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WEEK 4: Reflection on elective posting in Linkou Chang Gung Memorial Hospital

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WEEK 4: Reflection on elective posting in Linkou Chang Gung Memorial Hospital

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Name: Michelle Teng Qian Ying

Matric number: A195548

Date: 02/08/2025 - 09/08/2025

1. Were the objectives of the project fulfilled?
Looking back at my elective posting, I feel that I achieved most of my learning objectives, and some even surpassed my initial expectations.

Hands-on surgical exposure: I had the chance to observe and participate in a wide range of surgeries—from routine wound debridement and skin grafts to complex microsurgeries and transgender surgeries. Scrubbing in, and even using instruments like the skin mesher for the first time, gave me direct involvement in patient care and greatly enhanced my confidence in the operating theatre.

Observation of advanced techniques: Witnessing procedures such as free flap transfers, MSAP flaps, and chimeric flaps helped me understand not just the steps, but the reasoning behind flap selection and surgical planning. Seeing these techniques applied in real time allowed me to grasp the precision and strategy involved in advanced reconstructive surgery.

Clinical reasoning and decision-making: Observing how surgeons carefully weigh risks, anticipate complications, and make intraoperative decisions deepened my understanding of clinical reasoning. It also showed me how theoretical knowledge is applied under real clinical pressures.

Integration of theory with practice: Attending weekly case discussions, hospital-wide conferences, and postgraduate teaching sessions allowed me to connect textbook knowledge with practical application. For instance, understanding burn management principles or flap anatomy became much clearer after seeing them in actual patients.

Personal development and adaptability: Navigating a busy hospital with unexpected reassignments and unfamiliar procedures taught me to be proactive, independent, and flexible. I learned to communicate effectively with different teams and identify opportunities to learn.

Inspiration and motivation: Observing the dedication and skill of senior surgeons, as well as the lasting impact of their work on patients’ lives, inspired me to reflect on my own future as a doctor and the level of excellence I want to achieve.

2. What have you enjoyed or liked the most about the project?
During my elective posting, there were several aspects that I truly enjoyed and found immensely rewarding:

Hands-on surgical experience: One of the most exciting parts was finally being allowed to scrub in and participate in surgeries, such as using the skin mesher during a split-thickness skin graft. Feeling the texture of the tissue, handling instruments, and assisting under supervision gave me a tangible sense of my role in patient care and boosted my confidence in surgical settings.

Observing complex procedures: I found watching intricate surgeries, such as microsurgical free flap transfers, transgender surgeries, and reconstructive procedures, particularly fascinating. Seeing how multiple surgical steps come together to restore function and aesthetics made me appreciate the artistry and precision required in surgery.

Learning from experienced professors: Spending time with Professor Lin, Professor Huang, and other senior surgeons was incredibly inspiring. Their ability to explain complex concepts clearly, offer practical tips, and share their clinical reasoning in real-time enhanced my learning far beyond textbooks. I particularly valued how they patiently answered my questions and encouraged me to think critically.

Case discussions and conferences: I really enjoyed attending hospital-wide conferences and weekly case discussions. These sessions allowed me to see evidence-based medicine in action, hear different viewpoints, and understand how surgical decisions are debated and justified. It was stimulating to be part of an academic environment that encourages questioning and reflection.

Seeing patient outcomes: Witnessing patients’ transformations, especially long-term outcomes like the tibial flap case or the post-gender-affirming surgeries, was profoundly satisfying. Seeing the real impact of surgical care on patients’ lives gave me a strong sense of purpose and motivation to pursue excellence.

Personal growth and confidence: Every day offered moments that challenged me but also allowed me to grow. I enjoyed discovering that I could take initiative, ask thoughtful questions, and navigate a new clinical setting independently, which gave me a sense of accomplishment and reinforced my passion for medicine.

3. What have you found challenging about this project?
During my elective posting, I faced several challenges that pushed me beyond my comfort zone and taught me important lessons:

Complex surgical procedures: Some surgeries, especially microsurgeries and transgender surgeries, involved highly intricate techniques. Understanding the stepwise approach, flap planning, and vascular anastomosis was initially overwhelming. I had to focus intensely, take detailed notes, and review relevant anatomy and surgical principles afterwards to consolidate my understanding.

