Welcome to medical school... where they teach you virtually nothing despite paying the highest fees. You're supposed to learn stuff on your own, and by that I mean stumble and crash your way through the hospital and getting into other people's ways during clinical years, not just mug through tons of books.

Those were the days...
Got free time then cabut to Baretto's lol...

as for the questions that cybersetan posted...
1. ventricular ectopic beats
2. dunno.... my first thought would be scalp lipoma but they aren't exactly transilluminable eh?
3. metatarsal-phalangeal amputation of foot due to gangerene... an endocrine consultant once told me that he prefered a full Symes as it's easier to fit a prosthetic foot... MTP renders the foot useless for weight bearing and impedes prothesis fitting later on.
4. placenta... too easy the placenta is probably one of the ugliest yuckiest organs you'll ever see

This post has been edited by StarGhazzer: Sep 6 2009, 03:41 PM

Hardly surprising news as this was always a matter of "when" and not "if", no thanks to all the new and upcoming medical universities like Bond, Deakin etc. These additional number of graduates will saturate the allocation spots for interns, yet Australia still requires many more personnel particularly in sub-urban and rural areas - hence they are still spending money recruiting IMGs as mentioned below:


The excuse of lacking funds and resources for training is somewhat dodgy and will spark further debates, especially since international students pay 5-10 times more. Then again, these funds are mainly paid to universities rather than directly channeled into hospitals and medical institutions so the latter may actually lack the capacity to accommodate the rising number of students and graduates.

Victoria is still comparatively easy to get an internship position compared to other states, as most of us are able to be matched in the first round offers whereas students in other states usually have to wait for 2nd or even 3rd, 4rd rounds for fight for scraps. Having said that, most of my friends from other states still managed to secure a position after the 2nd round. I guess it's a trade-off - Vic's pay is the least !!

A is probably out of the question Melb uni students generally don't get preference over Monash, although some hospital schools are famous (or notorious) for selecting their own clinical school students. I ain't gonna open a can of worms, you would know which ones when the time comes.
B is quite likely, although I won't be too optimistic about the number of available positions. After all, you can't expect hospitals to double the number of intern positions as the hospital budgets won't be able to support all the pay.
C... why not lol. Become a Victorian resident (Group 1 match) and you'll be guaranteed a job, somewhere, somehow.

Of course, there are still a number of unfortunate international students for god knows what reason fail to obtain a spot even after 2nd round or subsequent late offers. But generally speaking, as long as you're not too picky + not too unlucky you'll get somewhere in Vic. The question is whether you want to accept it or not.

Tell that to the JPA scholars... There are simply too many scholars who actually applied and got a job, and la and behold, they're staying back probably by choosing to pay back the amount of money JPA spent on them. Then again, no one truly knows what the contract holds, even the JPA scholars themselves (or maybe they are just keeping quiet and not letting us know).

MARA is even more absurd as the amount they are required to pay back should they choose to break the bond is merely peanuts.

This post has been edited by StarGhazzer: Sep 7 2009, 09:28 PM

From what I know at the moment, JPA does not cover postgraduate training as one would be required to work as an intern after graduation, i.e. not studying anymore. Therefore the scholar has to return and serve his/her contract unless he/she manages to break the bond by paying back the full amount (normally the case) or sendiri cabut (less likely as their penjamin/parents are still in M'sia).

As for those who manage to stay back for postgrad training under JPA, well I don't think anyone really knows what the 'certain conditions' are unless you're the scholar him/herself. Like I said, most of my JPA friends don't really know the full details of their contract plus the conditions may change over time.

Not yet, but going to, if everything goes well

The 1% Mara thingy, that's what I've heard as well. Sounds really unfair, especially since that puny amount can be repaid in a glimpse of an eye if you're working overseas. Oh bugger... M'sia boleh, apa pun boleh.

