Mastodawn

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 17, 2025

Overcoming My Fear To Refer A Case I DO NOT KNOW | Housemanship Diaries

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What fears have you overcome and how?

At the moment of writing this article, I am in my sixth and final rotation which is in the Department of Emergency Medicine, pushing into my third month.

One might think that as we become more senior in our current job, it gets easier or the fear fades.

Well, the anxiety certainly reduces but that does not mean that it disappears.

For me, the fear is still there as to who I would be working with or who I would be referring to and most of all, referring a case that I not know.

I’m sure we’ve all been there before. Especially upon arrival to work and to be absolutely clueless about the patient and their case and progress and to not have anyone handover the case to you.

Not that we won’t take the time to understand. It is just that, we will or at least I would take the time to digest the initial presentation, clinical examination and findings followed by the initial management of the patient and other teams as well as the current progress.

Once I have finally understood the issue of the patient from A to Z, then I can confidently refer the patient for a simple thing.

That’ll usually take me about 5-10 minutes, especially if there is just one too many writing. To others that may seem like an eternity.

The thing is they will somewhat give me a template of what to say in regards to the patient but I am still absolutely clueless and wishes to kindly absorb the pages and information about the patient before I walk into the battlefield.

This is because, one too many times, I will be asked about things totally irrelevant to the case of the patient which will take me some time and if I’m not so lucky, ended up being shouted at. I mean, that’s the worst that can happen right? Certainly reminds me of my early days of housemanship.

Maybe it’s a form of childhood trauma or maybe not, but I need to at least have a reason to defend myself and the patient.

It’s like a debate or a business deal which I find that I may need to fib or exaggerate myself in order to get a test approved or to refer, all for the sake of the patient or sometimes the superiors.

It’s alright but at times it can be rather annoying especially when they want it done in a minutes time.

The next that I have to actually open my mouth and communicate. Being an introvert, I can easily talk to people but I dislike being in groups, small talks or actually talking at times.

I find it exhausting and thus upon the end of my shift, I just need time to recuperate.

However, back to the question of this article, my fear, to refer to other departments, especially, if it is a case I do not know and to a tiger of a person who loves finding any fault just to reject the case is still present to this day and what have I done to overcome it? Nothing, really, just extreme patience.

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The Theoretical Doctor Aug 15, 2025

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, 2025

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 Jul 10, 2025

The Most Enjoyable and Tiring Day In Medical 3

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I can’t remember which day it was but it was probably during the weekend or a public holiday as I remembered that I was allocated on call who was in charge of this ward.

I was allocated to “General” on that day and was I was alone at that time. I remembered sitting at the other end of the ward at around 11am when one of my colleagues who was allocated to be covering the “Neuro” patients went to have lunch.

The medical officer on call at that time, a rather “happy-go-lucky” and rather jovial person struts into the respiratory cubicle and asked if there were any house officers available?

To which I responded, we’re right here and he came over. He asked for the person who was in charge of the front cubicles which happened to be my colleague who went for lunch. I asked what’s wrong, is there anything I can help with?

He casually replied, nothing much, just walked in and saw a patient’s pulse oximeter reading 70% under room air. Then he laughed.

Me and my friend who happened to be there at that time were shocked and rushed to the patient. True enough, the pulse oximeter reading was 70%, well, 68%. Oddly enough, the patient seemed rather comfortable and not tachypnoeic. In fact, he was surprised as we crowded around his bed, looking concerned.

I asked him if he was having any difficulty breathing which he was not. Thus, our first instinct was probably the machine was faulty and proceeded to check with another vital signs machine.

This time, it was 65%.

I proceeded to take full set of bloods while my medical officer was writing his review and my friend attempted to call my colleague.

I ran his arterial blood gas and it showed Type 1 Respiratory Failure. Considering he did not have a baseline during this admission, we do not know if this was near his baseline or a sudden deterioration.

We called the Peri ICU team and referred the patient for non-invasive ventilatory support (NIV). Imagine, not knowing why this long stay patient was ever here in the first place to summarising the reason for admission down to his current progress. It turns out, he was due to be stepped down to a district hospital for continuation of antibiotics.