Time management with overlapping opportunities: There were multiple concurrent activities—ward rounds, clinics, OT sessions, case discussions, and conferences. Deciding which sessions to attend while maximizing learning without overexerting myself required careful planning and prioritization.

Integrating theoretical knowledge in real-time: Some cases involved advanced concepts that I had only read about in textbooks, such as flap physiology, complex burn management, or reconstructive options for rare conditions. Applying this knowledge in the clinical setting was challenging, but gradually, repeated exposure and discussions with supervisors helped me bridge theory and practice.

Emotional resilience: Witnessing patients with severe injuries, complex reconstructive needs, or life-changing procedures sometimes triggered empathy and emotional reflection. Managing my emotions while maintaining professionalism was a subtle but important challenge.

4. What has really worked?
Reflecting on my elective posting, several aspects of the project truly worked well and contributed significantly to my learning and growth:

Proactive engagement: Approaching different teams, asking to observe surgeries, and participating in discussions opened doors to opportunities that I might not have encountered otherwise.

Structured observation and note-taking: Recording observations, techniques, and insights during surgeries, clinics, and case discussions allowed me to consolidate and revisit learning efficiently.

Prioritizing learning goals: Planning daily sessions based on specific objectives helped me focus on high-yield areas such as microsurgery, reconstructive techniques, and wound care.

Reflective practice: Daily reflection on what I observed, learned, and how to apply it reinforced understanding and helped identify areas for improvement.

Seeking feedback: Asking supervisors and peers for clarifications or tips after procedures helped deepen my understanding and improved my performance.

Connecting with teams: Building rapport with professors, postgraduates, and peers helped me integrate better into the hospital environment, increasing my access to meaningful learning experiences.

5. What can be improved in this project?
Reflecting on my elective posting, there are a few areas I feel could be improved, both in terms of structure and personal approach:

Clearer initial supervision: During the first week, I felt uncertain and a bit lost due to not having a clearly assigned supervisor initially. While I adapted quickly, having a more structured orientation or clear point of contact from day one would have made the transition smoother and reduced early anxiety.

Hands-on practice opportunities: While I was grateful for the chance to scrub in during later weeks, having more opportunities for supervised hands-on experiences would have strengthened my confidence sooner. Small, incremental responsibilities in procedures could have accelerated my practical learning.

Pre-reading or case briefings: Some procedures were complex, and at times I struggled to follow all steps in real time. Having brief case summaries or suggested pre-reading material before surgeries could enhance understanding and engagement during observation.

Interdisciplinary exposure: I appreciated my exposure to plastic and general surgery, but incorporating short rotations or observation opportunities in related disciplines, such as anesthesiology or nursing-led wound care, could provide a more holistic view of patient management.

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Week 4: Wrapping Up My Working Holiday Journey in Taiwan

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Week 4: Wrapping Up My Working Holiday Journey in Taiwan

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Name: Quek Chew Geok

Matrics number: A196228

Date: 10/8/2025 - 16/10/2025

1. Were the objectives of the project fulfilled?

My objectives

i. To gain exposure to an area outside conventional medical field

ii. To challenge myself physically and mentally through learning scuba diving.

iii. To broaden my cultural perspectives by immersing myself in an international environment

Yes, all three objectives of the project were successfully fulfilled.

Firstly, I gained meaningful exposure to an area beyond the conventional medical field by immersing myself in scuba diving, marine safety and environmental awareness. These are areas that I rarely encounter in my medical studies.

Secondly, I challenged myself both physically and mentally through the PADI Open Water Diver Course and various island-based activities. I pushed past my fears, adapted to unfamiliar conditions and learned to stay calm under pressure and even underwater problems.

Lastly, living and working on Green Island allowed me to broaden my cultural perspectives. I interacted with people from Taiwan and other countries, learned about local customs, and experienced daily life in a unique international environment.

