Life's simple things.....

Thursday, October 29, 2009

Hey Jude

~Cover by Hugh Laurie (The Beatles)

My 1000th post=) Logged onto blogger to realise tt the number was 999. So I just had to post something today!=)

Have a great day everyone!

10/29/2009 07:44:00 PM

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Saturday, October 24, 2009

Where do we draw the line?

Where do we draw the line? Between a government's perception of national interests and that of humanity and individual good.

There is no doubt that most people do things for the "better good". However, different people and different groups have different perceptions on what they believe the "better good" to be. And to make this matter more complicated, politics has blurred this definition even further.

A nation's interest is important. It helps increase our affluence, bring recognition and increase opportunities. In order to do that, Singapore needs to advance and improve. The buzz phrase is, "we need to constantly change to keep ourselves competitive in this constantly evolving world".

But no change is without consequences.

For example, all my previous schools, my favourite spot at ECP, places etched within my memory have all changed beyond recognition. My primary school was totally demolished to make way for something bigger so as to accommodate more students. It even has a nice proper field that doesn't have a hole in the middle of it that converts into a pond after a downpour. My once-favourite bench at ECP is now a brightly lit hangout with a bar located right behind it, playing loud music into the wee hours at night. As for my other quiet hangouts? Needless to say, they are now either made of concrete or recently converted into construction sites.

But they now benefit more people and that is a good thing. No doubt about that.

"Happiness" has now become a collective definition.

There is no space for specialised areas of happiness in an island as small as this. Because in land-scarce Singapore, filled with individuals from so many diverse backgrounds, it would be more "economical" to allocate a space that makes 80% of the people "slightly/moderately happy", than to just cater to 5% of people---even if those spaces might bring these small groups of people "extreme happiness". All this is just arbitrarily speaking, of course. But the fact of the matter is that is the truth.

Due to our small size, it is also difficult to have a sustainable economy catering to different views and to different perceptions of "happiness". In other words, it is not possible to fragment Singapore's economy or land space into clusters whereby each cluster has a particular niche/view. There are simply not enough resources and space to do so.

With regards to the present debate over the changing medical education, there has been some interesting points being exchanged before us--be it through the newspapers, briefings, meetings, personal encounters or via online sites.

The logic for the change is simple, create more specialists in a shorter time, and Singapore will be less reliant on overseas doctors to cover up the "shortage". The plan is also simple, create a factory-equivalent production-line to churn out these doctors so that the new "system" will be able take in and produce more "specialists".

Once again, the root question that one would instinctively ask is, "what is this 'national shortage' of doctors?" But that would be best answered by someone else in a better position, who is in the know.

Whatever it is, I have no doubt that these people are thinking of the "better good" when they implemented these changes. In a country as clean as Singapore, one can rest assured that there is no personal gain to be gotten out of any of this. If anything, I am sure the advocates for this are losing sleep and are on the receiving end of numerous complaints.

So instead of talking from a national point of view, let's discuss this issue from the flip-side----that of the individual and of medicine.

1) I am currently a medical student, and as a lowly individual in this massive system, I must admit that it gets quite daunting at times. News of this radical change just broke out only a few months ago, and we only received our first official briefing a few weeks back. Now, we are forced to decide on the future of our lives even before we graduate.

With the merits of this unproven and unaccredited system still being debated by opposing parties, the students are scrambling about to find out as much as we can about the various specialties, working-life and the different hospital environments.

Overlooking the numerous ongoing debates on the pros and cons of the system, another main request by everyone (from senior doctors to students) is "why couldn't the residency program be designed to start after the one-year houseman-ship?"

