Mastodawn

My New Year’s Eve – 2025

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31st December 2025. I was NOT oncall.

It was a Wednesday and it was a normal working day. Hence, at 7:45am, I left to work as usual and was there by 8am. It was the New Year’s Eve. I thought that maybe, just maybe, there would be less patients in the clinic.

The day started off smoothly. Surprisingly, there were many patients who came for their follow up followed by additional patients (the defaulters and walk-ins) but it was manageable. We went about our day, seeing each patient and when lunch time came, we went for our lunch break.

At 2pm, we went about our work, seeing patients as usual and I was taking my time with each patient. The patient load in the afternoon shift was lower compared to the morning shift and both my colleagues were done with their patient load.

Suddenly, a staff nurse barged into my room saying that there is a massive accident that just occurred nearby, 2 patients were already brought in and 2 more were on their way. They called in all available doctors (which were only the three of us) to help out.

I told my colleagues to head out and help out first while I rushed through the consultation of my final patient. After that, I rushed to the tiny Emergency Room of the clinic. My colleague who was oncall on that day was already attending to a child. I went over to the other patient, an old lady and did my primary survey and fast scan.

She was desaturating badly under room air and needed oxygen support. She had an open skull fracture, multiple abrasion and laceration wounds over her face, upper and lower limbs as well as rib fractures and on top of that, her left leg appears shortened and she has a closed fracture over her right lower limb.

I didn’t think that we should proceed with an x-ray at our clinic even if we had the facility at that time, the best would be to send them straight away to the hospital because she could deteriorate further any time. Thankfully, her GCS (Glasgow Coma Scale) was full.

I was focused on my patient, stabilising while referring her to the specialists of various specialities as well as the emergency physician that when I finally got ready to transfer her out that I noticed the child that my other colleague was attending to. The child’s right arm was crushed and the distal limb of his right arm was pale and his right lung was obvious till mid-chest.

Just how in the world is he still awake? The poor child was crying out in pain…

Judging by the state of his and my patient’s injuries, it was definitely high impact.

The story was, the whole family were travelling back from Miri to Kuching. Both the parents were sitting in front and the father was driving whilst the two children and their grandmother were sitting at the back.

The father claimed that he was not speeding but as he was about to make a u-turn at a junction, he claimed to have hit the curb and the car turned many times into the other lane before finally stopping and the grandmother and one of the child were thrown out of the car.

It sounded like a very high impact collision. Thankfully, the parents and the other child were well and unscathed.

We had to transfer both patients in two separate ambulances to the Red Zone of the Emergency Department at Hospital Bintulu as one ambulance could only transport one patient at a time.

Upon arriving, I met my colleague and friend at the Red Zone of the hospital. After we have handed over to the medical officers and specialist in the Emergency Department, we headed back together. However, upon reaching back, there was another patient who came in who was extremely tachypnoiec.

Oh, here we go again… Another Red Zone referral…

We stabilised the patient and referred her to hospital again. The clock was already showing 10pm when we left. The journey to the hospital takes about 45 minutes to an hour for each journey and the both of us have yet to have our dinner. This time, I choose to accompany her for the referral, mainly for emotional support and also in hopes of stopping by McDonald’s to get a takeout.

Yes, we did stop by McDonalds after sending the patient safely to the hospital and yes, we used the ambulance and went through drive-through.

By the time we left, it was already 11pm. The journey takes around 45 minutes to an hour and it was raining heavily. At this point, I was wondering if we would end up celebrating New Year’s in the ambulance.

Me and my friend ate in the ambulance on the way back while we joked and exchange oncall stories. Thankfully, we reached a little before midnight. The day was completely unexpected, not to mention tiring but it was nice to have spent it with a friend.

It’s still the beginning of 2026, so if I’m not too late, Happy New Year!

If you are travelling anytime soon or in the future, do drive safely, stay within speed limits especially if it is raining. Remember to get your car and tyres checked before any long distance journey and NEVER drive under the influence.

