I like the fact that I was addressed as 'dear colleague'. Coming from senior/more exprienced persons, they still respect you and they shared/taught you, tak de kedekut2 ilmu punya.
Kat sini, the housemen n junior doctors are been ridiculed n 'verbally harrassed' without them realising that they were once 'inexperienced n not-so-clever-aka-******' housemen jugak dulu. No one was born clever kan?
In the world of medicine, never look down on your junior doctors for one day, she/he will be your working partner or might even be your boss/medical director or PM :)
They emailed as promised,
Berdebar2 jugak ni.
Nak jugak tahu where I stood kalau ikut standard mereka.
Maklumlah, they have been conducting this course/test for some time.
They even produced scientific paperS about the course.
and this group of 'teachers' was selected by ESHRE.
(I shall elaborate on ESHRE later ya).
Based on what type and the number of endoscopic surgeries we've been doing (kira exposure la ni),
Based on the criterias above, we were then allocated into groups : MINIMAL, INTERMEDIATE, MAJOR
I was allocated into the MAJOR EXPOSURE group :(
Saspen jugak, nape saya dimasukkan dalam 'major exposure' group ni? Patutnya saya masuk intermediate group je, senang sikit nak compete kan?
We were tested TWICE.
-before the course/teaching started (pre-test)
-at the end of the course (post-test)
-At each task, we were given 3 attempts and were timed on how fast we could complete each task.
We were compared like this.
For each exercise, the result was tabled like this.
Since I belonged to major exposure, let us concentrate on the lowermost row. Based on their cumulative data, 76.8% of those who have major exposure completed exercise 1 with excellent result! Exercise 1 tested us on 30' camera navigation ie how fast we can identify (using the laparoscope n focus it in the small circle on the monitor) the big and small objects placed at different angles. The time given was 120 seconds.
In the pre-test for exercise 1 ie 30' camera navigation, I got excellent performance, but I was positioned 64th in the rank, which meant; of 100 participants, there were 36 participants in the 'Major Exposure' group who performed this task bettter than me. As I remember, I managed to finish them in 75-90 sec. Hmm...janji masuk excellent. As told by Dr Rudi earlier on, this group (20 of us) was the first group that performed very well in this exercise. Almost 78% of us were placed 'excellent'.
In the post-test pulak, saya dapat result lebih teruk (main2 macam anak saya je ni, haha). Still excellent, tapi only positioned 59th and ada 41 org dalam Major group yg lebih cekap daripada saya dalam memegang/navigate teropong ni. Kira macam dapat markah 59% utk group Major Exposure ni. And 94% of this group were excellent in the post-test!
Exercise 2 was on hand-eye coordination, this involved placing small rings into the pins placed at different heights n angles. 48.8% with major exposure were excellent in completing, the time given was 180 seconds.
In the pre-test, I only fared "intermediate" in the 'Major Exposure' group and placed 23, maknaya ada 77 orang dalam 'Major Exposure' group tu yg lebih pandai daripada saya, sedihnya.... Actually I couldn't complete the 3rd attempt in time sbb the ring terpelanting n tersorok belakang board tu, terkial2 nak ambik balik sampai le masa tamat, haha. Our group pun tak ramai yg excellent, only about 1/4 of us.
However, in the post-test, I successfully positioned myself obtaining excellent score for the major group. This time, no more ring terpelanting :) In fact, I finished it in less than 50 seconds! And placed 94th, meaning; there were only 6 people in the 100-Major group who had better result than me. Yahoo!!!err...Alhamdulillah. Malaysia boleh!
and in exercise 3 (bimanual coordination), we had to take objects with the non-dominant hand, and use the dominant to take back the object before placing it into the short well. We were given 180 seconds. Based on their data, there were close to 44% people in the Major group who obtained excellent result in this exercise while more (48%) were categorised as 'intermediate skill' only.
In this pre-test also, I only fared 'intermediate' and not excellent, and positioned 27. Pun asyik terpelanting je sampai habis masa :) So, out of 100 dalam major group, there were 73 people better than me, pun sedih...
However, likewise, during the post-test, I seemed to have improved so much! Mana tidaknya, I managed to finish it in less than 90 seconds! See me hopped obtaining 'excellent' result and repositioned myself into 94th in the rank, so of 100 people in the Major group, there were only 6 people ahead of me. Yayy!!! Rasa macam dapat result exam SPM pulak.
Was the course beneficial?
Of course, within that short period, I saw myself gaining A LOT OF knowledge n improving my skill!
Would I recommend my colleagues to attend this course?
Of course! It was worth the money and time spent!
Am I more confident with myself?
