I think from your sentence you're actually suggesting that grand mal = generalised convulsions with the exception of petit mal; which literally means grand mal = generalised tonic-clonic (GTC), tonic, clonic, atonic, and myoclonic seizures.

My understanding is that "grand mal" = GTC and nothing more.
I could be wrong though, or maybe there has been changes made in the neurology realm which I missed.

Agreed.

That article has some points for pondering, but it's written in such a depressing way with mistakes mentioned as above. RM1000+ WTF? Is the doctor who wrote this living in the past?

On the other hand, I don't think the RM30 consultation fee is considered as "a lot". There's no doubt that a 30 buck medical fee for a single consultation can be a lot for less affluent families, but it's comparatively cheaper than other countries. It's definitely not cheap, but doctors have to feed their families as well... What I dislike is charging RM30 for a session where the doctor doesn't even talk to the patient properly, and just dispense panadols and antibiotics like candy. Alternatively there's the government klinik kesihatan which charges peanuts although the queue is horrendous, and I'm not going to go into this kettle of fish.

If it was a proper consultation session with adequate patient information and education, RM30 is reasonable. Doctors have the responsibilities not only treating but also teaching them; similarly patients have the privilege (and should have the awareness as well) to request for proper information regarding their illnesses and treatment.

As for the doctors' pay... it's pretty much like what you said; 3500-4500 basic salary, which I believe is pretty similar no matter where you go. We need bloody more since we are stuck in uni for longer periods than our friends who probably have accumulated a year or two's savings in the bank lol...

Anyway, I lol'ed at this:
Wow... are we expected to be godlike?

Caring, loving, self-sacrificing bla bla aside, at the end of the day medicine is still a profession, a service, an industry; and doctors too need to feed their families and have a life outside of the medical field. There are expectations to be met, but the society shouldn't have the perception of "oh, but you're a doctor; you should give up everything and dedicate your entire life to medicine and patients and do nothing else for yourself..."

This post has been edited by StarGhazzer: Jun 4 2009, 12:50 PM

AUD of course.

It's the doctor's job to educate patients about medications. There are still many people who expect antibiotics for viral URTIs. You try to educate them, they will say OK and probably head off to the clinic next door for antis. It's hard to get people into the right mindset, but that doesn't mean we can't try.

Take away the dispensing rights means taking away a source of income for the doctors, so expect the consultation fees to go even higher and this time you won't get medicine at all. A normal GP consultation in Aust probably will cost you 60 bucks and that only comes with a written prescription and you'll have to fork out more to get it at the chemist, i.e. additional travelling/costs/time required. Of course, over here medical cover and bulk billing cover most, if not all, of the costs; but in Malaysia where a majority of people pay out of their own pockets, it's not going to work.

Let's just say approx 50K/year as basic pay... 70K is probably adding up all the OTs and misc allowances. Yeah you get extra cash but less/no time to spend them. And again, when you manage to get 70-80K, the tax rates go even higher and voila, you're not exactly earning as much as laypeople expect you to. Not forgetting the fact that most hospitals now are very anal about claiming OTs - they would rather give you a 1/2 day off during the next day should you do overtime for today.

One won't be rich until >20 years down the road... and even so, "the seriously rich" is probably limited to hardcore specialists who does fancy high-tech procedures (mainly surgeons to be honest).

This post has been edited by StarGhazzer: Jun 4 2009, 08:02 PM

"better healthcare, education, social services, pensions, parks, good public toilets, good roads and highways and hardly any toll in sight......etc......."
True for all, but the reason why there aren't that many tolls is because they are all electronic like S'pore's ERP.

As for what we get, or rather don't get, in M'sia from our tax money, that's due to the government's unfair policies + corruptions which belongs to another thread I suppose.

Salary packaging. To put things in a simpler way, you spend on food/electronics/medical books and equipment/etc instead of paying tax lol.

I'm not a big fan of taking away doctor's prescription rights, but I'm not opposing it big time either. We just need to find a system that works in our country and currently it's still not exactly feasible. On the other hand, having a pharmacist double check the doctor's prescription before dispensing medicine is a benefit as it would reduce mixups. In an ideal world, doctors should be cautious enough to ensure there are no mistakes in medication regimes, but shit happens. Same with pharmacists, they too could make mistakes as well.

