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Week 3: PADI Open Water Diver Course in Goods Dive, Green Island of Taiwan

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Week 3: PADI Open Water Diver Course in Goods Dive, Green Island of Taiwan

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1. Your name, matric number, date

Name: Quek Chew Geok

Matrics number: A196228

Date: 3/8/2025 - 9/8/2025

2. Your progress so far

Looking back on my second week at Good’s Dive, I would say my progress has been very rewarding and meaningful. I successfully completed the PADI Open Water Diver course which was a huge milestone for me. Before the course began, I dedicated time to studying the theory lessons through e-learning and was proud to score 98% on the exam. This strong foundation gave me confidence to move into the practical sessions.

The PADI Open Water Diver Course took me 4 days to complete and earn the certificate. Throughout the 4 days, I noticed a gradual shift in my ability and comfort level.

On the first day of the course, my instructor reviewed and recalled the key theory lessons with us, ensuring that we fully understood the important concepts of scuba diving.

On the second day, we moved into confined water training in the swimming pool. It was an intensive six-hour session where we practiced and mastered the essential underwater techniques introduced in theory.

By the third day, we progressed to open water dives in the ocean. Under the close guidance of our instructor, we repeated all the underwater techniques in saltwater conditions, which felt more challenging yet exciting compared to the pool. On the fourth day, we continued with more open water practice, completing two dives each day on both the third and fourth days. This allowed us to practice more skills, gain valuable experience, and gradually build confidence in the ocean environment.

What made the experience truly memorable was not only learning to dive but also enjoying the beauty of the underwater world. I had the chance to see vibrant corals and fascinating aquatic creatures up close, making the journey both educational and unforgettable.

3. Your feelings and thoughts

Emotionally, this week was a rollercoaster of nervousness, excitement, and eventually pride.

At first, I felt nervous stepping into the practical sessions especially when thinking about moving from the swimming pool to the open ocean. The thought of being underwater for long periods and relying entirely on scuba gear made me anxious. However, once I began practicing with the instructor’s guidance, I gradually gained confidence.

On the third and fourth day, I was able to let go of the anxiety and focus more on the beauty around me. Seeing corals, fish, and the incredible marine environment for the first time made me feel grateful and amazed. It was a reminder of how vast and beautiful nature is, and how important it is for us to respect and protect it.

By the end of the week, I felt proud of myself for not only for passing the course but for pushing past my fears and accomplishing my bucket list - officially becomes a certified scuba diver!

4. How did you learn and apply the skill of decision making in your EP journey?

Throughout my elective posting, especially during the PADI Open Water Diver course, decision-making became an essential skill I constantly applied. Learning to dive required me to make quick yet thoughtful decisions for my own safety and comfort underwater. For example, I had to decide when to equalise, when to ascend slightly if I felt discomfort, when to signal my instructor and how to adjust my breathing to stay calm. These small but important decisions helped me stay calm and in control during the dives.

Outside of diving, I also applied decision-making in daily routines. I decided on how to plan my study schedule for the theory exam, how to divide my energy between volunteering tasks and course preparation and when to rest to avoid fatigue. Each choice influenced the quality of my learning and the overall experience while balancing work life balance in my elective.

This journey taught me that good decision making comes from being well-prepared, staying aware of my surroundings and understanding my limits. It encouraged me to think ahead, weigh risks and take responsibility for my actions. Over time, I became more confident in trusting my judgement, a skill that will continue to benefit me in both academic and real-life situations.

5. How did you manage your time throughout this EP journey?

With the PADI Open Water course, volunteer duties, personal study time and leisure activities all happening within the same week, I had to plan my schedule carefully.

I managed my time by prioritising the most important tasks each day. During the mornings, I focused on housekeeping responsibilities at the hostel. Once those were completed, I dedicated time to prepare for my diving lessons. First few days including reviewing theory, watching instructional videos, and mentally rehearsing the skills I needed.

During the 4-day PADI course, my afternoons and evenings were fully committed to confined water practice and open water dives, ensuring that I stayed focused and physically ready.

At the same time, I made sure to allocate moments for relaxation, proper meals and sleep, as diving requires good physical and mental condition. I avoided rushing and maintained a steady routine so I wouldn’t feel overwhelmed.

Through this experience, I learned how to balance responsibility, learning and personal well-being.

6. Your plan for next week (Week 4)

Going back to Malaysia! This will be my last week staying in Taiwan.

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Week 3: General Surgery at Kaohsiung Chang Gung Memorial Hospital

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Week 3: 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: 11/08/2025 - 15/08/2025

2. How is your progress?

My second week in the General Surgery department at Kaohsiung Chang Gung Memorial Hospital has been even more immersive than the first. I've really started to feel more comfortable in the clinical setting. The initial nervousness of Week 1 has been replaced with a stronger sense of curiosity and purpose. I've been dedicating more time to my specific area of interest: hepatobiliary surgery. I've spent extra time with the team in this specialty, deepening my understanding of liver and pancreas anatomy, pathology, and surgical techniques. The highlight of this week was definitely observing a few more procedures, including a laparoscopic cholecystectomy and a right posterior sectionectomy. Seeing these procedures performed with such precision was a great way to link my textbook knowledge to real-world application. Each day feels like a step forward in my medical journey.

3. Points to remember from week 2!

Active Observation: It’s not just about watching, but about actively analyzing what's happening. I’ve learned to pay close attention to the non-verbal cues from patients and the subtle ways that doctors communicate with their team.

Asking Questions: There’s no such thing as a "silly question." Asking for clarification has not only helped me learn but has also shown my mentors that I am engaged and eager to understand.

The Patient-Centric Approach: I was reminded this week of the importance of seeing the patient as a whole person, not just a set of symptoms. It's something we learn in lectures, but experiencing it firsthand has been powerful.

4. My feelings & thoughts

I'm feeling a lot more comfortable and confident now that I've settled into the rhythm of the hospital. The initial feeling of being overwhelmed has lessened, and it's been replaced with a deep sense of purpose and excitement. I'm inspired by the immense dedication and skill of the surgeons and staff. It's a privilege to be learning from them.

5. ONE good thing I did that I can practice now!

I've learned to be much more assertive in my learning. Instead of waiting for an opportunity to arise, I've started seeking them out. Whether it's asking a resident or nurse to explain a particular lab result or requesting to observe a specific procedure, I've realized that taking charge of my own learning experience is key to making the most of this elective. I can practice this by setting clear intentions and being vocal about my goals in all future rotations.

6. Any difficulties/concerns? How did I cope?

The language barrier is still a challenge, but I've found a new way to cope. I've focused on non-verbal communication and cultural understanding. I pay close attention to the patient's tone, body language, and facial expressions to grasp their emotional state. I've learned that a caring presence and a reassuring smile can make a patient feel seen and understood, even without a shared language. It's a powerful lesson in the universal language of human connection in medicine.

7. Your plan for next week (Week 3)

My elective has officially come to an end, and I'm so grateful for this entire experience. The past two weeks have taught me more than I could have imagined, both clinically and personally. I am leaving with a renewed sense of purpose and a deeper understanding of what it means to be a compassionate and effective healthcare professional.

