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The Theoretical Doctor Aug 21

My First Night Shift In Emergency & Trauma | Housemanship Diaries

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Remember when I mentioned that I love the night shifts?

No? Well, here are the articles advocating my love for that shift:

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My first night shift in this department was in the Red Zone and I was terrified.

Thankfully, it was with a fellow Registrar who is rather patient, kind and one who loves to teach.

The scary part however was that it is the Red Zone after all and on my first night!

The Red Zone basically caters to patients who are unstable be it haemodynamically or in terms of their vital signs or that they are in a state of severe acidosis, on the verge of collapsing, you name it. Basically, how severe of a state a person must be in to end up in that zone.

The night started off smoothly with cases coming in one at a time. Alright, I kept repeating to myself, “attend them, transfer them to another bed, vital signs, bloods, fill out forms, clerk and basically just listen to your superiors”.

The night eventually turned into midnight and into the wee hours of the morning and finally the sun has risen. Before I knew it, it was 7am and the AM shift House Officer has arrived. I am not alone again.

Time to prepare for handover rounds at 7:45am.

It was better after that, having another person with me as it felt less intimidating.

At 10am, I took off and headed home. Not a bad experience for the first night shift.

The good thing about the night shift in the Emergency and Trauma is that we are not alone. There is always a team or at least your superiors are always there.

However, I don’t quite prefer the night shift in this posting. Having actually completed this posting, at the time of writing this article, the daytime shift is definitely better.

Nonetheless, in all the night shifts, albeit that it could be a terrifying one especially prior to the start of your shift, always remember that you are never completely alone even if it feels like it and that help is always nearby.

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The Theoretical Doctor Aug 20

Life After Offtag In Emergency & Trauma | Housemanship Diaries

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The tagging hours in the Department of Emergency & Trauma is from 7am till 10pm, for a total of 10 days and one off day per week. There are no assessments required to off-tag, only hours required to cash in.

During our tagging season, we were not allocated for night shifts as well.

For me, tagging in this posting felt like an eternity. I remembered counting down my days before I would finally “offtag” and be switched to regular working hours. I also remembered being extremely exhausted at the end of my shift, wondering how did my fellow colleagues managed to pull through.

Tagging in this posting as compared to the other postings was considered less stressful as we were not required to arrive early for morning rounds. We merely had to arrive on time and upon the end of our shift, we leave, as compared to other postings where we would stay back almost every time, cash in “unpaid overtimes.”

Finally after 10 days of tagging, I officially “off-tagged“.

So how was life after that?

Much better. Thankfully.

Regular hours in the Emergency & Trauma Department meant working a 12-hours shift per day with an off day per week and a single night shift.

Basically, we had to ensure that in total, we had to meet the total 60-hours shift per week.

Thus are the timings for our respective shifts:

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

If you have read my articles on “The Joy Of Working The Night Shift As A House Officer” as well as “My Favourite Time Of The Day At Work“, I mentioned that I absolutely love the night shift. The disadvantage of working the night shift is that we are usually alone and the night shift can be rather unpredictable.

However, it is not the same for me in this posting. Out of the shifts listed above, my favourite is the AM shift, 7am till 7pm. Initially, getting up for work at 7am is tough especially after working the PM shifts back-to-back. But after the initial morning sleepiness wears off, the day proceeds as usual and we return home at 7pm which is nice.

Life after offtag in this department ensured that I had adequate rest prior to my shift starting. No doubt, it is a 12-hours shift every time, we usually arrive and leave work on time as compared to other postings.

Nonetheless, I was still exhausted after every shift. Perhaps it was due to the accumulated mental and physical stress throughout the previous five postings that when I am finally blessed with extra rest, I am still tired.

If you are still in the tagging phase, be it in this department or others, please stay strong. Remember that it doesn’t last forever, it is merely over a certain span of days or weeks.

Keep showing up, keep doing the good work to the best of your strength and abilities and keep moving forward.