Doctors who charge generics at branded prices are unscrupulous... if they have the intention of cheating patient's money then they would probably find other ways to squeeze more profit (eg charge higher consultation fees, pakat with pharmacies etc) should the dispensing rights be taken away.

As for generic medication vs branded ones, generally they should have the same efficacy and act equally good on a patient. Talk to people working in pharmacies - you'll find that most if not all of them would advise patients to buy generics if available as it saves costs and of course yields a better profit margin to the pharmacy.

Small daerah klinik kesihatan's have their own built in pharmacies, hence the doctors working there don't need to dispense, and they usually don't. It's different from private practices where it's not always possible to have a pharmacy nearby.

Assistant? Regardless of whether you're a nurse or any other allied health worker, you're important to doctors. Doctors don't run wards, nurses do. Surgeons don't run theatres, the scrub nurse does.

Without you, we fall. Patients die. Hospitals close. We all get screwed.

3K enough? Well you get pretty much 3-4K in Malaysia anyway. Don't convert AUD into RM, it doesn't work that way.

No one is complaining too much, I'm just pointing out the fact that working overseas doesn't necessarily mean you'll earn much more than working in Malaysia or even Singapore. Note that I did mention that internship pay is similar no matter where you go - It's enough to survive, but it's hardly what the layperson would expect.

Medical school makes you a cynic.

Some doctors treat patients as cashcows (unfortunately), but at the same time some patients treat doctors like thrash or servants.

I admire your noble thoughts, but come talk 5 years down the road and I guarantee you'll have different views. Again, compassion and emphathy are values which any doctor (in fact every profession, not just medicine) should have; but like I mentioned before every layperson out there should ditch the mindset of "oh, but you're a doctor and you should sacrifice everything you have for medicine."

Doctors are people providing healthcare service in order to feed their own families, they're not gods nor saints.

This post has been edited by StarGhazzer: Jun 5 2009, 12:17 PM

Not sure about palliative care, but allied health services are not given the appropriate emphasis that they deserve. No one arranged for followup physio and occupational therapy for my friend who severed his left extensor pollicis tendons during a work accident. They did the surgical repair well, but the follow up left much room for improvement.

Dr Cox kicks ass. Seriously.

To make things easier:



Group 1 (VGPR) technically has the advantage as they are "guaranteed" a job in Vic, but whether you get your desired hospital or not is uncertain.

Group 2 (Non-VGPR) is the dan lain-lain group, but whether they actually have any bias (eg prefer Kiwis over Internationals) or not remains unknown. Maybe they do, but they certainly don't tell anyone.

If you're not studying in Australia/NZ, you virtually have no chance to do internship in Vic, not sure about other states.
But you can apply for HMO and other more senior positions in the future.

I suck at pathology slides lol... and to be honest, most medical schools "force" students to know them as they come out in exams. I'm pretty lucky that I didn't have to encounter them too many times.

Everyone is saying alcoholic steatohepatitis, but no one thought about NASH? EtOH isn't the only cause of fatty liver, don't forget that. And it could be a fat patient with steatosis superimposed with other causes of hepatitis.

No history, no specific diagnosis... keep your options open.

This post has been edited by StarGhazzer: Jun 15 2009, 11:28 AM

Ziehl Neelsen stain with AFB, likely to be M.tuberculosis.... check clinical history, culture it, and DNA probe it

Let's put aside whether OMG is stealing articles from another blogger or not... I'll give him/her the benefit of doubt, maybe it's just a case of forgotten quotes or reference, or maybe he/she is indeed the author of the blog...

list of Australian Medical Universities: note not all of them are public... some like Bond are freaking expensive as well.



In Msia:

http://en.wikipedia.org/wiki/List_of_medical_schools

Seriously, in terms of "quantity" we're not too bad. In fact we have the same number of med schools available. I'm not going to comment on quality though, as they are surely many good doctors and academics around in our country. It's just whether their knowledge gets fully imparted to students or not.