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Week 3: Pediatrics in Linkou, Chang Gung Memorial Hospital, Taiwan - Division of Pediatric Hematology-Oncology

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Week 3: Pediatrics in Linkou, Chang Gung Memorial Hospital, Taiwan - Division of Pediatric Hematology-Oncology

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1.⁠ ⁠Your name, matric number, date

Name: Grace Liew Min Zi

Matric number: A195123

Date: 28/7/25 – 1/8/25

2. Your progress so far

In my final week of elective posting at CGMH, I rotated into the Division of Pediatric Hematology-Oncology under the supervision of Dr. Wang Yi-Lun, a second-year fellow. At first, I was anxious about this posting, because hematology often involves children with malignancies and complex conditions. I imagined the ward to be heavy and solemn, but the reality surprised me. The walls and floors were decorated with bright cartoons like Spiderman and Peppa Pig, giving the ward a lively atmosphere. It was a powerful reminder that even in the middle of serious illnesses, children deserve a childhood-like environment filled with color and hope.

Dr. Wang gave me the most intensive teaching compared to my previous two weeks. He would bring me to the wards even before the official rounds, explain each case in detail, then quiz me and expand into broader teaching points. He spoke quickly and confidently, with knowledge deeply rooted in his mind. Although I sometimes struggled to keep up, I truly learned a lot from his sessions. He introduced me to the big three pediatric malignancies:

Leukemia: the most common, divided into AML (FAB M0–M7) and ALL (L1–L3). Risk stratification (low, intermediate, high) determines prognosis and treatment intensity. I learned how ALL peaks between 2–5 years old and how relapse risk changes with subtype.

CNS tumors: especially medulloblastoma, categorized into supratentorial and infratentorial tumors. Treatment usually involves surgery, chemotherapy, and radiotherapy. In some cases, high-dose chemotherapy is followed by autologous stem cell rescue, though this carries a 5–15% risk of transfusion-associated thrombotic microangiopathy (TATMA), leading to renal failure.

Lymphoma: in cases of relapse, immunotherapy becomes an option, especially when the cancer carries a high mutational burden.

One of the most impactful cases I followed was a young girl with relapsed medulloblastoma. She had undergone multiple surgeries and chemotherapies, but her tumor had returned. Now she was admitted for symptom control and supportive care. Despite the poor prognosis, her parents continued to devote themselves fully—tracking her appetite, mood, and lab values daily. Even small improvements brought them joy. Watching this family reminded me that pediatrics is not only about prolonging life, but also about maximizing comfort, dignity, and family support.

Another highlight was attending a Mortality and Morbidity (M&M) conference. The case involved a nearly 3-year-old girl with posterior fossa group A ependymoma (WHO Grade 2) who had undergone tumor removal and VP shunt placement. She later developed vomiting, hypokalemia, and eventually suffered in-hospital cardiac arrest despite CPR. The discussion centered on whether fludrocortisone had been appropriately prescribed, as it may have worsened her hypokalemia. I learned that:

Severe hypokalemia can be just as life-threatening as hyperkalemia, leading to paralysis, respiratory failure, and arrhythmias.

Oral K⁺ replacement is safest; IV is for severe/symptomatic cases, with strict ECG monitoring.

Magnesium correction is essential before potassium replacement.

Medication reviews and clear documentation are crucial to prevent iatrogenic complications.

In outpatient clinics, I encountered more hematological conditions beyond malignancies. I observed cases of:

Aplastic anemia: usually presenting with pancytopenia but no hepatosplenomegaly or lymphadenopathy. I learned to differentiate Fanconi anemia (congenital, treated with HSCT or transfusions, not responsive to immunosuppressive therapy) from acquired aplastic anemia (which responds to immunosuppressive therapy).

Immune thrombocytopenic purpura (ITP): children presenting with bruises, gum bleeding, epistaxis, hematuria, and low platelets. Most remit in 2–3 weeks, though chronic cases require long-term steroids.

Dr. Wang even showed me peripheral blood smears under the microscope. For the first time, I saw ITP and leukemia smears in real life—moving beyond textbook images into actual patient findings. This experience deepened my appreciation for hematology as both a diagnostic and therapeutic specialty.

3. Your feelings and thoughts

This final week was the most emotionally challenging, but also the most meaningful. At first, I was nervous about seeing pediatric oncology cases, but I found the ward to be filled with hope, resilience, and humanity. The cartoon decorations, the kindness of nurses, the teamwork among doctors, and the unwavering strength of parents all created an inspiring environment despite the gravity of the illnesses.

The girl with relapsed medulloblastoma left a strong impression on me. It is heartbreaking to see a child suffer from relentless disease, but her parents’ love and optimism reminded me that medicine is not only about cure, but also about care.

The M&M conference was also eye-opening. It was the first time I saw doctors openly discuss a mortality case with humility and professionalism. Instead of pointing fingers, they identified learning points, asked tough questions, and focused on how to improve care in the future. It showed me the importance of accountability and continuous learning in medicine.

On a personal level, I sometimes felt overwhelmed trying to keep up with Dr. Wang’s fast-paced teaching. There were moments when I felt panicked or inadequate. But I also realized that growth happens when I am pushed beyond my comfort zone. By the end of the week, I felt proud of how much I had absorbed in just one week here.

4. How did you learn and apply the skill of decision making in your EP journey?

Decision making in pediatric hematology requires weighing risks and benefits carefully. For example, in leukemia, doctors decide treatment intensity based on subtype and risk classification. In relapsed lymphoma, the decision to proceed with immunotherapy was guided by its effectiveness in high mutational cancers. In CNS tumors like medulloblastoma, decisions often balance aggressive interventions against quality of life.

The M&M case showed me how one medication choice (fludrocortisone) may have contributed to a child’s death. It taught me that good decision making means not just following protocols blindly, but also questioning indications, anticipating side effects, and tailoring therapy to each patient.

Although I am still a student, I practiced decision making by mentally working through cases during ward rounds and then comparing my reasoning with the doctors’ plans. This helped me understand their clinical logic and sharpened my own thinking process.

5. How did you manage your time throughout this EP journey?

The schedule remained packed with 7:30am morning meetings, ward rounds, clinics, and conferences. To manage, I prepared by reading about hematology topics in the evenings, such as leukemia classifications, chemotherapy protocols, and aplastic anemia management. During rounds, I wrote down keywords from Dr. Wang’s fast-paced teaching, then expanded them into full notes later. Balancing observation, note-taking, and self-study kept me engaged and prevented me from feeling overwhelmed. Over three weeks, I became more efficient at organizing information and prioritizing learning opportunities.

6. Your plan for next week (Week 4)

Since Week 3 was my last week at CGMH, my plan now is to consolidate everything I have learned. I want to review my notes across pediatrics allergy, gastroenterology, and hematology, and integrate them into a clear framework. I also plan to reflect more deeply on the cases I encountered. Beyond academics, I want to stay in touch with the doctors and medical students I met, as they have been so welcoming and generous in teaching me. I am also planning to explore a bit more of Taiwan’s culture, food, and scenery before returning home. Most importantly, I aim to carry forward the lessons of patience, empathy, and teamwork into my clinical years and future medical practice.

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Week 3 in General Surgery of Linkou Chang Gung Memorial Hospital

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Week 3 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:2/8/2025

2. Your progress so far

During the week, I had the opportunity to observe several surgical procedures, attend clinic sessions with my supervisor and follow for ward rounds. The surgeries that I have observed include a hernia repair, robotic-assisted cholecystectomy and gastrectomy surgery, where I was able to appreciate the precision of minimally invasive techniques. I also observed an ultrasound examination, which highlighted the importance of imaging in diagnosis and surgical planning. My learning was further complemented by attending sessions at the surgical clinic, where I observed how patients are assessed and managed in an outpatient setting.

3. Your feelings and thoughts

I was truly amazed by the advanced technology used in robotic-assisted cholecystectomy. Traditionally, the procedure requires three laparoscopic ports, but with robotic innovation, it can now be performed through a single incision at the umbilical area. This advancement not only reduces scarring but also enhances surgical precision. I hope that one day such technology will become more widely available in Malaysia, including in government hospitals, so that more patients can benefit from it.

