing that Ebola Outbreak is not “just another wave of infectious disease” per se, rather it triggers our consideration on how harmonious humankind advancement can be attained in midst of intense conflict between human and pathogen. Everyone in this world has the responsibility to take dynamic and radical action for ensuring a sustainable tomorrow, for we are dealing in the same biosphere, our motherly Earth.We can hardly short of any accessible, comprehensive description of a disease but the motivation that drives us there. 





Tuesday, September 16, 2014

Physiology rhyme : Inspire Me !

Inhale, exhale, the air must flow!

Brings in O2 and CO2 is thrown.

Diaphragm contracts, thoracic volume grows,

Atmospheric air then happily follows. 

Quiet breathing, passive exhalation is kinda slow.

During exercise, gases are actively blown.

Cardio-Respi Integration, healthy men are well endowed.

‘CELLustomer’ servers –the hemoglobin working to and fro,

The subtle relationship is Bohr-ing, not boring that we all should know.

Efficient blood gas hemostasis is what our fitness owed,

Without which we all will definitely be K.O.!

Physiology Rhyme: Physiology + Understanding : PhUn

“Have ‘PhUn’ with physiology” is indeed a pun.

Understanding physiology can be a real big fun.

Many ways to throne of physiology, it’s not all or none!

Reading, Phyinking, Singing, Physcussing, a lot of more can be done.

Classroom learning is augmented by activities under the warm, red sun.

Overt integrative physiology presented to us when athletes run.

How many “Phyinking” attempts we had begun?

To propagate the excitement in learning, together we shout out “let’s have PhUn!” 

Physiology Rhyme: Physiology + Think : P.H.Y.I.N.K. !

Physiology scrutinizes phenomenon of life.

Humbly I steer through challenges with my mind.

You live and learn! Obscure yet sublime truths, faithfully I find.

Ignorance, arrogance impedes your try and you’ll stop asking “Why?”

Negative, positive feedback promote homeostatic learning, this you can’t deny.

Keeping low threshold, high sensitivity in our physiology learning, misconceptions may us descry.

Friday, September 5, 2014

医学系第二年:迷茫再迷盲!

迷迷糊糊度过了第二年医学系,也许最大的收获是 自己知道了当医生是什么一回事。第一年的傻冬瓜只管看戏太多,以为戏里的医生就像真实的那样拉风。

第二年可说是忙盲茫。参与的好多好多的活动,不懂是 出自于自愿还是为满足他人需求。刚开始,就参加的结业典礼展览会。真的好傻!基础病理学是多么的重要!我整整逃了一个星期的课。欣慰的是可以亲眼看到学长们毕业。不过有得重来,我会选择,只出席 结业典礼。

接着就是一连串学会活动,办了怪吃力的,大概是没什么兴趣,而又不小心 参与这么多活动!若大学宿舍不必拼积分,我大抵也不会这么活跃于校内的活动,有些办得并不很有意义,反之我会更专注于课业上的研究与探索自己未来的动向——这是第三年要做的事情。也许朋友花钱买积分的举动,虽然无意义,不过这不是在迎合校方的需求 ?

再接着就是承办所谓能够团结华人的活动(对某班人来说也许是对的 ),其实大家都挺压力的。为达到他人的期望而掏心掏肺,苦了自己,也达不到初衷。多少个不眠之夜?多少个需要迎合活动顾问的需求?而且,真的有意义吗?真的能传达中华文化吗?有没有做背景资料的查阅?把现代元素搬上舞台扭曲的原有的价值。也许我们不该这么守旧。算了,事情过了就算了 。专心读书吧。

迷迷糊糊的就过了半年,下半年还算平静,不过就一直在追赶之前所遗漏的知识,而且也不懂的很好的温习。考完了,就忘了,怎么考专业考试2 ?给第三年的备忘录,记得勤劳温习功课,而且要着重于思维,让自己更能记住知识。