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The Theoretical Doctor Aug 15

My Last Shift As A House Officer in Medical | Housemanship Diaries

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At the time of writing this article, I am no longer in my Fifth Rotation, Medical but already in my Sixth Rotation, The Emergency and Trauma Department and at the same time, due for my last shift in my Sixth rotation as well as being a House Officer.

Looking back, my last shift in the Medical Department seemed ages ago.

However, I remembered that I was night shift at that time and was at Male Medical Ward (MMW).

My duration working in this ward was around 3 weeks. However, it was my least favourite as compared to Medical 3, Medical 4, the Infectious Disease (ID) Ward or being part of the Perimedical team. The superiors were alright but it was the vibe of the ward in general that I found unsettling that I can’t quite place my fingers on.

The night shift in Medical is from 8pm till 9am. However, on that day, I recalled leaving home at 6:30pm to go to work as we were not allocated any “long day” shifts.

“Long Day” or “LD” are those who work from 7am till 10pm. Thus from 6pm till 8pm, prior to the night shift person coming, there is a 2 hours gap which is filled by them.

On that week, there were no “Long Day’s” and everyone had the opportunity to return home at 6pm. However, who would fill in the “2-hours gap”?

Thus, I remembered me and my colleagues at that time coming into a mutual agreement and compromise that one person would stay till 7pm and the night shift person would arrive an hour earlier at 7pm.

It was a good compromise except there would be nobody to accompany us till 10pm and usually their help is valuable. Those hours till 10pm can get rather hectic at times.

I remembered arriving around 6:45pm and started receiving handover from the AM teams and was cautioned to lookout for a particular patient in the acute cubicle who was rather unstable.

Upon finishing our handover, the Medical Officer on-call for that ward arrived and things started to go hectic.

I can’t exactly remember what happened but I was on my feet the whole time and did not begin my “coming mornings” till 3am.

Thankfully, I was still able to complete them before 5am and the morning bloods were out in the system on time.

That morning during my post night shift, I was “summoned” for minimal bloods which I completed immediately. Usually during my post night shift, I would remain within the sights of the “AM team” and offer to help out where I could.

But I remembered at that time that I was completely spent. I decided to rest in the House Officer’s room and take any bloods a little later prior to my shift ending, if there were any.

Surprisingly there were none after that. I recalled seeing a junior taking the blood of a patient as I was exiting the ward and asked him as to why he did not just ask me.

He claimed that upon arriving for his morning shift, I looked rather spent and after I left to take a short break in the House Officer’s room, he just did not want to disturb me. After all, he said, it was only one patient.

I was touched and grateful. It was a small gesture. However, it’s small, simple things that sometimes touches you.

After that, I clocked out for the last time as a House Officer in the Medical Department.

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The Theoretical Doctor Aug 15

Jobs That I’ve Had

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What jobs have you had?

Teacher

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My first job that I’ve ever had was as a Teacher.

I had just completed my STPM which is a form of pre-university course in Malaysia, equivalent to that of the UK A-Levels and I was waiting for my results.

At that time, I was on a holiday with my parents and was perusing through Facebook when I came across an advertisement on a job offer at a nearby language centre, looking for an English Language teacher.

Without any expectations, I applied for it. At least, I’d have some exposure and regularity prior to entering Medical School in September that year.

Shortly after I returned home, I received a call and an email responding to my application. I went for the interview session and was soon called back and offered a job to which I accepted.

Barista

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My second job, I was a barista at a coffee shop as well as worked at the cash register of a store, both at the same time during my first and second year of medical school after which I stopped and subsequently used to work as a waitress for an F&B company. That was my third job. My second and third jobs were jobs mainly to earn extra cash after classes amidst my free time.

Looking back, I probably should’ve just focused on my writing.

Junior Doctor

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My fourth and current job is working as a junior doctor at Sarawak General Hospital. I still am one since I started practicing in 2023 and is currently going through my sixth and final rotation (at the time of writing this article) before finally receiving my full APC or license to practice independently both in government or private sector.