Stay safe always!

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The Theoretical Doctor Jan 14

12 Hours Shift – Counting Down My Hours Each Time At Work

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How do you waste the most time every day?

At the time of writing this article, which was back in June 2025, I was going through my 6th Rotation of my Housemanship which is in the Department of Emergency and Trauma. As a House Officer in the Emergency Department, we go by the 12-hours shift.

This meant, our shift is from:

AM Shift: 7am till 7pm
PM Shift: 10am till 10pm
Night Shift: 10pm till 10am

In this department, they are strict in regards to adhering to a minimum of 60 hours per week in total. Thus, in a week, our schedule is as follows;

A total of at least 4 daytime shifts (AM or PM Shifts)
One night shift
One off day

That is provided one has off-tagged of course.

Perhaps, it is the “last paper syndrome” that I was experiencing being in the 6th and final rotation, I would be counting down my hours each day at work. Thus, upon arrival at work, I would start my “12-hours countdown“ on my phone.

On slow days, I made it a point to go to toilet every hour, technically my so-called “hourly break” whereas on busy days, the toilet break is the only time I could take a break. This is followed by ensuring I have at least one meal per day during my shift.

Otherwise, the schedule in the emergency department is relatively better as compared to my previous rotations. Nevertheless, the tiredness is still there.

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The Theoretical Doctor Jan 13

Lazy Days As A Medical Officer

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Do lazy days make you feel rested or unproductive?

While I’m at work, I’d be looking forward to returning home or towards my off day. In contrary, while I’m at home or on my off day, I’d be thinking about returning to work.

Do you feel the same way?

Previously, as a House Officer, I’m used to the “one off day per week”. Whereas, as a Medical Officer, weekends and public holidays are granted off days, except if you’re well… oncall and that depends on your current department as well as some departments require you to put in a half day shift during weekends or public holidays.

I’d say for me, considering I live alone and I don’t even own a car here in Sarawak, I’m pretty much lazy and unproductive to the point I get restless sometimes.

That’s counter productive as rest days are meant to make you feel… rested, right?

Thus, on my off days, since I’m an early riser, I try not to disturb my circadian rhythm by getting up at the same time as usual every morning, partly because I forgot to off the alarm or somehow, my body clock just wakes me up every time.

To feel so-called “productive”, I’d do some studying with my morning coffee till I well, lose my focus, then I start wondering about lunch and start cooking, handwash my clothes because I’m too lazy to walk downstairs with a bag of clothes and finally doze off for my afternoon nap.

I’d then wake up in the evening to have dinner and pack my essentials and bag for work the following day before finally, retiring to bed early.

I really need to be more productive during my off days.

Even me writing this just sounds too depressing.

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The Theoretical Doctor Jan 12

Reflection: 2 Months As A Floating Medical Officer

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At the time of writing this article, I’m on leave which I took from the 1st of October till 15th of October, which my Head of Department (HOD) was more than kind enough to allow.

I needed the break, perhaps it was an adjustment disorder on my side but I was struggling. Physically, I caught up, I showed up and I was there but mentally, I felt left behind and lost and on most days, I was low.

Perhaps, it was out of tiredness as I have just recently off-tagged and in combination with my low mood, I felt demotivated and in general, felt that I have lost my love for medicine. I decided then that clinical life in the hospital was not for me. True, we were lacking doctors in various departments and hospitals in general across Malaysia. However, during that time, even if there enough manpower, I don’t think I would still want to continue.

I tried looking on the bright side, tiny things as well as the positive aspects of things to help me to get through the day.

Firstly, I’m thankful to be in a subspeciality department instead of the bigger and more hectic departments, I think I would have broken down within the first week itself. Secondly, I was in the department with the sweetest and kindest bosses who were more than happy to teach or lend a helping hand when needed. We are small in number, yes. But it felt like being part of a family.

I was happy, the environment was good, kind and non-toxic. However, mentally, I knew that this is not my place.