Well now, he can’t.

We transferred hum to the acute cubicle for closer monitoring while awaiting the Peri ICU team.

While awaiting, my medical officer decided to check on a patient who was handover to him for afternoon reviews.

This lady was in her 60’s and was admitted for left pleural abscess, meaning there’s pus in her lungs and for this patient, the whole left lung was completely filled. Clinically, she seemed well, speaking in full sentences and laughing to her family members as well in the morning.

In fact. I was even taking her bloods that morning only to have it splashed all over me after attempting to fill the blood culture and sensitivity bottle.

I recalled walking past her as I made my way to the front of the ward and she seemed alright. However, the moment me and my medical officer oncall stood in front of her. She desaturated an started being tachypnoeic.

Well, here’s another one.

There goes the next referral to the Peri ICU team for intubation and also Urology for emergency suprapubic catheter insertion as we attempted to insert a urinary catheter multiple times but failed.

Now, all these events happened very fast but at the same time, time flew by fast. The second patient was intubated and we inserted a femoral venous catheter. My medical officer then wanted to excuse himself to settle the pending discharges in his other ward. However, the first patient wasn’t saturating well under NIV and needed to be intubated.

There goes another intubation as well as another femoral venous catheter insertion. Finally, after all the chaos, things began to finally settle down.

I proceeded to trace my coming mornings, considering that I was the only one in charge of “General” that day and nobody would be helping me. Finally, I proceeded to begin my oncall reviews. This was around 8pm by that time.

After completing my in all reviews with intermittent disturbance in between. I proceeded to aid my friend in preparation of her coming mornings.

It was close to 11pm, I was just clearing my stuffs and getting ready to go when a nurse informed me that a patient seemed rather tachypnoeic.

Annoyed and tired, I attended STAT to find a patient sitting at the side of the bed with his BiPAP machine unlatched and hanging at the side of the bed. The patient beside him then told me, he removed it himself an hour ago.

Boy… Why am I not surprised?

This is another impending intubation.

At this rate, I might as well not leave anymore.

The day was busy enough. I sometimes wonder why is it that we feel guilty to even desire to return home on time? To walk out with the family members watching us finally ecstatic to return home for the day while their family members are stuck in the hospital?

Back to that patient, I didn’t left him gasping on his own of course, I fixed back the BiPAP machine, took an arterial blood gas and alerted my night colleague and medical officer oncall to which they attended STAT.

Thankfully, the following day, I was allocated as night shift. Thus, despite returning home late, I was able to sleep in and recuperate a little before returning back to work that night.

It was a busy day but considerably a rather fun one considering that I happened to work with a rather jovial medical officer oncall and my colleague stayed back to accompany me despite her shift being till 6pm.

Working with certain people definitely helps alleviate some of the pressure of the day.

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The Theoretical Doctor Jun 8, 2025

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 Jun 3, 2025

40 Days Since I’ve Started Being Vegetarian

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Describe one positive change you have made in your life.

The positive change? Being vegetarian. Well, for 40 days then I’m non-vegetarian again.

Why did I even embark on this journey?

Every year during Lent, I would embark on a vegetarian journey, a lacto-ovo-vegetarian journey to be exact and this year, it was from the 5th of March till the 19th of April 2025.

Thus, I went from consuming meat to consuming tofu almost everyday as well as started consuming vegetables again.

Albeit being vegetarian, I try to reduce my rice consumption. Thus, I mainly mixed rolled oats into my dishes.

I started shopping for groceries even more (which may not be such a good thing) but I was surprised at the number of items I could buy and only spend minimal.

Well, vegetables are cheap, which is good.

Changing my diet in combination with my usual routine at work and ensuring I reach my daily steps of 10,000 steps, I started losing weight.

Not much. However, I’ve been struggling with losing the weight that I have gained during my time off in the Surgical Posting.

Now that I’m non-vegetarian again, obtaining food is easier and I actually miss being vegetarian.

Perhaps soon I will embark on this journey again.