Sure, private medical institutions can be costly, but it's not exactly that different in Australia either if you compare public unis and private ones. As mentioned by many others in this thread before, it's the selection process in public universities (racial bias, quota) that make people lose out on opportunities.

As long as there is demand, there will be private institutions setting up new medical schools in Msia. Like everyone else mentioned before, the mindset of "I got good grades, I should study med" is inappropriate. Students should be given the freedom to pursue their dreams, but in reality it's not the case.

Easier said than done.

How much is enough? How much is not extravagant?

Most freshies in professional fields earn similar basic salaries in their first year of work. OT pay, other investments, and add-ons not included of course, as these additional pay varies from company to company, institution to institution.

And for:

I don't disagree with the author, be it OMG! or Young the blogger.
Virtually no one will dare to say 'earn money' as their first reason why they did medicine, even though it might truly be their only motivation.

I did mention before, med school makes one a cynic. Probably makes one insane as well.

I probably should also add, med school makes one a chameleon. You say the right things at the right time, to the right people; but at the same time you don't compromise your integrity or appear arrogant/snobbish. If your patient has 3 months to live, you don't say "You're bloody gonna die." You put it in a nice and considerate way, while at the same time offering hope and support even though deep down you know it's probably goodbye.

And most important of all, lay people won't understand the pay we get. All they see is "wah, doctor woh... earn big money"... but they don't see the pennies we earn (and the crazy hours we work) as junior staff, or the mountains of debt caused by our medical education. You virtually don't earn big money until you're a consultant doing private practice, and by then you'll probably already be halfway throughout your career lifespan.

Doctors earn enough to feed the family, to live comfortably; but lavish luxuries? Nahhhhhh... not so soon, and not every doctor achieves that.
At the end of the day, there are still doctors who crave more than just monetary gains - the satisfaction, the pride, the passion in doing things that they love; these also play a role.

This post has been edited by StarGhazzer: Jun 17 2009, 10:48 PM

http://www.mimsonline.com/index.aspx

Select Malaysia... but you'll need a login password to gain access.

This post has been edited by StarGhazzer: Aug 8 2009, 12:09 AM

Looks like you're enjoying your course... good on you.

Meningomyelocoele aka spina bifida cystica... congenital malformation of the vertebrae and spinal cord due to defective neural tube folding, resulting in a protrusion of spinal cord and its surrounding meninges from the patient's back. Depending on the level of the defect, the MMcoele can cause focal neurological defects (eg loss of sensation, paralysis) to the levels below, which commonly are the lower limbs and/or bladder, bowel control. The exposed cord is also at risk of trauma and ulcerations.

Wiki and google have more specific details, and so does your text books... particularly paediatric surgery books.

Not to pour cold water over your achievements, but the truth is that most of the people who manage to enter med school will be around your level, if not better. Almost everyone else in your batch would be straight As students as well. My regrets if it sounds discouraging but it's the truth. Straight As don't mean anything except a passport to enter uni.

It's definitely a good thing if your results are good enough to enter med school, but it's a freaking long journey just to get a basic MBBS and anything could happen in between. Once you get your MBBS it's another matter as work performance and references will speak louder than your CGPA in uni.

If you wish to pursue any post-grad training in overseas, under your circumstances it would be best to take the PMS route and stay there after graduation to get a higher chance. It's still possible to go overseas with a local degree by undertaking qualification exams, but the competition would be much tougher plus there might be limited positions available as well. Not forgetting the different working culture and healthcare system that you will have to adapt to.

Good luck.... and seriously, enjoy your pre-med years

This post has been edited by StarGhazzer: Aug 15 2009, 08:36 PM

Infectious Disease.

Having said that, the trend nowadays for specialty medical teams is that they don't take anyone with more than 1 comorbidity.
Eg if your dengue patient also has AF with RVR likely secondary to the infection, ID will say no. Cardiology won't even want to see the patient for the rapid AF as well. In the end the patient ends up in General Medicine which unfortunately is often used a a dumping ground for A&E and specialty units.

This post has been edited by StarGhazzer: Sep 18 2010, 07:24 PM