Yes, having being assessed by the renowned group according to their standards somehow boosts my confidence to a higher level. Being grouped into Major Exposure and positioned 7th out of 100 persons (in 2 of 3 tasks) in the 'Major Exposure' group was sooooo exciting.
I hope that I have become a more skillful and still a safe doctor in performing laparoscopic surgeries, and would continue to upgrade my skill. In fact, at the nearest opportunity (and bila ada duit lebih), I would not hesitate to attend this course again (they are having it twice a year, same place). and if my patients ask; "how good are you with laparoscopic surgery?", I can reassure them and this time, with proof :). But I still have my limitation (saya tak le pandai semua) and would not hesitate to refer if the operations are better performed by other Drs. That's the hard part in some Drs, admitting their limitations. Drs should KNOW WHEN TO REFER to other colleagues (for the benefit of our patients, please) or WHEN TO CALL FOR ASSISTANCE and not just 'borong' semua kes and get suboptimal results. It doesn't mean that we are incapable or incompetent. The best chance/result is always during/from the first surgery, subsequent surgeries would always be more challenging/difficult. Also, we must always remember and have faith in Him.
So, what next?
Berangan2 (I call this vision :) lagi,
Tapi jangan tamak ya Mokcik,
Only 2 fields;
General gynaecology and infertility.
And 3 more fields;
Family, friends and hobbies :)
Sempat mengimbau kenangan lama.....
(insert music, please :)
Hampir 9 tahun yang lepas....
Before being allowed to sit for the final Part II Masters Exam, everyone had to prepare thesis comprising 10 write-ups on Obstetrics cases, 10 write-ups on Gynaecology cases, and a long commentary for each Obstetrics & Gynaecology (based on the researches we performed on HUKM patients).
During preparation of our thesis, we were guided by our lecturers and the cases/commentaries were revised (and revised and revised countless times) before finally being 'book'ed and sent to external assessor. We had to complete it at least 6 months before the exam. Saya sempat hantar just on time, haha memang suka procrastinate. Mine was assessed by Prof Dr Kulenthran (he also obtained degree in law) from UM.
I think the assessor was being kind/nice but hey, after tireless effort in finishing this thesis, I deserved a pat too.
Anybody notice the comments made on gynaecology cases that I chose to discuss? Not on infertility/endometriosis/PCOS. Bila masa minat/kepandaian infertility datang ya? ;)
I was so happy when I received this assessment report that I went into Prof Adeeb's room and showed to her and thanked her VERY MUCH.
and so I sat for the exam.
Berkat doa mak abah n cikgu2,
Passed on my first attempt.
-"The external examiner (Prof James Drife from Leeds, UK) was impressed with you" told Prof Adeeb (masa jumpa dia dalam bilik lepas dapat result), Prof Zainul (masa dia bagitau result) .
-I got the highest mark for theory
-and also for clinical cases
-but I didn't fare well in my Viva (oral) sangat teruk dalam ilmu interview ni
-So, I got 2nd place (by only 1 mark) for the exam.
-Janji pass kan Man?
But along the road,
Saya belajar teknik interview ni when I worked at LPPKN,
Asyik kena masuk TV je (thanks to the Minister yang pandai mengajar kita mem'project'kan diri).
Pokoknya kena belajar.
And nak belajar.
And nak meng-update diri.
In Europe, more and more are doing myomectomy ikut laparoskopi je. and I'm talking about LARGE fibroids (their limit is 12cm diameter!) .
(The fibroids are cut into pieces using a morcellator)
Apatah lagi ovarian cystectomy.
During the live surgery, Dr Arnold Wattiez performed multiple myomectomies laparoscopically (mind you, the sizes of the fibroids were 10cm and 6cm!) in less than 1.5hrs!
He said ; "the difficult part is not removing the fibroid, but suturing the uterus (after myomectomy)"
Saya belum sampai peringkat itu (tu sebab kena tabik hormat).
I only performed small and subserosal myomectomies laparoscopically.
and itu sebabnya saya gi belajar menjahit ikut laparoskop ni.
Rupa2nya ada teknik, patut pun selama ni saya 'kura-kura' dalam menjahit.
Ya la, yg mengajar pun tak attend this course :)
Hmm....now dah ada the 'right' knowledge ni, I just need to practice and practice to sharpen my skill.
I thank all my teachers.
Dari saya sekolah 'tumpang' ikut mak dan abah saya,
Especially the ones in MRSM Jasin - for opening the opportunity,
and the ones in HUKM - for 'moulding' me.
I can never thank them enough.
Kat rumah ni pun ada Cikgu:)
My husband is a better laparoscopic surgeon than me.
He's a better surgeon than me.
He was my teacher....
...and he still is.