I'm not quite sure about this. The RACP website doesn't specify that you need a PR or citizenship to enroll in their training programme... To put it in a harsh manner, if you've finished your PGY1, and is good enough and pay them $$ they'll take you. Most people start training in PGY3 although there's a fair share of people who started certain training programmes in PGY2.

Not quite sure about RACS and other colleges but I think it shouldn't be that much different.

This post has been edited by StarGhazzer: Sep 8 2009, 08:26 PM

Don't know... Things may change over time, but generally speaking if you're not a PR (ie in Group 2) you'll stand a lesser chance due to the quota.

I'm not too familiar with PR issues - some people tend to require quite a lot of time for it, some manage to get it even during their student time although the latter might be due to sponsorship from family members... not sure.

This post has been edited by StarGhazzer: Sep 10 2009, 09:29 PM

Bear in mind that GPs are far more knowledgeable and well trained than a typical freshie HO or even a first year MO... so honestly, if one can do everything that a competent GP can do the moment he/she graduates then it's good enough than most of his/her peers.

People (both layperson and sometimes fellow medical personnel) have the misconception that GPs only know how to treat cough and cold and prescribe antibiotics. Nevertheless, a competent GP's greatest achievement is to manage patients in the community and prevent them from ending up in the wards; and most of them manage to do that. Manage one's HbA1c and BP well and chances are you'll do more good for the patient and their family than performing a CABG everyday.

This post has been edited by StarGhazzer: Sep 14 2009, 05:33 AM

That's probably the reason. Barbs inhibit one's central respiratory centre hence one cannot breathe. Worth pointing out that there's no acidosis of the alveoli - acidosis occurs throughout the body, not just the alveoli; although hypoxia will probably kill the patient first.

Now it's unclear what "artificial source of oxygen" means as there are many ways of administering O2, but for patients who can't breathe you have to intubate and ventilate them mechanically.

I assume this is a hypothetical question for pre-clinical year studies since barbs are rarely used in anaesthetics anymore (benzodiazepines, propofol, and ether gases more commonly used now). Furthermore, the patient wouldn't have died on the table had the 'artificial source of O2' was via intubation with assisted ventilation.

Never say never in medicine, as theoretically barbs can cause paralysis of muscles. But as mentioned above barbs are seldom used now. Non-depolarising antiACh agents (pan/vercuroniums) are preferred for muscle relaxation during GA.

The more you are exposed to clinical medicine, the more you realise stuff that you learn in pre-clinical years are for academic interest. Most of the agents you study in pharmacology are no longer first choice in real-life, but the basics must still be taught and learned.

Because biology is not a requisite?
I didn't take biology either during SAM, instead I opted for Specialist Maths. That way I could still choose between engineering or medicine, while had I chosen biology without spec maths I wouldn't have such options.

This post has been edited by StarGhazzer: Jan 4 2010, 07:26 AM

Extending the compulsory sevice period will not solve the shortage problem. If anything, it will only deter those studying overseas from coming back home.

Most of those who stay back in Msia will opt to leave government service once they have fulfilled the required 2+3 years, mainly venturing into private practice or even leaving the country.

The reason why most doctors choose not work for the government is fairly obvious. I don't think the politicians are blind to the problems faced by our public hospital doctors, but being politicians in a murky, biased system it's unlikely that they are going to change anything much. Paying more salary is not going to attract people back either; M'sian doctors are considerably well paid even as a junior HMO.

The now defunct Product of the System blog used to reveal many fishy issues plaguing our public hospitals, in particularly the appalling situation in Sabah, but unfortunately the blogger has decided to call it quits by quoting personal reasons. I wouldn't be surprised if there were some higher ranking superiors forcing him to shut up, since his blog has been grabbing a fair share of attention from those who are involved in the health sector and medical students alike.

Increase or decrease, any alterations to the compulsory service period will only be a temporary measure. Many would still opt to leave once their time is up. Or venture down south to our neighbour across the causeway like many UK-grads do.

