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Week 1: Preparation week before elective posting at Kaohsiung Chang Gung Memorial Hospital

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Week 1: Preparation week before elective posting at Kaohsiung Chang Gung Memorial Hospital

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1.       Your name, matric no, & date

Name: Goh Kai Xin

Matric No.: A196314

Date: 28/7/2025 - 3/8/2025

2.       What have you done?

This week, I focused on preparing both academically and logistically for my elective in the General Surgery Department. Academically, I revised some common surgical conditions such as appendicitis, cholelithiasis, hernia and thyroid disorders. I also reviewed perioperative care and wound management to help me adapt quickly once I begin.

For travel preparation, I finalized my flight and accommodation, packed essentials, and ensured all documents, including my approval letter and hospital requirements were in order. I also familiarize myself a little about Taiwan and its healthcare system. Besides hospital-related matters, I planned a few short trips around Taiwan during my free time to explore the culture, food and landmarks.

3.       Points to remember from week 1

·       Preparation helps to reduce stress and build confidence before the posting

·       A focused revision on common surgical topics is more effective then trying to cover everything

·       Travel planning, including some leisure activities, makes the overall experience more balanced and enjoyable

4.       Your feelings & thoughts

I feel excited to start this elective, especially since surgery has always been an area of interest for me. I look forward to observing operations, following ward rounds and understanding the surgical decision-making process. At the same time, I feel a bit nervous about adapting to a new environment, especially the language and cultural differences, but I see it as part of the learning experience.

5.       Any difficulties/ concerns? How did you cope?

One challenge was deciding what to focus on during the revision, as general surgery is a broad specialty. I managed this by prioritizing common cases and reviewing notes from my previous rotations. Travel preparation was also slightly stressful, but making a checklist and discussing with my friends who are travelling together helped me stay on track.

6.       2 words to describe EP progress so far

Excited & prepared

7.       Your plan for next week (week 2)

Next week, I plan to attend the orientation, familiarize myself with the General Surgery Department and get to know the workflow. I aim to observe ward rounds, clinic and operating theatre sessions, take notes on cases I encounter, and set personal learning objectives. I also want to gradually adapt to the hospital culture at Kaohsiung Chang Gung Memorial Hospital.

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Week 1: Pediatrics in Linkou, Chang Gung Memorial Hospital, Taiwan - Division of Pediatric Allergy, Asthma & Rheumatology

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Week 1: Pediatrics in Linkou, Chang Gung Memorial Hospital, Taiwan - Division of Pediatric Allergy, Asthma & Rheumatology

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1.⁠ ⁠Your name, matric number, date

Name: Grace Liew Min Zi

Matric number: A195123

Date: 14/7/25 - 18/7/25

2. What have you done?

In my first week at Linkou Chang Gung Memorial Hospital (CGMH), I was assigned to the Division of Pediatric Allergy, Asthma & Rheumatology under the Pediatrics Department. On the first day, I reported at 8am and met my supervisor, Dr. Chih-Yi Lin (Chief Resident), who greeted me warmly, gave me a tour of the wards and clinics, and helped me settle in despite my nervousness. I was mainly assigned to follow Dr. Chao-Yi Wu, one of the attending physicians, but was encouraged to join ward rounds with other doctors as well. Each day usually started with departmental morning meetings at 7:30am—held three to four times weekly—covering topics like case discussions, EBM presentations, journal reviews, and systematic reviews. These were followed by ward rounds around 8:30am, where PGY doctors presented cases and consultants discussed next steps. I had the chance to see both general pediatric wards and the PICU. One memorable case in the PICU was a child with severe streptococcal septic shock and limb gangrene, where the team used ultrasound to assess perfusion and determine the need for amputation. Around noon, I joined classes with Chang Gung medical students, covering topics like asthma inhalers, pediatric obesity, pediatric malignancies, and drug efficacy in allergy treatment. In the afternoons, I attended outpatient clinics at 2pm, observing patient-doctor communication, follow-up planning, and management of both common conditions (asthma, atopic dermatitis, SLE) and rare ones (systemic JIA, Behçet disease). Beyond rounds and clinics, I also observed specialized procedures like nailfold capillaroscopy (NFC) for Raynaud’s phenomenon/systemic sclerosis and pediatric joint ultrasounds for arthritis and hemophilia follow-up. I also joined a subspecialty meeting reviewing a Kawasaki disease case in a 2-month-old, where we discussed diagnosis, the Kobayashi score, and updated IVIG management.

3. Points to remember from Week 1!

I picked up many key learning points this week. From the EBM review on abusive head trauma (AHT), I learned that retinal hemorrhages in AHT typically involve multiple layers, unlike other causes such as unintentional trauma, DIVC, infections (e.g., meningitis, malaria), or CPR. In the Kawasaki disease discussion, I noted the importance of recognizing persistent or recurrent fever >36 hours post-IVIG as a sign of IVIG resistance, and the role of the Kobayashi score in predicting this. From observing nailfold capillaroscopy, I understood how to differentiate primary vs secondary Raynaud’s, and how findings like dilated capillaries, microhemorrhages, and loss of density reflect different scleroderma stages (early, active, late). In ward rounds, I realized how communication differs in pediatrics compared to adults, as doctors often engage directly with parents while also reassuring anxious families. From the PICU case, I learned how septic shock can rapidly lead to critical complications like gangrene, and how bedside ultrasound is vital in decision-making. Lastly, in outpatient clinics, I saw how doctors tailored management of the same disease differently depending on presentation, and how empathy and memory of patients’ personal stories built stronger doctor-patient relationships.

4. Your feelings & thoughts

I feel deeply grateful to have started my elective in such a supportive and enriching environment. At first, I was anxious about being alone in a new hospital, but the warmth of Dr. Lin and the friendliness of the entire team—residents, consultants, PGYs, nurses, and even students—made me feel at home quickly. The pediatric wards stood out to me as especially heartwarming, with colorful cartoon walls, floor stickers, and notes of gratitude from children, which created a lively and hopeful atmosphere. Watching doctors interact with children—sometimes playful, sometimes gentle but firm—and then shifting their tone to reassure worried parents, really showed me the unique challenges and joys of pediatrics. I especially enjoyed the balance of academic learning and clinical exposure, from serious cases in PICU to lighter moments in clinics or student classes (even with bubble tea and lunchboxes during lectures!). Overall, I felt both academically stimulated and emotionally fulfilled, and I am beginning to really love this place.

5. Any difficulties/concerns? How did you cope?

My main difficulty at the start was the uncertainty and nervousness of entering a new environment with no familiar faces. I worried about not knowing the routines, not understanding enough, or not fitting in. However, my supervisor’s enthusiasm, the proactive inclusion in ward rounds and classes, and the friendliness of both doctors and students made a huge difference. I coped by keeping an open mind, asking questions when I didn’t understand, and allowing myself to slowly adapt. The doctors often went out of their way to teach and share knowledge, and even small conversations about Taiwan’s food and culture helped me feel welcomed. By the end of the week, I no longer felt like an outsider—I felt like part of a team.

6. Two words to describe elective posting progress so far

Enriching & Heartwarming

7. Your plan for next week (Week 2)

For Week 2, I will be rotating into the Pediatrics GIT subspecialty. My goals are to build on the confidence I gained in Week 1 by being more proactive in ward rounds, clinics, and academic discussions. I want to strengthen my understanding of pediatric gastroenterology conditions, such as chronic diarrhea, inflammatory bowel disease, and pediatric liver diseases. I also plan to observe the differences in management between acute and chronic GIT cases, and to learn about nutritional support in pediatrics. On a personal note, I hope to continue building connections with the doctors, PGYs, and students here, while also exploring more about Taiwan’s medical education system and daily life. Most importantly, I aim to approach every case and teaching opportunity with curiosity and openness, so that I can make the most of this once-in-a-lifetime experience.