Overall, the elective gave me valuable personal growth and a wider worldview.

2. What have you enjoyed or liked the most about the project?

What I enjoyed most was the opportunity to explore the ocean and experience the underwater world up close. Completing my dives, observing corals and marine life, and gaining confidence in open water were truly unforgettable moments. I also enjoyed the supportive environment at Good’s Dive through interacting with instructors, coworkers and travellers made each day lively and meaningful. The balance of learning, discovering nature, and forming friendships made this elective particularly enjoyable.

3. What have you found challenging about this project? (any part of the project you found hard to do)

Throughout this project, I faced several challenges that tested me physically, mentally, and emotionally.

Learning scuba diving was far more demanding than I initially expected. Mastering buoyancy control, staying balanced underwater and maintaining proper breathing patterns required intense concentration. Clearing the mask underwater and performing regulator recovery were especially challenging to me at first as I wore contact lenses. I panicked a few times when water entered my mask and it took effort to remain calm. The weight of the diving equipment, long hours of practice, and swimming against currents in open water also pushed my physical limits.

ransitioning from the controlled environment of the swimming pool to the open ocean was intimidating. The deeper water, unpredictable waves and limited visibility made me feel anxious. I had to constantly manage my thoughts and emotions to prevent panic. Learning to trust the equipment, the instructor, and myself took time. This capability of staying calm despite fear was one of the biggest challenges of the project.

Lastly, being alone in foreign country was extra difficult. Managing my own schedule, making decisions and solving problems alone in another country was challenging. From logistical planning to handling unexpected situations, I had to be responsible and proactive. This required a lot of personal discipline and adaptability.

Despite these challenges, overcoming each of them made the experience incredibly rewarding. Every difficulty helped me grow into more physically stronger, mentally tougher, and emotionally more resilient.

4. What has really worked? (any part in the project that you thought worked well)

Several things worked well throughout the project.

The structured PADI training, combined with consistent guidance from my instructor, made learning efficient and effective. My prior preparation including studying the theory, reading safety guidelines and mentally preparing myself also helped me progress faster during the practical sessions.

Additionally, the open and supportive atmosphere at Good’s Dive played an important role. Having approachable instructors and helpful coworkers made the learning process smoother and more enjoyable.

These factors contributed to a successful and fulfilling experience.

5. What can be improved in this project

Looking back at my experience, there are a few aspects that I feel I could improve to make future projects or similar opportunities even more meaningful and efficient for myself.

Although I managed to complete the PADI course, I realised that having a stronger stamina would have helped me feel more confident from the beginning of diving course. Strengthening my stamina and practising swimming techniques earlier would have made the transition to open water smoother and less tiring.

Moreover, I sometimes hesitated to ask questions or clarify instructions due to the language barrier or fear of troubling the instructor. In the future, I want to be more proactive in communicating especially in situations related to safety. Asking early and clearly can reduce misunderstandings and help me learn faster.

Lastly, the first few days were emotionally challenging due to loneliness, unfamiliar surroundings, and cultural differences. If I had mentally prepared myself better by setting realistic expectations, planning coping strategies or reminding myself that adaptation takes time, I think I could adapt faster.

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Week 4: Reflection on elective posting in Kaohsiung Chang Gung Memorial Hospital

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Week 4: Reflection on elective posting in Kaohsiung Chang Gung Memorial Hospital

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Name: Goh Kai Xin

Matric number: A196314

Date: 29/08/2025

1. Were the objectives of the project fulfilled?

Yes, the objectives of my elective posting were fulfilled. I was able to enhance my clinical knowledge and observational skills by participating in ward rounds, outpatient clinics and observing major procedures such as living donor liver transplantation, laparoscopic cholecystectomy, and right posterior sectionectomy. I also developed teamwork and communication skills through daily interactions with surgeons, residents, nurses and other staff, while gaining valuable insights into Taiwan’s healthcare system, which I could compare with my own practices in Malaysia

2. What have you enjoyed or liked the most about the project?

I enjoyed the opportunity to observe hepatobiliary surgeries and see textbook knowledge come to life in the operating theatre. Being able to follow the patient journey – from consultation to surgery to postoperative care – was extremely rewarding. I also appreciated the multidisciplinary meetings, where I witnessed how different specialties collaborated to decide the best treatment plans for patients. The supportive and welcoming attitude of the surgical team made the experience even more enjoyable.