4. How did you learn and apply the skill of decision making in your EP journey?

I believe I developed my decision-making skills during my elective posting in Taiwan, particularly in choosing how to spend my time each day. Since there was no fixed timetable, I had the flexibility to either spend my days exploring Taiwan or to stay in the hospital and observe clinical work and surgeries. While the idea of travelling and experiencing the culture was tempting, I made the conscious decision to prioritise my learning by going to the hospital every day and following my supervisor closely. I felt that this was a unique opportunity to learn directly from doctors in Taiwan and to gain first-hand exposure to their healthcare system, something I could not easily experience elsewhere.

Looking back, I am glad I made this choice because it allowed me to witness a variety of procedures, interact with patients, and better understand how the Taiwanese healthcare system functions. More importantly, it showed me the value of discipline and commitment in making decisions that align with my long-term goals. By choosing learning over leisure, I not only gained knowledge about advanced surgical practices and patient care but also developed insights that I hope to bring back and apply in Malaysia when I become a doctor.

5. How did you manage your time throughout this EP journey?

I managed my time during this elective posting by creating a daily timetable to balance classes, self-study, and travelling. Most mornings were spent attending classes until lunchtime, after which I would return to the dorm for a short rest before continuing with self-study in the afternoon. In the evenings, I allowed myself time to go out with friends and explore Taiwan. To stay organised, I prepared a daily to-do list and made sure to complete each task before the end of the day. This approach helped me stay disciplined in my learning while also giving me the freedom to enjoy my time abroad and create memorable experiences with friends.

6. Your plan for next week (Week 4)

This week was the final posting for my elective posting. For week 4, I did some reflection on the things that I have done throughout my whole elective posting journey.

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Pink and Blue Watercolor Background Poster (3)

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Week 3: General Surgery in Kaohsiung Chang Gung Memorial Hospital

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Week 3: General Surgery in Kaohsiung Chang Gung Memorial Hospital

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1. Your name, matric number, date

Name: Lee Rou En

Matric number: A196876

Date: 11/8/2025 - 15/8/2025

2. How is your progress?

I feel that I am adapting better compared to the first week. I am now more familiar with the hospital system, and I can follow the pace of ward rounds more effectively. I am also getting used to observing in the operating theatre, identifying key steps during procedures, and appreciating the teamwork required in surgery.

3. Points to remember from Week 2!

One of the most valuable lessons this week was when my supervisor explained how an endoscope works and how upper gastrointestinal endoscopy can be used to reach a diagnosis. I was able to appreciate how the scope allows direct visualization of mucosal surfaces, which makes it possible to detect conditions such as ulcers, bleeding, tumors, or strictures. In addition, I was also introduced to reading CT abdomen images. My supervisor highlighted the importance of correlating imaging findings with clinical presentation and anatomical landmarks. However, through this experience I realised that my anatomical knowledge is still not strong enough, especially when it comes to cross-sectional imaging. I found it challenging to confidently identify different abdominal structures and their relationships on CT scans. This made me more aware of the gap in my understanding and motivated me to revise anatomy in more detail to strengthen this skill.

4. My feelings & thoughts

This week, I feel more settled and confident in my environment. Although I still face a language barrier during some clinical discussions, I am learning to adapt and find ways to keep up. I feel motivated when I see different surgical cases and observe how surgeons manage complex situations. On a personal note, being able to explore the gym and snooker at the college made me feel more at home, reminding me that taking care of both body and mind is important especially in this career.

5. ONE good thing I did that I can practice now!

One positive habit I started this week was visiting the gym after completing my daily hospital routine. This not only gave me a chance to unwind after long hours of standing during ward rounds or observing in the operating theatre, but also reminded me of the importance of maintaining my own health. As I observed surgeons working tirelessly for long hours, often in physically demanding environments, I realised that physical fitness and stamina are crucial in this profession. Regular exercise can help build endurance, improve concentration, and reduce stress, which are all qualities needed to perform well as a future doctor or surgeon. This is a practice I would like to continue, as it helps me balance my academic growth with personal well-being.

6. Any difficulties/concerns? How did I cope?

One of the main difficulties I faced this week was the language barrier, especially when patients communicated in Hokkien. Since I am less familiar with this dialect, it was challenging to fully follow patient interactions during ward rounds and clinics. To cope with this, I tried to focus on observing non-verbal cues, clarifying key points with peers or residents afterward, and reviewing the patient’s notes to ensure I did not miss important information. Although it was difficult, this experience made me realise the importance of communication skills and adaptability in clinical practice, and it also motivated me to slowly pick up common medical terms in Hokkien to improve my understanding.

7. Your plan for next week (Week 3)

This will be the final week of my two-week elective posting in Kaohsiung Chang Gung Memorial Hospital in Taiwan.

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WEEK 3: Volunteering at PAWS UNITED CHARITY Cat Shelter in Hong Kong

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WEEK 3: 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, 2025 - 12th July, 2025

2. Your progress so far:

In my third week with Paws United Charity (PUC), I experienced a blend of rewarding moments and emotional challenges that deepened my connection to the cats and my commitment to animal welfare. The week began on Sunday with an adoption event at the WM Hotel, where I took on several key responsibilities. Arriving early, I helped set up the environment for the cats, which involved arranging cages meticulously to ensure each cat felt secure. I placed mats in the cages, set up litter bins, and positioned food and water bowls, all aimed at creating a comfortable space for the cats and potential adopters.

During the event, I engaged actively with visitors, answering their questions about the cats and guiding them through the adoption process. It was heartwarming to see the interest from potential adopters, especially when senior cats Pablo and Tasmina were adopted together. They had been inseparable since birth, and witnessing them leave with a loving family was a highlight of the day. This experience emphasized the importance of keeping bonded pairs together, making it a truly rewarding moment.

One of the most meaningful experiences of the day involved Georgina, a senior cat who had always struggled with fear during adoption events. I had seen her shake in previous events, and my heart went out to her. Under the guidance of duty manager Anita, we decided to take a patient approach. Anita sat beside Georgina, gently coaxing her with treats. I assisted by passing the treats to Anita, who applied them to her fingers to encourage Georgina to come closer. It was incredible to witness Georgina gradually calm down and eventually start to accept treats from my hand. The transformation from a trembling, fearful cat to one that purred while being fed was nothing short of miraculous. When Georgina was finally adopted, it felt like a triumph not just for her, but for everyone involved in her care.

As the week unfolded at the Repulse Bay shelter from Monday to Saturday, my routine consisted of a mix of cleaning, feeding, and building relationships with the cats. I continued to sanitize the litter boxes and bowls, and mopped the floors to maintain a hygienic environment. However, I also focused on engaging with the cats on a personal level. I took the time to observe their behaviors, which helped me understand their unique personalities better. For instance, Fossil, an energetic cat, always seemed eager for playtime, while King and Willow remained more reserved, often watching from a distance. I made it a point to interact with them more, offering treats and gentle encouragement to build their trust.

A significant change this week was the arrival of three energetic kittens: Rock, Stone, and Venus. Their playful antics brought a lively atmosphere to the shelter. I quickly recognized that they needed ample engagement to channel their energy. I initiated play sessions with them using feather toys and balls, and it was delightful to see their excitement. They would chase after the toys, pounce, and tumble over each other, filling the shelter with laughter. However, I also felt a twinge of concern for Daisy and Luna, who had recently been moved from a foster home. Their foster felt overwhelmed managing four kittens alongside her other pets, which led to their relocation. I spent time comforting them, ensuring they felt safe and secure in their new environment. I encouraged them to explore their surroundings, reassuring them with gentle interactions.