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Week 1: Preparation week before elective posting at Kaohsiung Chang Gung Memorial Hospital

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Week 1: Preparation week before elective posting at Kaohsiung Chang Gung Memorial Hospital

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1. Your name, matric no, & date
Name: Lee Rou En

Matric No.: A196876
Date: 28/7/2025 - 3/8/2025

2. What have you done?
The week before my elective, I focused on preparing both academically and practically. I revised important general surgery topics to refresh my knowledge. I also reviewed basic abdominal anatomy in preparation for imaging interpretation and operative observations. On the practical side, I finalized my travel arrangements, accommodation, and hospital posting confirmation. I made sure to pack essentials such as my white coat, stethoscope, and suitable attire for the ward and operating theatre.

Outside of academic preparation, I also spent time planning a short leisure trip to Taipei first before travelling to Kaohsiung. Finally, we checked into our hostel one day before the elective posting date to settle down and familiarize ourselves with the surroundings. We also toured around the hospital area to get a sense of the facilities and the daily route we would be taking. This helped reduce first-day anxiety and allowed us to start the posting with more confidence.

3. Points to remember from week 1
During the preparation week before the elective, I realised the importance of starting early and being well-organised. Revising core general surgery topics along with refreshing abdominal anatomy, gave me a stronger foundation for what I was about to encounter. Packing essentials like my white coat, stethoscope, and suitable attire in advance reduced unnecessary stress before departure. I also learned that planning leisure activities, such as a short trip to Taipei, was equally valuable in ensuring a good balance between academic learning and cultural exploration. On the practical side, preparing finances was an important step—I exchanged currency ahead of time and get a Visa card to be used in Taiwan, which gave me peace of mind for both daily expenses and emergencies.

4. Your feelings & thoughts
Before starting the elective, I felt a mixture of excitement and nervousness. I was excited about the opportunity to experience a new healthcare system in Taiwan and to learn from surgeons in a different setting, but at the same time, I was slightly anxious about adapting to a new environment, dealing with the language barrier, and managing daily life away from home. The preparation process—revising surgical topics, exchanging currency, preparing a Visa card, and planning for both academic and leisure activities gave me a sense of readiness and reduced my worries. Overall, I felt motivated and eager to make the most of this elective, while also reminding myself to stay flexible and open to new experiences.

5. Any difficulties/ concerns? How did you cope?

One of my main concerns during the preparation week was the possibility of facing challenges with communication in Taiwan, especially since Mandarin and Hokkien are widely used in the hospital setting. I was worried that the language barrier might make it harder to follow ward rounds or understand patient interactions. To cope with this, I prepared myself by revising some basic medical terms in Mandarin and planned to observe carefully, take notes, and ask for clarification whenever possible during the posting. Another practical concern was managing finances abroad, as I had to ensure I had enough cash in New Taiwan Dollars to pay for the tuition fee and also prepare a Visa card for convenience and emergencies.

6. 2 words to describe EP progress so far
Excited, anxious

7. Your plan for next week (week 2)
As my elective officially begins next week, my main plan is to adapt quickly to the hospital environment and daily schedule. I aim to be punctual for morning meetings and ward rounds, and to observe carefully how the surgical team works together. I want to familiarise myself with the workflow in the wards, operating theatre, and clinics, while also practicing proper etiquette in the hospital setting. Another goal is to actively take notes on cases I encounter and revise them in the evenings to reinforce my learning. Since language may be a barrier, I plan to focus more on observation and non-verbal communication, while asking peers or residents for clarification whenever needed. Beyond clinical learning, I also plan to maintain balance by exercising or using the gym regularly, so that I can keep my energy and focus throughout the posting. Overall, I hope to start the elective with an open mind, adapt to the new learning environment, and gradually build my confidence in participating in discussions and case observations.

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WEEK 1: Plastic Surgery in Linkou Chang Gung Memorial Hospital, Taiwan

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WEEK 1: Plastic Surgery in Linkou Chang Gung Memorial Hospital, Taiwan

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1. Your name, matric number, date

Name: Michelle Teng Qian Ying

Matric Number: A195548

Date: 14/07/205 – 18/07/2025

2. What have you done?

Before departing for my elective posting at Chang Gung Memorial Hospital (CGMH), Linkou, I prepared extensively to adapt academically, professionally, and personally. I researched CGMH’s structure and expectations for elective students, completed all administrative documents—vaccination records, insurance, elective forms, and travel documents—and revised key clinical skills, common cases, and updated guidelines to participate meaningfully during ward rounds and clinics. I also familiarised myself with basic Taiwanese medical Mandarin and hospital etiquette, planned transport and accommodation, and ensured my devices and data access were ready for clinical use. This preparation laid a foundation for a smoother transition.

On the first day, I was initially assigned to a doctor advisor but was reassigned to Dr. Huang, who was attending a conference abroad, so I was placed under another professor. There was initial miscommunication as the professor thought I was an attending doctor. Without a clear supervisor, I felt lost and unfamiliar with the environment. After explaining my situation, everything was settled, and I slowly adapted.

Besides following the professor, I explored the plastic surgery department by joining different teams and observing in various operating theatres. Everyone was welcoming. I became closer to Professor Lin and his team, joining their clinics and OTs more often. Professor Lin explained procedures in English, and his team ensured I fully understood.

During the week, I attended weekly case discussions where postgraduates presented cases, and a hospital-wide conference on toe-to-hand replacement surgery, discussing complications and treatment options involving skin, fascia, muscles, tendons, ligaments, and bones.

In the OT, I scrubbed in and assisted in a polydactyly corrective operation, my first close experience at the operating table, which was both exciting and eye-opening. I also observed free rotational hand flap surgery using SPY fluorescence imaging, a dacryocystorhinostomy (DCR) by Professor Chen, and complex facial reconstruction for a patient with prior buccal cancer flap surgeries.

Additionally, I explored the general surgery department under Dr. Gao, observing major procedures such as liver transplantation and Doppler studies. The doctors patiently explained anatomy, surgical steps, and concepts using diagrams and answered all my questions. I also joined the general surgery clinic for additional exposure.

3. Points to remember from week 1!

This elective taught me clinical, cultural, and personal lessons. Even before arriving, preparation—reviewing CGMH’s culture, revising exam techniques, and familiarising myself with medical terminology—highlighted the value of proactive learning.

I learned that unexpected changes can occur at any time. Initially unsettled by the lack of a clear supervisor, I felt lost and unsure where to go. This reminded me that challenges are normal, especially in a new hospital.

Proactivity and adaptability helped me cope. By approaching professors and surgical teams, I gained opportunities to observe in the OT, attend discussions, and receive detailed explanations.

I also observed the importance of teamwork and communication. The doctors ensured I understood procedures, and the operating theatre teams displayed clear communication, respect, and precision in every step.

Lastly, stepping out of my comfort zone led to growth. By overcoming initial discomfort, I gained hands-on experience, witnessed complex surgeries, and developed professional connections. Flexibility, open-mindedness, and eagerness to learn made the week highly valuable.

4. Your feelings & thoughts

At the start, I felt nervous and uncertain without a clearly assigned supervisor. Walking into a new hospital with unfamiliar faces and workflow was overwhelming, and I worried about adapting. Gradually, these anxieties eased. I gained confidence approaching doctors, asking questions, and finding ways to learn.

The warmth and openness of the doctors were encouraging. Their willingness to teach, involve me in discussions, and allow me to assist in procedures made me feel welcomed. Watching surgical skills up close was inspiring, and assisting in my first operation was unforgettable—the combination of precision, teamwork, and trust left a deep impression. By the end of the week, I was motivated and excited to continue learning, reaffirming my passion for medicine.

