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 15

My New Year’s Eve – 2025

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31st December 2025. I was NOT oncall.

It was a Wednesday and it was a normal working day. Hence, at 7:45am, I left to work as usual and was there by 8am. It was the New Year’s Eve. I thought that maybe, just maybe, there would be less patients in the clinic.

The day started off smoothly. Surprisingly, there were many patients who came for their follow up followed by additional patients (the defaulters and walk-ins) but it was manageable. We went about our day, seeing each patient and when lunch time came, we went for our lunch break.

At 2pm, we went about our work, seeing patients as usual and I was taking my time with each patient. The patient load in the afternoon shift was lower compared to the morning shift and both my colleagues were done with their patient load.

Suddenly, a staff nurse barged into my room saying that there is a massive accident that just occurred nearby, 2 patients were already brought in and 2 more were on their way. They called in all available doctors (which were only the three of us) to help out.

I told my colleagues to head out and help out first while I rushed through the consultation of my final patient. After that, I rushed to the tiny Emergency Room of the clinic. My colleague who was oncall on that day was already attending to a child. I went over to the other patient, an old lady and did my primary survey and fast scan.

She was desaturating badly under room air and needed oxygen support. She had an open skull fracture, multiple abrasion and laceration wounds over her face, upper and lower limbs as well as rib fractures and on top of that, her left leg appears shortened and she has a closed fracture over her right lower limb.

I didn’t think that we should proceed with an x-ray at our clinic even if we had the facility at that time, the best would be to send them straight away to the hospital because she could deteriorate further any time. Thankfully, her GCS (Glasgow Coma Scale) was full.

I was focused on my patient, stabilising while referring her to the specialists of various specialities as well as the emergency physician that when I finally got ready to transfer her out that I noticed the child that my other colleague was attending to. The child’s right arm was crushed and the distal limb of his right arm was pale and his right lung was obvious till mid-chest.

Just how in the world is he still awake? The poor child was crying out in pain…

Judging by the state of his and my patient’s injuries, it was definitely high impact.

The story was, the whole family were travelling back from Miri to Kuching. Both the parents were sitting in front and the father was driving whilst the two children and their grandmother were sitting at the back.

The father claimed that he was not speeding but as he was about to make a u-turn at a junction, he claimed to have hit the curb and the car turned many times into the other lane before finally stopping and the grandmother and one of the child were thrown out of the car.

It sounded like a very high impact collision. Thankfully, the parents and the other child were well and unscathed.

We had to transfer both patients in two separate ambulances to the Red Zone of the Emergency Department at Hospital Bintulu as one ambulance could only transport one patient at a time.

Upon arriving, I met my colleague and friend at the Red Zone of the hospital. After we have handed over to the medical officers and specialist in the Emergency Department, we headed back together. However, upon reaching back, there was another patient who came in who was extremely tachypnoiec.

Oh, here we go again… Another Red Zone referral…

We stabilised the patient and referred her to hospital again. The clock was already showing 10pm when we left. The journey to the hospital takes about 45 minutes to an hour for each journey and the both of us have yet to have our dinner. This time, I choose to accompany her for the referral, mainly for emotional support and also in hopes of stopping by McDonald’s to get a takeout.

Yes, we did stop by McDonalds after sending the patient safely to the hospital and yes, we used the ambulance and went through drive-through.

By the time we left, it was already 11pm. The journey takes around 45 minutes to an hour and it was raining heavily. At this point, I was wondering if we would end up celebrating New Year’s in the ambulance.

Me and my friend ate in the ambulance on the way back while we joked and exchange oncall stories. Thankfully, we reached a little before midnight. The day was completely unexpected, not to mention tiring but it was nice to have spent it with a friend.

It’s still the beginning of 2026, so if I’m not too late, Happy New Year!

If you are travelling anytime soon or in the future, do drive safely, stay within speed limits especially if it is raining. Remember to get your car and tyres checked before any long distance journey and NEVER drive under the influence.

Stay safe always!

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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 14

A short article during my 6th and final rotation of my Housemanship period where we were required to complete a 12-hour shift every day.

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http://theoreticaldoctor.com/2026/01/14/12-hours-shift-counting-down-my-hours-each-time-at-work/

12 Hours Shift – Counting Down My Hours Each Time At Work

A short article during my 6th and final rotation of my Housemanship period where we were required to complete a 12-hour shift every day.

The Theoretical Doctor

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 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 9

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

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Thank God. Seriously.

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

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

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

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

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

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

Am I confident now though?

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

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

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

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

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

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

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The Theoretical Doctor Jan 8

My First Tagging On-Call Shift As A Floating Medical Officer

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My first tagging oncall shift was on a Sunday with a fellow medical officer I knew when I was a House Officer in General Surgery. Back then, he was having his attachment in General Surgery.

Just like a House Officer, we had to undergo a period of “tagging“.

In the Department of Plastics and Reconstructive Surgery at Sarawak General Hospital, I had to undergo a tagging period of one month, every other day (EOD). This is because, I am a newborn medical officer with no previous experience in General Surgery (as a Medical Officer).

This is an advantage as I would be able to learn as much as I could within a span of 1 month. However, it was also a disadvantage as I’m afraid, I would be burnt out mentally and physically considering the on-calls were on every other day (EOD).

“I can do it. If others could, I could too.” , I repeated this mantra to myself but the learning curve is going to be an extremely steep one.

During my first tagging oncall, thankfully, it was with a fellow senior colleague who I was rather comfortable with.

We started with our morning ward rounds followed by passover and peri-rounds. After we were done, we went back to the ward to settle our pending job-lists followed by lunch.

As a tagging on-call medical officer, the first call would be to me for referrals. After which, I would discuss with my senior and proceed to see the referred patient together. After reviewing our newly electively admitted patients, pre-op rounds with surgeon and demarcating the op site and pre-op meeting, we went back home in the evening and returned at night together for our night reviews which we updated in the Department’s WhatsApp Group on the progress of certain patients. Incidentally, a patient whom we were awaiting for op was called into the operating theatre and the operation ended at 2am. Finally, we returned home for the night.

I was nervous of course as I usually get anxious easily. However, I took my shower and headed to bed.

My phone was kept beside me in case I were to receive calls or referrals. At 6am, I returned to the ward and started our morning reviews as well as prepared for our morning rounds.

Since, it was a Monday, it was morning ward rounds, handover and peri rounds as usual. However, since I was still tagging, I was expected to stay till 5pm or to join the ongoing surgeries.

Thus, my first postcall was spent in the operating theatre assisting till 6pm. However, despite the ongoing operation, I excused myself to return home and rest.

The following day will be another one, thankfully, not oncall but within office hours.

Thankfully, it was a good call with a fellow senior that I was comfortable with in terms of approaching in regards to my doubts which was undoubtedly, many.

I can only hope that I would be able to survive this whole month of tagging.

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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 Jan 6

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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