yesterday was my last day for end of posting examination.... waaaaa,.. the questions were very difficult. I studied, i read books for many times, i did my own notes, but still can't answer... questions that never across to my mind,. maybe i should read the whole pages of Baileys...hohoho..
and my clinical examination 2 days ago make me realize a lot more practice i need to do.. i got a very cooperative patient, a good and cheerful examiner... but, i did'nt do well,.. so, whats a point???
prof : ok amieza,,. what do you think the diagnosis of this patients??
me: GERD secondary to hiatal hernia.
prof: good.... can you show me how to palpate lymph nodes in the neck?
me: yes, of course.. ( i did confidently.... harap2 betol la cara aku nie....)
pro: hmmmm..... actually i impress u can name all groups of lymph nodes correctly. But your technique is WRONG.. how can u palpate by using your fingertips only??? u'll miss the findings, right? ( prof showed me to palpate correctly.... thanks prof). ok now.... palpate the liver..
me: hmm... we've to be in the same level as the patient. ( then, i start palpating)
prof: amieza....amieza... WRONG technique.... let me show you.... ( prof start palpating) u must dig deeper to the abdomen.. Dig, dig... and use ur fingers to feel the lower border of liver....( prof sigh again).
me: .............................
prof: Tell me what ur findings on the abdomen.
me: Patient also has paraumbilical hernias,, 2x2 cm, his umbilicus was shifted to the right,. i can appreciate bowel sound when i auscultate the mass...
prof: no...no.... there should be no bowel sound.. it did'n contain intestine, right???
me: but prof.....( huhu, my ears didnt lie)
prof: Ok,. please show me how to palpate right axillary lymph node
me: oppsss.... ( in my mind... class with mr R.....axillary lymph node....)...
prof: amieza........amieza.......amieza........ ( prof walked toward me and stood beside me).. WRONG technique again... ( prof showed me... he was struggling to find for axillary artery, i think..). ok,put ur fingers here and feel for the pulse.. Apical LN is somewhere there... Try to imagine the inner content of axillae..
me: ok prof...i'll try to do properly next time
Prof: lets finish ur history about this case.
me: Bla..bla..bla....
prof: give me pathophysiology of GERD.
me: ( I answer laaa... based on what i understand)
prof: good...( and prof me some other questions, that i thought i could answer them)
me:...........( silence)
prof: what grade did u got during PRO exam I in last preclinical year?
me:??????? I got A...hmm..( nape prof tanye nieee...)
prof: i already expected u are an A student. But..amieza, whats a point to have an average intelligence but poor in clinical exam..u must learn from the patient... not 100% from the books. u have to practice more and more in the future, right?
me: yes prof...( wat muke sedih...:((( )
prof: but today,.. i can't give u A..u can go now....
me: thanks, prof... ( if u give me ''pass'' is enough for me, doc..btw, i dont deserve to get high marks)
is it enough to be a medical student in five years time but we're expected to know everything?? not fair right??
However, it is possible if we are hardworking, willing to study more, read more, approach patients more.. and more more to do... but, the most important is our nawaitu... we study sincerely for the sake of Allah.. so that He will grant us for our good deed......and i want to be such doc too... ameen...