问诊体检可是糟糕透顶,穿上白袍就有像要躲起来的惭愧。怎么努力还是达不到所期待的水准——给第三年的自己,要努力再努力!每次临床教学都是心惊胆跳的经验。遇到苛刻的导师,被骂了没关系,就担心他只管骂他的,没有给我们什么教学,遇到超级随和的真的二话不说的就结束了模棱两可的教学。

对于小组讨论,同学们都也还没什么习惯这类教学模式,学习进度很慢!可我们又能怎样?束手无策!也许我要求高,不过这不是一个未来医生的准则?教学大纲是以前定制的,现在的需求当然会要更高。

到了最后还来个,斋戒月上课自习周,结果大伙们出来成绩差强人意!我算了,大概有一半了人当掉了。自己的成绩我也不怎么庆幸,那是考试前拼出来的,根本没有很深入的掌控到知识。真的怕怕专业考试2咯。

不过,感觉上专业考试2会很快的就挨过了。

第二年,淡淡的一股沧桑。

Thursday, September 4, 2014

Microbe and us

again, bacteria existed in this world long before us. The dynamics relationship between human and bateria never get equilibrium or reach steady state. How human be selected naturally by these microbes? What limits our growing capacity?





[Shared] To medical students: We’re all in the same boat

I am an imposter in a white coat. I’m not sure if anyone knows yet, I hope I am good at hiding it. It’s a well-kept secret amongst all medical students. In the hospital, I am at the bottom. I know the least and have the least power. Most patients don’t realize this and look up to me like I’m an all-knowing, wise muse or something of that nature. Sometimes, I seem to play it off well. I fooled them all! They think I’m actually smart! Then the attending asks me a basic question during rounds, and I’m back at baseline thinking I’m stupid and incompetent once again.
This is a cycle medical students experience once they get to the wards. We put on the short white coat that we were once so proud to wear on the day we matriculated into medical school. Now, after completing most of my clinical rotations, I find every excuse not to wear it. It’s not just because I always seem to spill a drop of coffee onto my sleeve every damn morning (of all colors, why white?), but also because I literally feel like I don’t deserve to wear something that presumes such greatness and authority. With it carries a huge responsibility, and I just don’t want to disappoint. Heaven forbids a medical student being a disappointment to society. We’d rather get hemorrhoids and drown in our own blood from our anus.
Every medical student is pretending to be smarter than they are and less stressed than they really are. We study way more than we claim we are, have much less fun than we brag about on Facebook, and are much more insecure than we put ourselves out to be. I know this to be true because I am guilty of this. I’ve been faking it till I make it since the beginning of time. It’s contagious, and it’s toxic.
Why do we put ourselves through this misery? For me, it’s because I have these unrealistic expectations of perfection. We’re a unique group of people, chosen from the top of our class from an elite group of students from each college. We’re used to achieving and striving to be the best at what we do, whether it’s academics, music, sports, art, or drinking. When you put a group of similar high-achieving, neurotic people together, you raise the bar exponentially, as well as individual expectations and competition. Our sense of self-worth, confidence, and thus degree of happiness then plummets. The medical school environment does not alleviate this disastrous outcome, especially since the root cause is us, the students.
It’s not really our fault either. From the beginning, we have been drilled to succeed and rewarded for our academic (and non-academic) achievements. That’s how we got here to begin with. I’m sure some of us did so at the expense of someone else. Not everyone could win first place in that piano competition, be valedictorian, or captain of the soccer team. Some of us are so used to success, that we don’t know how to handle failure. In medical school, many of us experienced our first failures, and many don’t know how to cope with that. We forget what made us truly happy, and why we came to medical school in the first place. It’s easy to get lost in our self-destructive thoughts: “I’m not good enough for this. I don’t deserve to be here. Why is (insert name) so much better at biochem than me? Why did (insert name) get a higher USMLE Step 1 score than me even though I studied so much longer? How come (insert name) has time to publish all these research papers, when I don’t have any? …”
You can tell how vicious this process of thinking can get. I know, because I have been through this.
To provide a sense of comfort to other medical students who feel the same as me, you’re not alone. I’m just as insecure about my abilities as the rest of you despite my determined attempts at hiding it. I hope that one day, this will all be behind me and I will truly be a competent physician who doesn’t have to pretend anymore. I hope that I will stop comparing myself to other “more competent” people who seem to have everything put together. I sincerely make an effort to try to only compete with myself, but some people make that extremely difficult when they are advertising their 250s in public and posting their publications and other vast achievements on social media. (And even after I get rid of Facebook, somehow I still hear about it.)
I genuinely try to feel happy for them, and part of me truly is proud, but there’s always this other side of me that feels jealously and shame towards myself — a nagging voice asking, “Why couldn’t that be you?”
I know I can’t avoid all of this thinking process completely, but I have taken steps to at least calm the waves down. I focus on the positive things in my life and have stopped placing unrealistic expectations on myself. I hang out with similar-minded people who make me happy and don’t patronize others. I reconnect with my old friends who I have seemingly ignored for the past three years. I rediscover the real things in life that make me happy — family, friends, my dog, nature, Ellen Degeneres, and wine.
Don’t get me wrong, I still study my ass off, but am not obsessed about it anymore. When I put on my white coat, I think about how privileged I am to have this incredible and rare opportunity to do so. Instead of feeling stupid after not knowing an answer, I think of it as a positive learning experience — why would I even be here if I knew all the answers anyway? I try to avoid people who can’t stop talking about how many clerkships they honored, how many clinics they started in a third world country, and how many attendings are so impressed by their knowledge of the purine synthesis pathway. I’ll be friends with them once they get over their own insecurities and stop having to constantly prove how “good” they are.
We’re all in the same boat here. Let’s keep the sea as calm as possible until we land.
Serena Zhou is a medical student.
SERENA ZHOU | EDUCATION | MAY 4, 2014
Retrieved from http://medicinemalaysia.com/wp2/?p=3083 at 04/09/2014 on 12:23 noon

