Introduction

Hi! My name is Daniel Lim Jhao Jian. Here is where I share my experience, knowledge and ideas. You are welcome to leave comments and follow my blog. You are free to copy anything from this blog. Please recommend this blog to your friends.


Saturday 12 August 2017

My 3rd year of MBBS course at NUMed

The 3rd year of the MBBS course at Newcastle University Medicine (NUMed) Malaysia is known as Stage 3. Semester 1 of Stage 3 is the Foundations of Clinical Practice (FoCP), while Semester 2 of Stage 3 is the Essential Junior Rotations (EJR). Stage 3 lasted for about 11 months from 29 August 2016 to 31 July 2017. During Stage 3, I lived in Horizon Residences, Bukit Indah which is accommodation managed by NUMed. Here, I am writing about my experience during Stage 3.


SEMESTER 1 - FOUNDATIONS OF CLINICAL PRACTICE (FOCP)

Week 1 (29 August - 3 September):

On 28 August, I moved into Horizon Residences. My parents drove me from Subang Jaya back to Bukit Indah. Then, FoCP began on 29 August. It was a bit earlier compared to the previous years where the FoCP used to begin on 1 September. This marked the end of my 3 month summer break. I felt quite sad about that because this was the last long break in my life. At that time, I was still in holiday mood. Week 1 was the introduction week. We did not go to hospitals on this week. There were introductory lectures on 29 and 30 August. 31 August was a public holiday for the National Day of Malaysia. Then on 1 September, there was a history taking practice session. During the session, I was introduced to Clinical Group (CG) 3. One of my close friend in my Stage 2 seminar group was in CG 3.

Week 2 (4 September - 10 September):

Week 2 was the critical illness week where we learnt about critical care and emergency medicine. I was in Critical Illness Group (CIG) O for this week. We again did not go to hospitals on this week. On 5 and 6 September, there were lectures and clinical skills sessions. I fell quite sick on 5 September, where I experienced tiredness, headache and back pain. I slept for a long time and managed to recover on 6 September without having to consult a doctor. On 7 and 8 September, there was a case-based group discussion on sepsis and shock. I worked with my group mates to solve the questions. Then, there was a debriefing lecture for the case-based group discussion on 9 September.

System Based Weeks (Weeks 3 - 9):

Weeks 3 to 9 were the System Based Weeks. During the System Based Weeks, I was in Clinical Group (CG) 3 every Monday to Thursday and in Simulation Group (SG) D2 every Friday. Every one in CG 1 to 4 were assigned to Hospital Sultanah Nora Ismail (HSNI) in Batu Pahat for the System Based Weeks. We learnt about a particular system of the human body every week. On Mondays and Tuesdays, there would be lectures and clinical skills sessions at NUMed. After class on Tuesdays, we would travel to Batu Pahat by bus. We would stay overnight at Crystal Inn in Batu Pahat on Tuesday and Wednesday nights. On Wednesday and Thursdays, we would go to the hospital. After class on Thursdays, we would travel back to NUMed by bus. On Fridays, there would be various sessions depending on the week.

Week 3 (11 September - 17 September):

On Week 3, we learnt about the cardiovascular system. 12 September was a public holiday for Hari Raya Haji. On 15 September, I and my CG 1-4 group mates went to Hospital Sultanah Nora Ismail (HSNI) in Batu Pahat for the first time. The environment at HSNI was quite nice. There was a seminar room there specially for NUMed students. On that morning, we had to listen to talks by the nurses about the rules at the hospital. Then in the afternoon, I and two of my friends clerked a patient in the ward. Because we still did not have experience, we took the history in a very unorganised manner. After that, we walked around the hospital just to have a look. Since we only went to HSNI for one day, we did not stay overnight in Batu Pahat. 16 September was a public holiday for the Malaysia Day.

Week 4 (18 September - 24 September):

On Week 4, we learnt about the respiratory system. On 20 September, I and CG 1-4 group mates went to Batu Pahat. We stayed at Crystal Inn for the first time. The hotel was small but comfortable and I was in the same room with two of my friends. At that time, I started becoming close to my CG 1-4 group mates. On that night, all of us went to Selera Rasa Aelynaz near Crystal Inn and had dinner together. Then on 21 September, I and a few of my friends had dinner at Crystal Cafe in Crystal Inn. At HSNI this week, I again clerked patients with two of my friends. This time, we followed the normal structure of history taking and managed to take a better history. On 23 September, there were seminars on dermatology and antibiotics.

Week 5 (25 September - 1 October):

On Week 5, we learnt about the gastrointestinal system. I and my CG 1-4 group mates went to Batu Pahat on 27 September. Throughout the journey, the engine of the bus kept emitting some strange noise, so I had the feeling that there was some problem with the bus. On 28 September, I and a few of my friends walked to Dataran Penggaram Batu Pahat to play frisbee. I was quite poor at frisbee, but my friends taught me how to play it. After that, we had dinner at Rex Food Junction. On the morning of 29 September, we waited at Crystal Inn for the bus to take us to HSNI, but the bus never arrived. Initially, the bus driver kept saying that he was on the way, but later he stopped answering our phone calls. After waiting for 2 hours, we decided to take taxi to HSNI because we did not want to waste time. We had to call several taxis because there were 28 of us. We also had to bring all our luggage to HSNI and put them in our seminar room. At HSNI on that day, I had my 1st Formative MOSLER. I performed poorly in the MOSLER, because of my lack of experience. After class on that afternoon, I and my friends in CG 1-4 had beriani rice at McBeriani. Then, we again waited for 1 hour before the bus came to fetch us. The bus driver told us that there was some problem with the bus. We requested him to change another bus because we were worried that the bus might break down during the journey back to NUMed. The driver took us to Batu Pahat Mall and we stayed there for another hour while he went to change the bus. It was already 9PM when we arrived at NUMed. On 30 September, there was a simulation session as a revision of what we learnt during Week 2. I was given a scenario where I was a house officer and I had to provide care to a patient that was in critical condition. There was a mannequin to act as the patient. I did not perform well due to lack of preparation.

Week 6 (2 October - 8 October):

On Week 6, we learnt about the central nervous system. 3 October was a public holiday for Awal Muharram. I experienced vomiting and diarrhoea on 4 October after eating fried noodles at the NUMed cafeteria. However, I recovered quite quickly without having a consult a doctor. On 6 October, I and my CG 1-4 group mates went to HSNI in Batu Pahat. We did not stay overnight at Crystal Inn since we only went to HSNI for one day. On 7 October, there was a hospital session at Hospital Sultanah Aminah (HSA) with Simulation Group (SG) D. Because I was still not close to my SG D group mates at that time, I could not find a friend to clerk patients with. As a result, I had to clerk patients by myself, for the first time. It turned out that I could actually do it quite well. The lecturers had always encouraged us to clerk patients by ourselves, and now I realised the benefit of that.

