Age of The Ultraman Doctors

8:27 AM


That was a term given by a Dr Helmi Razali, a Malaysian doctor working in UK. While most medical doctors from the pre shift system era or 'ONCALL FROM HELL' era have said some nasty things about him such as referring him as a 'weakling' and kacang lupakan kulit. He DID use some harsh language in his blog such as "...rasa macam nak hadiahkan sebijik pelempang dengan selipar Jepun" while referring to some old school-back-during-my-days doctors. But if you just take a deep breath, not be emotional...he does have a point. There is plenty of room for improvement. Not just plenty there is an ENORMOUS amount of room for improvement!

First off though, something needs to be done regarding the number of placements for medical students.Case in point the sudden addition of 100 more spots for medical students in public universities (The Star). The decision was magically made after a student complained to the press about not getting a place to study medicine. (refer to Supply and Demand)...but please I don't mean to be seditious here.





With regards to the oncall system of housemen, it is all a matter of perception. When I was a houseman I would curse all out about the oncall system. I would be the first to demand to call it off. It sucks the life out of a person. There was no life after work as I would be too tired. There was no life before oncall as I would be too demotivated (pre-call blues). Things changed when I became a medical officer. Looking back, I was very fortunate to have gone through the on call system. I was the last batch before shift system was implemented. If I had not been through the system I wouldn't know how to prioritize. It was during housemanship that I was able to prioritize which patient's need to be attended to first.

Do you do CPR for 30 minutes on an 80 years old gentleman with multiple comorbids or delegate the task to your nurse and focus on a 30 years old gentleman with no previous comorbids?

Which blood to send first FBC or RP?

What do I do if I don't have ABG?

How do you identify which patients are high risk with apparently normal vital signs?

Theory and practical are two different things. One might say "According to the latest study...bla....bla...bla" but when it comes to performing a procedure, he or she might not know the difference between an artery forceps and scissor. There was one incident when I was in ED;

Me:          Hi, I'm referring a case of UGIB. He is vomiting blood. May require urgent OGDS or                         Sengstaken Blakemore tube.

S:             Where got people use Sengstaken Blakemore. Better to use OGDS as recent                                         study....bla...bla...bla. That one also don't know!

Me:          Yes, I don't know. Please come down now while I stabilize the patient.

The MO came and unfortunately they can't bring down OGDS from the scope room. Don't know what happened. Long story short, they had to use the Sengstaken Blakemore tube.

Sengstaken Blakemore Tube: Quite rare nowadays


So, yeah...I did come from the age of Ultraman doctors albeit not so ULTRA la. Those who did housemanship before me were more ULTRA. They did all those procedures, save all those lives with more limited resources. For this reason, I respected them. I respected these consultants and specialists. They might not quote all these recent study but they do have EXPERIENCE. Experiences goes along way. No matter how much theory you learn, you can't match someone with experience. I'm not anti evidence based medicine because IT IS the way to go. I am just saying that you are NOTHING without EXPERIENCE.


ULTRAdoctor!

I was never called stupid by my superiors but getting shouted at was a norm. My muka dah tebal pun. I agree, it IS NOT really civilized. All that climb up staircases to perform procedures was hard. Following multiple ward rounds a day hurt my feet. Having to rush to send blood samples and trace the results were annoying (there was no computer system in my hospital). But ALL these challenges made me a stronger person, A BETTER DOCTOR.

Sacred book of Houseman stuff

MOfrust

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2 comments

  1. Thanks for chipping in, and writing a better, more objective post than I did.

    I have written a follow up entry, explaining how I really feel, and no it is not about being manja or malas. You could read it here.

    http://helmirazali.com/life/36-hours-oncall-system-in-malaysia-an-update-about-how-i-feel-about-it/

    Admittedly, my pelempang selipar was harsh, I should have been more careful with that.

    Again, terima kasih sebab berkongsi pendapat, and for being civilised and not calling me names.

    your lurking silent reader of a few years,
    Helmi

    ReplyDelete
  2. And the discharge summary!!! Gosh i hate doing those.

    ReplyDelete

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