5. Any difficulties/concerns? How did you cope?

I initially felt lost and unsure of my place due to the lack of a clear supervisor, which made the environment overwhelming. I coped by clarifying my situation with professors and staff and proactively joining clinics, operations, and discussions. Another challenge was understanding complex procedures and unfamiliar medical terms in plastic and reconstructive surgery. I managed this by asking questions, taking concise notes, and reviewing topics afterward, which improved my confidence and understanding.

Overall, these challenges encouraged adaptability and independence. By staying curious and putting in extra effort, I integrated into the department and maximized learning opportunities.

6. 2 words to describe elective posting progress so far

Engaging, Insightful

The posting has been engaging, with hands-on learning, observations, and active participation in clinics and OTs. I interacted with surgical teams, asked questions, followed cases, and assisted in procedures, keeping me fully immersed and motivated.

It has also been insightful, giving me a deeper understanding of clinical practice and Taiwan’s healthcare system. Observing advanced surgeries, teamwork, and doctors’ reasoning broadened my perspective. Their approach to patient care and ethical decision-making offered lessons beyond textbooks. This combination of active learning and observation made the first week enriching.

7. Your plan for next week (Week 2)

For Week 2, I plan to continue joining Professor Lin’s team for both clinics and surgeries, as his explanations have been incredibly clear and helpful in strengthening my clinical understanding. I also hope to observe more reconstructive surgeries, particularly cases involving microvascular techniques, so that I can broaden my exposure to complex operative procedures. In preparation, I intend to read up on the cases I encounter in the OT, including relevant anatomy and surgical principles, so that I can follow the operations more effectively and ask more meaningful questions.

I will also continue attending the weekly case discussions and hospital conferences, as they greatly enhance my clinical reasoning and give me insight into how specialists approach patient management.

Additionally, now that my original supervisor has returned from abroad, I want to make an effort to meet him formally, introduce myself properly, and update him about my progress so far. This will help ensure clearer communication and smoother guidance for the remaining weeks of my posting.

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Week 1 in General Surgery of Linkou Chang Gung Memorial Hospital

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Week 1 in General Surgery of Linkou Chang Gung Memorial Hospital

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1. Your name, matric number, date

Name: Naomi Choo Xin Ying

Matric number: A196189

Date:19/7/2025

2. What have you done?

I have had the opportunity to observe a variety of surgical procedures, including hernioplasty, liver transplantation, robotic-assisted Whipple surgery, and cholecystectomy. In addition, I regularly participate in clinical teaching sessions every Tuesday and Wednesday mornings, which involve detailed case discussions. On Fridays, I also shadow doctors at the general surgery clinic, gaining further exposure to patient management and clinical decision-making.

3. Points to remember from week 1!

Breast

1. BIRADS staging

Breast Imaging Reporting and Data System sorts the results of mammogram into categories 0 through 6 that helps doctors describe what is found on the mammogram.

2. Breast Cancer Classification (Based on Receptor Status)

Pathology reports usually include TNM staging and biomarker status:

ER (Estrogen receptor)

PR (Progesterone receptor)

HER2 (Human epidermal growth factor receptor 2)

Ki-67 (a proliferation marker, >20% suggests high growth rate, more aggressive).

Subtypes

1. HER2-positive breast cancer

ER/PR may be negative or positive.

HER2 overexpressed or amplified.

More aggressive than hormone-positive cancers, but targeted therapy (trastuzumab, pertuzumab, etc.) improves outcomes a lot.

2. Hormone receptor-positive breast cancer (Luminal type)

ER and/or PR positive.

HER2 may be negative (Luminal A, usually low Ki-67, less aggressive) or positive (Luminal B, more aggressive).

Often responds to endocrine therapy (tamoxifen, aromatase inhibitors, ovarian suppression) and can remain localised for years.

3. Triple-negative breast cancer (TNBC)

ER negative, PR negative, HER2 negative.

Typically more aggressive, higher recurrence risk within the first 2–3 years.

Higher chance of spreading to brain, lungs, and liver.

Limited targeted options (though immunotherapy + chemo and PARP inhibitors for BRCA mutations are newer options).

Hormone-positive can indeed be controlled with tablets.

HER2-positive used to be dangerous but now has targeted drugs.

Triple negative is indeed the hardest to treat, especially with brain mets risk.

Ki-67 >20% signals aggressive biology regardless of subtype.

Gastrointestinal

1. Panendoscopy

Is a comprehensive endoscopic assessment of Oesophagus, stomach and duodenum (OGDS)+ larynx, pharynx, trachea and bronchi

2. Diastesis recti

Diastasis recti can sometimes be mistaken for hernia

Diastasis recti occurs when your rectus abdominis muscles (six-pack ab muscles) separate during pregnancy from being stretched. The separation can make your belly stick out or bulge months or years after your last baby. You can repair it with special exercises that help close the separation.

4. Your feelings & thoughts

During each surgery, I found the experience to be truly eye-opening, particularly the robotic-assisted Whipple procedure, where I was able to appreciate the remarkable precision of each suture performed by the robotic system. My time at the general surgery clinic was equally valuable, as the doctor provided insights and explanations that extended beyond what I had previously learned during my surgery posting, further deepening my understanding of surgical practice and patient care.

5. Any difficulties/concerns? How did you cope?

At the beginning, when I first entered the operating theatre, I felt quite shy and hesitant to ask the surgeons any questions, which limited my understanding of the procedures being performed. However, I quickly realised that I would not be able to learn effectively if I remained silent. So, I gathered my courage and started asking the doctors about the steps and techniques being carried out during each stage of the surgery. This greatly enhanced my understanding and allowed me to appreciate the rationale behind each surgical decision.

6. 2 words to describe elective posting progress so far

Eye opening and exciting

7. Your plan for next week (Week 2)

I plan to ask the doctor if I could observe surgeries like mastectomy and also observe him doing ultrasounds.

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Week 1 in Kaohsiung Chang Gung Memorial Hospital

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Week 1 in Kaohsiung Chang Gung Memorial Hospital

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1. Your name, matric number, date

NAME: YONG WEI EU

MATRIC NUMBER: A196878

DATE: 10 AUGUST 2025

2. What have you done?

My first week of elective posting was an eye-opening experience as I joined the Internal Medicine Department with a focus on Rheumatology. Interestingly, my batchmate Joshua was also assigned to the same department, but we were placed under different supervisors.

The week started with structured academic sessions. Morning meetings, which resembled the Continuous Medical Education (CME) sessions back at UKM, were attended daily. These meetings were important for discussing recent cases, departmental updates, and learning points. In addition, I participated in morbidity and mortality conferences, similar to the grand ward rounds I am familiar with.

Day 1

The first day began with an introductory session led by a senior physician. She patiently explained the overall structure of clinical services and detailed what to expect during the next three weeks of my elective posting. Later that morning, I attended a teaching session on Emergency Medicine, focusing on managing patients who present with shock. Following the teaching session, I joined the morning meeting along with the Postgraduate Year (PGY) doctors, who are equivalent to house officers in Malaysia. Subsequently, I took part in ward rounds with my senior and my rheumatologist supervisor.

Day 2

I learned to navigate the hospital’s electronic health record system (EHRS). Under the supervision of my senior, I explored the advanced features of EHRS compared to CHETS I am used to in HCTM. For example, doctors can prescribe antibiotics directly without consulting an infectious disease specialist because the system provides antimicrobial susceptibility data. Although convenient, I found HCTM’s system more user-friendly with better organisation of clinical notes and patient histories. During ward rounds, I encountered several interesting cases including dermatomyositis, systemic lupus erythematosus (SLE), antiphospholipid syndrome, and idiopathic juvenile polyarthritis.

