I think the Dx is necrotizing fasciitis/soft tissue necrosis. I would be more confident in this Dx if the patient's history involved a history of trauma, and the wound is rapidly progressive.

Could someone explain to me how would u deduce there was a lipodermatosclerosis? just because the skin was darker than usual?

I dont think this is a venous ulcer. His leg doesnt look swollen. The ulcer is way too deep and extensive. On his foot there were several dark patches, my guess is there's bacteria eating from the inside (hence again, i dont think this is a venous ulcer).

Anyway, a house surgeon couldnt make such diagnosis. I would refer it to the orthopaedic/vascular team. I THINK chances are he needs an ABA.

Limeuu, i saw your post for lovestory a few months back. It was about making a choice for his medical education.

I'm from IMU, doing my 4th year in Auckland.

Before i enrolled to med school, everyone tells me that all med schools are the same, hence, why not you finish it locally, then u specialize overseas, you save money, you have more time with family. No one tells me that it was a TOTAL MISCONCEPTION, not until i have entered medical school myself, i realized there was no such thing as "specialize in overseas", there was no "tuition fees" for "specialist training", there was no such thing, all are bull shits. All you need to do is to get into a training program, and you are safe.

I was told that I could work overseas with a local medical degree. I was told that PMC is recognized worldwide. I was told that as long as I could pass the entrance exam for GMC AMC or whatever MC is that, I would be able to work over there. No one tells me the reality is way too complex than that. Was it because I did not do my research properly? or because I did not ask the right person?
I do realize that a lot of medical students/ wannabe medical students do not know much about the real concept of working overseas/ specializing. Hence they made wrong choices, ended up in a place they dont want to be in.

Would you introduce yourself limeuu? Just to get a rough idea about how senior are you lol.

Others, any opinions?

The author is indeed judgmental about the skimpy clothing and family diginity etc.

But bhypp I guess you dont know how severe the offense of cheating and plagiarism is in overseas universities, it is almost considered as a unforgivable offense that would eventually lead to someone being expelled. THERE SHOULD BE NO CHEATING IN EXAM IN A MEDICAL SCHOOL. A working world as a judge means that someone would have to die/suffer from his treatment/management/choice of medication before he or she is labeled as incompetent. What happened when a doctor does not know beta blocker is contraindicated in asthmatic patients? Chances are he'll kill the patient. Why? he didnt really study during his med school.

You can ponteng class, you can copy school work, but if you cheat in your final exam and shed tears for a pass, it's too much.

This post has been edited by cygoh9: May 28 2009, 06:23 PM

I have a question that is long in my mind here. Was PMC initially recognized by SMC? or PMC was never recognized by SMC before, and they only take in graduates on a case by case basis?

(coz I knew of PMC graduates that are working in SG)

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Added on June 2, 2009, 8:54 pmOh yea and...

Absence seizure is a type of generalised seizure known as petit mal seizure (i guess). Usually the person will blank out for a few seconds before regaining his consciousness again (posture remained).

I dont know what is coronory steal syndrome. I guess it's coronary artery got stenosed, so there was a higher pressure and blood flow generated from the collateral vessels to reperfuse areas which are supposed to be perfused by the stenosed vessel, leading to some hypoxia of the areas supply by the collaterals.

Ondine's curse is a curse when a patient lost in automaticity to breath (respi center something wrong). He can only breath when he remembered to breath. He must not sleep. (not sure about a mechanical ventilator).

Aseptic peritonitis means er... non infective peritonitis? I supposed it means it's a peritonitis without bacteria lol. Cause ar... er... autoimmune? foreign object?lol

But... are these important? i dont think i'll see a patient with ondine's curse in my life lol

This post has been edited by cygoh9: Jun 2 2009, 08:56 PM

Can someone answer my question regarding SMC and PMC? Lol looked like it got neglected.

And for it-int, are you still in your pre-clinical years? When I was in preclinical years I used to remembered quite a number of rare diseases too, cause the names and their pathophysio are cool. But after i entered my phase II, i realised it's all quite pointless. It is good to "know" about them so that you can impress your consultant if they happened to ask you lol, (eg Burgada syndrome in gen med or cardiology) but they dont usually expect you to know. If i encountered such patients i would have referred him/her to relevant specialists, hmm and I dont think i can diagnose an aseptic peritonitis by myself. (not even peritonitis lol)

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Added on June 3, 2009, 4:43 pmIn my opinion the reason is quite obvious why msia is lacking medical staffs and "best brains". If those going-to-be-best-brains people chose to return to msia instead of staying back in foreign country, chances are they are not going to be best brains anymore. And, best brains want a comfortable life too with sufficient $$ and msia does not offer much unless they venture into private practice.