3. What have you found challenging about this project?

The greatest challenge was the language barrier. Although I understand mandarin, the use of Taiwanese dialect and regional slang, especially during the patient-doctor conversations, sometimes made it difficult to fully grasp every detail. To overcome this, I relied on contextual understanding, careful observation of non-verbal communication, and clarification from the teams. This experience taught me the importance of adaptability and the role of empathy in bridging communication gaps.

4. What has really worked?

What worked well was taking a proactive approach to learning. By asking questions, seeking clarification, and showing initiative to observe specific procedures, I maximized my exposure and learning during the short posting at Kaohsiung Chang Gung Memorial Hospital. This helped me gain a deeper understanding of hepatobiliary surgery and built stronger connections with the surgical team. The hospital’s structured system of teamwork and patient-centered care also worked seamlessly, providing a model of efficiency and compassion that I greatly admired.

5. What can be improved in this project?

For me personally, I think the experience could be even better if I could have been more active in preparing focused questions before ward rounds and reading up more thoroughly on cases I was about to encounter. This would have allowed me to engage in discussions with greater confidence. I also noticed that I sometimes hesitated during patient interactions because of the language barrier.  While I could manage mandarin well, some patients preferred speaking in Taiwanese, which I wasn’t as familiar with. This occasionally made me less confident in joining the conversations. If I had prepared some basic phrases or familiarized myself with common medical terms in Taiwanese beforehand, I could have engaged more actively and built stronger rapport with the patients.

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Week 4 in General Surgery of Linkou Chang Gung Memorial Hospital

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Week 4 in General Surgery of Linkou Chang Gung Memorial Hospital

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1. Were the objectives of the project fulfilled?

Yes, the objectives of my elective posting were successfully fulfilled. I was able to learn about the healthcare system in Taiwan, observe the workflow in a specialized surgical department, and gain exposure to a wide range of clinical practices. I also had the opportunity to interact with patients, doctors, and medical staff, which enriched my understanding of both the technical and interpersonal aspects of healthcare delivery.

2. What have you enjoyed or liked the most about the project?

What I enjoyed the most was the chance to observe surgeries and clinical practices. I also appreciated the openness of the doctors and healthcare team, who were always willing to share their knowledge and explain procedures. Experiencing the cultural aspects of healthcare in Taiwan, including patient–doctor communication and teamwork, was also very meaningful for me.

3. What have you found challenging about this project? (any part of the project you found hard to do)

One of the challenges I faced was adapting to the language barrier, as Mandarin was spoken with a heavy Taiwanese accent. Although many doctors were kind enough to explain in English, there were moments where I struggled to fully follow conversations or patient interactions. Another challenge was adjusting to the fast-paced clinical environment, which initially felt overwhelming but ultimately pushed me to learn more actively.

4. What has really worked? (any part in the project that you thought worked well)

The structured schedule of the elective posting that I created for myself worked very well. It gave me a clear idea of what to expect each day while still allowing flexibility to explore areas of personal interest. The guidance from supervisors and the willingness of the medical team to involve us in teaching also worked effectively in making the learning experience smooth and impactful.

5. What can be improved in this project?

On a personal level, I believe I could have improved my own participation by being more proactive in asking questions and engaging with the medical team. At times, I held back due to language barriers or shyness, and this limited how much I could contribute to discussions. If I were to do this again, I would prepare more thoroughly before each session, such as by reading up on cases or surgical procedures, so that I could follow along more confidently and make the most of the opportunities given.

