Mastodawn

My Reflection Of 2025

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2025, was indeed a year.

The year started out great, I worked on New Year’s Day as usual in the Department of Medical and in April, I entered into my final posting, the Emergency and Trauma Department. In May, I attended my best friend’s wedding.

In July, I completed my internship and received my full registration under the Malaysian Medical Council (MMC) as well as my Annual Practicing Certificate (APC) and started locumming during my holidays back home and I also started floating as a Medical Officer in the Department of Plastic and Reconstructive Surgery. It was a steep learning curve for me, transitioning from a House Officer into a Medical Officer. The anxiety increased and I was constantly tired. I remembered my love for medicine and service fading to the point I took a long break in October to recharge and reflect.

2025 was also the year, I handed in my 30-days-notice to resign but revoke it the following day. Perhaps it was too much for me, although the working environment and superiors were more than sweet and kind. Physically, I was catching up but mentally, I was fading away.

Looking back, thankfully, I did not. I celebrated my birthday before travelling back to Kuching the following day. 2025 was also the year when my relationship ended. It was a good and lovely 19 months. Perhaps, it was just time.

November was the month I received my letter stating that I will receive my placement and I needed to report for duty on the 24th of November 2025. One thing for sure, I was sure to continue serving in Sarawak. The place? Unknown yet.

On the 18th of November, I found out that I would need to report to the Health Division of Bintulu on the 24th of November 2025.

Bintulu, that’s around 7 hours drive from Kuching. I didn’t have a place to stay nor a car and my things were all unpacked and I was just extremely busy. I packed whatever I could, shipped some boxes back home, those that I managed to do and on the 23rd of November, I flew to Bintulu.

Thankfully, the doctor-in-charge of the Health Division was kind enough to let me know which place or clinic that I would be placed at.

Yes, clinic setting. I did not apply for a clinic setting which so happened to be what many others in my batch longed for. Surprisingly, I got it!

Considering the state of my mental health, I was more than ecstatic to accept it.

2025 was also the year I moved and started working in a new place and also one that speaks a different dialect. I started doing oncalls as well and surprisingly, adapted very quickly into a General Practitioner’s setting as well as the new place. I also met another colleague who was previously my medical officer in the Department of Obstetrics & Gynaecology when I was a House Officer and made new friends and acquaintances.

Overall, 2025 was a mixed of both good and bad experiences. I felt both the highs and also went through a period of low mood. New people entered my life, some stayed and some also left. Nevertheless, I am thankful for all the experiences I went through as well as the lessons learnt.

Hopefully, I can learn from the errors that I have made and grow, making me into a better person.

Thank you 2025. Now, it’s time to move on, to 2026.

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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 10

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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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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The Theoretical Doctor Aug 21, 2025

Tagline: “Hourly Toilet Break”

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If humans had taglines, what would yours be?

Those who have worked with me know that I have such thing called “The Hourly Toilet Break”.

Firstly, because I consume lots of fluids and secondly, that is how I ensure I do get the break once in a while on a busy day or maybe, the day is quite slow and I am just, bored.

Of course when the day is rather busy and hectic, time just flies and that I do not even realise the time passing by. By the time I actually do complete my task and take the opportunity to just rest for a while, 2-3 hours have gone by.

How Did The Hourly Toilet Break Started?

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I didn’t actually planned for such thing at work. Obviously.

At home, I do frequently go for my toilet breaks as I’m forever consuming green teas or black coffees or water. All of which contributes to the filling of my bladder, in addition to the fluids being diuretics.

It wasn’t until I started my tagging in my sixth rotation, the Emergency & Trauma Department that I reinforced this so-called “hourly toilet break”.

The tagging hours in the Emergency & Trauma Department is long, just as in other postings whereby we had to work from 7am til 10pm everyday with an off day each week for 10 days straight.

Thus, it helped me in ensuring that I either get to sit and recollect myself during hectic days or to make the hours pass during slow days.

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The Theoretical Doctor Aug 21, 2025

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, 2025

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 2, 2025

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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