The merits for this request are overwhelming. They include the following:

As a doctor said in today's Straits-Times forum, houseman-ship acts as a good initiation process, during which important lessons and experiences are acquired.
By allowing fresh graduates to experience at least one year of working life, they will be in a better and more mature position to decide on their future specialty---a path where they are supposed to stay on for the rest of their lives.
By continuing with the tried-and-tested houseman-ship, this would give students the peace of mind to tackle each obstacle one at a time. The one mantra that every senior doctor/tutor have constantly drilled into us is that all of us should first aim to be a SAFE doctor. So that when we graduate, we can function as responsible doctors for our patients. After all, there is no point being an outstanding "know-it-all", if we are dangerous doctors. The MBBS, like all university final exams, is a daunting exam and the amount of content is immense. By giving us a buffer of one year, this would greatly reduce the distractions from us, students, and allow us to concentrate on gaining the necessary knowledge. Instead, now, on top of studying, we have to seriously consider about our futures, resumes, letters of recommendation, the various specialties, personal statements, hospital environments, interviews, ranking of choices, contacts etc etc etc.
The response by advocates to this request, is that this system is catered to those individuals who have already decided on their specialties. Why stick to a system that shortchanges those who have already decided on their specialty? That is indeed a fair and noble point. However, as numerous senior doctors have pointed out, their aspirations as a medical student were poles apart from where they are now. Their goals and views changed drastically after starting work. Priorities have also changed due to different opportunities, experiences gained and new circumstances, such as a spouse and a family. Things like these can never be accounted for unless given time to experience for oneself.

I have no stand on this. In fact, I have actually decided on a specialty and am pretty set on it, for now at least. But this decision is based on my limited exposure to that specialty as a medical student.

As our respected seniors and mentors, we trust them when they say that it would be good to work for a few years and take our time to decide. Especially when they themselves share their personal stories of how they initially wanted to be a surgeon/physician, but eventually ended up being where they are. Most of whom are extremely outstanding in what they do now. But then again, if given an opportunity to cut short our training time, most of us would rather choose that option.

At the end of the day, doctors who went through the system do feel very strongly for this one-year experience. And these are the exact same doctors who have been mentoring generations of medical students.

And the reality is if everyone simply acted out of their own free will since young, without the advice of elders, most of us would have quit school to become adventurers, soccer players, artists, dancers, boxers, firemen and singers. But goodness knows, we are simply not talented enough nor cut out for these jobs. Our decisions then were mere dreams, based only on the superficial attractiveness of glamour, shiny uniforms, excitement and half-baked stories.

So I thank God for my parents for keeping me in school all these years. Likewise, these senior doctors need to guide the future generations. Do not make political decisions without consulting these doctor----our mentors. More importantly, do not remove something as irreplaceable as experience for the sake of "cutting short the process". Especially when we are going to be doctors for the rest of our lives.
But then again, the actual trigger for this drastic change, and the reason as to why the deadline for this change has to be now may be something else altogether. Something that the public isn't made aware of. But that is politics.

2) They say medicine is a calling and that it is a noble profession. They also say that it is supposed to be about the patient, They say that the relationship between a doctor and his patient should be top priority. They say medicine is about healing, comforting and relief. But that is what they say.

After all, we are not doctors in a small community or doctors in a rural secluded village. As doctors in Singapore, we belong to a system that has to cater to 4 million residents, while ensuring that we live up to national goals of being a Medical Hub for the region/world.

The issue is not about who is right or wrong. The issue at hand is about balancing. Drawing a line between that of national interests and that of the community/individual/profession.

Medicine can't be totally viewed as a revenue-making commodity or a resource that needs to be maximised for best economical returns. Likewise, doctors need to understand that medicine cannot be so idealistic where it is all about doing what we want, how we want and whenever we want. The simple reality is we have to serve 4 million Singaporeans.

It's all about compromising and balancing both sides, so that we don't lose our humanity for the sake of national ambition, nor neglect a population of patients for the sake of practicing "idealistic" medicine.

At the end of the day, we must all remember that everyone has the "best interest" of everyone in mind. The difference is in our perspectives.

But for the sake of sanity and progression, we have to agree to disagree. Most importantly, decisions have to be made with due consideration and adequate consultation with the affected parties.

As a closing, I shall share a candid remark I overheard," We try so hard to emulate the American system and to make all these drastic changes but what we don't notice is the extent that they discuss these changes prior to actually implementing it."

A point in note would be the Healthcare Insurance Bill. I am definitely not saying that we need to discuss it with as much fervor, until it borders on unproductiveness, but definitely not to the extent where discussions are only opened after the decision to implement has been passed.