Throughout the week, I developed a strong bond with my duty manager, Helen. We often exchanged stories about our lives and shared interests, which made my time at the shelter feel more like a community. Helen brought me local chocolates from her recent trip to Kazakhstan, which sparked conversations about travel and culture. These interactions not only made me feel welcomed but also enriched my understanding of the challenges and rewards of working in animal care.

By the end of the week, I felt a stronger connection to both my coworkers and the cats. The animals began to recognize me, often coming to me for playtime or comfort. This acknowledgment was incredibly rewarding and reinforced the impact of my consistent presence. Overall, my experiences this week were filled with learning opportunities, emotional growth, and a renewed sense of purpose in my volunteering journey. I am now more eager than ever to take on additional responsibilities and continue enhancing my skills in animal care.

3. Your Feelings and Thoughts:

Throughout my third week at PUC, I experienced a mix of emotions ranging from joy to empathy. Witnessing the adoption of Pablo and Tasmina filled me with happiness, knowing they were going to a loving home together. It felt rewarding to see the positive impact of my efforts on the cats and the families interested in adopting them. However, I also felt a deep concern for cats like Georgina, whose fear made her adoption challenging. Helping her overcome that fear was profoundly satisfying, as it highlighted the importance of patience and understanding in animal care.

4. How did you learn and apply the skill of decision-making in your EP journey?

During my time at Paws United Charity, I developed important decision-making skills through specific experiences. For instance, during the busy adoption event on Sundays, I noticed that we were short-staffed. I decided to stay an extra 30 minutes to help manage the influx of visitors, knowing I could still return home in time to prepare dinner for my mother and sister.

On a weekday at the shelter, I encountered a situation where a new cat was particularly anxious. I had to decide whether to stick to my cleaning schedule or spend additional time comforting her. I chose to prioritize her emotional well-being, using calming techniques to help her adjust, which ultimately improved her chances of adoption.

Another critical moment arose when I saw a fellow volunteer struggling with a large litter-cleaning task. I decided to assist her instead of focusing solely on my own responsibilities. This decision not only helped maintain a clean environment but also strengthened our teamwork, benefiting the entire shelter.

These experiences taught me that effective decision-making involves evaluating immediate needs, balancing my commitments, and being willing to adapt my plans for the benefit of the animals and the team.

5. How did you manage your time throughout this EP journey?

It involved careful planning and prioritization. I used Google Calendar on my phone, adding it as a widget on my home screen to keep track of my daily schedule, which included shifts at the shelter and other responsibilities.

For instance, after finishing my shift at 2 PM, I had a two-hour commute home, aiming to arrive by 5 PM. From 4 to 5 PM, I needed to squeeze in grocery shopping and running errands to ensure I had everything ready for dinner. I made a list beforehand to maximize my efficiency, knowing I had little time to waste.

Once home, I immediately set to work cooking and cleaning the house, aiming to have dinner on the table by 7 PM. This often meant multitasking—while dinner was simmering, I would clean up the kitchen and prep ingredients for the next day. At the shelter, with four hours for my shifts, I focused on cleaning and essential tasks for about three hours. I was mindful of distractions, such as conversations with the Duty Manager or excessive playtime with the cats, ensuring that my responsibilities came first.

To stay organized, I set specific goals for each shift, allowing me to check off tasks as I completed them. As a reward for my hard work, I dedicated the last hour to socializing with the cats, which helped me bond with them and contributed to their emotional well-being. This structured approach allowed me to balance my commitments effectively.

6. Your plan for next week (Week 4):

In Week 4 of my EP journey, I plan to focus on compiling all my notes and videos from the previous two weeks at the shelter. This will help me organize the information I’ve gathered and prepare for my upcoming assignments.

I intend to start creating my Padlet, which will serve as a visual representation of my experiences and learnings. This platform will allow me to showcase the various aspects of my time at the shelter, including photos, videos, and insights from my interactions.

Additionally, I will reach out to Walter, the senior manager of the shelter, for assistance with my student evaluation form. I plan to share the form provided by the EP group and send him a digital copy of my log sheet. His feedback will be invaluable in ensuring that my evaluation accurately reflects my contributions and experiences.

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Week 3 in Kaohsiung Chang Gung Memorial Hospital

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Week 3 in Kaohsiung Chang Gung Memorial Hospital

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1. Your name, matric number, date

NAME: YONG WEI EU

MATRIC NUMBER: A196878

DATE: 27 AUGUST 2025

2. Your progress so far

Week 3 marks the final week of my elective posting at CGMH, and by this point, I have grown much more comfortable with the hospital environment and daily workflow. I feel more confident moving around the wards, interacting with patients, and communicating with the healthcare team. Compared to my first week, I have adapted well and can follow ward rounds, lectures, and case discussions with much better understanding. The cases were more complex, which encouraged me to think critically and ask more relevant questions. I also had more meaningful interactions with my supervisors and fellow students, which helped me broaden my perspective on clinical reasoning and teamwork.

Day 1

The day started with a busy schedule. In the morning, I attended a morning meeting discussing the management of upper gastrointestinal bleeding, where I learned more about the general approach and the role of endoscopy in both diagnosis and treatment. Later, I joined the HPB clinic, where I was assigned to clerk a patient presenting with right upper quadrant pain together with my batchmate, Joshua. In the afternoon, my rheumatologist supervisor gave a lecture on gout, emphasizing the updated ACR/EULAR guidelines. The day ended with a ward round.

Day 2

The highlight of the second day was an eye-opening echocardiogram lecture, where we learned how to perform and interpret the procedure, something I had never been introduced to in depth before. Following that, I joined the ward round and encountered an unusual case, a patient displaying behavioral issues, including an episode where she attempted to ingest her own feces. The nurses managed to stop her in time, and the case was referred to psychiatry for further evaluation, as dementia was suspected. This interaction highlighted the importance of social and family support in patient care, something my supervisor explained in detail.

Day 3

The morning began with a case discussion on a cancer-related deep vein thrombosis (DVT) complicated by subarachnoid hemorrhage. Before this, I had always perceived DVT as a relatively minor condition, but this case broadened my understanding of its severity and complications. Later, I clerked another intriguing case involving a patient with pitting edema extending up to the thigh. After ruling out cardiovascular, urinary, and hepatic causes, my supervisor suggested that it might be related to a Baker’s cyst, which took me by surprise and encouraged me to think more critically about differential diagnoses.

Day 4

Thursday began with a morbidity and mortality conference focused on a case involving a kidney transplant in a patient with hepatitis B. During the ward round, I encountered my first patient with classical signs of rheumatoid arthritis, such as boutonnière deformity, swan-neck deformity, ulnar deviation, and the piano-key sign. It was exciting to see these textbook findings in real life. Later, we observed my supervisor communicating with the family of an 87-year-old bedridden patient with end-stage heart failure.

Day 5

On the final day of my elective posting, I joined a session where medical students presented a topic on osteoporosis to my supervisor and other seniors. Afterward, my supervisor generously treated all of us to an expensive lunch to celebrate the end of our posting. We took photos together with him and the PGY doctors, marking the end of a memorable journey. Finally, I received my certificate of completion for the observership, marking the end of my elective experience at CGMH.