回忆过去之钟灵USM传统:十个为什么我要当医生的原因

当年我first year, 2012/2013届的钟灵学长团有 8个 5th year, 13个 4th year, 4个 3rd year 和 6个 2nd year.

现在我third year, 2014/2015届则有 3个 5th year, 6个 4th year, 6个3rd year 还有 6个 2nd year.

传统中,打电话最刺激的环节莫过于娓娓叙说“我要当医生的十个原因”,然后被学长们百针喷血的质疑与批评,可爱的学弟妹们则极力抵抗那天真的十个原因。

今年我第三年,听了两届的电话,我算是苛刻的学长 (心理有点变态 + 妄想症的那种 + 虐待心切的那种 ——〉都说了有“童年阴影”)。打电话时不时会深入探讨学弟妹们的十个原因——〉最近怎么大家都自行大打折扣,基本上,给超过5个原因的人少之又少,而且给的原因越来越可爱了。没关系,该做的要逃都逃不了,把狠话落在前头,欠了债可要分期付款 (又感到头上长魔角了-.-)我又不是故意刁难,我只是想知道更多而已,其实我很慈祥的。

以下是我当年的十个原因 + 如果我现在听到这些原因我会怎样开“枪” (全马力的开,小的看好了,你们中过的只不过是弹灰)这些枪是自己开给自己的,而且功课我也会做了upload上部落交功课给自己。

1) 因为我有家人的支持与期望
attack: 别老活在其他人的期望里,这是我的十个原因,不是家人的十个原因。那么家人要怎么支持你?
defence : 老实说,我还真的不懂怎么defence!? 父母不嫌辛劳两地载送我来回槟丹。每一年假期都带我到Kamal Book Store 买书籍? 父母替我拜神算命!? 总之是精神上与金钱上的支持啦。
attack: 这么多支持,自己要怎样学习独立?你要如何更接近社会?毕竟,到最后你还是要到社会服务的。你真的socially functional ?
ONE-HIT-KO
功课:回去想怎样结合你的talent, hobby and medical degree 去让自己支撑自己的生活。找十个然后画出来!