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novaTopFlex May 25, 2025

Conflict of Interest

Daily writing promptHow do you know when it’s time to unplug? What do you do to make it happen?View all responses Unfortunately, since I am actively pursuing computer science and/or cybersecurity goals, I may be less likely to attain my ultimate goals that may result in increased positivity. If I were speaking about “unplugging” myself, then I may have an easier time in the more rural areas where I would not have access to the materials of my career pathway. Therefore, I am a victim […]

https://novatopflex.wordpress.com/2025/05/24/conflict-of-interest/

Conflict of Interest

Daily writing promptHow do you know when it’s time to unplug? What do you do to make it happen?View all responses Unfortunately, since I am actively pursuing computer science and/or cybersecurity g…

novaTopFlex

The Theoretical Doctor May 10, 2025

My Teenage Years

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Describe a phase in life that was difficult to say goodbye to.

Upon reading this prompt, I was reminded of my high school days. The first year of high school was very tough for me in terms of adjusting to a new school, cultures and subjects.

I went from a comfortable place to a different one without any guidance nor advice and I went from being a senior to a freshie all over again, which I did not like.

In addition to that, I had a very bad temper and used to talk back to my seniors which did not aid in my reputation. Well, that was the first year, things started getting better the following year onwards and my grades picked up. I have accustomed myself to the flow.

It was during my teenage years that I met my good friends whom I still keep contact to this day albeit not meeting much.

Looking back, I enjoyed my routine and studying very much. Waking up early was the hardest part of the day, which surprisingly isn’t one for me now, I have transitioned into an early riser.

This is followed by shower, preparing my breakfast and lunch for school, which mostly just includes me grabbing bread or biscuits and stuffing it in my bag and wait for my parents to send me off to school, which is usually my dad. He would send me off prior going to work.

I was truly blessed to have experience that.

In school, it was about attending classes, completing homework or assignments, gossiping with my friends or attending extra-curricular activities. However, the place I truly enjoyed spending my time was in the library. Thus, if I were to bunk class, I would lock myself inside the library and just study or read. The perks of being a librarian. Thankfully, my teacher-in-charge of the library always had my back if I were to be questioned regarding my whereabouts.

After school, my mother would be the one who usually picks me up from school and most of the time, we would eat outside. Occasionally, she does cook at home and as I am writing this reflection, I truly miss these simple heartwarming dishes.

This is then followed by me showering, completing my homework, studying, chilling, going out with my mom and getting ready for tuition or extra classes which are usually in the evenings or on alternate days.

Life was simple and predictable. I remembered attending multiple tuition classes during the week, mainly because I was bored being at home as I was not allowed to simply go out with my friends as I pleased. Thus, I looked forward to those evenings.

Holidays and weekends were the things I looked forward to as well and I enjoyed recuperating or simply helping my parents out with their chores, watching movies or TV shows, studying with music, writing and playing video games.

Surprisingly, what aid me in studying back in high school was due to video games. Perhaps it was the way I “destress” and it drives my mind.

I was not allowed to work during the holidays as my parents feared that once I get the taste of my own earnings, studying will no longer be a priority. However, my pocket money wasn’t great either. But I still got by and occasionally, my dad would slip in some money without my mom knowing just so I could enjoy a nice meal across the road with my friend.

The stress back then were focused on exams and completing homework. Occasionally, life dramas do get in the way, all part and parcel of being a “teenager”, having crushes, jealousy and bullying.

However, for the most part, I enjoyed my teenage years and looking back, I wouldn’t change a thing except to be more disciplined in my studying and to learn more.

Those years flew by rather quickly. Before I knew it, I was a senior and the stress of choosing a major or course and the university applications kicked in. Over the years, I’ve accumulated multiple fond memories with my friends as well which were a mixed of beautiful ones, silly and extremely foolish ones, which we do look back and laugh about during our meet-ups.

If you are reading this, I hope that you did enjoy your teenage years as much as I did too. If you are a teenager, do not fill your time with just studying, immerse yourself in extracurricular activities as well and discover new habits. It is the season of discovering yourself, and hopefully in years to come when you do look back and ponder, it will be filled with sweet memories as well.

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