Week 7 (9 October - 15 October):

On Week 7, we learnt about the musculoskeletal system. On 11 October, I and my CG 1-4 group mates went to Batu Pahat. After arriving at Crystal Inn, we had a birthday celebration for 2 of our friends at the lobby of Crystal Inn. We bought a cake and ordered pizza. The management of Crystal Inn was happy to let us celebrate there, as long as we cleaned up the place after the celebration. On 13 October, I and a few friends went to the outpatient clinic of HSNI to practise drawing blood from patients. I was a bit slow when performing the procedure, so the doctor there kept asking me 'Do you know how to draw blood?' On that afternoon, an incident happened. The students in CG 1&2 decided to have lunch at a restaurant near HSNI together with the lecturers, but they did not invite me and other students in CG3&4. When I told them that I wanted to join them, they also did not seem to welcome me, so in the end I chose not to join them. I felt upset because of this incident. Later, my friends in CG 1&2 told me that they did not invite us for the lunch because we had different timing and different lecturer for the afternoon teaching session. Therefore, I no longer blamed them over the incident. On 14 October, there was a case presentation session, where we presented interesting cases that we came across in the hospital.

Week 8 (16 October - 22 October):

On Week 8, we learnt about the special senses which include eyes, ears, nose, throat, breast and skin. On 16 October, my parents came to Bukit Indah to visit me. Since 2 years ago, I had itchy rashes on my neck. On that day, my father noticed that the rash was getting worse, so he took me to consult a doctor. The doctor diagnosed me with psoriasis. He said that there is no cure for psoriasis because it is an autoimmune disease, but it won't be serious. He prescribed me with betamethasone cream for the rash. Coincidentally, I learnt about psoriasis on 17 and 18 October. In the evening on 18 October, I and my CG 1-4 group mates went to Batu Pahat. I decided that starting from this week, I would clerk patients in the hospital by myself instead of clerking with my friend. On 19 October, I and a few friends went to the radiology lab of HSNI. There, we observed the procedure of taking an X-ray. I and my friends in CG 1-4 had dinner together at Crystal Cafe in Crystal Inn on that night. On 20 October, we took group photos in front of HSNI. After returning to Bukit Indah on that day, I and a few of my friends celebrated someone's birthday at a Nasi Lemak stall in Jalan Indah 16/12. We bought a cake for her. On 21 October, there was another case presentation session. This was my last session with my SG D group mates, so we took group photos together at the end of the session.

Week 9 (23 October - 29 October):

On Week 9, we learnt about the endocrine and genitourinary system. On 25 October, a fire occurred at Hospital Sultanah Aminah (HSA). I was at NUMed at that time and no NUMed student was injured in the fire. On that afternoon, there was power failure at NUMed, causing the lectures to be cancelled. Later, there was a heavy thunderstorm and the lightning kept striking. I dared not walk to my car in the car park to get my luggage because I was afraid of being struck by lightning, so I had to ask a security guard to help me. In the evening, I and my CG 1-4 group mates went to Batu Pahat. The bus driver dropped us at Old Street Commercial Centre in Batu Pahat for half an hour. It was a very nice place and I took photos with my friends there. After that, the bus driver took us to Crystal Inn. On 26 October, I and my friends in CG 1-4 planned to have steamboat at Glow Park, but it was closed. Therefore, we went to Leezo Restaurant for western food instead. My last session with my CG 1-4 group mates was on 27 October and that was the end of the System Based Weeks. We again took photos and I felt sad about having to separate with them. After returning to NUMed on that day, I drove two of my friends back to Horizon Residences. At that time, looking back at the System Based Weeks, I realised that while I was very close to some of my CG 1-4 group mates, I was not close to the rest of them. Unlike me, my best friend was close to every one in CG 1-4. I regretted this mistake very much, but unfortunately I would not be able to correct it as I would no longer be with CG 1-4.

Hospital Based Weeks (Weeks 10 - 15):

Weeks 10 to 15 were the Hospital Based Weeks. During the Hospital Based Weeks, I was in Hospital Based Group (HBG) B1. We were assigned to a different hospital every week. We had to integrate everything that we had learnt during the System Based Weeks previously. Every Monday to Thursday, we would go to the hospital. Every Friday, there would be lectures at NUMed.

Week 10 (30 October - 5 November):

On Week 10, I and my HBG B group mates went to Hospital Sultan Ismail (HSI) in Johor Bahru. On 31 October, we went to the pathology lab of HSI. There, the doctors explained and demonstrated to us the procedure of carrying out tests on specimen such as blood and urine. We also had the opportunity to perform antibiotic resistance tests. There were self directed learning (SDL) sessions at HSI on 1 and 2 November. Many of my group mates went home, but I stayed in the hospital. It was difficult to find a place to sit down and rest in HSI. While HSI had a nice library, I did not know where it was located. The environment in HSI was not very nice and I preferred HSNI Batu Pahat much more. At that time, I was still not close to my HBG B1 group mates and I missed by CG 1-4 group mates very much. On 4 November, there was a lecture on career guidance and a formative professional assessment. During the assessment, the lecturer looked at my logbook for FoCP. I had still not completed many parts of the logbook and the lecturer reminded me to complete it by the end of FoCP.

Week 11 (6 November - 12 November):

7 November was a public holiday for the Hol Day of Johor. On Week 11, I and my HBG B group mates were supposed to go to Hospital Sultanah Aminah (HSA) in Johar Bahru. However, due the fire 2 weeks ago, NUMed reduced the number of students going to HSA on each day. Therefore, we only went to HSA on 8 November. I did not like HSA because the environment there was worse compared to HSI. On that day, a few of my group mates made some cakes and they gave the cakes to every one in HBG B1. We had to go to HSI on 9 and 10 November and join other groups. On 9 November, I joined HBG F2 for the teaching session. On 10 November, I wanted to join HBG F2 again but there were too many students, so I joined HBG F1 instead. I followed my friends in HBG F1 for lunch at Restoran Anisofea Asam Pedas near HSI. On 11 November, there was a lecture on Malaria, Dengue, Typhoid and Leptospirosis.

Week 12 (13 November - 19 November):

On Week 12, I and my HBG B group mates went to Hospital Sultanah Nora Ismail (HSNI) in Batu Pahat. We travelled to Batu Pahat on 13 November and stayed overnight at Crystal Inn on 13 to 16 November. I stayed in the same room with two of my friends. I was very familiar with HSNI because I was there during the System Based Weeks. At that time, I started becoming close to my HBG B group mates. On 14 November, we had dinner together at Restoran Nikmat Tandoori. On 15 November, we had wan tan mee for dinner. We were not full after eating, so we went to Seventy Two Foodcourt for more food. At HSNI on 16 November, we went to to the Emergency Department. There, we observed doctors providing care to patients in critical condition. My friends had dinner together again on that night and they phoned me to invite me to join them. However, I was sleeping at that time so I did not answer the phone. Eventually, I had dinner myself at Crystal Cafe in Crystal Inn. We travelled back to NUMed after class on 17 November. On 18 November, there were lectures on Alcohol Misuse and Gastrointestinal System. On that day, we received a call from HSNI because we did not return the key for our seminar room in the previous day and the door was left unlocked. What happened was that someone had placed the key on my chair in the room with the intention of passing it to me, but he did not tell me about that so I did not know the key was on my chair. Luckily, the staff at HSNI later found the key on the floor in the seminar room so the problem was resolved.