10/24/2009 01:59:00 AM

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Wednesday, October 14, 2009

My Sister's Wedding--Part 1

Here are my first batch pf photos of my sister's wedding in Melbourne. This set of photos are of the day before the actual wedding.

Due to my postings, I only reached Melbourne on Friday morning.

Our flight landed at around 5. So after reaching the service apartment, I promptly fell asleep. Only to wake up to an empty house because everyone had already left. So here are some shots taken during my walk from the service apartment to my sister's house.

Cute little cottages.

More cute little cottages.

MY church=)

Stephen boy and his favourite iggle piggle.

deep in concentration (watching tv)

Joanna--the maid of honour=) She was very helpful and useful=) She even made all the corsages and bouquets.

The wedding car. Apparently, wedding cars in Australia only have 2 strips.

After everything was more or less settled. I managed to squeeze out some time to catch up with Shu-en!=) She brought me to this quaint little spanish cafe which had really awesome food=)

Hot chocolate...=)

CHURROS!

Nice friendly shop-owners who were part spanish too! They were sisters..

Thank you Shu-en! It was so nice of you to come meet me despite your heavy schedule.

A cute old man reading his storybook in the cafe.

After which, Su-en brought me to the shophouse next door to see something cool.

It was an open-air restaurant on the second storey of the shophouse. It was actually a normal shophouse with all 4 walls surrounding the place, but the roof was missing. In place there numerous colorful lanterns floating from beams tt filled the sky above.

It was really enchanting=)

After the short catch up, miss shu-en drove me home..

Thank you!

Back at my sister's house.

As the night progressed, more and more relatives started dropping by for some chit chat and makan=)

Meanwhile, I also had to repair the lock on the toilet door, so that it could close properly.

Come here, stephen!!=)

run away!

The girls + Stephen.

More photos of the actual wedding day coming up next!=) Am slowly editing them now. See you...

10/14/2009 02:09:00 PM

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Tuesday, October 06, 2009

A residency thing....

It is most evident that whatever is happening is definitely going to happen regardless of anyone's approval/disapproval. And with the MBBS coming up in a few months time, it is a much wiser choice to concentrate on consolidating our knowledge and aim towards passing our finals.

I think the stand most students have consciously taken is that of "going with the flow", with some bordering towards that of "resignation". Although the residency issues are indeed concerning and worrying, practically speaking, there is no point concerning/worrying ourselves with such uncertainties when they are constantly evolving.

However, trying to concentrate on the MBBS is no easy task with numerous distractions everywhere.

First and foremost, this whole idea of a residency only cropped up a few months back. The concept of having to decide on a life-path even before we graduate is indeed a daunting thought. To make matters worse, the uncertainty of what criteria the "program directors" are looking out for in their future residents is proving to be very unsettling to the graduating batch, especially when every senior in the past (ranging from recently graduated HOs to senior consultants) have told us, "just aim to pass MBBS!". Their age-old advice is that "grades are never a true reflection of how good a doctor one usually is."

Imagine the confusion and helplessness when final year students are told that certain aspects of their medical school years are taken into consideration for their selection into the residency program.

Admittedly, numerous assurances that no one will be "adversely disadvantaged" have been made. But the fact remains that with just a few months left to our final year, our previous humble mindset of aiming to gain a holistic education and just passing MBBS, is now turned 180 degrees to that of....make an impression, get to know the "right people", choose your specialty soon, and start earning some "brownie points".

And do it quick!

The next set of distractions is that of the numerous "roadshows" held by the individual clusters/hospitals.

To cut a long story short, each hospital does not have the full picture. Most of them are honest enough to admit this. But despite their honesty, most hospitals paint very variable pictures of what they interpret the residency program to be. These varying details include the application process, the transitional year, the issue of NS, timelines, exams, etc etc etc.

