NUS Medical Society

27/04/2024

"Quite a lot of people have asked me what an EMT does. An EMT is pretty much like a medic. Usually, the ambulance has a three-man crew: the paramedic, EMT and driver. The paramedic makes the decisions and has the most medical knowledge of the three. The EMT is the hands of the team - we prepare the equipment, manoeuvre the stretcher, handle equipment such as oxygen tubing, ECG electrode placement and do procedures such as taking hypocounts."

- Wong Yee Howe, M4 YLLSoM Co'2025

Read the full story here:
https://www.instagram.com/p/C6Q8KIoSuat/?igsh=MTR4b2Y2c2xmdzh6Zg==

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24/02/2024

“We are all very different, but yet very much the same, just that we express ourselves in different ways.”⁣
⁣
[On Motivational Interviewing⁣]
I undergo psychological training as part of MI, and I issue homework to them (my patients). It’s all about asking people - what gives you joy? It gives people a chance to see a light in the darkness, to have the courage to choose these things, when life is telling them to choose something else. Counselling for depression is very much like MI just as smoking cessation is. Life goes on mindlessly for many of us, but it takes courage and effort to be mindful and aware of certain things. But I think if we know what makes us happy, what our true needs are, we will be able to find the courage to make certain decisions. And you will be able to make happy choices not only about you, but for those around you. And with enough courage you can also choose to go against the general flow in pursuit of what you want. ⁣
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In life, when it comes to making “different” decisions, some people have always followed the books and they wished they could do something different. There are societal rules but some people feel the need to break certain rules and boundaries for certain periods of time. It’s also about autonomy: who am I? Must I look like you exactly? Eventually they come back from making a bad decision and this is how it is. So they can’t be judged for these moments because it’s an experimentation - figuring who I am, what matters to me. And honestly speaking, we are all very different, but yet very much the same, just that we express ourselves in different ways. Back in medical school, I looked at my friends in the Arts & Social Science faculty trying new things while I needed to study. This shaped my post graduation years, which I spent doing things like learning a third/fourth language or dabbling with something new. That’s the thing with dabbling - sometimes it stays with you, other times that's not what you want. All of these are an inkling of desire - Why can't I experience this? Why do/How do societal rules hold us back and affect how we make decisions? (cont in comments)

17/02/2024

“It’s very human, not about the disease but the people. We are given the privilege to experience their life, share their joys and suffering and at the end of the journey, we go home. All of us will go home. That's the journey of being a family physician.”⁣
⁣
Why Family Medicine?⁣
"A lot of people do Family Medicine. Of course there’s the business aspect of it, but the truth is many people really enjoy the work of Family Medicine. Most importantly, we enjoy interacting/working with people. When you do Family Medicine, you will see people from all walks of life ⁣
that come into your door, so something in you must enjoy working with people. In Family Medicine, you must enjoy working with families, with a Grandma and Grandpa, and even young children who may become medical students one day. It was interesting when I met this medical student who told me that I was the family physician who did his developmental assessment (DA) back when I was working at the polyclinic. It is certainly very heartwarming and forms a slice of the joy of Family Medicine. What we have is a long term relationship with our patients. No matter which specialty or field you enter in Medicine, you do not see your patients on such a long-term basis. Though I have friends as specialists who also see their patients for many years, but having a long-term relationship with patients is particularly the case in Family Medicine.⁣
⁣
It's not so much about the upper respiratory tract infections,COVID-19 cases and MCs, that’s not why we go to work. It's really the ability to work with people on a long-term basis. And once we have that connection in the long run, we can start to talk about preventive care. As family physicians, we know the bigger picture in the family, such as patients having family history of different cancers across different generations. (Cont’d in comments)

