Fun in the Eyes of novaTopFlex

List five things you do for fun. Preamble I do not believe in the idea of “fun” as a cultural or societal category, nor as a category of distractions or disruptions from work categories. However, I believe in ensuring the success of my YouTube channel, with visibility often outweighing security in my future lifestyle and even luxury dependency remaining largely unethical with higher subscriber counts. Introduction Even though I do not have “fun” activities, my five (5) preferred […]

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Fun in the Eyes of novaTopFlex

List five things you do for fun. Preamble I do not believe in the idea of “fun” as a cultural or societal category, nor as a category of distractions or disruptions from work categories. However, I…

novaTopFlex

Five Little Things That Make My Heart Smile ❤️

List five things you do for fun. Sometimes, it’s the small things that bring the biggest joy. I want to share five little things that always make my heart smile. Morning Coffee in Peace ☕ There’s something magical about sipping coffee in the quiet of the morning. Just me, the warm cup in my hands, and the world slowly waking up. It’s my little moment to breathe and feel happy. Walking in Nature 🌿 A short walk in the park, listening to birds, feeling the wind on my face, makes […]

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Fun and Games

Zähle fünf Dinge auf, die du tust, weil sie dir Spaß machen. So heißt das Album des 2025 verstorbenen Jazz-Musikers Chuck Mangione - und es bildet #sozusagen das Leitmotiv dieser Gedanken zum Tag. Photo by Rob Gamble on Pexels.com Das Leben ist nämlich zu kurz, um sich mit Dingen abzugeben, die keine Freude bereiten. Nun mag man sich an der Stelle zwar trefflich über den Unterschied zwischen Spaß und Freude streiten - entscheidend ist aber doch die innere Haltung, mit der man […]

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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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My FIRST SOLO Oncall Shift As A Floating Medical Officer

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My first solo oncall shift was on the 17th of August 2025 a few days after I have completed my tagging period.

I had a passive oncall on standby just in case things got out of hand, which is a good thing. However, I was adamant to try to survive on my own as if I only had myself and the specialist. Thankfully as well, it was on a weekday which meant I was able to reach out and ask for help if needed and the others would be able to assist if needed or advice me.

As usual, morning rounds, followed by peri rounds. The role as an oncall medical officer of the day is to update the progress of the patients in the specialist’s WhatsApp group as well as to upload any latest wound pictures, if any.

The day was rather busy with rounds and in between I would receive calls from Klinik Kesihatan (Community Clinics), usually requesting a clinic date. Thankfully, no referrals yet.

After rounds, I headed back to the ward to complete any pending joblists before heading into the operating theatre (OT) for a patient that was awaiting her call to OT.

During that operation, there was a referral from the Emergency and Trauma (ETD) Department, referring a case of laceration wound over the forehead for a 3 year old boy.

The medical officer at the ETD was kind enough to assist in taking the bloods as well as admitting the patient. My colleague on the other hand came to check in on me after her day in the clinic and attended to this kid.

After the first operation, the following case was called which was the 3-year-old kid. I have always enjoyed being in the operating theatre, or any hands on procedures.

Despite knowing that I should be conserving energy, instead, I proceeded to carry on and after the second op, I entered an ongoing flap operation next door to assist.

Another referral came for a laceration wound over the forehead for an Orthopaedic patient who was post-operative and transferred to ICU. Apparently, it was missed when the patient arrived at the Emergency Department as he suffered multiple opened fracture and was posted for operation immediately. Thankfully, he was intubated and sedated and I was able to perform a bedside toilet and suturing for him.

By the time I was done, it was midnight. I went back to the oncall room to shower and change for the night. I would usually change into scrubs again if I were to be oncall, just to be on standby in case I was needed immediately.

I did not sleep that night, it just felt wrong as the flap operation was still ongoing since 8am.

I went in again to check in on them, however, I was not needed at that time. Thus, I kept a fellow colleague company.

At 2am, I returned back to ward to complete the planned discharge of a patient and started my morning review. Thankfully, I did. In between, I was referred a new case of another kid who suffered another laceration wound at his right eyebrow. Thus, counselled the parents, obtained consent and admitted the patient.