This further saddens me as I have always looked forward to being part of this lovely department. Yet, I knew, it’s just a matter of time before I slip and broke down. My body knew that I wouldn’t last long here nor do I foresee myself handling the complex and complicated cases here. If my interest is not here, how would I even make it through to specialise?

Amidst the business and my mind and body trying to keep up with the steep learning curve place before me, I was unable to view my options or to consider other departments.

I was just done in general and sadly, I wouldn’t be able to fulfil my quote in my medical school yearbook, I feel myself losing my will every single day nor do I find the strength within myself to serve.

Sadly,“sometimes what we like is not necessarily what is suited for us”, a fellow colleague told me and that hit me hard. I had no interest in other departments either or practicing in general at that point. All I could think of at that point was to quit and to hand in my resignation letter. After all, I have successfully completed my 2 years of internship / housemanship training. I can still locum if I wanted to. But of course, I didn’t enjoy it either. All I was ever passionate of was to teach. Thus, I considered changing my field and entering university as a lecturer did not sound appealing either as I did not like research at all.

Thus, after much contemplation, I approached my Head of Department (HOD) to validate my 30-day-resignation letter. My HOD is another kind soul who enquired to know what prompted me to come to such a decision. She signed my papers but advised me to consider changing departments instead of quitting.

However, at that time and at that current state of mind, I was fixed on my decision. Hence, the following week on a Monday, I submitted my 30-Days-Notice of Resignation, only to have it retracted the following day. Although I have handed in my 30-Days-Notice, a part of me felt a tinge of regret and sadness. Somehow, some part of me did not want to leave but I could not see any way out of this virtual box that I appear to be caged in.

My colleague and my parents played an important role in my decision to retract my resignation. Instead, despite my limited amount of leaves left for the rest of the year, I chose to take some time of work. Perhaps it was due to tiredness that contributed to my rash and impulsive decision.

On the 1st of October 2025, I took the first flight out and then throughout my leaves, I locummed at several General Practitioners. Remember when I said that I did not like locum either? This time, I decided to give it a second try and to keep an open mind.

The first GP I locummed at was a rather chill one with only 3 cases being seen throughout the whole day. The subsequent GPs were hectic and had multiple procedures, literally from the beginning of my shift till the end. In all of those times, I was the only doctor in the clinic. In my previous experiences, I have locummed at clinics which had 2-3 resident doctors.

Honestly, I don’t know how I managed to pull it off. Despite the hecticness and the patient load, I found myself looking forward to return and I enjoyed talking, listening and consulting the patients. It was fun. Slowly, I found myself enjoying and falling back in love with medicine and practicing medicine and thinking on how I could improve myself to serve better.

Then, I realised, perhaps venturing into family medicine might not be such a bad thing. True, there is abundant of family medicine doctors now and lack of doctors practicing in the hospital but that doesn’t mean that they are still not needed. Sadly, as much as I want to force myself to carry on and stay practicing in the hospital, I knew that it is not meant for me in the long haul or for me to last for even a year.

The opportunity to specialise is there but how can I continue if I can’t even see myself as one, or even have the inspiration?

Suddenly, the plan and my pathway seems clearer and I’m more than ecstatic to embark on my next journey. It was definitely the rest that I needed. To think and to reflect. If I were to stick to this journey, how can I do so for the long haul and at the same time, enjoy it?

I hope that in months or years to come, the decision to stay is the right choice. Perhaps, I still need time to discover my interest in this vast field. At times, I wish that it can be simple and that I would know what or which department I’m fitted to or destined to specialise in.

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The Theoretical Doctor Jan 7

My First Day As A Medical Officer In KKM

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Housemanship or Internship for Doctors in Malaysia lasts for a duration of 2 years, upon completion of our medical school journey.

For some, they began shortly upon graduation whilst for others, they took a gap year.