17/02/2024

“It’s very human, not about the disease but the people. We are given the privilege to experience their life, share their joys and suffering and at the end of the journey, we go home. All of us will go home. That's the journey of being a family physician.
⁣
Why Family Medicine?⁣
A lot of people do Family Medicine. Of course there’s the business aspect of it, but the truth is many people really enjoy the work of Family Medicine. Most importantly, we enjoy interacting/working with people. When you do Family Medicine, you will see people from all walks of life ⁣
that come into your door, so something in you must enjoy working with people. In Family Medicine, you must enjoy working with families, with a Grandma and Grandpa, and even young children who may become medical students one day. It was interesting when I met this medical student who told me that I was the family physician who did his developmental assessment (DA) back when I was working at the polyclinic. It is certainly very heartwarming and forms a slice of the joy of Family Medicine. What we have is a long term relationship with our patients. No matter which specialty or field you enter in Medicine, you do not see your patients on such a long-term basis. Though I have friends as specialists who also see their patients for many years, but having a long-term relationship with patients is particularly the case in Family Medicine.⁣
⁣
It's not so much about the upper respiratory tract infections,COVID-19 cases and MCs, that’s not why we go to work. It's really the ability to work with people on a long-term basis. And once we have that connection in the long run, we can start to talk about preventive care. As family physicians, we know the bigger picture in the family, such as patients having family history of different cancers across different generations. (Cont’d in comments)

27/01/2024

Most M5s will know Mdm Juliana, whom we affectionately refer to as Mdm Ju. Mdm Ju is our Advanced Simulation coordinator, and she works closely with Prof Suresh and many others to make our posting a fruitful one. To juniors who will be M5 soon enough, Mdm Ju is truly a motherly figure to all of us. Her cheerful demeanour, morning greetings and heartfelt encouraging messages were but just some of the things we love and look forward to. And so we just had to know…

“What do you love most about your job?”

What do I love about my job? It is as simple as seeing my colleagues, my pool of BCLS instructors & students. They are like love pills on the job. I love the human connection that we are now usually deprived of. Technology has unfortunately, somehow slightly taken away the importance of it. I work with a team of awesome colleagues that never makes a day too hard to deal with. I started off with the 2016/2017 cohort, and although I meet over 1000 students yearly, (even during the Covid-19 season when it was more difficult to connect names with eyes), I still look forward to seeing students in every class that I have supported.
“After tirelessly planning and seeing through many batches of BCLS/ACLS certifications. Are you BCLS certified too?” 
I used to be BCLS certified. Prof believes that if we teach students BCLS, the rest of the team should also be certified, so that we will also know what happens and what students go through.

I have had pneumothorax twice in 2022. I even remember the dates clearly, because it was during our BCLS audit when I had to undergo surgery. I had to “cut a quarter of my lung out”- (I am unsure if it’s a quarter, but I went for a bullectomy and pleurectomy) so sometimes my breathing is shallow.

Now I am still on follow up at NUH, and I can’t wait for the go ahead to start flying and going overseas! Afternote: I have just been given the green light to fly 😊

Cont’d in comments

30/12/2023

My Emergency Medicine Journey

“When I started in Emergency Medicine (EM) in the late 1980s, the NUH Emergency Medicine Department (EMD) was run by Heads who were not emergency physicians. They were Orthopaedic Surgeons or General Surgeons. They were basically administrative heads only. They did not see patients in the EMD. The only specialist in my department was my then Registrar, Dr Ng Yuen Yen. In the whole of Singapore, she was the only one who had an EM postgrad qualification. After she left our department, even though I was still a MO, I was basically doing the day to day running, like planning the roster and teaching programme for my fellow MOs. This continued on till A/P Manning joined our EMD in the mid-1990s.
Another interesting feature of NUH EMD in the early 1990s was that the only permanent people in the department were the nurses since the MOs would rotate in and out. Even for myself as an EM trainee, I would be rotated outside of the EMD. So the NUH EMD was actually under the Nursing Department till I think the late 1990s when A/P Manning became the HoD!