Week 13 (20 November - 26 November):

On Week 13, I and my HBG B group mates went to Hospital Enche Besar Hajjah Khalsom (HEBHK) in Kluang. We travelled to Kluang on 20 November and stayed overnight at Ailang Hotel on 20 to 23 November. Only me and 3 of my friends took the bus to Kluang while the others drove there. During the journey, the television on the bus was showing the movie Skiptrace and I watched it. It was a funny and interesting movie. Ailang Hotel was not so nice compared to Crystal Inn, but it was still comfortable. I had the room by myself because my roommate went to stay at his relative's house. I had never been to HEBHK previously. The environment there was quite nice and I felt that it is even better than HSNI Batu Pahat. On 21 and 22 November, we went to the outpatient clinic of HEBHK. There, we had a lot of opportunity to draw blood and measure vital signs of several patients. The nurses were friendly and they taught us a lot. It was a great experience and I felt like a doctor. I and my friends in HBG B went to Gwee Lek Assam Pedas for dinner on 21 November. We had dinner at 128 Restaurant on 22 November. After that, we went to Kluang Mall to buy gifts for the nurses at the outpatient clinic. On 23 November, my friends had dinner together again at 128 Restaurant and they invited me to join them, but I declined because I wanted to eat something different. I had dinner myself at a burger stall in front of Ailang Hotel. At HEBHK on 24 November, I had my 2nd Formative MOSLER. This time, I performed much better compared to the previous time. We travelled back to NUMed after class on that day. On 25 November, there were lectures on Endocrine System and Clinical Chemistry.

Week 14 (27 November - 3 December):

On Week 14, I and my HBG B group mates did not go to hospitals. We only had sessions at NUMed. On 28 and 29 November, there were a revision sessions for the WriSkE (Written Skills Examination) and SBA (Single Best Answer) Paper. Then, there were clinical skills revision sessions on 30 November and 1 December. During the session, I volunteered to let 9 of my friends practise performing ECG on me. On 2 December, there were induction lectures for the Essential Junior Rotations (EJR) next semester. EJR seemed to be quite difficult and stressful. The student group list for EJR was released at that time. Most of my CG 1-4 group mates were assigned to Group 1, but I was assigned to Group 2 instead. Only 2 of my CG 1-4 group mates and 2 of my HBG B group mates would be in Group 2, and I knew very few students in Group 2. I really wanted to be in Group 1 instead, so I requested the lecturer in charge to switch me to Group 1. Unfortunately, the lecturer told me that it was not possible to switch groups because it had already been finalised. I felt very sad and disappointed about that. For a few days, I kept ranting on Facebook and I even created a Hitler Rant video. Some of my friends gave me words of encouragement to help me get over that.

Week 15 (4 December - 10 December):

On Week 15, I and my HBG B group mates went to Hospital Sultan Ismail (HSI) in Johor Bahru. At that time, my friends showed me the way to the library of HSI. I went to the library to do revision for the oncoming examination during the Self Directed Learning (SDL) time on 5 and 6 December. On 7 and 8 December, one of my friend in HBG D1 joined my group for the teaching sessions. He was supposed to go to HSA but he came to HSI because NUMed reduced the number of students going to HSA due to the fire previously. The hospital visit of the Stage 2 students were also on 7 and 8 December. We were in charge of the Stage 2 students who came to HSI. I found patients for them to clerk and had a discussion with them about the patients' case. Then, I took them around the hospital and also gave them some tips for the Stage 2 assessments based on my past experience. On both days, I and my friend went for lunch at Bharat Curry House near HSI. There, we met some students from HBG C1 and D1. On 9 December, there was a summative professionalism assessment. The lecturer again checked my logbook for FoCP during the assessment. I had completed the logbook at that time so I passed the assessment.

Week 16 (11 December - 14 December):

Week 16 was the examination week. Since the examinations were just formative, I took it easy and did not feel too stressed. I prepared for the OSCE and SBA Paper but not the WriSkE, because unlike OSCE and SBA, the WriSkE would be summatively tested only in Stage 5. On 13 December, it was the OSCE. I felt that I performed reasonably well and better compared to the Stage 2 OSCE. On 14 December, it was the WriSkE and SBA Paper. The WriSkE started first, followed by the SBA. The WriSkE was quite easy and I could answer reasonably well even though I did not prepare for it. The SBA Paper was not too difficult, except that I had to rush to finish answering all questions within the time limit. After that, it was the end of Foundations of Clinical Practice (FoCP).

Winter break:

There was a winter break which lasted about 2.5 weeks from 15 December 2016 to 2 January 2017. This was the first time since I entered NUMed where the examination was scheduled before the winter break instead of after it, so I could fully enjoy the winter break. On 15 December, I took a flight back to Subang Jaya. I went back to Kulim on 17 December. Then, I returned to Subang Jaya on 22 December. During that time, I met up with my Taylor's College friends on 24 and 29 December. I went for the Escape Room Challenge with my cousins on 25 December. On 1 January, I took a flight back to Johor Bahru.


SEMESTER 2 - ESSENTIAL JUNIOR ROTATIONS (EJR)

During EJR, I was in Group 2, which was further divided into a few subgroups for each rotation. EJR consisted of 5 rotations which are Long Term Conditions (LTC), Primary Care (PC), Mental Health (MH), Women's Health (WH) and Child Health (CH). There were MOSLER and Professionalism assessments for each rotation as well as OSCE and SBA examinations at the end of EJR. Summative assessments would count towards the final outcome of Stage 3, while formative assessments would not.

January 2017:

The Long Term Conditions (LTC) rotation began on 3 January. My subgroup for the LTC rotation was Group G. During LTC, we would go to hospitals or clinics every Monday to Thursday while there would be lectures at NUMed every Friday. There were no class on certain days. From 4 to 12 January, we were posted to Hospital Sultan Ismail (HSI). We mostly learnt about cancers during that 2 weeks. At that time, I got to know my group mates in Group G and started becoming friends with them. I started doing revision for the LTC Summative MOSLER which would be in the following month. I had the assumption that the MOSLER would only test on conditions that are in the learning outcomes for LTC, so I only revised those conditions.