3. Your feelings and thoughts

This week, I felt much more confident and comfortable in the clinical setting compared to the first two weeks. I was able to approach patients and talk to the healthcare team without feeling as nervous as before. During ward rounds and discussions, I found it easier to follow the conversations and even asked questions or shared my thoughts when I could. One moment that stood out to me was watching my supervisor talk to the son of a patient whose condition was getting worse. He explained the situation gently but clearly, helping the son understand and prepare for what might happen. This reminded me of the Professional and Personal Advancement (PPA) values from our UKM curriculum. It showed me how important social and family support is in patient care, and that being a good doctor is not just about treating diseases but also about showing care and empathy to patients and their families.

I also felt proud of how much I have grown during this posting. By this week, I could follow complex case discussions better and even contribute during academic sessions. It made me realize how much I had learned in just three weeks. Overall, this final week made me feel fulfilled and thankful for the opportunity to learn and grow in such a supportive clinical environment.

4. How did you learn and apply the skill of decision making in your EP journey?

During my elective posting, I learned and applied the skill of decision-making through close observation and active participation in the clinical setting. In the first week, I mainly focused on observing how my supervisors approached each case, from gathering patient history to interpreting investigations and planning management. As I became more familiar with the workflow, I started to think critically about each patient’s situation, asking myself what the next best step would be before my supervisor explained it. This helped me understand the reasoning behind their decisions and how every choice is made with the patient’s overall condition and needs in mind.

By the second and third weeks, I became more confident in sharing my thoughts during ward rounds and discussions. For example, when reviewing ECGs or lab results, I tried to suggest possible interpretations or management plans, even if they were basic. My supervisors would then give feedback, helping me see where I was right and where I needed improvement. These experiences taught me that good decision-making in medicine requires gathering accurate information, considering different options, and always keeping the patient’s best interest at the center.

5. How did you manage your time throughout this EP journey?

During my elective posting, I gradually learned how to manage my time better so I could balance clinical activities, self-study, and rest. In the first week, it was a bit overwhelming as I was still adjusting to the hospital schedule and the fast pace of the wards. I often felt drained after long ward rounds and discussions, which left me with little energy to review cases at night. By the second week, I started to get the hang of it. I planned my days more carefully by setting aside time to revise topics discussed during the day and to prepare questions for the next session. This made me feel more organized and ready for what was coming each day.

By the third week, I felt much more in control of my routine. I learned to prioritize tasks, like completing case notes or reviewing patient histories during quieter moments in the ward, which gave me more free time in the evenings. This experience taught me that good time management isn’t about pushing myself harder but about being smarter with my time, planning ahead, making use of every small opportunity to learn, and keeping a healthy balance between work and rest so I could stay focused and make the most out of this posting.

6. Your plan for next week (Week 4)

As I return to Malaysia at the end of my elective posting, my plan for the week is to take some time to rest and recover from the busy three weeks in Taiwan. I also want to reflect on my overall experience during this journey and think about the skills and lessons I’ve gained.

I will start working on the remaining tasks for this posting, such as completing my reflective writing and shooting the video required for the report. Besides that, I plan to organize the notes, learning materials, and photos I collected during the posting so I can keep everything neat and ready for future reference.

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Week 3: Internal Medicine in Linkou Chang Gung Memorial Hospital, Taiwan

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Week 3: Internal Medicine in Linkou Chang Gung Memorial Hospital, Taiwan

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1. Your name, matric number and date

Name: Marcus Chin Yi Khai

Matric number: A196073

Date: 25/8/2025

2. Your progress so far

As I enter Week 4 of the elective posting, I noticed that the schedule continues to follow a similar structure as in Week 1 and Week 2, with morning meetings, patient reviews, ward rounds, journal readings, and clinic teachings forming the core of the daily activities. However, what makes this week distinct is that I was given more opportunities to take patient histories and perform physical examinations. This allowed me to not only strengthen my clinical skills but also build more confidence in approaching patients directly.

Week 3 also marks the final week of my elective posting, and it has been a truly meaningful conclusion to this valuable experience. One of the most memorable highlights was being invited to a dinner gathering with my supervisor, Prof. Chen, together with the doctors and fellows from the geriatric department. It was a wonderful opportunity to bond outside of the hospital setting, and during the gathering, we exchanged thoughts about the cultural differences in the practice of medicine between the two countries. These conversations broadened my perspective, giving me a deeper appreciation of how medical practice is influenced by culture and healthcare systems.

In addition, we also had a thoughtful discussion about the importance of quality of life in palliative care. This reminded me that medicine is not only about treating diseases but also about caring for patients as human beings, especially in their final stages of life. It reinforced the idea that compassion and holistic care are equally as important as medical knowledge and technical skills.

Another meaningful moment was when my supervisor offered me personal advice. He encouraged me to view “being a doctor” not merely as a job, but as a lifelong career and calling. He also reminded me to always remain hungry and curious when it comes to medical knowledge—to continuously ask questions and to never stop learning. This advice left a strong impression on me, and I believe it will guide me throughout my future journey in medicine.

Clinically, I also had the valuable experience of examining a patient with pleural effusion. Under guidance, I learned the proper techniques of conducting a detailed respiratory examination, which was an excellent learning opportunity to apply textbook knowledge into real-life practice. This hands-on experience has deepened my understanding of clinical signs and how to approach respiratory cases systematically.

Overall, Week 3 has been a fulfilling and enriching conclusion to my elective posting. I am grateful for the experiences, the mentorship, and the friendships I have gained here in Taiwan. This journey has not only enhanced my clinical skills but also shaped my mindset on what it truly means to be a doctor.

3. Your feelings and thoughts

Looking back at my final week of the elective posting, I feel both grateful and inspired. Grateful because I had the opportunity to be exposed to different aspects of clinical work, from history taking and physical examination to discussions on broader issues such as palliative care and cultural differences in medicine. Inspired because this experience has reminded me why I chose to pursue medicine in the first place—it is not only about gaining knowledge, but also about understanding people and caring for them with compassion.

I also feel a sense of growth compared to when I first started. Initially, I was more hesitant to approach patients, but this week I gained more confidence in interacting with them and applying my clinical skills. The advice from my supervisor to treat medicine as a career and not just a job resonated strongly with me, and it gave me motivation to approach my future studies with curiosity, humility, and passion.

Overall, I feel that this elective posting has been a valuable and eye-opening journey. It not only sharpened my clinical skills but also broadened my outlook on the human side of medicine.

4. How did you learn and apply the skill of decision making in your EP journey?

During my elective posting, I realized that decision-making is not only about choosing the right clinical action, but also about carefully balancing patient needs, medical knowledge, and available resources. I learned this skill gradually through observing my supervisor and the doctors during ward rounds and patient reviews. They would explain their reasoning step by step—why they ordered certain investigations, how they prioritized management, and how they considered the patient’s overall condition and quality of life.

I applied this learning when I was given the chance to take histories and perform physical examinations. For example, while assessing a patient with pleural effusion, I had to decide which clinical findings to focus on and how to present them in a structured way to my supervisor. This taught me the importance of gathering relevant information, filtering out less important details, and making clear clinical judgments.

Most importantly, I also learned that good decision-making in medicine is not done alone—it involves teamwork, discussion, and being open to feedback. This experience helped me build confidence in my clinical reasoning and showed me the importance of being both systematic and thoughtful when making decisions.

5. How did you manage your time throughout this EP journey?

Throughout my elective posting, I managed my time by setting small, clear goals each day and aligning them with the department’s schedule. Since the daily routine included morning meetings, ward rounds, patient reviews, and clinic sessions, I made sure to be punctual and fully engaged during these activities. Outside of clinical hours, I spent time reviewing cases I had seen, reading up on related topics, and preparing questions to clarify with my supervisor the next day.

I also tried to balance academic learning with personal reflection. For example, after patient interactions or discussions with doctors, I would take a few minutes to write down what I learned and how I could apply it in the future. This helped me consolidate my knowledge and use my time more productively.