Am I ready for it? Certainly not.

However, somehow I haven’t quit and I kept pushing through. I don’t know how or why and before I knew it, 2 years has flown by.

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The Theoretical Doctor Aug 14

Reflection – After Almost 2 Years Of Practicing As A Junior Doctor

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“Would you want to return back to medical school?”

No.

I enjoyed my 5 years of medical school very much and I appreciate the memories formed throughout those years.

However, after working as a junior doctor for 2 years, I would not consider turning back time, just to go through medical school all over again. I enjoyed studying and it was equally tough and fun. Besides that, I had the best study group, “The Impostors”.

Going through the COVID-19 Pandemic season of social distancing and online classes made the journey easier. I remembered staying back in Kuala Lumpur and waking up in the morning prior to starting class just to set up my laptop and my connecting screen, sending the link earlier to the group, sharing the slides if needed and while the classes are on-going, I would go about cooking, cleaning or folding clothes.

My coffee and tea would be on standby and everything was prim and proper. Besides that, breakfast, lunch and dinner would always be prepped by me, for me or my friend who lives upstairs. After that, I would proceed to study during the wee hours.

I think the time I managed to complete reading various textbooks were during the COVID pandemic.

Then, I graduated and started my housemanship. It was extremely tough at first and it’s still difficult now at times but I’ve grown to accept the fact that there will be difficult days as well as good days.

Three months later after starting my housemanship journey, my first pay was banked in and subsequently, every month I received my monthly pay.

Eventually as I become more and more senior, things became more and more familiar and easier and some things or procedures became a reflex, even the management plans.

Thus, considering, the things that I’m doing now which I think is much easier as compared to my medical school days, would I want to turn back time?

Nope. Medical school is important and equally tough. On top of that, I’m not getting paid. Instead, my parents had to pay for my medical school fees.

So, no. I cherished those days as I said. But I certainly do not want to relieve them again.

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The Theoretical Doctor Jun 8

A Junior Doctor In Boots

Tell us about your favorite pair of shoes, and where they’ve taken you.

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Prior to having my first pair of boots in 2021 while I was in my third year of medical school, I have always dreamt of wearing boots. Be it short cut or the long ones till mid calf or up till the knee, I loved them all.

I prefer them over heels or flats or slippers.

Partly because I have always imagined myself as a “country girl” in summer dress or jeans, always paired with boots.

However, I’ve never had a pair of boots till I was in my third year of medical school, even that, was given by my aunt. I remembered using it to almost every occasion because it was so comfortable and versatile. The colour was dark green, an ankle length boots with zips on the side. I wore it till one of the shoe had a hole on the side and even then, I was still adamant to wear it till my mom got me a new pair of boots and threw my first pair away.

Since then, I’ve gone through another 2 pair of boots, one pair with heels and another flat. I occasionally wear the one with heels and often use the flat one. The flat one is my go-to everyday boots be it for outing or travelling or a simple trip to the market. However, I rarely use them to work. At work, I have specific types of shoes that I usually wear since I’m on my feet most of the time and these shoes gives me the sole support that I need (if you know what I mean).

But there are days when I’m feeling fancy that I would dress up a little and don a nice blouse over my black leggings to work. Those would be the days when I would wear my favourite regular pair of boots to work, which boosts my self-esteem for the day considering that it is my style, one that I feel brings out the inner-me, the junior doctor-in-boots.

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The Theoretical Doctor May 20

My Next 6 Months (Post Housemanship)

What is the biggest challenge you will face in the next six months?

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At the time of writing this article, it is the 8th of April 2025, Day 644 of my Housemanship Journey. I have just completed my Fifth Posting in Medical and is currently on leave as well as due to begin my 6th and Final Posting in Emergency Medicine on the 11th of April 2025.

One posting or rotation lasts for a total of 4 months if there is no extension, for House Officers.

Thus, it’s safe to say that for the upcoming 4 months, my focus would be on leaving and enjoying my final posting and the challenges I would most probably face then would be the completion of my logbook, preparing my presentation for CME and preparing for my end of posting assessments.