On 12 January, the results of the Formative SBA, OSCE and WriSkE examinations for the FoCP last semester were released. I had been waiting of the arrival of that day, but much to my disappointment, I failed the SBA, getting only 54% while the pass threshold was 60%, and I also failed the WriSkE very badly, with a score of 37%. I got 0 mark in 4 out of 8 questions in the WriSkE because I made some critical errors. The only thing that saved me from a complete failure was the OSCE, which I managed to pass 9 out of 10 stations and get an overall score of 72.2%. Later on that day, it was my 1st Formative MOSLER for LTC. My patient was in the Oncology ward, and he had cough, shortness of breath and chest pain, so I immediately knew he had lung cancer. However, when taking the history from him, I did not ask anything about how he was managing his cancer. I also ran out of time before I could finish examining him. Then, I simply gave the diagnosis of newly diagnosed lung cancer. The lecturer said that the patient actually had pneumonia with underlying lung cancer and I did not recognise the pneumonia. As a result, I failed all domains of the MOSLER. 12 January was an extremely disappointing day for me as I failed multiple assessments, even though they were all just formative.

From 16 to 26 January, we were posted to Klinik Kesihatan Mahmoodiah (KKM). During that 2 weeks, we learnt about Diabetes, Hypertension, Asthma and Thyroid Diseases. We underwent the teaching sessions together with the students from Group H. On 17 and 25 January, I and my friends in Group G and H went out for lunch together at Restoran Yasin near KKM. On 24 January, we made a home visit to a patient with diabetes to assess how she was managing her daily life. My 2nd Formative MOSLER for LTC was on 26 January. My patient had hypertension which was well controlled. I managed to pass all domains of the MOSLER, for the first time. The Chinese New Year was on 28 January and there were 4 days of holiday from 27 to 30 January. In the morning on 27 January, I took a flight from Johor Bahru to Penang. My parents picked me at Penang airport and drove me to Kulim. I celebrated Chinese New Year in Kulim. Then, I took a flight back to Johor Bahru in the afternoon on 31 January. I decided to skip a day of class on 31 January.

February 2017:

From 31 January to 2 February, we were posted to Hospital Sultanah Aminah (HSA). 1 February was the one and only day throughout EJR where I went to HSA. This was a good thing since I didn't like the environment in HSA which was very hot and uncomfortable. There was no class on 2 February. At that time, I heard from one of my senior that the LTC MOSLER would not necessarily test on conditions that are in the LTC learning outcomes, instead any chronic condition we had learnt during the FoCP last semester could be tested as well. This worried me greatly since I had not revised anything outside the LTC learning outcomes. I quickly started revising those chronic conditions. On 3 February, it was the Formative Professionalism Assessment for LTC. At that time, I had the assumption that it is possible to pass the Professionalism Assessment without a complete logbook as long as I had no other issues with Professionalism, since the logbook was just one of the many criteria in assessing Professionalism. Therefore, I went to the assessment with an almost empty logbook. The lecturer said that this was absolutely unacceptable and he gave a fail. I felt a bit disappointed, but this incident made me realise the importance of completing the logbook.

From 7 to 9 February, we were posted to Hospital Sultan Ismail (HSI). My LTC Summative MOSLER was originally scheduled to be on 9 February according to the timetable. However on 7 February, the lecturer suddenly informed that he wanted to do the MOSLER earlier on that day itself. I immediately panicked because I wasn't prepared to do it on that day. Even though I had just finished my first round of revision for the chronic conditions that are outside the LTC learning outcomes, I felt that it wasn't sufficient and I was planning to do a second round on that two days. I explained to the lecturer that I wasn't prepared to do the MOSLER on that day, but his response was that I had known that my LTC Summative MOSLER would be on that week so there was no excuse for me to be unprepared. He insisted that I must do the MOSLER on that day, so I had no choice but to proceed with it. The patient in the MOSLER had abdominal pain at the right-upper quadrant, fever, vomiting and lethargy. He had a history of diabetes.

Then, I gave the differential diagnosis of Hepatitis and Cholecystitis. However, the lecturer immediately said that both my diagnosis were wrong. He asked for another diagnosis and gave me the clue that it was related to diabetes. I had no idea at all, so I tried answering Diabetic Nephropathy and Diabetic Neuropathy, but both were wrong. Eventually, the lecturer told me that the correct diagnosis was Diabetic Ketoacidosis (DKA). He asked me a few more questions about DKA. I had not revised anything about DKA, because I had assumed that it is an emergency acute condition instead of a chronic condition so it wouldn't be tested in the LTC MOSLER. As a result, I was unable to answer any of his questions. In the end, the lecturer let me pass the Information Gathering, Technical & Procedural Skills and Communication Skills domains, but as expected he gave me a fail for the Clinical & Diagnostic Reasoning domain. This was the first summative assessment I failed in the MBBS course and I was very disappointed. After that, I started revision for the ID Summative MOSLER which would be on 23 February.

From 13 to 23 February, it was the Infectious Diseases (ID) weeks. For the first ID week, we were posted to Hospital Sultanah Nora Ismail (HSNI) Batu Pahat, while for the second ID week, we were posted to Hospital Enche Besar Hajjah Khalsom (HEBHK) Kluang. I heard from my friends that the lecturer might once again do the ID Summative MOSLER earlier, possibly in the first ID week. Luckily, not many conditions would be tested in this MOSLER and they were not difficult to revise, so I could complete a few rounds of revision within a few days. On 12 February, we travelled to Batu Pahat. Eventually, the lecturer decided to do the ID Summative MOSLER on 14 February. My patient had shortness of breath with no other symptoms. He had a history of asthma. I gave the diagnosis of community acquired pneumonia, but the lecturer said that the patient's chest X-ray was clear. I then tried giving a list of several diagnoses including COPD, laryngitis, pharyngitis and epiglotitis. For each of the diagnosis, the lecturer asked me if there were supporting features of it. I wasn't sure of the answers, so I tried to divert the lecturer's attention by simply saying anything I knew, even if it wasn't really relevant to his questions. I thought I was going to fail the Clinical and Diagnostic Reasoning domain again, but luckily the lecturer decided to give me a borderline pass for all domains of the MOSLER.

After passing the ID Summative MOSLER, I was quite relaxed for the remainder of the ID weeks. We were taught by the same lecturer throughout the two ID weeks. His teaching was unique such that every day he would take us on a ward round with bedside teaching, while we didn't have to clerk patients ourselves. On 15 February, I and my friends in Group G went for dinner together at Leezo Restaurant in Batu Pahat. We returned to NUMed in the afternoon on 16 February. On 19 February, we travelled to Kluang. Every morning on 20, 21 and 22 February, I and my friends in Group G would have breakfast at Kluang Railway Station before going to the hospital. Then on 22 February, we went for dinner together at Kenny Rogers in Kluang Mall. During that week, I spent some time in the hospital looking for patient cases to fill up my logbook. The grouping for the oncoming PC rotation was released on 22 February. I would be reallocated to a different subgroup for PC, and I did not like someone in that group because I had the impression that she was very fierce. As a result, I was unhappy about the PC grouping. In the afternoon on 23 February, we returned to NUMed.