I think EM has really come a long way since it was first recognised by MOH as a distinct specialty in the mid-1980s. In the past, EM was viewed as a specialty where anybody could just come and run it as long as they were trained in some other areas. However, it is a well-established specialty now. Nobody untrained in EM would now dare to step in to lead and run a clinical shift in the ED. I think all EDs in Singapore have 24/7 specialist cover. Many new areas of subspecialty interest within EM have emerged over the past 10-20 years. Among some of them include Emergency Ultrasonography, Geriatric EM, Palliative and End-of-Life Care in EM. However, in contrast to the early days of EM in Singapore, Emergency Physicians(EPs) are now as equally respected as our colleagues in the other more well-established specialties. Only in the past 10 to 20 years, EPs started to hold positions of leadership in their individual institutions and healthcare clusters, among them include chief executive officers, chairman and deputy chairman medical board, etc..” (Cont’d in comments)

30/12/2023

27/12/2023

My road map⁣
⁣
"One of my mottos in life is to always seek discomfort. This has led me to pursue many things that I wouldn’t have otherwise done and has helped me realize that there's so much more to life than becoming a specialist.⁣
⁣
I went on my first-ever solo trip to New Zealand after my HO year, spending 1 month soaking up New Zealand’s scenery, nature and hiking. I felt so liberated at how their society didn’t define success as going to a good school, getting good grades or earning a high salary.⁣
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Over the next year, I worked as a locum GP while still figuring out what I wanted to do, but I still harboured the dream of building something larger than myself to give back to the community. I travelled extensively when I wasn’t locuming, exploring Australia, Korea, Hanoi, the UK and Alaska. Travelling reframed my perspective on the kind of life I wanted and gave me the confidence to go out and pursue it.⁣
⁣
I always thought I’d start my own business in my thirties or forties, not in my twenties. But a few months back my mentor Dr Hisham, a Public Health Specialist, asked if I was interested in co-founding a clinic. I leapt at the chance to nurture something from the ground up and to learn business through firsthand experience.⁣"

20/12/2023

The road less travelled ⁣⁣
⁣⁣
"If I had served out the bond, I don't think I would be who I am today.⁣⁣
⁣⁣
The first two years of medical school felt like JC all over again - lectures and tutorials on repeat. Once it hit M3, and quickly thereafter M5, it became very real that working in hospitals was going to be a big part of my future and I realised that that wasn't really what I wanted for myself.⁣⁣
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At the end of the day, I still love medicine. I love treating people and I still find it fulfilling. But for the pay and the amount of working hours, I realised that this wasn't a sustainable lifestyle for me. One year might still be alright, but in the long run, if I had served out the bond, I don’t think I would be who I am today. I feel like no matter how much you love a job, it can’t become your everything, because at the end of the day, a job doesn't love you back.⁣⁣
⁣⁣
Finances were my biggest consideration when choosing to break bond. I fully acknowledge my privilege and having unconditionally supportive parents. Personally, there was no dream of doing a residency. I saw how difficult residents' lives were, how many years they had to wait to get in and all the sacrifices they had to make. For me, lifestyle has always been my priority and if it was going to be difficult to put that first, I knew in the long run that I would be happier elsewhere.⁣⁣
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Having friends to support me during these tough times really helped a lot. I could openly share my problems with them and they could understand what I was going through. Slowly, through my blog, people started messaging me saying they could relate to the stuff that I was writing. They felt heard because I was writing about things no one was sharing about and even if no one dares to speak out, I want to speak out on their behalf and let them know that they're not alone."
⁣

07/12/2023

The problem today is many don't want to know more. They want to know less. I'm in a constant struggle to remind scholars that they are scholars. “Aren't you scholars? the guys who scored the A's?” When the scholars who scored the A's and A+s come and say, "We don't want to study any more, we don't want to read anything, we just want bullet points." That’s a problem. But I'm complaining again.