The way this whole residency thing is being advertised has also resulted in several groups of unhappy people.
1) The incoming batch--- for the respective reasons.
2) The equally clueless graduates (including HOs and present BST/AST trainees) who have been told that the residency program is not open to them. Most of them seem upset because from the way the various sources have "advertised" the residency program, the present system that they are in is painted as a flawed one, while the residency program is painted as a "solution". Of course, these "paintings" lack details. Some have also expressed concern over the success in integrating the 2 systems concurrently and whether they will be disadvantaged.
3) The senior doctors and teachers. A significant proportion of senior doctors who actively engage in teaching are unaware of the details of the change. Most have shrugged off this issue with nonchalance saying that they will continue to teach the juniors with similar passion and methodology. Whereas, some have taken the issue to heart with sincere concerns over the merits of the system----- taking in fresh graduates into a specialty program and the need to revamp a system that has served well for all these years.

Looking at the 3 groups stated above, they practically encompass the majority of the medical fraternity. Which begs the question, who are making these decisions?

It is an accepted fact that these decisions are political in nature and were made in line with "national interests". What these "national interests" are is another pandora's box that is best left unopened.

For now, the main point of this little discussion is that of distractions.

As a medical student, the pursuit of knowledge (should) remains top priority. Choosing which specialty one is interested in should and must take a back seat to first becoming a safe doctor. (Whether or not it is fair to expect medical students, with no working experience, to choose a specialty is not even a topic of discussion here, since it is pointless discussing about an issue that has been decided already.)

We trust that each hospital/cluster is aware of these changes. We do not doubt the capabilities in MOH/MOHH in disseminating information to them. There is no need for them to hold roadshows to tell us that they are "planning" something, especially when the full details are not yet confirmed.

Personally, the most useful piece of information is regarding that of the individual specialties---like what they entail, their experiences, their scope etc etc.

There is no real point advertising the differences in the training program. Doesn't the advertising of the individual training capabilities defeat the purpose of having a residency program? The supposed whole idea of a residency program was conceptualized so that MOH/MOHH can have better control over the quality and content of teaching of junior doctors--- ensuring less inter-cluster/hospital variability and quality of teaching. So it does not make much sense for hospitals to go on "advertising campaigns/roadshows" to showcase their "superior" training programs.

At the end of the day, if someone has a passion for general surgery and his first choice cluster does not accept him/her, does it mean that he should choose a different specialty just so that he can get into that cluster, since it "promotes" itself to have a "better" training program?

Let MOH/MOHH finalize their details and brief everyone about them, including us. When they have answered everyone's questions, it would be best for everyone to take a step back and digest all these details.

Let the roadshows wait? (It almost seems like a competition amongst clusters to "fight" for the "best future-residents", while painting a picture that they are the "best".)

It is not like we will be running anywhere. We are bonded for 5/6 years.

This is an important decision, and we will definitely consider everything carefully in due time.

Just do not distract us? There is no point making us come back for roadshows twice a week on evenings (or making us feel guilty when we don't) and we end up failing our MBBS.

But then again, the fault cannot be placed on the clusters/hospitals either, especially when the deadlines are so rushed. (Application supposedly opens in October). Most of the time, the doctors giving the briefings have our best interests at heart. Moreover, some of these sessions were organised in a bid to answer some of the students' numerous questions that surround this whole residency issue. Unfortunately, most of these answers are yet to be finalized from above. Hence, only creating a situation of increased uncertainty instead of the initial intention of quelling it.

At the end of the day, this residency thing is going to happen. Period

We understand.

10/06/2009 12:43:00 AM

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Wednesday, September 30, 2009

Isle of Skye (D1)--The drive down

For the second week in Edinburgh, we planned a short getaway to the famous Isle of Skye. A rural and well-preserved island located north of Edinburgh. It was a 7 hour drive from Edinburgh, which seems kind of long, but on hind-sight, it was a rather comfortable and fun road-trip=)

It was geat fun driving down to Isle of Skye in our little betsy. We also made several stops along the way which actually made the trip much more enjoyable and scenic.

The place was breathtaking-ly beautiful.

And here are the photos from Day 1 of our road trip---journey to isle of skye=)

For our first stopped by this giant lake that had a boat house and a bistro.

We saw a lot of cute ang-moh kids=) Glistening blonde-haired kids in their colourful sweaters=)

The Bistro.

Despite the sun shining brightly, it was an extremely windy day. Luckily we were all nicely bundled up=)

The lake was quite massive and they had boat rides which brought tourists to some castle ruins located across the lake. We decided not to go cuz we were going to see tons more ruins and there was a long journey ahead. Besides, we were having a good time enjoying the scenery already.