By planning ahead and staying disciplined, I was able to make the most of each day, while still leaving space to rest and appreciate the cultural experiences in Taiwan. Overall, time management played a big role in helping me maximize the value of this journey.

6. Your plan for next week ( week 4 )

Since Week 3 is my final week of the elective posting, I plan to take week 4 as a period of reflection. I want to look back at what I have learned in the past weeks—both in terms of clinical knowledge and personal growth—and identify areas where I can improve myself further. I hope to refine my clinical skills, especially in history taking and physical examination, by practicing more confidently with patients.

At the same time, I want to reflect on the advice given by my supervisor and think about how I can apply it to my long-term journey in medicine. My goal is to carry these lessons forward, so that I not only become more competent academically, but also more compassionate and thoughtful as a future doctor.

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Week 3: Plastic Surgery in Linkou Chang Gung Memorial Hospital, Taiwan 

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Week 3: Plastic Surgery in Linkou Chang Gung Memorial Hospital, Taiwan 

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1. Your name, matric number and date

Name: Briand Wong Teng Ming

Matric number: A195901

Date: 23/8/2025

2. Your progress so far

Reaching my last week in Plastic Surgery at Linkou CGMH, I can really appreciate the progress I have made. At the start of this posting, everything felt overwhelming — the microsurgeries were long and complex, the ward rounds were fast-paced, and I often struggled just to follow the discussions. I began mostly as an observer, quietly watching and trying to absorb as much as I could from the surgeons and fellows.

As the weeks went by, I became more comfortable in the operating theatre and slowly gained hands-on opportunities. I was able to assist with simple but meaningful tasks like retraction, suturing, and observing flap preparation closely. These moments, although small, gave me a sense of contribution and helped me improve my technical understanding of plastic surgery.

Beyond the operating theatre, I noticed progress in how I approached clinical reasoning. Early on, the rationale behind choosing one flap over another seemed too advanced for me to grasp. But after repeated exposure during ward rounds and discussions, I began to pick up the key considerations — such as defect size, donor site morbidity, patient comorbidities, and functional outcomes. By actively questioning myself and reflecting after rounds, I started to anticipate some of the surgeons’ decisions, which showed me that my clinical thinking was developing.

I also grew in non-technical aspects, like adapting to the long hours in surgery, managing my time between OT, clinics, and personal study, and building relationships with peers and mentors. These experiences taught me resilience and teamwork, which are just as important as technical skills. Overall, my progress has been not only about knowledge and skills, but also about becoming more confident, adaptable, and engaged in the field of plastic surgery.

3. Your feelings and thoughts
I feel grateful and inspired after this journey. Plastic surgery here is not only technically impressive but also deeply patient-centered. Seeing patients recover in the ward after complex operations gave me a strong reminder that behind every long case is a patient hoping for better function and quality of life. I also feel proud of the small progress I made, whether in learning sutures, observing flap monitoring, or simply being able to follow surgical decision-making discussions. At the same time, I realize how much more there is to learn, and this motivates me to keep improving.

4. How did you learn and apply the skill of decision making in your EP journey?
Decision-making in plastic surgery is both art and science. I learned that choosing the right treatment plan requires balancing function, aesthetics, donor site morbidity, and the patient’s long-term recovery. For example, I observed how surgeons decided between different flaps depending on defect size, patient comorbidities, and available tissue. I applied this by actively questioning myself during ward rounds and discussions: “Why this option and not another?” Over time, I was able to anticipate certain decisions and appreciate the reasoning behind them.

5. How did you manage your time throughout this EP journey?
Time management was crucial, especially since surgeries could last 8–10 hours. I learned to prepare myself mentally and physically for long days in the OR, while also balancing time for clinics, ward rounds, and self-study. Outside hospital hours, I made sure to rest and recharge, and I also joined meals with colleagues to build connections. Managing my time well helped me maximize both learning opportunities and personal well-being.

6. Your plan for next week(Week 4)

Since Week 3 marks the end of my clinical attachment in Plastic Surgery, I plan to use Week 4 as a period of reflection. This will be a chance for me to consolidate the knowledge and experiences I’ve gained over the past three weeks, and to think about how these lessons can shape me as a future doctor. I want to take time to review the cases I observed, the surgical principles I learned, and the soft skills I developed, such as teamwork and resilience. By putting these experiences into writing, I hope to carry them forward meaningfully rather than just letting them fade as memories.

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Week 3: INTERNAL MEDICINE IN KAOHSIUNG CHANG GUNG MEMORIAL HOSPITAL, TAIWAN 🇹🇼 

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Week 3: INTERNAL MEDICINE IN KAOHSIUNG CHANG GUNG MEMORIAL HOSPITAL, TAIWAN 🇹🇼 

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1. Name, Matric Number, Date

Name: Koh Joshua

Matric number: A196985

Date: 24/8/2025

2. Your progress so far

Week 3 marked a significant turning point in my observership experience. With the hospital environment now familiar, I felt more confident stepping into a more active and thoughtful role within the clinical team. I noticed a shift in my clinical maturity—engaging more meaningfully in ward rounds, case discussions, and patient care. I was particularly drawn to the complexity of internal medicine, where I encountered patients with multisystem involvement, requiring a nuanced and holistic approach.

Each day this week brought unique learning opportunities—from interpreting diagnostic imaging and physical signs to understanding the deeper implications of treatment choices. Encounters like performing an abdominal examination under supervision, attending a morbidity and mortality discussion, and engaging in clinical teaching on diuretics and renal physiology truly enriched my understanding. I also appreciated the chance to witness the real-world application of theoretical knowledge, such as during discussions on UGI bleeding, echocardiography, and gout.

Day 1 – 18/08/2025

The day began with a lecture on upper gastrointestinal (UGI) bleeding, focusing on its diagnostic investigations and management strategies. Following the lecture, I attended the Hepatopancreatobiliary (HPB) clinic, where I had the opportunity to clerk a patient who presented with right upper quadrant abdominal pain. In the afternoon, I attended another insightful lecture on uric acid and gout in rheumatology. It was particularly interesting as the lecturer shared numerous images and rare case examples in the slides, enhancing the learning experience.

Day 2 – 19/08/2025

The day started with a lecture on 2D echocardiography, including guidance on interpretation techniques. Afterward, I continued with my daily routine, which included writing patient progress notes and joining the ward rounds. During the day, my supervising physician (SV) also took time to teach me about the four classes of diuretics, as well as the anatomy and physiology of the renal tubule.

Day 3 – 20/08/2025

I began the day by attending a case-based discussion presented by a House Officer, focusing on a patient with a history of cancer who presented with bilateral lower limb swelling and tenderness lasting two weeks. Later, I had the privilege of joining bedside teaching with a highly experienced hepatobiliary specialist, Dr. Yang Zhi Hong. During the session, I was able to perform a full abdominal physical examination on a patient who exhibited a positive Murphy's sign.

Day 4 – 21/08/2025

The day commenced with a morbidity and mortality discussion led by registrars and medical officers, centered around a case involving hepatitis in a post-kidney transplant patient. The discussion highlighted how even a minor error by a healthcare worker can lead to serious consequences. This was a valuable reminder of the importance of diligence and responsibility in clinical practice. The day ended with ward rounds and writing patient progress notes.

Day 5 – 22/08/2025

My final day at Kaohsiung Chang Gung Memorial Hospital began with a teaching session by my SV, where I learned how to interpret abdominal ultrasounds. At the end of the session, my SV presented me with a certificate of appreciation for completing my three-week observership. I also took some farewell photos with my seniors and expressed my gratitude for their support and guidance throughout this enriching experience. It has truly been a memorable and valuable journey, and I hope to see them again in the future.