But how about for the subsequent 2 months after that?

That’s a grey area for me.

First of all, I do not know myself on the department that I would want to serve in as a Medical Officer as I enjoyed every posting that I have ever rotated in.

Next, the state or hospital that I would be interested in practicing in for at least the next few years. Currently, I am practicing in Hospital Umum Sarawak, otherwise known as Sarawak General Hospital or “SGH”, in Kuching, Sarawak.

Personally, I would like to stay back over here and serve here rather than to go back as I absolutely love it here and feel like this is where I am meant to be.

However, things might change in the future considering that I would want to get married and my partner is living in Peninsular Malaysia. That’s one as well as the consideration of my parents, having grown up as an only child.

Thus, a grey area for me, nevertheless. Me, being comfortable with procrastination has pushed this thought to the back of my head and refused to entertain since I have to submit my full MMC application by the 13th of April 2025.

This means, I have to set my mind on a department as well as my choice of state (location) or hospitals of choice.

Oh dear…

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Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department

An article regarding my life as a Peri-Medical House Officer in my Fifth Posting, The Medical Department (Part 1).

The Theoretical Doctor

The Theoretical Doctor Apr 28

Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department

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Upon entering the Medical Posting, I was stationed into the “Peri-Medical Pool”. My “birthplace”, so-called.

Prior to entering the Medical Posting, many of my colleagues commented that the Peri-Medical pool is probably one of the worst place to enter considering that it is rather hectic, busy and messy, not to mention the joblist is never ending.

The working shift for a Medical House Officer is as such:

Short Day (SD): 7am till 6pm
Long Day (LD): 7am till 10pm
Night Shift (ON): 8pm till 9am

The Emergency Department in Hospital Umum Sarawak is rather huge and consists of:

Green Zone
EDAU
CSSD
Yellow Zone
Yellow Respi Zone
Green Yellow Zone
Red Zone I
Res Zone II
Decon

Usually a House Officer is allocated to take care of more than one zones.

For example:

Green Zone / EDAY / CSSD
Yellow Zone / Green Yellow Zone
Red Zone I / Red Zone II / Yellow Respi Zone

When the amount of manpower is high, the job gets done quickly and keeping track of the patients is easier.

However, in days where we are stretched thin it is rather difficult.

The Day Shift

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Since I entered the Peri Medical Pool on my Day 1 of tagging in the Medical Posting, my working hours were from 7am till 10pm every day till I offtagged.

I begin my day by first tracing the casenotes of the patients in the zone I am allocated to, snap pictures of the chest x-rays, any relevant radiological reports as well as to trace their bloods.

If bloods were not taken or not in the system, we would then proceed to “summon” the post-night team for help with their bloods.

After all the patients have been traced and the Google Lists have been updated (this is to aid us during our rounds as well as following up on their location later, to ensure that they are not being missed), then I would proceed with my morning reviews.

The morning reviews are just as usual as any morning ward reviews, rounds with the Medical Officer and Specialists and finally carrying out any active joblists.

Since we are in the emergency department, there is usually no afternoon reviews. It depends on the medical officer. Most of the time, rounds are just once daily.

After we are done with our morning joblists, we have to actively screen through the patients in our allocated zones as there is constant movement of the patients in both in and out of the emergency department.

Thus, this means assisting the current on-call team for the day with any STAT bloods or STAT radiological requests as well as updating their progress.

On most days, it is manageable despite the chaos. However, on days where we are lacking in manpower, the difficulty sets in.

The Night Shift

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The night shift begins at 8pm till 9am the following day or until we are done with our “summons”.

I was blessed enough to have gone through perimedical with a partner. Thus, there were two House Officers allocated for the night shift.

As night House Officers in Peri-Medical. We are expected to continue screening through all the casenotes for any new joblist or patients in all the zones in the Emergency Department as well as to assist in any procedures, take STAT bloods or request STAT radiological procedures.