Li=) She was my navigator for the whole trip. We were supposed to use a GPS initially, but ended up using paper maps in the end. It turned out to be a blessing, cuz we were able to plan our routes much easier and could easily make pit-stops whenever we wanted to=) Plus, we actually got to know the area better and had a better orientation around.

Kids in their multi-colored sweaters playing with stones.

One of the sandwiches that we packed for our road trip=) The hot chocolate came from the bistro...yum!

Some random kid that appeared out of the forest trail alone...haha.

After a short break, we were back on the road continuing on ur journey. We planned the route such that we would drive pass the major lakes including Loch Ness (above). In fact, most of our journey was spent driving beside these lakes.

The place was just massive. And pictures simply does not do any justice to the atmosphere and wonder of that place. The place was strangely calm yet eery.
It was no surprise that people could imagine up stuff like the loch ness monster and stuff.

Anyway, we made a lot of pit-stops along the road to take photos and to see the sights. On one of them, we came across a sign that said "beach". We followed it and lo and behold, there was a staircase that led down to the shores of Loch Ness!=) So not only did we see Loch Ness, we also touched it.=)

The place was just beautiful. It was enchanting. And somewhat un-nerving. There were times I actually expected some creature to appear above the water-surface or have some monster walk up from the shoreline.

The vast waters stretching into the horizon just added to the whole mystery of the place.

Our warm and comfortable Betsy. It was an awesome feeling coming back to a heated car!

Loch Ness and our little Betsy.

Our reliable little Betsy!
In any case, if any of you are intending to rent a car in scotland, do rent them from Arnold Clark. They are the most reliable and affordable car rental company there. Plus most of their cars are new! We got this 5 seater, 2 door-hatchback for really cheap. And we also managed to get a liabilty waiver too. Which meant tt we could wreck the car or get it stolen and we wouldn't need to pay an extra cent too. (Luckily we got that waiver, cuz we actually burst one of the tyres in the forgotten lands of Skye)

Our sustainence for the roadtrip---Wine gums, chocalate and Walker chips!

My navigator throughout the 7 hr journey.

Quaint little brick cottages and their nicely groomed gardens..

Just imagine driving along scenic roads like these....=)

Just as we crossed the suspension bridge to Isle of Skye, the sun started to set....just in time!

We barely lasted a few minutes out in the cold and wind. We quickly took some shots and immediately rushed back into our car.

This scenery was just a taste of what's to come=)=) And this was taken with the sun almost gone.

The first town in Isle of Skye was Portsmouth. From there it was another 1.5 hours to our B&B.

We drove to a nice scottish pub for dinner, that had a really kind and friendly bar-owner=) Where we saw drinking scots singing and watching soccer=) The food was pretty good too.

As night time came, the whole place became totally pitch black! This whole place was really rural, there weren't any street lamps. The only light was from our headlights.

In fact, we made a wrong turn (one turn too early from our house) and actually drove poor betsy off a cliff and almost had her marooned on a cliff cuz the wheels weren't touching the floor.

Luckily it was a small "cliff" and and we decided to release the brakes and just "fall" off the cliff. =)

We did draw some weird/concerned stares from the owners of the house whose land we were on.=P

But we made it safe and sound to our B&B.

More photos to come soon.

9/30/2009 03:22:00 PM

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Tuesday, September 29, 2009

Quintfac Bash 2009

And here are the photos from Qunitfac bash 2009!

Performance by the M2s

Some Roman dude from Pharmacy.

Li=)

M1s (I think)

Nursing Performance

OMG, Im wearing a canon strap....=S

Backrow heroes!

The judges for the night.

Dance performance from Medicine.

Made up solely of M5s.

AROM==> 0-180
PROM==> 0->180
Full ROM

You gals were awesome!

9/29/2009 06:03:00 PM

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Preparation for Quintfac Bash 2009

This year's inaugural QUINT-fac (inaugural because DUKE-NUS joins in the fun as the 5th member) bash was held at Zouk once again.