On 24 February, it was the Summative Professionalism Assessment for LTC. Since I had completed my logbook at that time, I passed the assessment. That was the last day of the LTC rotation. I met the lecturer in charge for PC to request for a change in the subgroup. The lecturer refused to let me switch groups because he wanted me to 'learn to work with different people' and also because the grouping had already been finalised. I had no choice but to remain in the group that I was allocated to. Later on that day, I started feeling sick. My friends in Group G except one were sick as well. We probably got infected by one of the patients when we were at the Kluang hospital. Over the next few days, my sickness became worse and I was very tired all the time. This was the first time where I fell really sick ever since August 2009. On 27 February, the Primary Care (PC) rotation began. During PC, we would go to clinics every Monday to Thursday while there would be seminars at NUMed every Friday. Because of my sickness, I had to skip class on 28 February.

March 2017:

From 28 February to 9 March, we were posted to Klinik Kesihatan Taman Universiti (KKTU). On 1 March, I felt better so I was able to attend class at KKTU. I got to know my group mates in my PC group. The group leader named our group as Prime Prime Care Group. On that day itself, I realised that I had misjudged the person which I earlier thought was very fierce. In reality, she is not fierce and she is actually quite nice. In fact, every one in Prime Prime Care Group is very nice and they quickly became my close friends. We went for lunch together at Shibam Hadramawt Restaurant on that day. At KKTU, most of the patients had either Acute Gastroenteritis or Upper Respiratory Tract Infection. The lecturer who taught us for that two weeks was my personal tutor and her teaching sessions were really interesting. On 3 March, there were student presentations at NUMed, during which I presented together with my group mates. I fully recovered from my sickness on that day, after about one week. At that time, I started doing revision for the PC Summative MOSLER.

Every day, I and my friends in Prime Prime Care Group would drive to the clinic together, and this further strengthened our relationship. We had lunch together at Pomegranate Garden Restaurant on 6 March and at McDonald's on 8 March. On 7 March, two students from another group joined our group at KKTU as their lecturer was on leave. We went for lunch together with them at SDS Restaurant. Then on 9 March, once again another two students from a different group joined our group. Being an awesome group, we were very welcoming towards anyone who joined our group and we made them feel as being part of our group. Occasionally, there were student presentations at the clinic. I was able to present quite well each time because I made adequate preparation for it. One thing that I really liked about the PC rotation compared to the other rotations was that the lecturer guide us in finding patients and then observe us when we clerk the patients.

From 13 to 22 March, we were posted to Klinik Kesihatan Mahmoodiah (KKM). For that two weeks, we were taught by a different lecturer. Her teaching sessions were also interesting, except that she was a bit strict. I and my friends in Prime Prime Care Group went for lunch together at a Chinese restaurant on 13 March and at Sedap Corner on 15 March. On 14 March, we were once again joined by two students from another group. We had lunch together with them at McDonald's on that day. Then on 16 March, I drove my friends for the first time to KKM. We went for lunch at Restoran Yasin on that day. My Formative MOSLER for PC was also on that day. My patient had subclinical hyperthyroidism. I was able to pass all domains of the MOSLER and this greatly boosted my confidence. On 20 March, we had lunch together at a Malay restaurant. The grouping for the oncoming MH rotation was released on that day. I would be placed in Group B for MH and I was really happy about that, because many of my friends in Prime Prime Care Group and LTC Group G would be in Group B as well. This was a win-win situation because I would not have to separate with my friends in Prime Prime Care Group and I would also get to reunite with my friends in LTC Group G. I was really lucky as my position in the name list was at the 'borderline' between Group B and C, and the lecturer in charge decided to put me in Group B instead of Group C.

Three of my friends in Prime Prime Care Group had their PC Summative MOSLER on 21 March. All of them passed all domains of the MOSLER. After that, we went for lunch together at Nasi Kukus Ayam Dara. On 22 March, it was my PC Summative MOSLER. I once again drove my friends to KKM on that day. My patient in the MOSLER had a skin lesion on his right toes. I gave the differential diagnosis of Cellulitis and Impetigo. The lecturer told me that Cellulitis was the correct diagnosis. She then asked me a few more questions about Cellulitis and I could answer many of them correctly. Therefore, I successfully passed all domains of the MOSLER. This MOSLER was the first MOSLER where I performed quite well and I was very glad about this. After that, it was the Summative Professionalism Assessment for PC. While my friends were undergoing the assessment, I quickly filled up a part of my logbook which I hadn't filled up earlier as I was busy revising for the MOSLER. I finished it just in time when it reached my turn for the assessment, so I passed the Professionalism Assessment. Then, I and my friends went to Hua Mui Restaurant for lunch. After lunch, we walked around the area nearby and had desserts at Sangkaya.

My birthday is on 23 March and it was a public holiday in Johor on that day. I received birthday wishes from many of my friends. I felt very grateful on my birthday this year, due to the fact that I passed the PC Summative MOSLER and got allocated to Group B for the MH rotation which I really liked. On 24 March, it was the last day of the PC rotation. On that afternoon, I took a flight back to Subang Jaya for just one night. My parents brought me for dinner at The Ship on that night to celebrate my birthday. Then, I returned to Johor Bahru on 25 March. On 27 March, the Mental Health (MH) rotation began. Unlike the LTC and PC rotations, most of the MH topics were completely new topics that I hadn't encountered previously, so I expected that MH would be difficult. Since I had previously known every one in Group B, I was already close to them on the first day itself. From 27 to 31 March, all teaching sessions were conducted at NUMed. There were a few simulated patients at NUMed and we had to clerk them. I clerked a simulated patient with Schizophrenia on 28 March. Due to the fact that history taking in MH was quite different compared to the other rotations and that I lacked experience, I performed quite poorly. Later on that day, I received a birthday card from one of my Taylor's College friend who was studying in UK. It was a lovely card and I really appreciated it.

April 2017:

On 3 April, we were posted to Hospital Permai and that was the first time I went there. The environment at Hospital Permai was quite nice, but its compound was very large so we had to walk a lot. On 4 April, we were posted to Hospital Sultan Ismail (HSI). I decided to travel to HSI by GrabCar instead of following the bus arranged by NUMed. However, the GrabCar driver never arrived after I waited for a long time. Worse still, I couldn't call the driver because my phone's service was suspended temporarily by Maxis. I tried booking another GrabCar or GrabTaxi ride, but there were no other drivers available. Eventually, I was able to book a GrabTaxi ride only after trying several times. As a result, I arrived late for class at HSI and had to explain to the lecturer what happened. Later on that day, we made a home visit to a patient with dementia to assess how she was managing her daily life. I and my friends in Group B had lunch together in the hospital on 3 and 4 April. We were posted to Cure and Care (C&C) Rehabilitation Centre on 5 April. At C&C, I clerked two patients with substance misuse disorder for about 1 hour per patient. After that, I and my friends went for lunch together at Boat Noodle Teh O Ice 50 Cent.