If there's any form of dilution, it hurts Singapore in the long run. When I grow old, I want to be in the hands of a very good doctor who reads his physiology and pathology who knows what's going on.
~Eu Chong, Manager of Researchbooksasia

[On taking ownership of knowledge]
In academic study you are supposed to read broadly, then review your knowledge and produce your own notes. That's what Nigel Fong did right? He's famous for it. But you have to go through that process to solidify that knowledge in your brain. Just reading and then closing the book or senior’s note doesn't help. 

We are here to remind students that you are academics. The overemphasis on the practical takes away the academic. At its core, medicine really is an academic role. Actually, at the very basic fundamental level of doing anything is understanding. If you don’t understand what you do on a daily basis, you feel disillusioned.

You feel like just a cog in the wheel. “I go to work every day. I don't know why I became a doctor. I want to quit, but I'm bonded. Just tell me what to do. I just do. I don't care why. I just want to get by. I pass, but I don't know anything. I’ll just ask my seniors what to do.” That's a problem. You end up with a disillusioned doctor. 

Many pick up Nigel Fong’s Algorithm book and say, “This is it, That's all I need. Oh, I don't need anything else. I don't need to know anything else. I'll just follow his book. And what it says for each approach.” But that's not medicine, is it? Do you make a clinical decision, or does Nigel Fong make it for you? It has to be you. Then you feel empowered. Then you don't feel disillusioned. But if you're just following protocol, then it's fair to feel disillusioned. “Just do your job.” That's no fun. (Cont. in comments)

25/11/2023

PART 1: LIFE AS A DOCTOR

Pursuing Respiratory Medicine did not come to my mind at the start. I remember being approached at a careers fair by the Programme Director, who asked if I ever considered the specialty. This encounter prompted me to reflect on where my strengths lie and where I would choose to devote my time in clinical training. While I was rotating through Respiratory Medicine as an Internal Medicine resident, I frequently encountered patients with rapid clinical deterioration, and I always emerged from assisting in resuscitations inspired by my seniors who remained calm and handled such situations very competently. I aspired to be like them one day.

Looking back, I realise that I enjoy various aspects of providing acute medical care – the need to constantly think on one’s feet, in addition to performing procedures and investigative work. I enjoy the dynamic nature in Respiratory Medicine – when we need to be on top of a spectrum of changing acute and chronic presentations.

The best part about this speciality is being able to help and hopefully bring relief to patients with our skill sets when they are affected by impairments to their fundamental bodily function. For example, when patients present with breathlessness – we are able to help them make sense of their symptoms and hopefully provide comfort and reassurance through our expertise. Seeing the looks of relief on patients’ faces at the end makes all the hard work worthwhile.

During my training as a senior resident, I was constantly encouraged to achieve my maximum potential. Even as someone who has completed formal specialty training, I remain firm in my belief that learning never stops. I do believe that one still has to keep up with the latest advances in the field and on top of that, one now has the responsibility to pay it forward by teaching one’s juniors.

19/11/2023

“Hello Humans of Med YLL & NUSMedSoc! Sorry that this is not the usual format and content featured on this page, but I hope that this will be a meaningful post nonetheless :”)
Today marks D-100 to start of MBBS for the Class of 2024, and this post aims to encourage all M5s as we finally reach this last stretch! Navigating the past 5 years hasn’t been easy, and it is only through the unwavering support of those around us that we’re here today — be it the guidance of kind seniors, the understanding of countless doctors, or camaraderie of fellow batch mates. Personally, M5 has been a constant tug-of-war between savouring the many “lasts” and maximizing study sessions. But through this mini-project of collating encouragement from the batch, it made me slow down and appreciate the company of those I’m journeying with! As such, huge thank you to all who have so kindly contributed to this post, and for the endearing & thoughtful words of encouragement 😊
Let’s make the rest of our days in medsku the best of our days ⛅ All the best for MBBS! 💪🏻"
- Joanna Yang, 74th PR Director