As long as political/racial bias, lack of promotion/advanced training opportunities, and appalling work hours persist; the public health sector would find it hard to attract professionals to stay on. And this isn't just limited to doctors, but also includes dentists, pharmacists, and other members of the health system.

We all have our own reasons whether to go back or not. Most of us here, including myself, would jump at the opportunity to go back home; after all it's where our roots are. But the reality is that every one would choose the best possible option when given the chance, and for myself I have been given an offer which exceeds what I would get back home. It's not in terms of financially as I would probably get the same pay, if not even more, should I decide to return home. Would the shortening of compulsory government service plus increase in salary attract overseas graduates (by this I mean those who get the chance to practice overseas) home? I don't think the impact would be as big as the ministers expect.

It's true that most of those who graduated from places like Russia, Ukraine, or Indonesia will end up returning as the aforementioned places are less attractive than back home. Those who graduated from local universities will eventually stay back as well. But it's interesting to know what happens to them once they finish the 2+3. Some, if not most, will venture in GP land and make a better living than staying in the public sector. Others, in particularly who fail to obtain a training programme due to quotas and SLAB, probably will be lured down south as mentioned previously by POTS before his blog went AWOL.

Anyway, apart from SLAB which almost nobody realises until they enter the workforce; nobody really knows what the induksi programme is until they get registered for HO. Listening to my friends' experiences, it's just a racist, brainwashing propaganda not unlike the various camps provided to JPA students. I'd like to hear from those here who have underwent the induksi to understand whether it's really as appalling as it seems, or what I've heard are merely exaggerations.

130K may not be a lot, but 1M sure is.

Sterling is not as high as it used to be, and many forget that people working in Western countries are subjected to relatively high tax. You simply cannot calculate like that; as people earning pounds are spending in pounds as well, not RM.

The issue of breaking JPA contracts have been discussed to death. Most of those who choose to do so are people who will pay back. After all, their parents are usually their guarantors so if they don't pay back their parents will be the ones facing the consequences. MARA contracts are more ridiculous.

Tropical sprue is associated with bacterial overgrowth. I don't think the term "bacterial overgrowth" is a strong and valid independent diagnosis but I'm no gastro expert and I could be wrong.

If it's angmoh then celiac would be high on the list, but that doesn't mean that non caucasians won't get celiac. Check anti-TTG and endomysial Ab, if positive then scope + biopsy. Tropical sprue would have similar biopsy results as celiac without the autoantibodies.

Also think about IBD eg Crohn's even though she doesn't seem to be febrile.

If it's a real life case, keep us updated on the progress and the diagnosis

GP is a must? Nope. If I'm not mistaken, you just need a basic MBBS to become a GP. In other countries, GP is a specialisation and requires specific training programmes which often include family medicine, a bit of paeds, a bit of O&G, sometimes even a bit of psychiatry.

This post has been edited by StarGhazzer: Feb 2 2010, 07:42 PM

"to help others." is probably one of the worst cop-out answers one can ever give, and if replied in an interview one will provide much ammunition for the interviewers to fire. You can help people by being a lawyer, an engineer, a policeman, or even a politician (if you're honest enough); not just by being a doctor.

I'm not shooting anyone either; merely reminding those going for interviews to be prepared for certain questions and don't give vague answers like "I want to help people". Almost every candidate will say that, and unfortunately will get shot.

If you earn Euro, you spend Euro as well; so never ever compare pay after currency conversion. I'm not sure how much surgical trainees in Malaysia get paid, if you get 80K ringgit per year it's not too bad compared to other countries although this is not taking into account working environment and racial bias and all those factors.

Again, some people tend to think that money is the sole factor that overseas graduates do not return to Malaysia upon graduation. It's not so simple, and in fact the main deterrence is actually the internal power struggle plus political/racial bias.

Doubling the numbers of junior medical staff might not be a bad idea. Assuming that all of them are competent (or at least willing to learn if they are not), having more junior staff should be able to shorten the length of shifts and on-calls, and hence reduce the workload and burden.