ok next!
2)认为自己有毅力读下去/做下去,有志者,事竟成。<——好萌的想法
attack: LoL 跟我讲一讲你至今为止做过最有毅力的事情!
defence: 我很勇敢的走过matriculation, 在里头哭了两回…… <——超萌的!
attack: 那么你在医学系里头不也要三天两头哭上一遍 ?天天以泪洗脸?(只哭过2次,感谢丹州理大佛学会)
ONE-HIT-KO
功课:找出来历史上10个有毅力的名人,然后跟我讲故事!

next!
3) 符合自己的价值观
attack: 根本都不必 attack, 不堪一击!什么是你的价值观?
defence: 越活越清醒,利用自身的知识帮助他人,提高生活素质,让自己在精神层面上有更高的发展。
attack: 我不懂你现在是不是清醒,不过你最好是。难道你要像孔子说的四十不惑?hahahahaha! 百无一用是SUSAN (书生),讲你要怎样用你的知识帮助人?帮卖hokkien mee的aunty 算 dy/dx 啊?
ONE-HIT-KO
功课:从现在起要怎样实现你的价值观,不要说到好像未来很远酱,说到好像自己不会有死去的那一天。画出来!

next!
4) 有稳定的收入
attack: ok, 这个我接受,你的稳定是指什么稳定?
defence: ... science student 不会 finance...
attack: 酱,怎样稳定!?
ONE-KIT-KO
功课:找出来医学系毕业后,你领的工资有多少钱,取学要怎样稳定你的收入与开销!science student 不会finance... wahahahaha! 如果你是借钱的要怎样还!如果你是被bond的要怎样bond!

next!
5) 生活可以忙得很充实
attack: 何谓充实?卖 hokkien mee aunty 每天熬虾汤也很充实的。
defence: ... T^T (饶了我吧)
attack: SO!? 还没有跟我讲到什么是充实
ZERO-HIT-KO
功课:给我十个你能力所及的作了有意义的事,能让生活更充实的。

next next next~ 听到耳朵都红了
6) 能从病人与其他医护人员身上体验生活 (生老病死)
attack: 讲很哲学酱, i like it. 要怎么体验?
defence:  O^O''' 用心?
attack: (顿时血洒满地)
Attacker-severely injured
功课:什么是病医关系?什么是同理心?请讲出病人各种不同的心态(对自身健康)。patient behavioural science. patient expectation on health delivery. patient dr. communication skill. 

next
7) 能帮助病人减轻痛苦
attack: 那么你应该去做护理师 (Nurse)
defence: 我选MD wor...
attack: 你不懂medicine 讲究teamwork?!
ONE-HIT-KO
功课:去问一下Nursing student about the role of nurses in health care. Doctor-Nurses partnership. 找出历史上5个帮助减轻痛苦的nurses. 什么是 Palliative care?

next:
8)一个通往国际的职业
attack: good 很有理想。
defence: phiew~ 松口气
attack: (乘胜追击) 你懂怎样么?
ONE-HIT-KO
功课:找出 medicine 可以通往国际的方法。

next:
9) 一门专业的职业
attack: good. 很有专业精神
defence: phiew~ 再松口气
attack: 什么是专业?
ONE-HIT-KO
功课:找出什么是 professionalism ? Professionalism 与Monetary issue 冲突时的ethical and legal issue.

finally...终于!耳朵在这时候已经严重烤焦
10) 规律中有新奇的行业
attack: 哇,你还真有点变态,以后一定不会怎么正常
defence: 夸奖了~~
attack: 酱,什么是新奇?
ANOTHER-HIT-KO
功课:找出来什么专业是规律中有新奇的,and PLAN your pathway towards it. 画出来。