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Pink and Blue Watercolor Background Poster (4)

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WEEK 4: Volunteering at PAWS UNITED CHARITY Cat Shelter in Hong Kong

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WEEK 4: Volunteering at PAWS UNITED CHARITY Cat Shelter in Hong Kong

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Name: Ashba Khan

Matric number: A192231

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

1. Were the objectives of the project fulfilled?

Looking back at my four weeks PUC, I do believe the objectives of my project were fulfilled, though the outcomes went beyond what I originally expected. At the beginning, I set very practical aims, to improve my time management, to challenge myself to maintain consistency with a demanding routine, and to gain hands-on exposure to animal welfare work. These goals seemed straightforward on paper, but the reality of achieving them required persistence and daily commitment.

For time management, I can confidently say I achieved growth. Managing a two-hour commute, being punctual for morning shifts, and still balancing my household responsibilities at home forced me to think ahead in a way I hadn’t before. I relied on structured planning tools like Google Calendar, but also learned to be flexible when unexpected things happened, such as transport delays or sudden shelter needs.

In terms of animal care, I gained more practical knowledge than I initially imagined. Beyond cleaning tasks, I learned to adapt to the different personalities and health needs of the cats. Some required patience and quiet reassurance, while others needed energetic play to release their restlessness. Over time, I became more confident in understanding these differences and tailoring my approach.

Finally, an objective I hadn’t anticipated was the emotional resilience I developed. At the start, I worried I might not meet expectations, but by the end, I had learned that consistency and sincerity mattered more than perfection. This was perhaps the most fulfilling outcome of all.

2. What have you enjoyed or liked the most about the project?

What I enjoyed most wasn’t a single task or event, but the way small, everyday moments built into a sense of belonging at the shelter. By the final week, I felt less like a “visitor” and more like part of the routine. I could sense the cats recognizing me, responding with familiarity when I entered the room, which was rewarding in a quiet but powerful way.

I particularly enjoyed observing the subtle changes in the cats over time. Cats that were once shy began edging closer, and some who had been restless grew calmer once they became familiar with the routine. It reminded me that progress in animal welfare is rarely dramatic, it’s often made up of tiny shifts that only become visible if you are consistent and observant.

I also enjoyed the interactions with the team, which gave me a sense of community. Conversations with duty managers about their own experiences in animal rescue helped me understand the bigger picture, the challenges of rehoming, the importance of managing resources, and the value of volunteer support. These exchanges enriched the experience beyond just the tasks at hand.

Most of all, I liked how this posting allowed me to connect with my values. It wasn’t just about cleaning or playing with cats, it was about contributing to something meaningful and learning to find joy in small acts of service.

3. What have you found challenging about this project?

The project was not without challenges, and in hindsight, these were the moments that stretched me the most. The most obvious challenge was physical exhaustion. The combination of a two-hour commute, physically demanding shifts, and household responsibilities often left me drained. Some mornings I questioned whether I had the energy to repeat the cycle, but I pushed through by structuring my day, eating properly, and giving myself breaks when possible. Over time, I noticed my stamina improving, which was encouraging.

The most difficult challenge, however, was emotional fatigue. I grew attached to certain cats, and it was emotionally draining to see them struggle with health issues or prolonged stays. Saying goodbye to cats who were adopted was bittersweet, I was happy for them but also sad to let go. It took effort to remind myself that my role was to prepare them for their next chapter, not to hold on.

4. What has really worked?

What worked best for me was learning how to shift from a scattered way of working to a structured system. In my early days, I would jump from one chore to another, starting to clean a litter box, then halfway through grabbing supplies to wipe a cage, then trying to mop while things were still unfinished. This made the shelter crowded with tools everywhere and created confusion for both me and the cats. Over time, I created a more logical flow, starting in the cat room, moving to the outside area, cleaning non-diseased cats before those in isolation, and always following the same sequence, litter trays first, then cages, then a final sweep and mop. Once I put this structure in place, the work became faster, cleaner, and far less stressful for everyone.

Another thing that worked well was preparing everything before I started. Instead of stopping mid-task to fetch gloves, sprays, or cloths, I began laying out all the supplies I needed at the start of each shift. This simple change prevented delays and gave me a clear “path” to follow, so I could focus on the animals rather than scrambling for equipment.