3. Your feeling and thoughts

In Week 3, I noticed a clear change in myself compared to Week 1 and Week 2. I felt much more comfortable with the hospital environment and more confident in participating actively during ward rounds and discussions. Instead of just observing, I found myself asking questions, contributing my thoughts, and engaging more meaningfully with the clinical team. This shift gave me a sense of growth in both confidence and clinical maturity.

One of the most impactful moments was on Day 4 during the morbidity and mortality discussion. Listening to how a small mistake by a healthcare worker could lead to serious consequences for a patient left a strong impression on me. It made me realize the weight of responsibility that comes with being part of a healthcare team and the importance of diligence, accuracy, and communication in patient care. This experience reminded me that medicine is not only about applying knowledge but also about maintaining a high standard of responsibility and vigilance.

4. How did you learn and apply the skill of decision making in your EP journey

Over the course of my three-week EP journey, I gradually learned how to approach and apply the skill of decision making in a clinical setting. In the first week, I was still adapting to the hospital environment, so most of my focus was on observing how seniors and supervisors made decisions. I paid close attention to the way they gathered information, weighed different possibilities, and explained their reasoning during ward rounds and discussions. This stage helped me understand that good decision making is always followed with very strong reasons and points to support . Besides good decision making also always grounded in careful history taking, physical examination, and correlation with investigations.

By the second week, I started to become more involved in the process. I practiced decision making in a safe learning environment by forming my own impressions before hearing the team’s plan. For instance, when writing progress notes or listening to case discussions, I tried to think through what I would do next and compare it with the actual decisions of my supervisors. This gave me the confidence to start thinking more independently, while still relying on guidance from seniors.

In the third week, I felt a clear shift in my confidence and clinical maturity. I became more active in asking questions, contributing my thoughts, and engaging in deeper discussions, especially in internal medicine cases with multisystem involvement. A key moment was the morbidity and mortality discussion on Day 4, where I learned that decision making is not just about choosing the right treatment but also about being accountable and aware of the consequences of every action. That experience reinforced the importance of diligence, teamwork, and responsibility in every step of patient care.

Overall, my decision-making skills evolved from observation in Week 1, to practice under supervision in Week 2, and finally to more confident and active participation in Week 3. This progression has made me more aware of the complexity and responsibility that come with clinical decisions, and it has motivated me to continue developing this skill as I grow in my medical journey.

5. How did you manage your time throughout this EP journey.

Time management was one of the most important skills I developed and applied throughout my EP journey. In the beginning, during Week 1, I found myself adjusting to the hospital’s workflow and the pace of ward routines. At first, it was overwhelming to balance admission clerking, progress notes, attending lectures, and still finding time to revise my knowledge. To cope with this, I started making a structured daily plan—prioritising patient-related tasks in the morning and using quieter afternoon hours or evenings for revision and self-study.

By Week 2, I became more efficient with documentation and patient clerking, which allowed me to free up more time for active participation during case discussions and conferences. I also learned to use unexpected breaks wisely—such as the typhoon day closure—by revising important topics like AKI and CKD. This helped me keep momentum even outside the hospital setting.

In Week 3, as I grew more confident and integrated into the team, my time management shifted toward balancing deeper clinical learning with reflective practice. I made it a habit to prepare questions before ward rounds or teaching sessions, so I could make the most of every learning opportunity. I also dedicated time in the evenings to consolidate new knowledge from lectures on UGI bleeding, echocardiography, or diuretics, making sure I didn’t just attend passively but reinforced my understanding afterward.

6. Plan for week 4:

I’ve finished my 3 weeks EP journey at Taiwan!! As I step into Week 4, my focus is on slowing down and truly reflecting on this entire journey. Instead of simply moving on, I want to take time to organize my notes, revisit the cases that challenged me, and think about how the lessons I’ve learned can shape the kind of doctor I aspire to become. Beyond the clinical knowledge, I hope to carry forward the values I’ve observed—diligence, humility, and responsibility—and let them guide me in future patient care. I also plan to keep in touch with the mentors and friends I’ve met here, because their support and perspectives have left a lasting impact on me. For me, Week 4 is less about adding new experiences and more about consolidating, appreciating, and translating this growth into my ongoing medical journey.

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Liver Transplantation at Chang Gung  Memorial Hospital in week 3 

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Liver Transplantation at Chang Gung  Memorial Hospital in week 3 

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1 Name :Teoh June Jern

Matirks no : A195158

Date : 22/8/2025

2. Your progress so far

In Week 3, I feel that I have made meaningful progress both in my clinical exposure and in my personal study. During my clinic rounds, I observed how doctors interact with patients and manage complex cases, which gave me a clearer picture of the responsibilities and decision-making required in medical practice. I also had the opportunity to see more about liver transplant surgery, which deepened my understanding of how intricate the procedure is, from pre-operative preparation to intraoperative steps and post-operative care. On top of that, I continued reading medical texts, especially on the Glissonean pedicle approach, which allowed me to connect theoretical anatomy with what I saw during surgery. Compared to Week 1 and Week 2, I feel my foundation is getting stronger, and I am more confident in asking questions and linking knowledge with real-life cases.

3. Your feelings and thoughts

At the start of the week, I felt a little anxious about keeping up with both clinical rounds and self-study. However, the more time I spent in the clinic, the more I realized how much I can learn just by observing and reflecting on the cases presented. Watching a liver transplant surgery was inspiring—it reminded me why I chose medicine in the first place, as it truly combines science, precision, and teamwork to save lives. Reading about the Glissonean pedicle in parallel with seeing liver surgery gave me a sense of satisfaction, because I could see the structures and steps come alive beyond the textbook pages. Overall, I feel more motivated, curious, and driven to keep learning at a deeper level.

4. How did you learn and apply the skill of decision making in your EP journey?

This week, decision-making was tested in small but important ways. For example, during clinic rounds, I had to decide how to prioritize my note-taking—whether to write down every detail or focus on the key learning points. When reading about the Glissonean pedicle, I had to choose how to allocate time between memorizing anatomical branches and applying the knowledge to surgical contexts. I learned to make decisions by balancing what was most relevant for my progress, rather than trying to do everything at once. Discussing cases with peers and observing how doctors weigh risks and benefits for patients also shaped how I thought about decision-making.

5. How did you manage your time throughout this EP journey?

Managing my time this week was a challenge because I had to balance clinical rounds, study, and self-reflection. I planned my day by dedicating mornings to clinical work, then using afternoons or evenings to revise what I had seen. For instance, after observing the liver transplant surgery, I spent time that same evening revisiting the Glissonean pedicle anatomy to consolidate the surgical steps. By matching clinical exposure with textbook reading, I saved time and reinforced my memory. I also gave myself breaks to avoid burnout, which helped me remain consistent throughout the week.

6. Your plan for next week (Week 4)

For Week 4, I plan to build on this rhythm by making my clinical observations more active—for example, asking more questions during rounds and discussing cases with my peers. I also want to review more surgical anatomy and perhaps move into reading about other aspects of hepatobiliary surgery, so I can expand my knowledge beyond the Glissonean pedicle. My aim is to keep linking what I see in real life with what I study from books. Additionally, I want to refine my time management even further, making sure I strike a good balance between clinical exposure, personal study, and self-reflection.