看到功课那么多,那个要做功课的不禁吓得要上厕所小便……

其实,“十个当医生的原因” 对不同的人有着不同的效用,而也许在某些人眼中它根本没什么价值。在我看来,在自己不断审视自己当初的原因后,我们更能够取得更个性化的成功,因为那些是自己当初想走的路。当我们不断阅读不同成功人士的成功故事时,肯定会被那晶光闪烁的成就所瞠着,不过那毕竟是别人的成就,只供观赏借阅。我们还是要问:那我的成功故事呢? 一年的课业实在繁重,而且会让自己身心疲惫忘了初衷,能够为自己在与自己辩论的过程,寻找乐趣与新的思维,的确是不错的做法。就要记得要把那个当初的自己想成现在”欺负“小的时候那样,要够残忍犀利(这是算哪们儿的欺负?这是升学辅导,赶快给我酬劳!)

每一年我都会让junior写下所有资料在纸上,好让以后的自己查阅。至于有没有人那么做我可就不知晓了。毕竟那是变态的senior 叫做的变态差事。

不过近年来的理由/原因还蛮坑爹的~ 喜欢性荷尔蒙的,喜欢解剖罐装的器官的,无缘无故想读医的(err..无可否认我也使个无缘无故误闯医门的傻子——结果日子读久了就变态了。既然把青春都挥洒在这块儿上了,不如就闯出个热腾腾的夏天!)

well, this is not the end of the story... hiak hiak hiak...

TO BE CONTINUED

Newbies are such adorable and fragile and innocent. Yet they are so malleable and likened that of pluripotent stem cells that endowed with great potential. Well, I always treat myself as newbies.

[Shared] Medical curriculum in Oxford University

Medicine
The practice of Medicine offers a breadth of experiences that it is impossible to find in any other subject. Every day brings different patients with different needs. It’s a great choice for scientists who strive to understand and apply research findings to improve the lives of the patients in their care. It offers a meaningful career that is prestigious, secure and relatively well paid. However, practising Medicine can be arduous, stressful, frustrating and bureaucratic and it’s not suited to everyone. You need to be sure that Medicine is the right choice for you. These pages will help you work that out, but there’s no better way to find out for sure than by gaining insight of medical practice by seeing it in action and talking to those who provide healthcare. Studying Medicine because that is what is expected of you is never a good idea: make sure that your motives for choosing to do so are well reasoned.


Medicine at Oxford

Medicine has been studied at Oxford from as early as the 14th century, although a Clinical School was established as recently as 1936 by a benefaction from Lord Nuffield for postgraduate teaching and research. Clinical student training started during the Second World War when medical students were evacuated from London. Today, the Medicine course at Oxford provides a well-rounded intellectual training with particular emphasis on the basic science research that underpins medicine. We have retained a distinct three-year pre-clinical stage that includes studying towards a BA Honours degree in Medical Sciences, followed by a three-year clinical stage.
Although the Medical School at Oxford has expanded in recent times, it remains relatively small, allowing students and staff to get to know one another and benefit from a relaxed and friendly atmosphere.

Careers

From becoming a GP to training as a brain surgeon, a vast array of speciality training pathways is available after obtaining a medical qualification, ranging from anaesthesia or emergency medicine through obstetrics or ophthalmology to paediatrics or psychiatry.
Of course, you need not remain confined to the surgery or the operating theatre: the lecture theatre or the laboratory could also beckon. Some of our graduates end up leading the education of the next generation of doctors or directing biomedical research. You don’t need to know right now what you want to do when you qualify: the Medical School organises careers sessions for final-year clinical students and helps students learn about and apply for foundation house officer posts.
BM BCh graduates are entitled to provisional registration with the General Medical Council (GMC) with a licence to practise, subject to demonstrating to the GMC that their fitness to practise is not impaired.
Brad, who graduated in 2004, currently works as a Forensic Psychiatrist with mentally disordered offenders at Broadmoor high security psychiatric hospital. Brad developed through tutorials at Oxford the strong academic knowledge base and confidence to challenge ‘received wisdom’. This has allowed him to diversify his clinical career to include roles in leadership and innovation in the NHS.