Day 3

On day three, I attended outpatient clinics where I assisted my supervisor in clerking patients and organising their medical records. The hands-on experience was invaluable, especially learning how to approach patients presenting with joint pain. My supervisor demonstrated focused physical examination techniques, particularly of the hands, to detect signs of inflammation or joint damage. This exposure broadened my clinical skills and improved my confidence in patient interaction.

Day 4

I was tasked with clerking a 20-year-old female patient with longstanding SLE diagnosed at age 12. She was on long-term immunosuppressants and corticosteroids and had been admitted due to pedal oedema. On examination, classic rheumatological signs were evident: Raynaud’s phenomenon, a maculopapular rash, vasculitis and alopecia. She also showed cushingoid features such as a moon face, side effects attributed to prolonged corticosteroid therapy. When I presenting this case to my supervisor, it turned out into an in-depth discussion about the challenges and complications of long-term immunosuppressive treatment. Additionally, I attended a hospital lecture on gender equality that day, which addressed women's rights, workplace harassment, and LGBT healthcare. Taiwan’s position as the first Asian country to legalise same-sex marriage added an important social and cultural context to the lecture, helping me understand the broader healthcare environment.

Day 5

The final day of the week began with a hospital-wide lecture on medicolegal issues, a topic highly relevant to everyday clinical practice. The talk stressed the importance of clear documentation, effective communication, and legal awareness to minimise risks. Later, I observed the removal of a central venous line. I assisted by preparing equipment, maintaining sterility, and helping position the patient.

3. Points to remember from week 1!

i) Value of pre-round case discussions

Preparing and discussing each patient’s case with my supervisor and senior before ward rounds greatly improved efficiency and reduced unnecessary delays. This approach also gave me more confidence during ward rounds as I was already familiar with the patient’s background and management plan.

ii) Differences in hospital systems

Taiwan’s CHETS system offers broader prescribing capabilities with built-in antibiotic susceptibility data, which speeds up decision-making. However, I noticed that HCTM’s system is more organised in terms of patient history layout, which can be more user-friendly for documentation and follow-up.

iii) Key clinical and cultural learnings

I improved my recognition of important rheumatology signs such as Raynaud’s phenomenon, ungual telangiectasia, maculopapular rash, alopecia, and Cushingoid features. I also observed the heavier procedural workload carried by nurses in Taiwan, and the strong emphasis on infection control through universal masking and smaller patient rooms. Adapting to Mandarin medical terminology was initially challenging, but knowing the local dialect helped me communicate effectively with elderly patients.

4. Your feelings & thoughts

I felt a rush of excitement stepping into a completely different medical system for the first time. Everything here felt unfamiliar yet fascinating. The terminology alone took some getting used to: “PGY” here is the same as a house officer back home, “clerk” means medical student, and “CR” is like our medical officer.

The wards are also set up differently, just three patients per room. It feels more private, and I think it’s a smart way to lower the risk of hospital-acquired infections, especially airborne ones. I was also struck by how strictly everyone here wears masks including patients, family members, and staff. In HCTM, this isn’t as common, but here it’s clearly part of the culture and a sign of how seriously they take infection prevention.

Still, I’d be lying if I said I wasn’t nervous. Even though I’m Chinese, my training has been in English for as long as I can remember. But thanks to my family, I can understand the Taiwanese dialect, which turned out to be a blessing during ward rounds. When my supervisor spoke to elderly patients in dialect, I could follow along without needing a translation, and that gave me a little boost of confidence.

5. Any difficulties/concerns? How did you cope?

i) Language barrier
I had to speak medical terms in Mandarin, but I only knew them well in English. In Malaysia, we can mix languages when talking, but here I had to speak only Mandarin. This was hard for me, so I often had to search the words on Google before I could continue. My senior helped me a lot during clerking, and slowly I became more confident in speaking fully in Mandarin.

ii) Different way of working
In Malaysia, house officers do most procedures like taking blood and putting in catheters, but here nurses usually do these jobs. At first, it felt strange and I did not know what to expect. I learned by watching, asking questions, and trying to understand why the system works this way. Over time, I got used to it.

iii) New environment
The third challenge was moving to a new hospital and city by myself. I did not know the place, the wards, or the hospital rules. It was tiring at first. I tried to cope by talking to colleagues, asking for help when needed, and joining small conversations. Slowly, the hospital felt more familiar and comfortable.

6. 2 words to describe elective posting progress so far

Eye opening, enhancing

7. Your plan for next week (Week 2)

Next week, I plan to continue my attachment in the Rheumatology department, taking a more active role in ward rounds and clerking patients. Additionally, I hope to attend relevant lectures to expand my knowledge. I am also looking forward to joining an abdominal ultrasound class and bedside teaching sessions by other specialists to broaden my clinical skills.

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WEEK 1: INTERNAL MEDICINE IN KAOHSIUNG CHANG GUNG MEMORIAL HOSPITAL, TAIWAN 🇹🇼

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WEEK 1: INTERNAL MEDICINE IN KAOHSIUNG CHANG GUNG MEMORIAL HOSPITAL, TAIWAN 🇹🇼

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1. Your name, Matric number, date

Name: Koh Joshua

Matric No : A196985

Date: 10/8/2025

2. What have you done?

Day 1 ( 4/8/2025)
Our person-in-charge (PIC) led us through the final registration process before officially starting our elective posting at Chang Gung Memorial Hospital. At 9:30 am, my senior—a friendly and approachable medical officer—gathered us for a briefing on how the hospital operates.

I learned that I’d be joining the General Internal Medicine Department for the next three weeks, from 4th August to 22nd August 2025. The morning continued with a lecture on the emergency department setting—covering what to expect and what to prioritise when encountering ED patients. Later, my senior introduced me to the hospital’s medical records system, which allows us to track patient progress and write admission notes after clerking. By the end of the day, I already felt more confident navigating my new clinical environment.

Day 2 – (5/8/2025)
Today, my senior assigned me to cover seven patients, each with different diseases. The morning began with admission clerking, followed by monitoring how each patient was responding to treatment.

Ward rounds with my senior and the attending doctor were both busy and insightful. I had the chance to perform shifting dullness and fluid thrill examinations on a patient with liver cirrhosis awaiting a transplant. The feedback I received on my technique was direct but constructive—lessons I’ll carry forward to ensure I don’t repeat the same mistakes.

The day ended on a lighter note. My senior invited me to join them at Ruifeng Night Market (瑞丰夜市), one of Kaohsiung’s most famous food spots. We sampled countless local delicacies, laughed, and shared stories. It wasn’t just a delicious dinner—it was a chance to connect with the team beyond the wards.

Day 3 – (6/8/2025)
A radiologist kicked off the morning with a fascinating lecture: “How to Interpret Chest X-rays—Common Diseases and Their Management.” It was a reminder of how much detail hides in plain sight on a simple film.

The rest of the day followed my now-familiar routine of admission clerking and ward rounds. But as I moved from patient to patient, I realised something—some of the pre-clinical knowledge I once knew by heart had slipped away. I decided not to let it pass.

That afternoon, I went to the hospital library to revise. It wasn’t just any library—it had an “immersive healing relaxation area” where students could unwind or take a nap after a demanding morning. It felt like the perfect balance between hard work and self-care.

Day 4 – (7/8/2025)
We began the day with an eye-opening lecture on “Providing Equal Care for All Patients” and “LGBT Healthcare.” It reminded me that medicine is not just about diagnosing and treating—it’s about respect, empathy, and fairness for every patient, regardless of their background.

The rest of the day was devoted to my usual duties. Ward rounds in internal medicine are indispensable; they keep us closely updated on patient progress and help prevent complications like hospital-acquired pneumonia.