Sad but true.

This post has been edited by cygoh9: Jun 3 2009, 04:43 PM

yes i'm sure. He has just got into BST.

I'm not quite sure about the loopholes currently. 2 days ago SingHealth came to my uni to give a talk (wanna drag doctors to sg la what else), one of the doctors that gave speech talked about how some debt company in msia came specifically to sg to find for a JPA scholar lol. The scholar then disappeared from sg without official resignation to SingHealth, and he/she did not return to msia either.

JPA loan is good, especially when they pay you everything in one shot lol, but i'm uncertain about how does it work. Just imagine you have that money in ur FD with interest paid monthly, imagine how much extra can u spend for daily expenditure? xD it's quite a sum of money eh!

I have a question for all ppl here:
If you are a JPA scholar, and there are loopholes for not returning to msia, would you choose to abandon msia and not come back? Will you still go back to serve our super ultra duper beloved MSIA?

This post has been edited by cygoh9: Jun 3 2009, 09:21 PM

Imho, charging rm 30 for consultation fee is not much, medical doctors worked REALLY REALLY HARD before they could sit on the chair consulting patient. If I couldnt even charge rm 30 in private practice after studying 5 years in med school, work in hosp for 15 years, I dont think I could take it. With my salary I couldnt afford to send my children to med school.


For doctors salary, I think the working hours per week counts as well. And yes I agreeee to the max that medicine is still a profession or industry for whatever you want to call it, and doctors are just normal humans, they need to earn a living too, with such hard work, i think they deserve more, and there's nothing wrong with it.

If public doesnt want that, go to government hosp. I dont study medicine for not being able to charge even rm30. I'm not so noble.

It's good if you're so noble 10 years down the road, especially when u need a car, a bigger house, and ur children want to go to uk to study med.

Just a question, how about housemanship in NZ?

I heard that there are a few new Aussie medical schools coming up, the first batch of graduates will be flooding the aussie PGY1 soon. Does anyone know the exact year for it?

When will the vacancy in Aussie be fully filled? Considering the competent authority pathway that AMC created + the new schools.

To be honest i'm a NZ medical student graduating in year end of 2011, dying to go to aussie for my intern but the uncertainty is bothering me. There's various hearsay stating that aussie are taking in doctors to fill up the regional rural areas. Cities like brisbane are already flooded with doctors to an extend that there's a 4:3 ratio for postgrad training.

I have got a lot of questions in my mind lol.

Hows the exact policy in UK like for non-EU medical grads actually? I know it's really hard to stay on in UK after 2 years of intern, does that mean you have no chance at all to get into post grad training? What is the rough percentage of being kicked out of UK each year during the yearly contract?

Does Aussie give priviledge to international grads from NZ (non-NZ citizen /PR) over UK/US/Canada citizens/PR in selection for intern? Although NZ schools are accreditated by AMC; but i've heard somewhere that the NZ international Grads are of the lowest priority, and it's lower than the US UK Canada citizens/pr that apply through competent authority pathway.

This post has been edited by cygoh9: Jun 9 2009, 01:41 PM

What if I want to apply for PGY1 in aussie? lol i have to compete with all fellow aussie grads? or also the other UK US grads (which have done their intern years in their respective country).

Sigh work all my way back, means it'll be like... 3 years?

tons of reasons, one of it : there's no air asia in nz.
second : =) i'm greedy

and true, beggars cant choose, i'll be considered lucky if i got in. And the reason why i want to get in as soon as possible is to avoid competition from the increasing grad in new schools....

Thanks for ur information. At least it's of a higher priority to be in NZ. How do I search for such information? I could not really find it.

Thank you for your information. It means I'll have no chance to apply to mel because i'll be a international grad from NZ medical school.

Can i ask where can i get such information from? I have no clue really to find from the net.

This post has been edited by cygoh9: Jun 9 2009, 10:52 PM

Is monash malaysia recognized by AMC?

How about applying to aussie to work after internship in Msia?

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Added on June 13, 2009, 2:33 amI do think that the grass is greener overseas. lol

This post has been edited by cygoh9: Jun 13 2009, 02:33 AM

As i have always asked, how about houseman in NZ? Does that give me a better advantage in applying jobs in oz.

Btw i checked SA medical registration council (or something liddat), they ranked interstate and NZ international med grads at the same level.

fatty liver with minor hepatic necrosis?
i'll just send it to the path lab lol

lets change a topic, lol, why is it so dead.