Finally, utilising my commuting routine also made a big difference, 2 hours going and coming back meant wasting 4 hours of my day. I started using it to journal or write my diary for the day of the way back, to ensure I fully remember my learning points and note them down on a timely manner. I also used it to stay in touch with my family, especially my grandmother, I made sure to bring along my earbuds, so I can call her on the way without speaking too loudly and disturbing other passengers. I also used this time to start my EP tasks like my padlet posts, I started writing drafts on my laptop, using the notes I made everyday. This allowed me to save time for myself once I reach home, whioch greatly improved my mental health as I could relax in peace without feeling gulity due to pending tasks.

5. What can be improved in this project?

One clear area for improvement is how I handled the arrival of new cats at the shelter. Often, when foster returns or rescues came in, I had to stop whatever task I was doing to shift them into their new cages. This left some cats temporarily outside or confined in carriers while cleaning supplies were still scattered around, litter boxes untouched, and routines left incomplete. At times, a cat might step into a dirty box before it had been sanitized, undoing the progress I was making. Looking back, I realize I could have avoided this by always keeping at least two cages prepared in advance. That way, unexpected arrivals could be managed smoothly without disrupting the flow of cleaning or compromising the cats’ comfort.

Another area that could be improved is my confidence in engaging with the medical aspects of shelter care. I often observed the managers giving oral medication or tending to cats with more complex needs, but I hesitated to ask if I could participatein fear of rejection. While I did manage basic tasks like applying creams, I now see that I could have learned far more by taking the initiative to shadow those moments closely or ask questions on the spot. This is something I’d like to change, by stepping forward rather than waiting to be invited in.

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Week 4: Reflection in Linkou Chang Gung Memorial Hospital, Taiwan

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Week 4: Reflection in Linkou Chang Gung Memorial Hospital, Taiwan

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Name: Grace Liew Min Zi

Matric number: A195123

Date: 1/8/25

1. Were the objectives of the project fulfilled?

Yes, I believe the objectives of this elective posting were fully achieved, and even exceeded my expectations. Coming into CGMH, I hoped to broaden my exposure to pediatrics subspecialties, observe different approaches to patient care, and strengthen my clinical reasoning. Over these three weeks, I rotated through allergy & rheumatology, gastroenterology, and hematology, each of which offered unique perspectives and learning opportunities. I gained exposure to both common pediatric complaints—such as diarrhea, asthma, and atopic dermatitis—and more complex conditions like intussusception, Kawasaki disease, and childhood leukemias. Beyond knowledge, I also learned to appreciate the holistic and family-centered care that pediatrics requires. Watching how doctors reassured parents, communicated with children, and worked together as a team showed me the human side of medicine. In this sense, the elective more than fulfilled its objectives by shaping both my medical knowledge and my professional attitude.

2. What have you enjoyed or liked the most about the project?

What I enjoyed most was the openness of the doctors and staff at CGMH. Despite their busy schedules, they always took the time to teach me, explain cases, and even share personal stories. I particularly liked the morning meetings at 7:30am, where I got to learn from case discussions, EBM reviews, and journal clubs. These sessions exposed me to a culture of continuous learning and collaboration, which I found very inspiring. I also deeply enjoyed the hands-on opportunities—observing nailfold capillaroscopy, watching abdominal ultrasounds, attending scopes, and seeing blood smears under the microscope for the first time. Outside of clinical teaching, I liked how welcoming everyone was, from supervisors and PGYs to medical students. They often included me in their conversations, recommended local food and places, and made me feel at home despite being in a foreign hospital. These meaningful interactions are what I will remember the most.

3. What have you found challenging about this project?

The most challenging part was keeping up with the depth and breadth of knowledge in pediatrics subspecialties. For example, in hematology, Dr. Wang explained complex classifications of leukemia and CNS tumors at such a fast pace that I often struggled to take notes and process everything. Similarly, in gastroenterology, I had to quickly learn how to differentiate bacterial from viral colitis, or how to interpret ultrasound findings for conditions like IHPS and fatty liver. Another challenge was experiencing emotionally heavy cases, especially in hematology where I met children with relapsed medulloblastoma or families coping with poor prognoses. Witnessing their struggles was heart-wrenching and at times overwhelming. However, I realized that challenges like these are also opportunities for growth. I learned to review topics each evening, ask more questions during ward rounds, and reflect on my emotions so I could learn from them without being paralyzed by them.