After that, I was requested to collect bloods or bags packed cell for the patient who was still ongoing operation. When the commotion was done, I returned to continue my early morning reviews.

By 4am, I went back inside the operating theatre to check in on the ongoing operation. Technically, still far from done. Scrubbed in to assist with harvesting the skin for split thickness skin graft and refashioning of the affected limb.

At 8am, we were finally done. The operation officially lasted for 24 hours. All of us scrubbed out and I changed out of my attire to return to ward and follow rounds.

During peri rounds, a patient was called to OT and I entered organ as I dislike peri rounds. After the OT, all of us were just beyond tired and I went home for the day.

No doubt, it was my first “solo oncall”, it did not feel lonely at all as since there was an ongoing operation, physically, I felt comforted knowing that there were people nearby and felt more like a slumber party instead.

And the most important part… I survived it!

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I SURVIVED My First Month Of Tagging As A Floating Medical Officer

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Thank God. Seriously.

I started my journey on the 21st of August 2025 and officially off-tag on the 14th of September 2025 after my last tagging oncall shift.

Technically, it was not a month but 3 weeks. Nevertheless, a very tiring 3 weeks with every other day oncalls and one sick leave in between.

The tagging oncalls were every other day (EOD), this meant an oncall shift followed by postcall and the following day is an office hour shift only to be followed by oncall again.

Overall, it was a mixture of fun and tiredness. My sleeping schedule was definitely off as I am usually disturbed in the middle of the night as the time I am usually able to sleep peacefully is during my postcall shifts.

Thankfully, I always had a senior with me to guide me. Thus, every referral I received, I would discuss on the management plan with them. It was mentally challenging as well as the learning curve is extremely steep for a junior medical officer such as myself.

Having completed my tagging period, I am still at lost in terms of management especially for extremely complicated cases. Thus, I find myself running to any of my seniors or the specialists.

Am I confident now though?

Not really. Less terrified and yes somewhat a tad bit confident than when I initially begun. However, just a tad.

The fear is still there as I just do not know what to expect on the types of referrals I will receive during my call.

Some things just don’t change. The fear that I felt during my House Officer days are still there and at times, I wish that I could just simply disappear run away from the issue but doing so, does not help.

Thus, the only solution for me is to dive head on into the issue and call for help whenever needed.

If any of you are experiencing this, just know that you are not alone and sometimes the feelings felt internally just can’t be expressed properly either via words or verbally.

If you are showing up everyday despite feeling this way, you are doing a good job. Take comfort in that as it is not an easy thing to just do. Sometimes, showing up daily in itself is a hard task.

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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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Surviving 10 Days Of Tagging | Emergency & Trauma Department

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My tagging days in my sixth and final rotation, Emergency and Trauma Department, lasted for a total of 10 days which was from the 11th of April till the 23rd of April 2025. This is excluding our one “off day” for the week.

Did I manage to last throughout the tagging days?

Not quite.

I did take a sick leave during my second week of tagging. The reason was that I was just extremely tired.

Photo by Pixabay on Pexels.com

The tagging hours in the Emergency and Trauma Department is from 7 am till 10pm, just in other postings.

The good thing about this department is that we do not need to do morning reviews. Thus, coming way early prior to our shift is unheard of. We merely come and leave on time.

However, considering that it is the Emergency Department, things are unpredictable whereby things could be quiet one moment and hectic the next.

Hence, on days which burn, it can be extremely tiring. But, completing these tagging days are a must and so on slow days where the hours seem to pass by really slowly, I make it a point to have an “hourly toilet break“. On busy days, it may be the only time that I am given a chance to sit and breathe.

On top of that, I made sure I took my lunch and dinner break. Not because I was hungry as I was used to having my meal for the day after work. It was merely my way of spending my time during my tagging days.

At 10pm, the shift is over and I leave, even if the floor is busy because the following day my shift begins at 7am again.

Finally after 10 days of “tagging“, I have finally off-tagged and shifted to “shift hours“.

Photo by Andrey Grushnikov on Pexels.com

There are no assessments in order to off-tag. as there were in other postings, which is a good thing. However, tagging in this posting felt long and seem to went on forever for me. Perhaps, this was because I was mainly tagging alone as I entered a month later than my fellow peers.