The standard course (A100)

We have retained a course with distinct pre-clinical and clinical sections that includes studying towards a BA Honours degree in Medical Sciences.
Applicants are initially admitted to the pre-clinical section of the course. Entry to the Oxford Clinical School is competitive; however, currently a joint admissions scheme (under review) is in place with the Universities of Cambridge and London to ensure that all suitably qualified Oxford pre-clinical students will be allocated a clinical school place within the scheme. The majority of students continue their clinical training in Oxford. Upon successful completion of clinical training and the award of the BM BCh degree, subsequent years are spent on Foundation and Specialist Training programmes.

The Pre-clinical stage

The first five terms of this course are devoted to the ‘First BM’ (the 'First Examination for the Degree of the bachelor of Medicine and Surgery'). This addresses not only much of the science that underpins Medicine, but also the clinical problems that arise when systems fail. Students are introduced to the major systems of the body and study all aspects of their structure and function in health and also the principles of disease processes. Students are encouraged to develop an enquiring approach and to consider the experimental basis of the science in the course. Matters of clinical relevance are illustrated from the outset. There are clinical demonstrations in hospitals, and students make regular visits to GP tutors.
The First BM is followed by a four-term BA Honours course (the ‘Final Honour School’) in Medical Sciences. Students specialise in an area of biomedical science selected from one of five options. They will become fully accustomed to working from research papers and primary sources in the literature, and will be encouraged to think both critically and creatively. Students will gain in-depth knowledge of their chosen option, and will improve their technical ability both at the bench and in the use of electronic resources to handle and present experimental results and to search scientific databases.
The Principles of Clinical Anatomy course, delivered at the end of the third year, is designed to teach students clinically relevant aspects of anatomy that will be of immediate use in their clinical years. This is compulsory for students progressing to clinical training at Oxford or elsewhere, but does not impact on the degree classification obtained for the BA in Medical Sciences.

Teaching methods and study support

During the pre-clinical stage of the course, the college tutorial system is a central feature: students see their tutors and are taught weekly in groups often as small as two. This teaching can be tailored to individuals’ needs and interests. Most University lectures, seminars and practical classes take place in the Medical Sciences Teaching Centre in the Science Area. Lecturers are drawn from Oxford’s extensive pre-clinical and clinical departments, all of which have international reputations for excellence in research, and the courses are organised on an interdisciplinary basis so as to emphasise the interrelatedness of all aspects of the curriculum.

Research work

In addition to taking written and computer-based examinations, and submitting practical reports and an extended essay, students undertake a research project as part of their BA course. This will be in a field of interest to the student, and will offer valuable first-hand experience of scientific research. Students have the opportunity to undertake research in a laboratory from a wide range of departments within the University.

A typical weekly timetable

During the First BM, lectures and practicals occupy about half of the time, and the remainder is free for tutorial work, self-directed study and extra-curricular activities. During the BA course, formal lecturing is kept to a minimum, and students are mostly free to pursue their research and to prepare for tutorials and seminars. Strong academic support ensures that students manage their time effectively.
First BM Part 1 - Terms 1-3
Courses
  • Organisation of the body
  • Physiology and pharmacology
  • Biochemistry and medical genetics
  • Population health: Medical sociology
  • Patient and Doctor course
 Assessment
  • Three core knowledge computer-based assessments
  • Four written papers
  • Satisfactory practical record
First BM Part 2 - Terms 4 -6
Courses
  • Applied physiology and pharmacology
  • The nervous system
  • Principles of pathology
  • Psychology for medicine
  • Patient and Doctor course
Assessment
  • Three core knowledge computer-based assessments
  • Four written papers
  • Satisfactory practical record
Final Honour School in Medical Sciences - Terms 6–9
Courses
  • Option (one from: Neuroscience; Molecular medicine; Infection and immunity; Cardiovascular, renal and respiratory biology; Cellular physiology and pharmacology)
  • Research project
  • Extended essay
  • Principles of clinical anatomy
Assessment
  • Written papers
  • Submission of extended essay and research project write-up
  • Oral presentation of research project
  • Qualifying exam in Principles of clinical anatomy: computer-based assessment
To progress to clinical training, at the end of Term 9 students take:
Course
  • Principles of Clinical Anatomy
Assessment