On 6 April, it was the Formative Professionalism Assessment for MH. My logbook was largely complete at that time, so I passed the assessment. After the assessment, the students in Group A wanted to watch the movie Beauty and the Beast at TGV Cinema, AEON Bukit Indah. I and my friends in Group B decided to join them in watching the movie. This was the first Disney movie I ever watched and it was really interesting. At that time, even though I was really happy to be in Group B for the MH rotation, there was something that made me feel insecure. Since my position in the name list was at the 'borderline' between Group B and C, I might be reallocated to Group C for the oncoming WH and CH rotations. I really liked Group B and I didn't want to separate with my friends in Group B. Worse still, when I checked the previous groupings for WH and CH, I noticed that the student at the same 'borderline' position was always placed in Group C. On 7 April, I decided to meet the lecturer in charge to request in advance regarding the subgroup for WH. He confirmed that I had indeed been allocated to Group C. Even though there was still 4 weeks until the start of WH, he told me that the grouping was close to being finalised and that it would be troublesome to make changes to it. I refused to give up on the request. After a long talk with him, he said that he would 'consider' letting me switch to Group B, but he didn't sound quite promising. This made me feel very distressed for a few days after that.

From 8 to 24 April, there was 2 weeks of Easter break. On 8 April, I took a flight back to Subang Jaya. Later on that night, my parents drove me to Kulim. I stayed in Kulim for one week. I started my revision for the MH Summative MOSLER at that time. The revision was quite relaxing because there were only a few learning outcomes for MH. On 11 April, the lecturer in charge informed me that he had decided to let me switch to Group B for the WH rotation. I was very happy and relieved that my efforts was successful in the end. However, I didn't tell my friends in Group B about that because I wanted to give them a surprise. On 15 April, I took the Electric Train Service (ETS) back to Subang Jaya and I stayed there for one week. Then, I returned to Johor Bahru on 22 April. NUMed reopened on 25 April. We were posted to Hospital Permai on 25 April and HSI on 26 April. On both days, I and my friends in Group B had lunch together in the hospital.

On 26 April, I happened to meet some of my friends from EJR Group 1 who were my group mates during the FoCP last semester. I found out that they had recently created a WhatsApp group for Group 1. I requested them to add me into their WhatsApp group so that I could better keep in touch with them. However, the admin of the group who is my close friend stated that he couldn't add me in because if he did, he would also have to add in every one else who made similar requests. I wasn't actually upset about that as I understood his position. Nevertheless, my interest in Group 1 waned after that incident. I decided to fully embrace Group 2 as my one and only group for EJR and to make efforts to further strengthen my relationship with my friends in EJR Group 2, particularly Group B. On 27 April, I and every student in EJR Group 2 went to C&C Rehabilitation Centre. There were student presentations at C&C by the students in Group A and C. The audience were our lecturers and a few staffs at C&C. After the presentations, the lecturer provided lunch for every one of us as well as the C&C staffs. Then, we returned to NUMed. Since I and my friends in Group B didn't give presentations at C&C, we presented at NUMed on that afternoon instead. On 28 April, I went to meet the lecturer in charge to request in advance regarding the subgroup for the CH rotation, 5 weeks before the start of CH. Similarly to WH, I had been allocated to Group C for CH. The lecturer was very nice and understanding. She instantly agreed to let me switch to Group B and the whole process was done within a minute. I was definitely very delighted by this.

May 2017:

On 2 May, there were clerking sessions at NUMed. Two real patients with substance misuse disorder came to NUMed and we clerked them. The grouping for the oncoming WH rotation was released on that day, and it confirmed that I would be in Group B. My friends in Group B were really surprised about that. After I told them everything, they congratulated me for my efforts and said that they too were very happy to continue have me in Group B. My MH Summative MOSLER was held at NUMed on 3 May. My patient in the MOSLER had visual hallucinations, delusions, thought withdrawal and thought insertions. The patient was quite cooperative which made the history taking easier. I gave the diagnosis of Paranoid Schizophrenia which was right, and I correctly answered most of the lecturer's questions. The lecturer said that I performed very well and I passed all domains of the MOSLER successfully. On 4 May, it was the Summative Professionalism Assessment for MH. I passed the assessment since I had completed my logbook. The last day of the MH rotation was on 5 May. Later on that day, the lecturer in charge informed that there would be some changes to the subgroups for WH. I remained in Group B, but two of my friends in Group B were reallocated to Group C. This change was due to the concerns raised by the students in Group C regarding the large number of boys compared to girls in their group which may adversely affect the teaching in WH. They were convinced that it was possible to request for a change in the grouping after they knew that I successfully requested to switch from Group C to B earlier.

I started feeling sick on 7 May. My sickness was almost as bad as the one I had at the end of February previously. On 8 May, the Women's Health (WH) rotation began. During WH, we would go to hospitals every Tuesday to Thursday while there would be seminars at NUMed every Monday and Friday. There were a lot of topics in the learning outcomes for WH and they were all completely new topics that I hadn't encountered previously, so WH was definitely the most difficult rotation in Stage 3. From 9 to 18 May, we were posted to Hospital Sultan Ismail (HSI). Due to my sickness, I was unable to do any revision. I initially wanted to skip class on 9 May, but I eventually decided not to because I was worried that I might miss out a lot if I did so. 9 May was a terrible day for me. There was long hours of teaching session on that day, while I was feeling tired all the time due to my sickness. The teaching session was also quite intense as the lecturer was rather strict. Even during the lunch break, we had to spend some time clerking patients. I was truly exhausted at the end of the day. Luckily, it was a public holiday on 10 May so I could rest. On 11 May, I was still sick although I was getting better. There was only half day of class on that day so I attended it. I definitely chose to skip the optional evening shift on that night.

I fully recovered from my sickness on 13 May. My parents came to visit me on 14 May. I began my revision for the WH Summative MOSLER at that time, but I was already left behind by quite a lot compared to my friends. On 16 May, we went to Klinik Kesihatan Taman Universiti (KKTU). At KKTU, we observed the antenatal and postnatal check-ups. On 17 May, once again there was long hours of teaching session at HSI. Because I was struggling to catch up with my studies, I was unable to engage actively in the teaching session, and this gave the lecturer a bad impression on me. We were supposed to go to the obstetrics operating theatre on 18 May, but the lecturer decided to have teaching session instead because this was more important. There was a Formative Professionalism Assessment for WH on 19 May. My logbook was mostly complete at that time so I passed the assessment. On 20 May, there was a Saturday session at HSI. There was a case of Caesarean section on that day and I wanted to observe it at the operating theatre. The surgeon agreed to let me observe, but the nurse wouldn't allow because the patient had Hepatitis and she was afraid that I might get infected. I then went to the labour ward. There, I had the opportunity to observe three cases of delivery. On that afternoon, I and my friends in Group B went for lunch together at The Toast. After lunch, we walked around the surrounding area for quite some time.

