An article regarding my Reflection of 2025.
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#writing #doctor #malaysia #medicalofficer #houseofficer #2025 #reflection #blogging #healthcare
http://theoreticaldoctor.com/2026/01/16/my-reflection-of-2025/
An article regarding my Reflection of 2025.
-
#writing #doctor #malaysia #medicalofficer #houseofficer #2025 #reflection #blogging #healthcare
http://theoreticaldoctor.com/2026/01/16/my-reflection-of-2025/
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:
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;
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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My First Day Of Locum And As A Medical Officer
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A locum or locum tenens, is a person who temporarily fulfils the duties of another; the term is especially used for physicians or clergy.
– Wikipedia.
The first time I ever tasted or ventured into locum or a so-called “part-time doctor” was on the 3rd of August 2025.
At that time, I was back in my hometown and on a 3-weeks-break post housemanship / internship at a small private clinic, yet to officially begin as a Medical Officer.
While I was in medical school, I would occasionally hear this term “locum” from my fellow seniors or batch mates, lecturers, parents or even friends of my parents. However, in order to locum, one would need to be fully registered with the Malaysian Medical Council (MMC) and possess a valid Annual Practicing Certificate (APC). In short, I had to graduate medical school, finish my internship or housemanship first, then only am I able to dive into this.
Thus, upon acquiring my full MMC and APC licence, I was looking forward to locum. Looking forward to it as well as nervous to dive into this. Thankfully, I had just completed my final rotation in the Emergency and Trauma Department.
In the Emergency and Trauma Department, there are various zones in which the patients would be triaged into in terms of presenting complaints, severity and their vital signs. The least critical in severity would be triaged into Green zone. The Green zone is similar to a clinic setting, thus, it gave me some idea on the type of cases I would be expecting.
My first locum was just 3 hours long, from 7pm till 10pm. I figured that since I am just starting at that time, it would be better to start with minimal hours in order to get used to it and also.. if I would enjoy it.
The clinic was quaint and small but equipped with basic necessities and a scan machine. The only thing that it did not have, was an x-ray facility. The moment I sat down, the patients kept coming back-to-back. As soon as I was done with one, another came.
For a first-timer, I felt it was equivalent to the Green Zone in General Hospital whereby the cases were always there but the patient load was manageable.
However, I was extremely scared.
Mainly afraid that I might accidentally jeopardise the patient’s safety in terms of mismanagement. Thankfully, by 9:30 pm, the clinic assistant stopped accepting new patients and prepared to close the clinic.
For a first experience, it was a good one despite it being rather terrifying for me.
But, we all have to start somewhere and build our confidence, don’t we?
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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:
Photo by Chauhan Dixant on Pexels.comMy 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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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:
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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Day 1 Of My Final Posting – Day 647 Of Housemanship
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My first day of my final posting, The Emergency & Trauma Department, commenced on the 11th of April 2025.
Day 647, finally. Finally! I’ve pulled through and entered the last pit stop of my journey as a House Officer.
In every posting, I have always looked forward to this posting. Prior to joining, I’ve always had mixed feelings and initially wanted to join Anaesthesiology. However, a few weeks prior to entering, the other postings such as Psychiatry, Klinik Kesihatan and Anaesthesiology were removed from our options and everyone had to rotate in the Emergency and Trauma Department.
This is good. This meant more manpower.
However, just as the previous postings, prior to joining any new department, I’ve always had this fear and mixed feelings because it is after a new environment.
My fear was stumbling too badly on my first day. Thus, of course, I did my research and questioned the people I knew who were already in the posting.
My First Day began on a Friday in the “Yellow Respi Zone“.
The Yellow Respi Zone consists of patients who are unable to saturate well under room air, usually less than 90%. Having just completed the Medical Posting, the patients allocated there are primarily Medical patients or in particular, having respiratory issues such as patients developing acute pulmonary oedema or fluid overload secondary to non-compliance to their fluid restriction.
Thankfully, I have just completed Medical. Thus, I am able to apply my knowledge learnt which was still fresh at that time.
I arrived a little before 7am since the tagging shift is from 7am till 10pm, introduced myself to the medical officers and talked to a fellow friend who arrived and would be working in the same zone as well. I went through the triages and casenotes of the patients to see if there were any active cases or cases that were due tracing of bloods or referrals.
The day started off rather quietly and it was manageable. I followed the morning handover rounds at 7:45am and after that attended to any new patients or refer if needed.
Basically, when a patient comes in, especially to this zone where the patients’ chief complaint is “shortness of breath“, the first person who attends would usually auscultate or “listen” to the lungs and check the vital sigs prior to taking blood or doing a “full clerking” such as obtaining their past medical history or history of presenting illness.
The next person that steps in usually helps with the bloods and fills the forms.
Everyone worked together as a team and somehow indirectly we were communicating with one another without actually voicing it out. It seemed almost like a dance, or a workout.
Afternoon came and afternoon handovers started at 2:45pm. I met a lovely medical officer who is a junior herself but one who was extremely upbeat and more than happy to guide me.
I learnt a lot during my first day with her. She even encouraged me to consider joining this department during my floating period.
The evenings became extremely busy to which I did not really realise. Maybe because it was my first day or maybe because I have just completed my Medical Posting (and it was much busier over there), or perhaps because I simply enjoyed working with my superior or team on that day.
The day ended at 10pm and I walked back home. Thankfully, I lived within walking distance thus I saved time and did not have to worry regarding transportation or parking issues.
My first day in my last posting or rotation started off well which is something I’m more than thankful for.
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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.comThe 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.comThere 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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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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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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Jobs That I’ve Had
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What jobs have you had?
Teacher
Photo by Tima Miroshnichenko on Pexels.comMy 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
Photo by Barcelona Albertus on Pexels.comMy 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
Photo by RF._.studio _ on Pexels.comMy 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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