4. What has really worked?

One thing that worked extremely well in this project was the structure of my elective. Being rotated into a different subspecialty each week allowed me to gain wide exposure within pediatrics in a short period of time. The combination of morning meetings, ward rounds, outpatient clinics, procedures, and academic conferences created a very balanced learning environment. For instance, in Week 1 I learned about Kawasaki disease and EBM reviews in allergy/rheumatology; in Week 2 I saw OGDS, colonoscopies, and abscess drainage in gastroenterology; and in Week 3 I attended an M&M conference and blood smear teaching in hematology. This structure ensured that I not only observed clinical care, but also engaged with academic discussions and critical thinking. Another thing that worked well was how approachable the supervisors were—they encouraged questions, gave mini-teachings during rounds, and sometimes even allowed a “chill” atmosphere with lunch or bubble tea during class. This culture of inclusiveness and support made my learning very effective.

5. What can be improved in this project?

Overall, I found the elective experience very enriching and well-organized, but one area that could be improved is perhaps having more structured teaching materials for elective students. Since the schedule was very busy and each subspecialty had so much to cover, sometimes I felt a bit lost about which topics to focus on. If there were a short guide or orientation booklet for elective students (e.g., “key conditions in pediatric allergy, gastroenterology, hematology”), it would help us prepare in advance and follow the cases more effectively. Another improvement could be arranging more opportunities for direct student involvement, such as practicing case presentations, participating in small procedures under supervision, or having short debriefs at the end of the day. That said, I am truly grateful for how much I was already included, and the warmth and generosity of everyone at CGMH far outweighed any limitations.

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Week 4: Reflection on elective posting in Kaohsiung Chang Gung Memorial Hospital

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Week 4: Reflection on elective posting in Kaohsiung Chang Gung Memorial Hospital

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Name: Lee Rou En

Matric number: A196876

Date: 29/08/2025

1. Were the objectives of the project fulfilled?
Yes, the objectives of the elective posting were largely fulfilled. I was able to experience the daily workflow of a general surgery department, including morning meetings, ward rounds, operating theatre sessions, and clinic attachments. This gave me valuable exposure to how surgical teams function and manage patients in a different healthcare system outside Malaysia. I achieved my goal of observing surgical procedures and gaining a better understanding of operative techniques, patient safety, and teamwork in the OT. I also improved my ability to follow clinical discussions, even though the language barrier sometimes made it challenging. Outside the hospital, I managed to balance professional learning with personal well-being by exploring the local culture, using the gym, and planning short trips, which helped me maintain motivation and focus. While I still need to strengthen my anatomical knowledge and confidence in interpreting imaging, the posting has motivated me to continue revising these areas. Overall, the elective met my expectations and provided me with both academic learning and personal growth.

2. What have you enjoyed or liked the most about the project?
What I enjoyed the most about this elective posting was the opportunity to observe a wide variety of surgical procedures especially liver transplantation in the first class liver transplant centre in the world. Being in the operating theatre allowed me to appreciate not only the technical skills involved but also the coordination, communication, and teamwork required during surgery. I also enjoyed the exposure to outpatient clinics, where I observed how surgeons explained conditions and treatment options to patients with clarity and empathy. Beyond the hospital, I liked the chance to explore Taiwan’s culture, food, and lifestyle, which made the experience more meaningful and well-rounded. The balance between professional learning and personal growth—whether it was observing interesting cases, discovering new perspectives in healthcare, or simply enjoying the gym and local activities after hospital hours—was what I valued most about the project.

