Final Professional Exam MBBS USIM 2010/2011

As-Salam.

Alhamdulillah, hari ini tamat sudah final professional exam MBBS USIM 2010/2011. setelah 11jam 40 minit bertarung, otak ni rasa nak pecah, walaupun dah rase penuh, tapi ilmu disumbat2 masuk last minute...bila memikirkan, begitu cepat masa berlalu. rase macam baru je semalam menggelabah nak masuk study leave, tapi hari ni dah tamat exam dah? fuuhhh!

minggu lepas ialah minggu paper teori. dimulakan dengan PMP I ( medicine + O&G), PMP II ( Surgery + Paediatric), diikuti data interpretation (osce - 5 minit per station), MCQ dan OBA ( 120 soalan kesemuanya)... sangat memenatkan.. terlalu banyak benda yg nak dihafal.. bila dah bace bab ni, baru teringat 1 lagi bab.. bace bab baru, bab yg lama mula dah terbang macam kertas..haih..

tapi, yang paling penting ialah hari ini, clinical exam.. untuk kali ini, clinical exam bagi pelajar usim dibuat di HUKM (kami menumpang wad peperiksaan dan juga pesakit di sana..) examiners2 kami terdiri dari oversea examiner ( 3 org, nama diorang x ingat, 1 medicine, 1 O&G dan 1 Surgeon) prof lokman saim (bekas dekan medic ukm), prof Raymond ( dekan medic ukm sekarang), prof nik nasri (our dean..), examiners dari CUCMS ( prof. Latiff, prof. Amaludin) examiners dari ukm ( mr. yazid, prof rohana, dr. sharina, prof. Ismail Sagap, prof. Jamil, prof. Masbah, dll) specialists dari teaching hospitals ( ms Aisyah, mr. Felix, Dr. Sia, Dr. Murali, Mr. Sushil, Dr. Lazli) dan specialist dari USIM ( Dr. Maiza, prof. Siva, Dr. Azlina, Dato' Siva) serta Dr. Ramli dari UIAM dan Prof Hatta (lupa dari mana..haha)

Peperiksaan bermula seawal pukul 8.15. semua candidates perlu ada di wad peperiksaan lebih awal, maka semua menaiki bas dari pandan mewah ke hukm. aku adalah antara candidates yg bermula pukul 8.15. sangat cuak!!! dah takleh nak sumbat dah ilmu pagi tadi, hanya mampu selawat, bace "rabbi ishrahli sodri...ila akhir" dan " rabbi yassir wa la tu'assir wakhtimli bilkhair" sahaja. pada waktu pagi, semua bermula dengan long case. masa diberi sejam untuk clerk case dan examine serta prepare ape yg patut. Alhamdulillah, untuk long case, aku dapat case breast carcinoma (dah bace n discuss sebelum tuh..) patient plak sangat cooperative.. habis sejam, semua diberi masa 15minit untuk susun balik data, sebelum masuk bilik examiner..

bila aku disuruh masuk, ade 3 examiners ( prof latiff, prof george dan dr. ramli). maka bermula lah sesi case presentation dan discussion selama 30 minit.. banyak jugak yg ditanya, antara yg aku ingat ialah

- present history and examination findings

- your impression? why?

- differentials?

-how do you manage this patient? (triple assessment)

- what do you know about FNAC? what is the interpretation from the FNAC?

- other than FNAC, what else you can do? (tru-cut biopsy) what it tells you?

- what findings can you get from mammogram?

- other investigations that you would like to do? ( tumor marker, FBC, LFT, RP, UFEME, CXR, Bone scan, bla bla...)

- TNM staging for breast ca?

- for the treatment, what would you offer to this patient? (modified mastectomy with LN clearance + chemo/radiotherapy) why you choose that treatment for this patient?

- how you differentiate local, advanced and very advanced breast ca?

- if patient come with SOB, what is happening to the patient? how you investigate? (CXR)

- if patient come with bone pain, what it tells you? (bone mets) investigations? ( bone scan) what is the finding you would expect from the investigation?(hot nodule)

- is the patient have depressive symptoms ( from psychiatrist, dr. ramli)

- what is your opinion regarding annual mammogram for women more than 40 y.o? (from proff. Latiff)

- what is the latest news/ issue that you know about breast ca?

TETTTT!!!! ( masa tamat)

habis neraka pertama aku.. lepas tu dikuarantin, mula bincang pasal case member lain dapat (pulmonary TB, AVN, BPH, Stroke, MDD + OCD, Schizo, brachial plexus injury, hypothyroid / heart disease in pregnancy, febrile fit, DFU, uterine fibroid, bronchial asthma, renal ca, n etc...

then, pukul 1.45, group pertama untuk short case dipanggil untuk start exam.. aku adalah antaranya. dan aku yg pertama dipanggil untuk memulakan short case. examiners untuk short case aku ialah prof Lokman Saim ( ENT), Dr Singh (x ingat nama die, O&G from Singapore) dan Prof Rahmah (paeds ukm).

ENT

-examine the patient's right ear (perforation at the tympanic membrane with rinne test inconclusive) i did otoscopy 2x (not find the perforation) n then rinne & webber few times (finding x convincing).. so much time spent for examination..shoooott!!

- impression? (CSOM)

- differential? (ASOM)

TETTT!!!

O&G

- examine the abdomen (46 y.o, uterine fibroid - so many mistakes done here, initially i thought it was ovarian mass!! thank god the examiner was so helpful)

- diagnosis ( multiple uterine fibroid)

- treatment? (TAH + conserve ovary for hormone benefit. another answer is TAHBSO, but the examiner insist on keeping the normal ovary, so we as candidates must concur...)

- what is the age of menopause in Malaysia ( 50-51 y.o)

TETTTT!!!!

Paeds

- do general examination ( baby with Down syndrome - describe the physical findings seen)

- examine the chest and auscultate the heart ( sternotomy scar, continuous machinery murmur (PDA)

-What is your diagnosis? (baby with Down Syndrome)

- what other abnormalities that you would find in this patient? ( CVS, GIT, Hormone, musculoskeletal, developmental delay, low IQ)

- how you are going to counsel the parent ( it's genetic mutation d/t non-dijunctional, translocation n mosaic)

- what non-disjunction related to? ( elderly mother)

- which one is inherited? (translocation, happen in young mother)

- what is the risk for the parent to have 2nd child with same problem? ( for non-disjunctional - low risk. for translocation, the risk is higher after having child with down syndrome)

- TETTT!!!

habes sudah clinical examination aku... member lain ade yg dapat facial nerve palsy, valve replacement, developmental assessment, polyH, ACL, diabetic retinopathy, glaucoma, inguinal hernia, thyroid, sebaceous cyst, oblique lie fetus, n etc... semua habes dalam lebih kurang pukul 4.40pm... diberitakan takde yg perlu re-sit clinical (means either you pass or fail, you know!!). so, balik la ke asrama. the end

kini menunggu dengan hati yg tak keruan untuk result petang esok... harapnya aku lulus exam kali ini.. tak sanggu untuk repeat after 6 months.. aku dah tak sabar nak balik untuk bercuti (3 minggu je kot) sebelum dipanggil untuk induksi dan kerja (kalo lulus la..heh)

apa yang mampu dibuat sekarang ialah menulis blog, menonton movie, bermain futsal dan tengok semi-final champion league man utd vs schalke 04 then tido...haha

Ya Allah, Aku mahu lulus kali ini... amin (T_T)