A small but thoughtful gesture made my afternoon—my senior bought me a drink after rounds. It was a simple act of kindness that lifted my spirits. Later, I clerked a rare and fascinating case: a 21-year-old woman with systemic lupus erythematosus (SLE), diagnosed at just 12 years old. She presented with a butterfly rash, reticular rash, pitting edema, and Raynaud’s phenomenon. I clerked her alongside my colleague, Wei Eu. Despite being international students, she warmly welcomed us, allowing us to learn from her case.

Day 5 – (8/8/2025)
The morning began with a lecture on “Hospital’s Medical Dispute Case Handling Procedures.” It was a sobering topic, emphasising how failing to communicate treatment plans clearly can lead to serious misunderstandings or even legal. The day closed with a chance to observe a minor procedure: the removal of a central venous catheter. Watching the careful precision of the process was yet another reminder of how much skill lies in even the smallest of procedures.

3. Points to remember from week 1

a. General Observations

I must try my best to familiarise myself early with the hospital setting, workflow, and medical record system to adapt quickly.

Building rapport with seniors and colleagues outside of work strengthens teamwork and communication is a must.

b. Clinical Skills & Learning

Admission clerking and regular ward rounds are essential for patient monitoring and management planning.

Always seek feedback after performing physical examinations—constructive criticism helps refine technique.

c. Professionalism & Communication

Clear, thorough explanations to patients are critical to avoid misunderstandings and potential legal.

Observing even minor procedures is an opportunity to learn fine motor skills and clinical judgment.

4. Your Feeling and thoughts

Over these five days, I experienced a mix of excitement, challenge, and growth. Stepping into Chang Gung Memorial Hospital for the first time felt both thrilling and slightly overwhelming, but the warm welcome from my senior and colleagues quickly made me feel at ease.

Social moments, like visiting Ruifeng Night Market with my seniors, added warmth to my experience. These bonds not only enriched my time in Taiwan but also strengthened teamwork in the hospital.

Above all, this week deepened my appreciation for the balance between clinical skills, continuous learning, and human connection in medicine. I ended each day feeling both exhausted and fulfilled—knowing that I was growing into a better, more empathetic future doctor.

5. Difficulties/concern & how I coped

One of my main challenges during the first week was adjusting to a new hospital system and workflow. The electronic medical record system was different from what I had used before, and at first I was worried it would slow down my clerking and documentation. To overcome this, I set aside extra time on the first two days to practise navigating the system, asking my senior for tips, and observing how other doctors used it efficiently.

Another difficulty was realising that some of my pre-clinical knowledge had faded, especially when interpreting findings during ward rounds. Initially, this made me feel less confident in contributing to discussions. Instead of letting it discourage me, I made it a habit to revisit these topics in the library immediately after rounds, using the cases I saw as my study triggers. This not only helped me recall forgotten details but also strengthened my clinical reasoning.

Lastly, I felt a bit nervous about performing physical examinations on patients in a new setting, especially under observation. Receiving direct feedback—sometimes pointing out mistakes—could be intimidating. However, I reminded myself that this was an invaluable learning opportunity. By actively asking for feedback and practising again, I turned these moments into confidence-building experiences.

Through these challenges, I learned that preparation, humility, and a willingness to adapt are key to thriving in a new clinical environment.

6. 2 different words to describe progress

Evolving

Revealing

7. Plan for week 2

I will deepen my clinical knowledge by actively participating in admission clerking and ward rounds, focusing on strengthening my understanding of common internal medicine conditions. Each day, I plan to review relevant textbooks and clinical guidelines, especially topics that frequently arise during rounds, to ensure my knowledge is both current and practical.

I will improve my practical skills by regularly practising physical examination techniques and seeking constructive feedback from my seniors and doctors. I aim to observe and assist in more bedside procedures to gain hands-on experience and build my confidence in clinical settings.

Finally, I will continue to engage actively in teamwork by building strong relationships with my seniors, doctors, and colleagues, both through clinical work and social interactions. During ward rounds, I intend to participate more by asking relevant questions and contributing to clinical discussions, thereby deepening my learning and collaboration.

Through these focused efforts, I am confident that my next week at Chang Gung Memorial Hospital will be a meaningful and productive step forward in my medical training.

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Week 1 in General Surgery at Kaohsiung Chang Gung Memorial Hospital 

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Week 1 in General Surgery at Kaohsiung Chang Gung Memorial Hospital 

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1. Your name, matric number, date

Name: Goh Kai Xin

Matric Number: A196314

Date: 04/08/2025 - 08/08/2025

2. What have you done?

My first week in the general surgery department at Kaohsiung Chang Gung Memorial Hospital has been incredibly dynamic and educational. I am particularly honoured to be doing my elective posting under Dr Yong Chee Chien, a distinguished general surgeon specialising in living donor liver transplants. I’ve been a part of the daily ward rounds which provided a comprehensive look into patient management, from postoperative care to diagnostic planning. I also had the opportunity to observe several clinic sessions, where I saw the initial consultation and follow up care for various surgical cases. The meetings that I joined were particularly valuable as they not only involved case presentations and surgical planning but also featured multidisciplinary discussions and approachs to patient care. This gave me an excellent perspective on how different specialities collaborate to create the best treatment plans.

Beyond the ward and clinic, I was fortunate enough to observe a few surgical procedures. The highlight was witnessing a living donor liver transplantation and a L-RAMP (Laparoscopic radical antegrade modular pancreatosplenectomy). This was an incredible opportunity to see the theoretical knowledge of anatomy and surgical principles applied in a live operating theatre setting.

3. Points to remember from week 1!

Teamwork is essential: I’ve seen firsthand how crucial it is for the entire surgical team from surgeons to nurses to administrative staff to work together seamlessly to ensure patient safety and positive outcomes. The multidisciplinary approach I observed in the meetings further reinforced this point.

Precision medicine: The smallest details in a patient’s history or any examination can change the entire course of their treatment. I’ve observed that it is important to choose the correct and suitable treatment according to each patient’s conditions allowing them to have a better outcome and reduce the mortality of surgery.

4. Your feelings & thoughts

I feel a mixture of excitement and being slightly overwhelmed. The pace is fast and there’s a steep learning curve but I’m absolutely fascinated by the cases I’m seeing. The team here has been very welcoming and their dedication is truly inspiring. I feel grateful for this opportunity to experience a new healthcare system and learn from such experienced professionals.

5. Any difficulties/concerns? How did you cope?

The primary difficulty has been the language barrier, especially during the patient-doctor interactions. Although I understand both Chinese and English but some of the words pronounced in their slang is still abit different. Other than Chinese, some of the patients also speak Taiwanese which is also abit difficult to understand. To cope, I’ve been focusing on understanding the medical context and observing non verbal cues. I also make sure to ask the senior students or residents for clarification wherever needed.

6. 2 words to describe elective posting progress so far

Challenging and fulfilling.

7. Your plan for next week (Week 2)

To become more proactive in the ward rounds and other sessions and ask questions to the doctors. I also want to focus on a specific surgical sub specialty such as hepatobiliary to gain a deeper understanding of the anatomy and common procedures.

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Week 1 in Kaohsiung Chang Gung Memorial Hospital , Taiwan 

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Week 1 in Kaohsiung Chang Gung Memorial Hospital , Taiwan 

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1. Your name, matric number, date

Name : Yap Sin Yin

Matric number : A195900

Date : 4/8/2025 - 8/8/2025

2. What have you done?

This week was packed with diverse clinical activities that gave me a comprehensive introduction to liver transplantation. The week began with administrative tasks, including payment of my elective posting fees and undergoing a mandatory health screening at the hospital's Family Health Department. After receiving my hospital ID, I immediately began my clinical rotations.