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Week 3 : Liver Transplant at Kaohsiung Chang Gung Memorial Hospital

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Week 3 : Liver Transplant at Kaohsiung Chang Gung Memorial Hospital

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1. Name, Matric Number, Date

Name : Yap Sin Yin

Matric number : A195900

Date : 18/8/2025 - 22/5/2025

2. Your progress so far

Compared to Week 2, I have made noticeable progress in understanding both theoretical and practical aspects of surgery. Last week, I primarily focused on observing cases and familiarizing myself with basic surgical principles. This week, I actively participated in general surgery meetings and case discussions, which allowed me to gain insight into how decisions are made collectively and how surgical principles are applied in real clinical scenarios. I learned about the RETREAT score, a tool used to predict HCC recurrence after liver transplantation by taking into account AFP levels, microvascular invasion, and tumor burden. Understanding how surgeons use this score to guide post-transplant monitoring gave me a deeper appreciation of evidence-based decision-making.

3. Your feelings and thoughts

I was particularly impacted by attending the surgeons’ reflection meeting, where previous cases were reviewed in detail. The discussion was thorough, covering not only clinical outcomes but also the thought processes behind each decision, the challenges encountered, and how complications could have been anticipated or mitigated. The atmosphere was both honest and constructive, emphasising learning and optimising patient care rather than assigning blame. I felt humbled observing senior surgeons openly acknowledge errors and share the lessons they had learned, which reinforced that reflection is a strength rather than a weakness and a vital part of continuous professional growth.

During the week, I also experienced a mild earthquake for the first time. As a Malaysian, this was completely new to me, and I felt a mix of surprise and apprehension. I am grateful for seeing how calmly the hospital team responded, ensuring patient safety and maintaining order despite the mild disruption. This experience made me reflect on the importance of preparedness, adaptability, and composure, and I feel thankful for the opportunity to witness professional teamwork in an unexpected situation.

4. How did you learn and apply the skill of decision making in your EP journey

Decision-making was reinforced this week by observing both intraoperative choices and postoperative discussions. I learned that effective decisions are based not only on knowledge, such as the use of the RETREAT score to stratify risk, but also on anticipating potential complications, preparing backup plans, and reflecting afterwards. In my EP journey, I am starting to apply this mindset by considering not only the correct procedural steps but also why each step is important and what could go wrong, which helps me develop more thoughtful and proactive clinical reasoning.

5. How did you manage your time throughout this EP journey

I managed my time by balancing ward exposure, clinic attachments, conference, and self-study, while also ensuring I had personal time for self-care and relaxation. After clinical sessions, I dedicated time to reviewing key topics such as transplant risk scores, which helped consolidate my learning. I made it a habit to document my reflections soon after meetings, ensuring that the lessons remained fresh and could be applied to future cases. At the same time, I maintained my well-being by going to the gym, playing pool, jogging, and exploring local food, which helped me stay refreshed, focused, and motivated throughout the week.

6. Your plan for Week 4

For Week 4, I plan to spend more time actively participating in case discussions and asking questions to clarify decision-making processes. I want to deepen my understanding of surgical anatomy, particularly the vascular structures relevant to transplantation, and observe more intraoperative decision-making to understand why certain choices are made. I will continue reflecting weekly to track my growth, identify areas for improvement, and ensure that I am learning not only the technical steps but also the reasoning and adaptability that make a competent surgeon

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WEEK 3: Plastic Surgery in Linkou Chang Gung Memorial Hospital, Taiwan

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WEEK 3: 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: 28/07/2025 – 01/08/2025

2. Your progress so far

It was the third week of my elective posting. I continued to attend the weekly case discussions and conferences, followed the morning ward rounds, and observed cases in the OT and during clinic attachments.

In the OT, I observed a scalp tumour removal and reconstruction surgery. I also finally had the chance to see a real-life negative pressure therapy machine in use. Back in UKM, I had only heard about it during my surgical posting, but since it was considered expensive, doctors often resorted to DIY alternatives, and I never had the opportunity to see the actual machine being used. Witnessing it in real life here was a valuable experience. I also went to observe a transgender surgery again, this time alongside my Japanese teammates who had just arrived. With the microsurgery team, I observed more free flap transfer surgeries and learnt a lot from the process.

This week was especially memorable because my supervisor gave me the opportunity to scrub in. I assisted in surgery and had my first hands-on experience using the skin mesher for a skin graft. It was an exciting and enriching moment.

Since it was the final week of my elective posting, there was a sense of closure and gratitude. Dr Huang kindly treated us to coffee and croissants, which made our last few days feel warm and memorable. I also took pictures with my team members, including Dr Huang, a Japanese exchange student, a local medical student, and a postgraduate colleague. I managed to take photos with Professor Lin Cheng Hung and Dr Steven from Singapore as well. Meeting Professor Lin left a deep impression on me—he is a very wise professor with a strong reputation, and I could see the positive impact of his work through the way patients specifically sought him out in clinic, either to thank him or to ask for his help. His contributions demonstrated how meaningful a doctor’s legacy could be.

Before leaving, I prepared a small gift for Dr Gao from the General Surgery Department to thank him for his kindness in showing me around and sharing valuable, eye-opening insights that I will continue to reflect on as I move forward in my medical journey.

Beyond the hospital, there were personal moments of farewell too. I said goodbye to one of my roommates from France, who was finishing her posting earlier than me. Living together had given us chances to share cultural perspectives and daily conversations, and parting ways was bittersweet—it reminded me how quickly bonds can form and how exchanges like these enrich the overall experience of an elective posting.

3. Your feelings and thoughts

This final week was a blend of gratitude, excitement, and bittersweet emotions. I felt grateful for the invaluable opportunities I was given — from being able to observe advanced procedures such as microsurgeries and transgender surgeries, to finally being trusted to scrub in and handle instruments myself. It boosted my confidence and reassured me of my passion for surgery.

At the same time, I felt touched by the kindness of the doctors and teammates I met. Small gestures, such as Dr. Huang treating us to coffee or Dr. Gao sharing his wisdom, left a deep impression on me. Saying goodbye to my French roommate also added to the sense of closure, as I realized how much these temporary yet genuine connections enriched my elective experience.

4. How did you learn and apply the skill of decision making in your EP journey?

Decision-making during this posting came in both clinical and personal forms. Clinically, I observed how surgeons made careful, stepwise decisions under pressure in the operating theatre, balancing risks and patient outcomes. For example, in reconstructive surgeries, the decision of which flap to use was not only a technical matter but also a judgment of what would give the best long-term function for the patient.

On a personal level, I had to make decisions about how to spend my limited time during the elective. With so many clinics, OTs, and team attachments happening simultaneously, I learned to prioritize which opportunities would benefit me most. Sometimes this meant stepping out of my comfort zone to join a new team or approach a professor. This taught me the importance of being proactive, adaptable, and open to learning from every chance available.

5. How did you manage your time throughout this EP journey?

Time management was a challenge at the beginning, especially without direct supervision in the first week. It felt unfamiliar as I was unsure where to go or what was expected of me. However, I gradually learned to organize my schedule more effectively by being more proactive, reaching out to teammates, asking around, and checking the daily ward round and OT schedules.

By the later weeks, I had established a rhythm where I divided my time between ward rounds, clinics, OTs, and conferences. I also learned the importance of balancing academic commitments with rest and bonding moments, such as dinners or casual chats with fellow exchange students. This balance allowed me to stay productive without burning out, and it made the overall journey more meaningful.

6. Your plan for next week (Week 4)

Since this was my final week, my plan for Week 4 is to reflect on all that I have learned from this elective posting. I aim to consolidate my notes, review the cases and procedures I observed, and integrate the lessons into my future clinical practice. I also hope to maintain connections with the friends and doctors I met here, as their influence and guidance will continue to inspire me in my medical journey.