I submitted my application to pursue my internship in the Ministry of Health, Malaysia (Kementerian Kesihatan Malaysia, KKM) shortly after my graduation but did not actually begin till 6 months later in 2023. Two years later, thankfully, I’ve completed and fully registered with the Malaysian Medical Council (MMC) and possess a valid Annual Practicing Certificate (APC).

Post housemanship, I went on a 3-weeks-break and on the 21st of August 2025, I reported for duty as a Medical Officer.

Upon my completion of housemanship, one would have to go through a “floating period” of maximum 6 months prior to receiving their placement in whichever department, hospital or state of choice. Usually, the floating period occurs in the same hospital that one had completed their housemanship or internship in.

Thankfully, I was offered to float in the Department of Plastic and Reconstructive Surgery. However, I was diving into the world of Surgery with no experience or knowledge in basic suturing.

During my first day, I reported for duty at the Hospital Director’s Office to receive my “floating” placement letter, checked my remaining leaves and proceeded to Burn Ward of Sarawak General Hospital.

The Burn Ward.

I’ve had good memories previously as a House Officer here and I was beyond ecstatic as well as relieved to be accepted into this department which is filled with understanding and helpful bosses.

I was then given orientation by one of the medical officers, clerked a burn patient that was just admitted and spent most of my time accompanying a fellow friend who thankfully is in the same department. Considering it was my first day and a rather slow one, I was able to return home at 5pm.

There’s just so much more that I have yet to learn. Hopefully, I’ll have both the mental and physical strength to push through.

Thankfully, the environment is one that is filled with love and encouragement.

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Excellent webworld Dec 24

Doctors are expected to deliver better care, faster while handling more data than ever before. The right medical apps can make that possible. In 2026, these 9 platforms stand out for supporting clinicians across diagnosis, patient management, and daily workflows.
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The Theoretical Doctor Mar 16, 2025

My Experience as A Plastics House Officer | Housemanship Diaries

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When I entered the Surgical Posting, we initially did not have the privilege of experiencing subspecialities like other batches.

This was due to the fact that there were lack of house officers.

However, mid-Nov, there was redirection of House Officer allocation and suddenly, the posting was overflowed with House Officers.

Hence, subspecialities were reintroduced. The subspecialities reintroduced are neurosurgical, plastics and urology.

Ever since my first posting in Orthopeaedics, I’ve always wanted to experience being in Plastics after assisting my medical officer at that time with SSG.

Thus, during my final weeks, I was given the priviledge.

The Burn Ward is located at Level 3 of the Main Building, and is able to host at most, 10 patients, with each patient having their own room/cubicle.

Usually the burnt patients are kept at Burn Ward whereas other patients who are admitted for AVF creation or SSG are placed at Surgical Ward.

The timing for us House Officers is from 7am till 6pm, Sunday till Friday with an off day on Saturday.

During my time in Plastics, I would usually arrive on time at 7am and proceed to trace the bloods first. After all the bloods have been traced, I would proceed to help out with morning reviews.

Morning reviews are usually done by the postcall medical officer. This is then followed by rounds with the surgeons, usually starting with the acute or rather, the intubated patients followed by the rest.

Rounds at Burn Ward is only once daily. After morning rounds, we would gather at the “Handover Room” whereby the patients who are not in the Burn Ward but is being seen by Plastics as another team or as a primary team are being handed over in terms of case and progress as well as the newly admitted ones.

Next, we will proceed to follow the “Peri rounds” and change dressings if needed. Usually after the Peri rounds is when us House Officers go about our joblists in terms of posting case, referrals or bloodtakings or imaging request.

The rest of the day could be pretty chill if there is nothing going on but usually, there would be new patients to be transferred in, take blood or any post-op patients to be reviewed.

Sometimes there are cases being called and we are more than welcome to join the operation. In between, there are arterial blood gases (ABGs) to be take in between or bloods to be sent.

Finally, in the evening, prior to leaving at the end of our shift, we would prep the coming mornings and leave them nearby before informing in our Surgical House Officer’s group in regards to the “coming mornings”.