I attended the liver transplant clinic, where I observed post-transplant follow-up consultations. Here, I learned how doctors meticulously monitor patients' recovery by reviewing serial liver function tests, immunosuppressant drug levels, and kidney function markers. The consultants demonstrated how they adjust medication dosages based on lab results and clinical findings, emphasizing the delicate balance required to prevent rejection while minimizing drug toxicity.

I observed a few surgeries in the operating room, which were the highlight of my week. I also participated in ward rounds with the transplant team, where we reviewed post-operative patients. These rounds provided insight into the comprehensive care required after transplantation, including monitoring for complications like rejection or infection, managing pain, and ensuring proper wound healing.

Additionally, there was another impactful learning came during case presentations by Taiwanese medical students, who systematically detailed living donor liver transplantation (LDLT) selection criteria. In this session Dr specified the reason of using MELD score instead of Child Pugh Score for evaluation is because of creatinine level to access the hepato -renal syndrome .

3. Points to remember from week 1!

This week taught me that living donor liver transplantation follows strict criteria, particularly the non-negotiable requirement that donors must retain at least 30% of their original liver volume to ensure safety. The evaluation process is comprehensive, assessing not just medical fitness but also psychosocial readiness and anatomical suitability through advanced imaging. For recipients, selection involves more than just MELD scores—the multidisciplinary team carefully considers comorbidities, social support systems, and rehabilitation potential before approving candidates.

A particularly eye-opening lesson was understanding Taiwan's unique HCC epidemiology, where many current transplant recipients belong to the pre-1984 generation that missed childhood HBV vaccination, leading to a high prevalence of hepatitis B-related liver disease in older adults. This historical context shapes their approach to transplant eligibility.

In the operating room, I learned how critical precision is—especially with techniques like the Pringle maneuver, where surgeons strictly adhere to the 30-minute occlusion limit to prevent liver damage. Post-transplant care requires equally meticulous attention, with immunosuppression regimens carefully adjusted based on daily lab results and close monitoring for early rejection signs

4. Your feelings & thoughts

This first week was both exhilarating and challenging. Initially, I felt somewhat overwhelmed by the complexity of cases and the rapid pace of clinical activities. However, as the week progressed and I became more familiar with the routines and I slowly adapt to this new environment as my confidence grew.

Watching the Pringle maneuver performed in real-time was undoubtedly the most memorable moment. Seeing how the surgeons applied this technique with such precision - carefully monitoring the occlusion time while maintaining complete control of the surgical field - gave me new appreciation for the skill required in hepatobiliary surgery.

I also found great value in the teaching sessions, where the consultants' case discussions helped bridge the gap between my textbook knowledge and real-world clinical practice. Their explanations of complex concepts in simple terms were incredibly helpful for my learning.

5. Any difficulties/concerns? How did you cope?

First, the language barrier was tough. When doctors and patients spoke in local dialect during consultations, I couldn't understand anything. I learned to watch carefully and ask my classmate to explain important points to me afterward so that I could catch up the conversation

Second, the huge hospital confused me at first. I kept getting lost trying to find clinics , meeting rooms ,wards and operating rooms. I solved this by arriving early to study the hospital map and marking key locations on my phone.

Third, following surgeries was quite hard because the anatomy looked different from textbooks. When I didn't understand, I asked Dr. Cornejo, one of the fellows, to explain things to me in English during breaks. And I studied the case one day before to ensure better understanding of the procedure of surgery .

6. 2 words to describe elective posting progress so far

Adapting , eye opening

7. Your plan for next week (Week 2)

Next week, I will focus on active learning by preparing for cases in advance, asking targeted questions during procedures, and closely observing clinical decision-making. I'll concentrate on understanding surgical techniques, anatomical landmarks, and post-transplant care protocols. Each day, I'll take notes to track my progress and identify areas for further study, moving from passive observation to engaged participation within the scheduled activities.

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Week 1 in Kaohsiung Chang Gung Memorial Hospital

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Week 1 in Kaohsiung Chang Gung Memorial Hospital

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1. Name: Teoh June Jern

Matric No.: A195158

Date: 10/08/2025

2. What have you done?

Observed ward rounds, familiarised myself with hospital workflow. Spent time learning about patient care approaches and communication styles in the local setting.

Watched RAMPS procedure

(Radical Antegrade Modular Pancreatosplenectomy)

In this suregry aims to have clear tumor margins by resecting ( pancreas, spleen , lymph nodes , Adrenal glands infront gerota fascia ) landmark .Dr performed this surgery in a older age of women diagnosed with SPN

( solid pseudo-papillary neoplasm ) This is not a common as usually happens in younger women age between 15-35 , composed 90%

Ultrasound is important in any abdomen surgery ,opening abdomen allows a direct visualisation on the  external organ but not internally

polycystic kidney also observed in the left kidney . SPN is not confirmed until histopathology . Imaging findings had done before the surgery and shown mixed solid and cystic tissue.

3. Points to remember from Week 1

On my first day, I learned the importance of orientation, as understanding the hospital’s workflow, safety protocols, and cultural norms helped me adapt more easily. I realised it is best to observe before acting, taking time to watch how local staff communicate, perform procedures, and manage patients before attempting tasks myself. Building rapport early by greeting colleagues, introducing myself, and showing willingness to learn created a welcoming atmosphere. I also learned to respect differences in medical practices, as these methods are shaped by local needs, resources, and patient culture. Lastly, I found that staying alert and proactive is essential, as learning opportunities often arise unexpectedly.

4. Feelings & thoughts

During my first week of elective posting, I felt both excited and slightly nervous as I stepped into a new healthcare environment. The nurses and doctors were very welcoming and always willing to guide me, which made me feel supported and motivated to learn. I noticed clear contrasts in healthcare systems compared to my home country, particularly in workflow and resource utilisation. Taiwan, although vulnerable to natural disasters, displays impressive resilience and preparedness in its medical services. This experience made me appreciate the importance of adaptability and cultural sensitivity in healthcare. Overall, I felt inspired and eager to grow further.

5. . Difficulties/concerns & how I coped.

Liver transplantation is a new topic for me , and it takes time for me to learn and digest. I coped by seeking advice from professionals and Dr Coneja who helped to explain everything to more simple way .

6. Two words to describe progress so far

Eye-opening, encouraging

7. Plan for Week 2

I plan to engage more with the healthcare team by asking questions and discussing cases to deepen my clinical reasoning. Additionally, I will continue observing different approaches to patient management, noting any practices that could be applied in my future work. Lastly, I intend to document my daily learning experiences to track my progress and reflect on areas for improvement.

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Week 1: Plastic Surgery in Linkou Chang Gung Memorial Hospital, Taiwan

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Week 1: Plastic Surgery in Linkou Chang Gung Memorial Hospital, Taiwan

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1. Your name, matric number, date

Name: Briand Wong Teng Ming

Matric number: A195901

Date: 9th Aug 2025

2. What have you done?

I touched down in Taiwan on 30th July, feeling a mix of excitement and a bit of “where’s the nearest bubble tea shop?” energy. After landing at Taoyuan International Airport, I headed to the dorm to check in — and surprise! My roommate turned out to be our very own Year 4 senior, Bryce.

My posting kicked off on 1st August in the Plastic Surgery Department, where I was greeted by my supervisor, Dr. Yang. Afternoon was clinic time, and that’s when I realised — medical terms here are in Chinese. My brain was like “loading… buffering…” the whole time. On 4th August, I got to follow a skin graft surgery. The burn wound we saw was quite something… let’s just say it’s the kind of sight that makes you suddenly appreciate healthy skin a lot more.