Throughout the WH rotation, I hardly clerked patients in the hospital, except when required by the lecturer, because I felt that it was no longer important since I had already passed the Information Gathering, Technical & Procedural Skills and Communication Skills domains in four Summative MOSLER's which was the minimum required. I only cared about the Clinical & Diagnostic Reasoning domain which I still needed to pass in one more MOSLER, and I kept doing revision to pass this domain in the WH Summative MOSLER. On 22 May, there was a new update for my favourite video game Clash of Clans known as the Builder Base update, which was one of its greatest update in history. I just couldn't resist my temptation to try out the update, and this affected my revision for the WH Summative MOSLER to a certain extent. On 23 and 24 May, we were posted to Hospital Sultanah Nora Ismail (HSNI) Batu Pahat. We travelled to Batu Pahat on 22 May. At night on 23 May, I and my friends in Group B, together with a few students in EJR Group 1 who were also in Batu Pahat, went for dinner at Grand Sea View Restaurant. On 24 May, I and my friends in Group B had breakfast together at Ramli Kopitiam before going to the hospital. My Formative MOSLER for WH was on that day. My patient was admitted for induction of labour because she had hypertension during the pregnancy. I didn't recognise that the patient had preeclampsia and I couldn't answer some of the questions that the lecturer asked me. In the end, I passed the Information Gathering and Communication Skills domains while I failed the Technical & Procedural Skills and Clinical & Diagnostic Reasoning domains. After class, we went for lunch at Asam Pedas 2000 together with the lecturer before returning to NUMed.

On 30 May, it was my WH Summative MOSLER at HSI. My patient in the MOSLER had bleeding in early pregnancy. At once, I thought of the differential diagnosis of miscarriage, ectopic pregnancy and molar pregnancy. I felt rather relieved because it seemed to be an easy case. When taking the history from the patient, I mostly focused only on the bleeding and I did not explore further. I was not serious in the history taking because I already had the differential diagnosis in mind. I was also quite rushed and I showed little empathy to the patient. Then, I poorly performed the physical examination on the patient due to my lack of practice. Based on the history, I figured out that the patient most probably had an incomplete miscarriage, and I gave that as the first differential diagnosis. I was able to answer most of the questions by the lecturer fairly well. I felt that I should be able to pass at least the Clinical & Diagnostic Reasoning domain, which was all I wanted. However, much to my disappointment, the lecturer gave me a fail for all domains of the MOSLER including Clinical & Diagnostic Reasoning. He said that the patient had a fever which I did not enquire about, and that the actual diagnosis was septic miscarriage instead of incomplete miscarriage. The outcome of the MOSLER was extremely devastating for me. Worst of all, I was the first student in the history of NUMed to have failed all domains in a single summative MOSLER. After the MOSLER, I and my friends in Group A and B had lunch together at Wafu Restaurant, but I had no mood for that because I failed the MOSLER. Later on that day, the grouping for the oncoming CH rotation was released, and it confirmed that I would be in Group B. My two friends who were reallocated to Group C for WH would be back in Group B for CH.

June 2017:

On 1 June, it was the Summative Professionalism Assessment for WH. Since my logbook was complete, I was able to pass the assessment. During the assessment, the lecturer who had known about my failure in the MOSLER encouraged me not to give up. That was the last day of the WH rotation. Later on that day, I tried to make an appeal for the Clinical & Diagnostic Reasoning domain of the WH Summative MOSLER, on the grounds that I was still able to make a reasonable diagnosis based on what I got from the patient. However, I was told that I failed because of my poor history taking which prevented me from making the correct diagnosis, and that all domains of the MOSLER were viewed as a whole. Since I failed the Clinical & Diagnostic Reasoning domain in both the LTC and WH Summative MOSLER, this put me in a difficult situation. It was a must for me to pass that domain in the oncoming CH Summative MOSLER, otherwise I would fail the entire Stage 3. I tried to identify all the factors that contributed to my failure in the WH Summative MOSLER so that I could avoid repeating the same mistakes in the CH rotation. I also started revising for the CH Summative MOSLER at that time.

On 5 June, the Child Health (CH) rotation began. During CH, we would go to hospitals every Tuesday to Friday while there would be seminars at NUMed every Monday. There were many topics in the learning outcomes for CH, but many of them were similar to the topics learnt in FoCP last semester, so CH was easier than WH. Unlike the other rotations, in CH we take most of the history from the patient's caregiver instead of the patient since they are children. We went to Klinik Kesihatan Taman Universiti (KKTU) on 6 June. At KKTU, we observed the immunisation and assessment of developmental milestones of children. Then, we visited the Johor Cerebral Palsy Association on 7 June. The visit was interesting in the beginning, but as time went on it became quite boring because it was too long. On 8 and 9 June, we were posted to Hospital Sultan Ismail (HSI). The Paediatric wards at HSI were quite nice compared to the other wards. Throughout the CH rotation, I would clerk cases in the hospital whenever there was opportunity so that I could improve my skills. I had realised that making the right diagnosis requires taking a good history. I also made sure to engage actively in all teaching sessions, which was possible since I did prior revision. The lecturer who knew that I failed the WH MOSLER gave me extra guidance for CH by making me answer many questions during the teaching sessions to stimulate me to think. My friends also tried to help me by observing me when I clerk cases and giving feedback afterwards. I was definitely thankful about that.

From 13 to 15 June, we were posted to Hospital Sultanah Nora Ismail (HSNI) Batu Pahat. On 12 June, we travelled to Batu Pahat. I wanted to stay with one of my friends at the hotel in Batu Pahat, but he chose to stay with another friend. I and my friends in Group B went for dinner together at an Arabian restaurant on 12 June and at Warung Pokok Ubi on 13 June. On 14 June, we again had dinner together at Riverside Foodcourt. After dinner, we went to a roadside stall to buy some desserts. Then, we returned to NUMed after class on 15 June. My friends were practising for the oncoming OSCE on that afternoon, but I didn't join them because I wanted to focus on the CH Summative MOSLER. We had a ward round at HSI on 16 June. From 20 to 23 June, we were posted to HSI once again. We went to the Neonatal Intensive Care Unit (NICU) on 20 June. At the NICU, we saw many cases of prematurity and neonatal jaundice. Then, we went to the day care of HSI on 21 June. There, I clerked a case of brain tumour. On 22 June, it was my Formative MOSLER for CH. My patient had fever and fits and he was recently infected with chickenpox. I gave the diagnosis of Febrile Seizures Secondary to Varicella Zoster Infection and I could answer many of questions asked by the lecturer. However, the lecturer said that the actual diagnosis was Meningitis Secondary to Varicella Zoster Infection. I had forgotten that Meningitis is an important complication of chickenpox. Eventually, I passed the Information Gathering and Communication Skills domains while I failed the Technical & Procedural Skills and Clinical & Diagnostic Reasoning domains. My friends who observed my MOSLER said that I did perform fairly well despite failing the two domains and that I got a really difficult case. On 23 June, it was the last day of hospital teaching session for Stage 3.