In addition to that, we also have to cover the main building and the side building. This means, if there are any medical patients lodging in non-medical wards, we are in charge of them as well. Most of the time, it is just new transfer ins, sometimes, it is attending to any acute issues.

This is then followed by taking the “coming mornings” or bloods of the stranded patients in the Emergency Department of the lodging patients.

The amount of patients in the Medical Department is extremely high and thus, the medical patients can be stranded up to days in the Emergency Department which can even last till they are being discharged.

Thus, this ensures that the patients are being continued on their treatment irregardless of their location within the hospital.

The night shift as a perimedical house officer can get rather hectic if there are back-to-back influx of new patients in the Emergency Department, tons of coming mornings as well as acute issues in the ward.

In the morning, the “summoned” list can get rather extensive and chaotic as well and can be rather endless.

Hence, on top of the constant walking about the whole hospital, it can get rather tiring. But like I said, it is doable and manageable.

In fact, I enjoyed life as a perimedical house officer a lot.

If you are due to join Peri-Medical, fret not. Keep yourselves equipped with necessary forms and just work quick and as fast as you can.

On some days, one might get lost in the sea of chaos. However, stay strong and know that help is always within reach and that you are not alone.

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My Evening Routine In The Medical Posting | Housemanship Diaries

An article regarding my Evening Routine while I was serving as a House Officer in my Fifth Posting, the Department of Medical.

The Theoretical Doctor

The Theoretical Doctor Apr 11

Working on New Year’s Day (2025)

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This will be the second year in a row that I’ve chosen to work on New Year’s Day. If you’ve read my previous similar article last year, I’ve mentioned how my father has this tradition of working on New Year’s Day every year, ever since he started working at the age of 18. It is something that I’ve adapted as well.

This year, I began my year in the Department of Medical which is my Fifth Posting in my Housemanship Journey. I entered this department on the 11th of December last year.

Having just off-tagged the week before, I was still allocated in my first pool which is the Perimedical Pool.

Looking back as it is currently April 2025, at the time of writing this article, I do not quite remember where I was allocated to. I think that I was most probably taking care of the stranded Medical patients in the main building.

Thankfully, I remembered it not being a hectic day and I was allocated the “short day” shift, meaning that I had the opportunity to return home at 6pm.

Considering it was New Year’s Day which is a Public Holiday here, things were rather slow and tuned down.

Thus, it was a rather slowed down and uneventful day, ending with me returning home on time and unwinding early.

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The Theoretical Doctor Apr 7

Surviving Tagging And Finally Celebrating Christmas In The Medical Posting – Housemanship Diaries

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In the Medical Posting, seniors were required to tag for a minimum of 10 days prior to off-tag while juniors had to tag for a full 14 days.

I was due to have my off-tag assessment and in the Medical Posting, we were required to off-tag with Physicians, meaning the specialists.

Tagging everyday in the Medical Posting was rather annoying for me since we had to stay until 10pm and being a regular early riser, I would start feeling sleepy around 8pm as that is the time I start to unwind and go to bed.

However, I can’t because I am still tagging. On top of that, since I am tagging, I would be too exhausted by the time I reach home to even consider studying. I had to prioritise my sleep more or I would crash.

Thus, I tagged for a total of 12 days which consisted of two off days. Thus, in reality, I only actually tagged for 10 full days.

In order to officially off-tag, I had to have my logbook signed by the physician who assessed me as well as to have each procedure filled and countersigned by the medical officers.

Long story short, I finally off-tagged on Christmas Eve and did not realised that I have been allocated an off day on the 25th of December.

This was perfect as my parents flew in on the 24th night. Thus, upon having officially off-tagged, I left and started getting ready to travel to the airport to meet my parents.

The following day of course was Christmas which was well spent with my parents.

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My First Day In Medical Posting – Tagging Day 1 | Housemanship Diaries

An article regarding my first day of tagging in my fifth posting, Medical, as a House Officer.

The Theoretical Doctor