The next day started bright and early at 7:30 am with the morning meeting, followed by a trip to the Taoyuan branch of CGMH. This place had everything — a Rehab Centre, an Aesthetic Medical Centre — and the best part, my supervisor taught me how to operate a laser machine. On 6th August, I attended a mind-blowing lecture on Toe-to-Hand Transplantation by the legendary Prof. Fu Chan Wei. This professor is famous in the microsurgery world, and hearing him speak felt like a TED Talk but for surgeons. Later, I joined a surgery involving a Palmaris longus tendon graft.

On 7th August, it was another surgery day, plus I met an exchange student from Poland, Marysia. Finally, on 8th August, I gave my scrubs a break and went to explore the city with my friend Marcus, enjoying the food, sights, and slightly more relaxed pace before the next week’s adventure.

3. Points to remember from week 1!

Adaptability is key

– Medical practice differs between countries. From language barriers to different surgical setups, adjusting quickly makes learning smoother.

Learning happens everywhere

– Whether it’s in the operating theatre, a morning meeting, or during an informal chat with a supervisor, every interaction adds to my knowledge.

Networking broadens horizons

– Meeting international students and experts opens doors to fresh perspectives and future collaborations.

4. Your feelings & thoughts

This first week has been both exciting and eye-opening. The exposure to advanced surgical techniques and equipment is incredible, but I also realised how much there is to learn beyond textbooks — especially cultural and linguistic aspects of medicine. I feel grateful for the opportunity, and motivated to make the most out of every single day here.

5. Any difficulties/concerns? How did you cope?

The main challenge was the use of medical terms in Chinese, which made it harder to follow clinical discussions. To cope, I started noting down unfamiliar terms and asking for translations from my supervisor or peers. I also used translation apps and reviewed surgical vocabulary in Mandarin during my free time.

6. 2 words to describe elective posting progress so far

Eye-opening & Inspiring

7. Your plan for next week (Week 2)

My supervisor plans to rotate me to the Microsurgery Department, allowing me to gain deeper insights into the full scope of plastic surgery — from intricate reconstructions to high-precision procedures. I aim to observe at least two microsurgical operations and learn more about post-operative care.

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Week 1: Preparation before starting my elective in Green Island, Taiwan

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Week 1: Preparation before starting my elective in Green Island, Taiwan

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1. Your name, matric number, date

Name: Quek Chew Geok

Matrics number: A196228

Date: 27/7/2025 - 2/8/2025

2. What have you done?

Before choosing to do my elective at Good’s Dive, located on Green Island in Taiwan, I carried out extensive research to find a placement that aligned with both my goals and interests. I was determined to look for a diving hostel because one of my bucket list was to obtain a diving licence. With this aim in mind, I explored various platforms offering volunteer opportunities and compared different places that accepted foreign volunteers. Besides Green Island, I also considered opportunities on Lanyu (Orchid Island) and Xiaoliuqiu (Lambai Island). After attending several interviews, I finally received an offer from Good’s Dive.

Once my placement was confirmed, I began preparing myself for this journey. Since Green Island is accessible only by sea, I planned my transportation route carefully. I booked a flight to Kaohsiung as the first step of my journey. From Kaohsiung, I travelled by train to Taitung and lastly after arriving in Taitung, I took the ferry to reach the island. By arranging my itinerary early, I ensured a smooth transition from Malaysia to Green Island and avoided last-minute travel issues.

I also prepared myself for both the work expectations and the environment I would be entering. I familiarised myself with the hostel’s daily routine by exploring their social media, watching diving videos and reading highlighted stories from previous volunteers. I also checked with the team regarding anything specific I needed to bring to Taiwan.

Understanding that communal living would be part of the experience, I prepared myself for shared responsibilities such as cooking. I practised cooking more regularly at home and even brought some Malaysian ingredients like curry paste and nasi lemak sambal to share authentic Malaysian flavours with them.

In addition, I researched Green Island’s geography and outdoor activities, learning about snorkelling spots, scenic coastlines, hiking trails  and popular local food places. This helped me plan how to make the most of my free time while exploring the island safely and responsibly.

3. Points to remember from week 1!

i. Researching Volunteer Opportunities
Before confirming my elective, I explored multiple placements that accepted foreign volunteers. I compared opportunities on Green Island, Lanyu (Orchid Island), and Xiaoliuqiu (Lambai Island), aiming for a diving hostel that aligned with my goal and with more favourable facilities and environment.

ii. Understanding the Work Environment
I spent time browsing Good’s Dive’s social media, watching their diving videos and reading highlighted stories from previous volunteers. This helped me understand the hostel’s work culture, daily routine and expectations.

iii. Preparing for Communal Living
Knowing that meals would be prepared together, I practised cooking more regularly at home. I also prepared small Malaysian ingredients like curry paste and nasi lemak sambal so I could introduce authentic Malaysian flavours to them as part of cultural exchange.

iv. Planning My Multi-Step Journey
I carefully mapped out my transportation route by flying to Kaohsiung, taking a train to Taitung and then boarding the ferry to Green Island. I checked ferry schedules, weather conditions and connections to avoid travel issues.

v. Mental Preparation for Cultural and Lifestyle Differences
I reminded myself that the food, communication style, and pace of life would be different on a small island. Keeping an open mind was crucial to adjusting smoothly.

4. Your feelings & thoughts

Before leaving for Taiwan, I felt a mix of excitement and nervousness. It was my first time travelling alone and the idea of living on a remote island brought both curiosity and anxiety. I was eager to pursue my dream of diving and to step out of my comfort zone, but I was also worried about adapting to a new lifestyle, making new friends, and handling responsibilities in a foreign place.

Despite these worries, I felt mentally prepared. I had researched thoroughly, organised my travel route and packed all necessary items. I kept reminding myself that this elective was not just a placement but also a chance to grow personally, gain life experience and challenge myself in new ways.

5. Any difficulties/concerns? How did you cope?

One concern I had before leaving was whether I would adapt well to island living especially transportation since most people use scooters on the island and I do not have a licence. To cope, I prepared alternative plans such as walking routes, cycling options and checking if volunteers travelled together.

6. 2 words to describe elective posting progress so far

Excitement, Well-prepared

7. Your plan for next week (Week 2)

For the 1st week on Green Island, my plan was:

to familiarise myself with the hostel routine and cleaning schedule

to adapt gradually to communal living and shared responsibilities

to get used to the environment through short walks and exploring nearby areas

to build confidence in the water by starting with snorkelling sessions

to observe how the team works together before fully immersing myself

My long-term goal for the placement is to start my PADI Open Water training, but Week 1 would be focused on settling in, adjusting to the island lifestyle, and mentally preparing for the diving course.

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WEEK 1: Internal medicine department at Linkou Changgung Memorial Hospital Taiwan

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WEEK 1: Internal medicine department at Linkou Changgung Memorial Hospital Taiwan

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1. Your name, matric number, date:

Name: Marcus Chin Yi Khai

Matric number: A196073

Date: 4/8/2025 - 8/8/2025

2. What have you done?

During my first week in the Geriatric Department, the day would begin with a morning meeting from 7:30 to 8:30 a.m. The doctors would present interesting cases for discussion, allowing everyone to learn from real patient scenarios. For example, we discussed the challenges of managing SIADH in the elderly and strategies for handling acute kidney injury in patients with malignancies. These sessions were insightful, as they combined clinical reasoning with practical approaches tailored to the unique needs of geriatric patients.

After the morning meeting, I would follow my PGY and consultant to review patient details before starting ward rounds. This review session was crucial for planning the day’s management, including adjustments to drug dosages to avoid polypharmacy complications, which are common in elderly care. During the ward rounds, the consultant actively engaged me by asking questions related to the cases, making me feel involved and encouraging me to think critically. These interactions not only tested my knowledge but also guided me toward areas I could improve on.