There were 4 days of holiday from 24 to 27 June for Hari Raya Aidilfitri. On 28 June, it was my CH Summative MOSLER at HSI. I felt quite nervous because the outcome of this MOSLER would determine my fate. My patient in the MOSLER had fever, fits and cough. She started crying and moving about when I performed the physical examination on her, but I could still complete the examination. I gave the differential diagnosis of Meningitis and Febrile Fits Secondary to Pharyngitis. The lecturer asked me a few questions and I could answer most of them fairly well. She then said that the actual diagnosis was Febrile Fits Secondary to Pharyngitis. She gave me a pass for all domains of the CH Summative MOSLER, but she also noted that I still had room for improvement. I was very happy about that and my friends congratulated me for that. Every one else in EJR Group 2 passed the MOSLER as well. Later on that day, I and my friends in Group B went for lunch together at The Toast. On 29 June, it was the Summative Professionalism Assessment for CH. I made sure to complete my logbook because I didn't want to disappoint the lecturer who gave me all the guidance during the CH rotation. She gave me very positive feedback during the assessment and I passed it successfully. Later on that day, there was a role play session about medical ethics. The last day of the CH rotation was on 30 June.

July 2017:

After the CH rotation ended, I started my revision for the SBA examination. The SBA would test on everything learnt throughout all rotations. Thanks to the fact that I had previously done a lot of revision for the MOSLER's for every rotation, this made my revision for the SBA much easier. It didn't make me feel too stressed, in fact my revision for the Stage 2 Progress 2 examination was much more stressful. On 3 July, there was a revision session for the OSCE and SBA examination at NUMed and I attended it. During the session, there were three Mock OSCE stations on ECG, Thyroid Examination and Giving Explanation. On 9 and 10 July, I did revision for the OSCE. I went through the checklists for each clinical skill and watched the clinical skills videos by Geeky Medics on YouTube. I also practised the OSCE with one of my friend on 10 July. On 11 July, it was the Exemption OSCE. The OSCE stations were not difficult and I felt that I performed fairly well in all stations. I was quite confident that I would be able to pass it. After the OSCE, I continued revising for the SBA examination.

Paper 1 of the SBA examination was on 17 July. The paper was rather difficult. Although there were some easy questions, many of the questions were quite tricky. I was able to finish the paper 45 minutes before the time was up. On 18 July, it was Paper 2 of the SBA. Paper 2 was similar in difficulty to Paper 1. I estimated that I would be able to score at least 56% in the SBA, but the pass threshold was usually higher than 60%. Immediately after Paper 2 ended, the list of students required to attend the Confirmation OSCE was released. I was not required to attend it, and this meant two possibilities, either I had passed the Exemption OSCE, or I failed it so badly that even getting 100% in the Confirmation OSCE wouldn't be sufficient to pass. The actual results of the Exemption OSCE wasn't released at that time. However, I was pretty sure that the second possibility was extremely unlikely. Later on that day, I went to the Student Office to make an advance request regarding the grouping for the oncoming Stage 4. I knew that NUMed would most probably reallocate students to different groups again, but I wanted to continue to be in the same group with my friends in Group B. Unfortunately, the Student Office refused to consider my request no matter what. This was definitely disappointing, and I could only hope that I would be lucky enough to be in the same group as my friends. Starting from 19 July, I had 6.5 weeks of summer break until 3 September. Compared to the previous years, the break was much shorter this year.

On 20 July, I and my friends in Group B went for breakfast together at a Chinese restaurant in Bukit Indah. Later on that day, my parents came to Johor Bahru and drove me back to Subang Jaya. Then, I went back to Kulim on 23 July. Even though all my examinations were over at that time, I still felt quite worried and stressed because the SBA examination results was yet to be released. Quite a number of students failed the SBA in the previous year due to the high pass threshold. Anyone who failed the SBA would have to repeat the entire Stage 3 as the final attempt. On 31 July, the overall Stage 3 results was released. I was so nervous that I dared not check the overall results straight away. Instead, I checked my results for the Professionalism Monitoring first, followed by the Exemption OSCE and finally the SBA. As expected, I passed the Professionalism and OSCE. In fact, I performed quite well in the Exemption OSCE, passing all 10 stations and getting an overall score of 76.9%. Then, I was so happy to know that I passed the SBA. My score in the SBA was 67% which was a borderline pass, while the pass threshold was as high as 64.3%. With that, I passed Stage 3 of MBBS successfully and could proceed to Stage 4. It felt like a miracle that I managed to overcome all difficulties that I faced and pass Stage 3. That marked the end of Stage 3.


CONCLUSION:

I definitely had a great experience during FoCP which I will remember forever. Initially, I was unhappy that I was assigned to HSNI Batu Pahat for the System Based Weeks and I preferred HSI or HSA instead, because I didn't like the idea of having to travel to Batu Pahat and stay overnight there. It turned out that I enjoyed Batu Pahat a lot. My experience definitely wouldn't be that good if I was assigned to HSI or HSA. In the past, I had always thought that FoCP would be very stressful. It turned out that FoCP wasn't stressful actually, because all the assessments were just formative. Instead, Stage 1 and 2 were more stressful. FoCP was very interesting. In fact, I think it is the most interesting semester in MBBS. During FoCP, for the first time I felt that I am really studying Medicine, unlike Stage 1 and 2. My awesome friends in CG 1-4 and HBG B made my FoCP experience even better. We had a lot of interesting activities together. In particular, we were very close whenever we were in Batu Pahat or Kluang, which is why I like these two places a lot.

I also definitely had a great experience during EJR which I will never forget. Compared to the FoCP, EJR was more stressful mainly due to the monthly Summative MOSLER's. However, the MOSLER's were really helpful as they keep me engaged with my studies consistently, which later made my revision for the SBA examination much easier. My greatest disappointment in EJR was my failure in all domains of the WH Summative MOSLER, but it was actually a 'blessing in disguise' because it forced me to change my approach to avoid the same mistake during the CH rotation. I was quite satisfied with my results in the SBA examination even though it was just a borderline pass, as it was a huge improvement compared to the FoCP SBA which I failed. During Stage 1, Stage 2 and FoCP, I relied entirely on the lecture notes when revising for examinations. However, just reading the lecture notes was no longer sufficient for EJR, so I read the textbooks as well. The textbooks actually gave me a better understanding than the lecture notes. I had a lot of opportunities to be together with my group mates during EJR, and this strengthened our relationship. I had lot of nice memories with my awesome friends in Group B, Prime Prime Care Group and Group G, which made my EJR experience even better. In overall, my most favourite rotation was PC, followed by CH, MH, WH and finally LTC.


Plot twist:

On 4 September 2017 which was supposed to be the first day of Stage 4 of MBBS, NUMed unexpectedly announced that the results of the Stage 3 SBA examination in July was invalid due to a security breach and that every student had the resit the SBA examination on 14 and 15 September. I wrote about the whole incident here:
http://daniellimjj.blogspot.com/2017/09/4-september-2017-incident.html


If you liked this story, you may want to read these too:
http://daniellimjj.blogspot.com/2018/08/my-4th-year-of-mbbs-course-at-numed.html
http://daniellimjj.blogspot.com/2016/12/my-2nd-year-of-medicine-course-at-numed.html

For information about the MBBS course at NUMed, go to this link:
http://daniellimjj.blogspot.com/2017/07/information-about-mbbs-course-at-numed.html

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