Markedly reduced yes, but continuous on-calls for 36 hours are still inhumane and will make the medical staff more prone to errors.

The return of Russian/Ukraine graduates will definitely be welcomed as the more personnel available the better. However, if they are really sub-standard (this includes graduates from any uni, not just from Eastern Europe), they should have a proper retraining programme under well-supported supervision for them to obtain whatever skills required to work in Malaysia.

It works both ways - the sub-par graduates must be willing to learn the tools of the trade, while the more senior staff should be accomodating and willing to retrain them. Constant b*tching and whining about their incompetencies will never solve the problem; we might as well retrain them instead. The sad part is, do we actually have a well-planned and supportive training programme for those who are not-accredited, or do we simply throw them into the fray?

There are many skills which you will only get to learn when you enter the real world, not as a medical student. Having said that, basic clinical skills such as history taking and venepunctures should already been acquired upon graduation, and sadly there have been stories where some graduates can't even perform them properly. I don't think anyone really knows how the accreditation process in Malaysia is made or what criteria universities have to meet before being recognised by the medical board and health ministry, unless he/she is working for the authorities. The current issue is that they are now back in our country, and instead of ostracising them and constantly shunning them as useless bunch of people we might as well take the proper steps to train them - that's what the hospital staff should do. The government on the other hand has a role to play in deciding which university's course in up to expectations; and if they are not their graduates should not be registered until they pass the medical competency exams.

In Australia there are training/mentorship programmes available if your degree are not recognised. The international medical graduates (IMGs) have to undergo accreditation exams before they receive the AMC certificate. It is not uncommon to see IMGs who were specialists in their original country working as residents or even interns before they get re-accepted into the respective specialist colleges by sitting for exams. These IMGs are a valuable asset to the health system as long as they are properly trained, even as junior medical staff. I cannot see the reason why we cannot do the same in Malaysia for those who graduated from areas where their training may not be fully suitable for our country's health scenarios.

This post has been edited by StarGhazzer: Feb 27 2010, 07:19 PM

These are things that we already know, but unfortunately can't do much to change it unless one has huge 'connections' with those that yield the power. Recognition of universities can only be decided by the authorities, but within the hospital itself things can be done to help improve the quality of the junior staff.

We're going in circles here; what we're seeing now is many senior medical staff complaining on the media and blogs about the sub-par standards of certain foreign university graduates, but how many of them are actually pushing for a proper mentorship/training programme within the hospital to help them? Supervise them, guide them the proper way of doing things, show them how it's done, assess and provide constructive feedback, rectify and countersign paperwork, it sounds like babysitting but if it helps them to improve then it's a win-win situation.

This post has been edited by StarGhazzer: Feb 27 2010, 10:50 PM

Biology still has more relevance in medical studies, but only the parts regarding the human body, not those ecosystem/alam sekitar stuff.

Chemistry is also important but more in undergraduate studies especially during pharmacology and physiology although pharmacy students will probably find it more relevant. They have to know how to draw molecular structures whereas I don't.

Physics becomes of absolute importance if you're specialising in radiology/rad onc (you have to know the basics of different scans and radiation machines);but otherwise you won't need to know too much about it. I don't remember how to calculate trajectories, vectors, or energy levels anymore as I don't need those in my work.

It's hard to say why most medical courses don't classify biology as a requisite and instead put more emphasis on chemistry, but one of the reasons I could think of is maybe it's because you will be taught the relevant and required biology during your pre-clinical basic sciences.

This post has been edited by StarGhazzer: May 18 2010, 11:08 AM

Check the list by MMC:
http://mmc.gov.my/v1/docs/Jadual%20Kedua%2...r%20website.pdf

There are a few unis from Bangladesh, Indonesia, and Russia that are not recognised, and will require you to sit for qualification exams should you graduate from there.