My time in Plastics was rather short-lived and I felt that there was so much more to be learnt. But my time spent there was extremely wonderful and the medical officers and surgeons were more than helpful and welcoming towards the new people into their team.

Definitely, a department that I would want to return to.

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The Wards In The Surgical Department | Sarawak General Hospital

An article regarding the Types of Surgical Wards, us as House Officers had to rotate in during my fourth posting in Sarawak General Hospital.

The Theoretical Doctor

Sunrise Technologies Mar 14, 2025

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Best Online Medical Consultation App | Sunrise Technologies

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The Theoretical Doctor Sep 25, 2024

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While growing up, when I was asked regarding what I looked forward towards in the future, I always had the answer.

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The answer was simply, I wanted to be a Doctor (coz that’s what I knew my whole life and indirectly working towards albeit having other interests).

Thus, from primary school, next would be high school, moving towards science stream in school and pre-university in a course which would serves as a prerequisite into entering medical school.

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In medical school, my focus was always on the exams, completing that particular posting, completing that year, completing preclinicals and moving onto clinicals, studying for the grand finals, completing medical school and graduating.

Upon graduation, applying for housemanship to start practicing. I always knew that I wanted to practice in Sarawak General Hospital. Thus, that didn’t require much thinking. Working my way there, and finally, starting housemanship.

Now that I’m a House Officer, completing each posting, working towards completing a year, now focusing on completing the whole journey.

But after that? I feel lost and aimless.

Previously, when asked regarding my need to have a family, I would brush it off. Not that I didn’t want to but I’ve yet to meet the person that I would want to spend the rest of my life with and build a family.

My aim was mainly catered towards my parents. But they’re doing just fine on their own. Thank God for that. I don’t see my purpose anymore actually.

In regard to post-housemanship, I have no idea of which speciality I would like to dive into. In terms of being surgical based or medical based, the thing I learnt over this past 1 year is that I’m definitely a surgical based person. Though, I have enjoyed paediatrics very much (which I supposed is a very much toned down version of the chaotic medical posting).

I wouldn’t know, as upon writing this article, I’ve yet to complete my medical posting.

The medical field is not just tied to 6 different postings. As a House Officer in Malaysia, we are required to rotate to 6 different postings throughout our 2-year-duration in housemanship which are, Surgery, Medical, Orthopaedics, Obstetrics and Gynaecology and Paediatrics. The sixth posting, we have the privilege to choose among Emergency Department (ETD / ED), Anaesthesia, Klinik Kesihatan (Community Clinics) and Psychiatry.

However, in reality, the clinical field is vast and there are other specialities that we as House Officers have yet to enter. In terms of non-clinical field, it is another vast category.

Which of it am I?

At times I wished that I always knew of what I wanted to be, such as a Cardiologist or a Surgeon but after assisting in the operating theatres and working as a junior doctor, none of it appeals to me 100%. Sure it is interesting but is it something I would want to be doing for the rest of my life?

Having completed a year of housemanship, I thought that the answer would be clear to me by now. Yet, I’m still as unsure as I had been before. I’ve approached multiple seniors, medical officers and specialists and talked to various doctors from different fields regarding their experience. I seem to have the information but my heart was not fully captured by any of it.

Everything seems nice and interesting. I hope that in time to come, the answer would be clearer. The least I could do at the moment is to put my best foot forward in whatever department or sector that I go through.

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Reflection of the Paediatrics Posting

An article regarding my overall reflection of my third posting, Paediatrics as a House Officer.

The Theoretical Doctor

Kevin Pho, MD Jan 26, 2023

The sacred connection: physicians and patients

The power of trust in medicine is truly remarkable. As doctors, we may only interact with our patients for a short time, but the bond formed is undeniable. Even when our patients are asleep for the majority of our interactions, there is still an intimacy and shared humanity that cannot be ignored.

David Alfery is a cardiac anesthesiologist.

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The sacred connection: physicians and patients #shorts

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