  • Three computer-based assessments

Progress to Clinical training

In December of the third year, students must apply to be accepted by a clinical school. Currently a joint admissions scheme (under review) is in place with the Universities of Cambridge and London to ensure that all suitably qualified Oxford pre-clinical students will be allocated a clinical school place within the scheme. Of those who choose to apply to the Oxford Clinical School, about 85% have been successful in past years. The rest mostly go to London or to Cambridge. No student is guaranteed a place in Oxford, but there are sufficient places in the system to ensure that all qualified students will find a place for their clinical training. Upon completion of the clinical stage of the course, the subsequent years are spent on Foundation and Specialist Training programmes.

[Shared] Curriculum MBBS Universiti Malaya

Please refer to : student guide book 2013/2014 edition

[Shared] Curriculum of MBBS National University of Singapore - Yong Loo Lin School of Medcine

Bachelor of Medicine and Bachelor of Surgery (M.B.,B.S.)
The undergraduate medical programme is a five-year course leading to the degrees of Bachelor of Medicine and Bachelor of Surgery (M.B.,B.S.).
The broad mission of the curriculum is to nurture servant leaders to transform healthcare by producing doctors who are caring, competent, safe, and professional towards patients, who will make a difference to the community and change the practice of medicine for better.
The outcome-focused curriculum establishes a firm foundation in the basic medical sciences while providing students with high quality clinical experiences. Throughout the course, the curriculum emphasises the clinical relevance the basic sciences. Beginning in the first year of medical study, students meet and interact with patients and begin the lifelong process of honing their professional behaviour, communication skills, and understanding of ethics, law and information literacy. The first year of the course emphasises normal structure and function of the human body, underscoring the clinical relevance of what is taught. Progressively in the second year, the course focuses on abnormal structure and function including principles of pharmacotherapy, general pathology including cancer biology, and the body’s defences (immunology and infection). The primary focus from the third to the fifth year is high quality clinical experience in medical and surgical-related disciplines with underpinning medical sciences. Students also have the opportunity to take local and overseas electives during this period.
Outcome-focused Curriculum
Phase INormal Structure and Function with clinical relevance
Phase IIAbnormal Structure and Function with clinical relevance
Phase IIICore Clinical Practice
Phase IVAcute and Specialty Clinical Practice
Phase VStudent Internship Programme

Highlights of the undergraduate medical curriculum are:
Early meaning clinical exposure
Ambulatory and community care experiences
Emphasis on developing caring and ethical medical professionals
Significant curriculum time devoted to interactive small group teaching
Use of cutting edge education technology tools such as the Human Patient Simulator and the Harvey Simulator
Option for student electives in local and overseas institutes
Student Internship Programme to provide students real-life practical opportunity for clinical care

Broad-based curricular components in the M.B.,B.S. course include:
Core content, which includes fundamental science and clinical principles, providing a knowledge base essential for the undergraduate to become a proficient doctor
Longitudinal tracks, which begin in Year 1 and continue throughout the greater part of the curriculum, integrated with the biomedical science components and clinical teaching. They include Health Ethics, Law and Professionalism; Medicine and Society; and Information Literacy, Critical Thinking, Evidence-Based Medicine, and Research Methodology.
The Patient-Based Programme, which starts with guided patient exposure in a clinical environment in the first year, allows the further training of patient interaction and communication, physical examination and procedural skills in the second year under the Clinical Skills Foundational Programme. The clinical training is culminated in full-day clinical postings in the third through the final year. Such intensive bedside clinical instruction and experience help undergraduates to acquire clinical knowledge and skills in order to be effective house officers and proficient medical practitioners.


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