By noon, it was lunchtime — the hospital food was both clean and surprisingly tasty. After lunch, there would be a journal reading session, where the PGY would prepare slides on specific topics. One of the sessions I attended was about managing dizziness in elderly patients. The consultant would then elaborate on the topic, provide teaching points, and offer constructive feedback. We were also encouraged to share our thoughts and reflections. The consultants emphasized the importance of the “5Ds” in geriatric care — Dementia, Delirium, Depression, Disability, and Drugs — as these are major factors affecting patient outcomes.

In the afternoons, I often took the initiative to clerk patients in the ward. This was a valuable opportunity to learn more about their conditions, treatment histories, and personal stories. Listening to their backgrounds helped me appreciate the human side of medicine beyond the charts and lab results. Outside of hospital hours, I was also grateful to explore various beautiful places with my friend Briand. We enjoyed delicious food, shared laughter, and made wonderful memories, adding a personal touch to my overall experience during this first week.

3. 5 Points to remember from week 1

a. Start the Day with Active Learning
Morning case discussions are a valuable platform to sharpen clinical reasoning. Topics like SIADH in the elderly and acute kidney injury in malignancy highlight the importance of understanding pathophysiology and applying it to real-life cases.

b. Pre-round Reviews are Essential
Reviewing patient details before ward rounds ensures a focused and efficient plan. This step is crucial in geriatrics, where small adjustments — such as fine-tuning medication doses — can significantly impact outcomes and prevent polypharmacy-related harm.

c. Engagement Enhances Learning
Being asked questions during ward rounds keeps you actively involved and helps identify gaps in knowledge. It also creates a collaborative learning environment between students and consultants.

d. Structured Afternoon Learning
Journal reading sessions reinforce evidence-based practice. Presentations, followed by consultant feedback, encourage critical thinking and emphasize key geriatric care principles such as the “5Ds” — Dementia, Delirium, Depression, Disability, and Drugs.

e. Connect with Patients Beyond the Charts
Clerking patients offers the chance to understand their medical conditions as well as their personal stories. This holistic approach builds empathy and reminds us that every patient is more than just their diagnosis.

4. Your feelings and thoughts:

1. Gratefulness
I feel grateful for the warm guidance and teaching from the consultants and PGYs. Their willingness to engage me in discussions and involve me in patient care made me feel valued as part of the team. This supportive environment encouraged me to learn more actively and confidently.

2. Fulfillment
I feel a sense of fulfillment from both the clinical learning and the personal experiences outside the hospital. Gaining insight into patient care while also exploring new places and enjoying good food with friends gave me a balanced and memorable start to my elective posting.

5. Any difficulties / concerns? how did you cope

Difficulties / Concerns:
In the beginning, I struggled to keep up with the medical terms and discussions in Mandarin, especially during the fast-paced morning meetings and ward rounds. It was sometimes challenging to fully grasp the details of the cases being discussed.

How I Coped:
I took quick notes of unfamiliar terms, asked my PGY or consultant for clarification when appropriate, and reviewed the topics in English after the session. This not only helped me understand the cases better but also gradually improved my medical Mandarin vocabulary.

6. 2 words to describe elective postings progress so far:

Enriching and memorable

7. Your plan for next week / week 2:

I plan to be more proactive in ward rounds by asking relevant questions and sharing my thoughts on patient management. I also aim to clerk more patients to strengthen my clinical skills, improve my medical Mandarin, and deepen my understanding of common geriatric conditions.

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WEEK 1: Volunteering at PAWS UNITED CHARITY Cat Shelter in Hong Kong

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WEEK 1: Volunteering at PAWS UNITED CHARITY Cat Shelter in Hong Kong

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1. Your name, matric number, date:

Name: Ashba Khan

Matric number: A192231

Date: 29th June, 25 - 12th July, 25

2. What have you done?

My elective posting starts from next week at the Paws United Charity, so currently this week is being used for preparation of my project.

Firstly, I signed up to be a volunteer for PUC, which asked me about my interest for animals and previous experiences with handling them, also my personal contact details. After completing the form, I received an automated message on WhatsApp that sent the booking links for volunteering shifts, for both the cat and dog shelters.

But first, I contacted the shift manager, Walter, whose contact was available through the form I used to register. I messaged him on WhatsApp and informed him about my elective programme, for which he informed me that for academic certification, a volunteer has to work for a minimum of 40 hours, and is required to fill in a log sheet everyday with the respective duty manager's signature. The final sheet is then submitted to Walter, from which he will compile the feedback for the academic certificate.

However, prior to that I must show him evidence for the need for academic proof, such as the elective posting verification letter. Afterwards, I must book my slots and inform him accordingly. Then on the day of the first shift I have to collect my log sheet from the dog shelter, which is neighboring to the Cat Shelter.

After noting down all his instruction, I booked my dates for my volunteering shifts. There were two shift options, the morning shift (10:00-14:00), and the evening shift (14:00-19:00). I selected the morning shift options as one of my aims of this project is to improve my time management skills, that includes my morning routine of waking up early and being punctual for my commitments.

Then I planned out my commuting route, as I will be taking public transportation, which turned out to be a two hour journey consisting on two buses and one train. Therefore I planned my morning schedule, where I will wake up at 7am, leave the house by 8am, and reach by 10am, punctually for my shift.

3. Points to remember from week 1:

Firstly. I have to make sure to remember and note down my commute journey, as getting lost or stuck can result in being late for my shift. Therefore, my mother helped illustrate my journey in my diary, which I can refer to whenever I'm unsure of where to go.

Secondly, I have to remember to collect an empty log sheet from the dog shelter before going to my first shift at the cat shelter.

Thirdly, I have to remember to get my log sheet signed from my duty manager everyday, as backdating a shift is strictly forbidden. And I will be getting different duty managers for every shift, depending on their availability.

Fourthly, I have to make sure to remember and practice all safety instructions mentioned in the confirmation email. Which includes wearing closed toed shoes, comfortable clothing that may get dirty during the shift.

Fifthly, on both sundays, I will be volunteering at the Sai Kung WM Hotel Adoption event, not at the cat shelter in Repulse Bay, therefore I have to mindful of the change in time and location. The sunday shift is at 1pm-6pm, hence I have to leave home at 11am, using a different route to reach, which my mother also illustrated for me separately.

4. Your feelings and thoughts:

Currently I feel anxious and nervous as I'm unaware of what lies ahead, and am afraid that I won't be able to achieve their high expectations. However, Im keen to learn so I can become a helpful volunteer to help the cats in need, therefore, Im certain that after 2-3 days of practice, I'll be able to carry out the duties swiftly and efficiently.

5. Any difficulties/ concerns? How did you cope?

I haven't dealt with many difficulties as of yet, however I was concerned about the availability of the slots I wanted to book for my project, 29th June- 12th July. Because getting morning slots for 2 week in a row was crucial yet difficult to obtain, as only 1 volunteer is permitted per shift. Luckily, all the shift slots were available, so I was able to book my ideal period.

6. 2 words to describe elective posting progress so far:

2 words I would use to describe my progress are structured and proactive, because this week has been structured as I carefully organized my volunteering plans, including registering, communicating with the shift manager, and mapping my commuting route. This methodical approach ensures that I am fully prepared for my upcoming shifts.

Additionally, I have been proactive in securing my volunteering slots and addressing potential challenges ahead of time. This forward-thinking mindset helps alleviate my anxiety and prepares me to contribute effectively to the charity's mission.

7. Your plan for next week / week 2:

Since I have utilised this current week for planning my week ahead, which is also my first week with the shelter, I already have an organised and structured plan. This includes arriving punctually, carefully recording my shifts, and being a proactive volunteer at the shelter.