Nonetheless, I was glad to be done with this schedule and shift back to a regular 12-hours shift.

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Surviving The Night Shift As A House Officer In Medical 3 | Housemanship Diaries

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The Medical 3 Ward of Hospital Umum Sarawak or “Sarawak General Hospital” is located on the 9th floor of the main building.

Thankfully, being allocated as the Night House Officer, we only had to take care of one ward, unlike being allocated in Medical 4 / Medical 5 / Infectious Disease Ward or being in the Perimedical Team whereby we were always on the go.

The Medical 3 Ward consists of three teams, which are General Medicine, Respiratory and Neuromedical.

During the daytime, we have allocated House Officers for each team. However, during the night shift, we are in charge of the whole ward.

The jobscope of the night shift House Officer in this ward is the same as in other wards and postings which are transferring in of new patients, attending to acute issues and most importantly, coming mornings.

If you have read my previous article on Surviving The Night Shift In The Medical Posting In General, I mentioned that in this posting, upon my arrival to the ward for my night shift, I would begin taking my coming mornings.

The same goes for Medical 3. However, unlike the night shift in Perimedical, I do not take my arterial blood gases with my coming mornings.

I begin from the Respiratory cubicles which is located at the back of the ward and then move to the front cubicles before finally continuing at subacute and acute cubicles which are the beds located in the middle of the ward, in front of the nursing counter.

If I were late for my coming mornings, then I would proceed with taking the arterial blood gases together. But if I finished early, I would take the blood gases much later.

By 5:30am – 6am, I would start running my blood gases and paste them in the casenotes of the patients. Around 6am – 7am is when the morning team starts arriving to trace the bloods as well as begin their morning reviews.

Thus, I wait to be summoned for my bloodtaking or certests.

Finally, at 9am, I return home from my shift.

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Surviving The Night Shift In The Medical Posting In General | Housemanship Diaries

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The shift that I have always dreaded but enjoyed the most were the night shifts. I dreaded it because I knew that I would be alone most of the time and afraid that I would not be able to cope with the adrenaline rush or anxiety or the craziness that might ensue. However, I enjoyed it because that meant that I will be able to sleep in prior to going for my shift and the following day at 7am, the morning team will start arriving and I am not alone anymore.

The Medical posting in general is a “heavy” posting because of the patient load. Almost all of the patients are so-called Medical patients once Surgical, Orthopaedic, Psychiatric or other causes have been ruled out, and it could stem from something as simple as electrolyte imbalance to myocardial infarction or stroke.

Thus, imagine the amount of coming mornings.

Prior to entering this posting, I’ve always enquired and listened to my fellow colleagues’ input and experiences. Most of them would say that “In the Medical posting, the rule of thumb for surviving the night shift is to start taking the bloods as soon as you arrive for the night shift”.

True enough. That is something I have practiced since and even in other postings as you do not know just when something may happen and next thing you know, the sun is rising and your coming mornings are late and the morning team have arrived and the bloods are still pending or not in the system or yet to be taken and the medical officers and specialists have arrived.

Sadly, when there is a delay in the blood investigations, there is a delay in management.

Thus, it is a tachycardic moment for me. Prior to entering my shift, I would screen through the coming morning list and upon arriving, I would usually prep my trolley, ensure my coming mornings are divided and arranged according to their cubicles, ensure enough syringes and needles are set aside as well as the alcohol swabs and cotton swabs.

Then, I will begin taking my coming mornings, usually working my way from the back of the ward then towards the front cubicle, subacute cubicle and finally, ending with the acute cubicle.

Usually in between, something will occur, maybe a patient newly admitted into ward or a patient will suddenly be hypotensive or hypertensive or hypoglycaemic or starts throwing up or wants to have a small talk.

Normally, I would not mind entertaining them. However, if I’m still due to complete my coming mornings, I would proceed to complete it and I usually will not rest until I do. At least I’ll be rest assured that should anything occur in between, I would not have to worry about the completion of my coming mornings.

The night shifts can be rather unpredictable as one minute it can seem rather quiet and calm at first and hectic the next. At times, it can get overwhelming as well.

However, have faith and know that help is always nearby and start taking your bloods as early as possible.

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