Here are some photos of the pre-event rehearsals/dry runs/preparations. More photos coming up of the event proper soon.

Back row heroes---Jonk, Kelvin and Benjamin

The Backrow Heroes---Paul, Jonk, Kelvin, Benjamin

Li=)

The Medicine girls hard at work practicing their dance moves.

Lynette!

Concentrate...

The girls from M5

Yiuming

More photos coming up of the event itself.
(Too many to upload all at one shot, so I decided to split the photos into 2 sets=)..)

9/29/2009 01:14:00 AM

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Sunday, September 27, 2009

Glasgow Part 2=)

And...here is the second set of photos of our Glasgow trip!

University of Glasgow

Flower Buddies!=)

The flower that turned behind...

=) imagine having a view like this in our school.

Ams and me.

hahahaa!

i would walk home if it meant being able to walk thru this.

Red buddies...=)

So cool! Like Zero Kelvin!

Our travelling group

Li goes hunting for her flower shots.

Fields of purple and blue...

The rest take a breather while li goes flower shooting...

I wanna grow old, wear a jacket, sit on a park bench in cool weather and take a nice long nap...sigh.

I actually remember thinking to myself what a beautiful day it was when i took this photo.

There's supposed to be a trolley down there somewhere.=P

Playground.

Some cool museum that Ambika brought us to.

Am's cosy hall room.

Marcus' stare of death

Thank you Sarah and Ambika for the wonderful dinner in a quaint little restaurant. (where the waiters wore kilts)

Really miss the UK...

More photos coming up soon. This time of our road trip to the isle of Skye!

9/27/2009 11:15:00 PM

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Monday, September 14, 2009

Glasgow Part 1=)

Finally, my computer is built=) And I am able to start editing my huge backlog of photos that have been stored in my com.

Here are some photos from our Edinburgh Electives. This set is from our weekend getaway to Glasgow, where we met up with Ambika, who kindly brought us around Glasgow to see the sights=)

It was such a beautiful place...sigh. Missing the UK...

Imagine walking down this street..

Marky, Ams and Li..

Walking behind Li....

Ambika brought us to a place called Mussel Inn, where they served awesome mussels at affordable prices.

Ams and Li=)

Huilin and Marcus..=)

Giant pot of mussels!

After lunch, Ambika brought us to see her medical school.

Thank you Ambika!

Welcome to Hogwart's!

Seriously, this was where Harry Potter was filmed.

Arches of Hogwart's!

I really loved the architecture.....

=)=)=)

!!!!

=)!!!

Floating arches

Walking into the light...

Marcus and Ambika walking into the light..

Sigh....=)

Potions classes on second level.

Defence against the dark arts down the aisle...

VW <3

More photos from Glasgow coming up soon..am slowly editing photos over the weekend...more to come=)

9/14/2009 08:33:00 PM

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Wednesday, August 05, 2009

Candleburn

~Dishwalla

One of my favourite songs from a long time ago.....hidden in my abyss of i-tunes.

Haven't been editing much photos cuz my laptop is slowly dying on me. Need to build my PC soon. On another note, I've actually shifted into hall..=)

Happy m5s everyone! Take care and let's get through this patch together. HO/MO/Residency seems to be a question mark...a very big question mark. With so many pertinent questions raised, it makes one wonder if there will be satisfying answers.

One of the major questions that should be answered is, "Why the change to Residency?"

ie..What was lacking in the HO/MO model that the new residency model is supposed to fix.

Maybe the right way to approach this would be to explain the necessity in revamping the HO/MO model. After explaining that Residency is the only way to go, the next step would be to bring everyone on board and make this new residency programme work. (I think no matter how difficult the truth may be to swallow, as long as we can see the undeniable fact that the HO/MO model is failing in some aspects which only the Residency model can fix, most of the people will be understanding enough to make it work).

Everyone needs to be patient and understanding. A new model will not be perfect, and will definitely have a lot of kinks that need to be ironed out.

But if the ones in charge beat around the bush, or fail to bring across the true necessity of this change, then there will be a major question/source of frustration lingering in everyone's mind----Why can't we keep the HO/MO model since the Residency programme is so problematic?

8/05/2009 12:33:00 PM

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