3. What have you found challenging about this project?
One of the biggest challenges I faced during this elective was the language barrier. Many discussions during ward rounds and patient interactions were conducted in Mandarin or Hokkien, which sometimes made it difficult for me to fully understand the clinical details being shared. I often had to rely on observation, non-verbal cues, or asking peers and residents afterward to clarify key points. Another challenge was my limited anatomical knowledge when it came to interpreting CT abdomen scans—I realised how important it is to have a solid foundation in anatomy to connect imaging with clinical findings. Adapting to a new healthcare system and its workflow also required effort, especially in the first few days, but touring the hospital in advance and being open to learning helped me settle in. Despite these challenges, I viewed them as valuable learning opportunities that pushed me to revise more actively, improve my adaptability, and strengthen my communication skills.

4. What has really worked?
What has really worked for me during this elective was being proactive in the department’s daily routine. By actively participating in ward rounds, I was able to follow patient progress more closely and understand how clinical decisions were made. Attending clinic sessions gave me insight into how surgeons communicate with patients and manage cases from an outpatient perspective. Observing in the operating theatre allowed me to appreciate the workflow, teamwork, and technical skills required during surgery. Instead of staying passive, I tried to stay attentive, take notes, and ask questions when appropriate, which made the experience much more meaningful. This proactive approach helped me adapt more quickly to the hospital environment and maximise my learning opportunities.

5. What can be improved in this project?
One area that could be improved is my own preparation in terms of language and anatomy. The language barrier, especially with Hokkien, sometimes limited how much I could follow during ward rounds and patient interactions. Having some form of pre-learning of some common medical terms beforehand would have made communication smoother. Another area is anatomical knowledge—when interpreting CT abdomen images, I found it difficult to identify certain structures confidently. Spending more time revising cross-sectional anatomy before the elective would have helped me make better use of these learning opportunities. From the project side, the learning experience could have been enhanced further if we were given the chance to participate in simple clinical tasks under supervision, such as assisting in minor procedures, practicing basic suturing, or performing physical examinations. These practical opportunities would not only strengthen clinical skills but also help reinforce the theoretical knowledge gained during observation. Having a more active role would make the elective more engaging and provide a better balance between passive learning and practical application.

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WEEK 4 : SELF-REFLECTION IN KAOHSIUNG CHANG GUNG MEMORIAL HOSPITAL , TAIWAN 🇹🇼 

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WEEK 4 : SELF-REFLECTION IN KAOHSIUNG CHANG GUNG MEMORIAL HOSPITAL , TAIWAN 🇹🇼 

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Name: KOH JOSHUA

Matric Number: A196985

Date: 2/9/2025

1. Were the objectives of the project fulfilled?

The 4 objectives of my Elective posting project are :

a. Clinical Exposure

Yes, this objective was fulfilled. Throughout the three weeks, I was exposed to a wide range of cases in internal medicine—ranging from common conditions like pneumonia, UTI, and hypokalemia to more complex cases such as systemic lupus erythematosus, post-transplant hepatitis, and patients with multisystem involvement. I not only observed but also actively participated in patient clerking, physical examinations, ward rounds, and case discussions. Learning opportunities such as bedside teaching with hepatobiliary specialists, ECG interpretation, ultrasound interpretation, and lectures on UGI bleeding and echocardiography strengthened both my clinical knowledge and practical skills.

b. Cultural Competency

This objective was also achieved. Being immersed in a Taiwanese hospital system allowed me to appreciate differences in healthcare practices, patient communication, and hospital workflow. Interactions with patients—such as the young woman with SLE who welcomed us despite language and cultural differences—helped me understand the importance of empathy and respect. Beyond the hospital, experiences like visiting the Ruifeng Night Market and engaging with local colleagues enriched my cultural awareness and reminded me of the close link between cultural sensitivity and good medical practice.

c. Professional Development

Yes, this was accomplished. I grew more confident and active as the weeks progressed—moving from passive observation in Week 1 to active participation in case discussions and ward rounds by Week 3. I also learned valuable lessons in teamwork, such as during morbidity and mortality meetings where accountability and collective reflection were emphasized. Simple gestures of kindness from seniors and shared activities like exercising together strengthened my sense of belonging and collaboration within the team. This experience shaped my communication, adaptability, and awareness of the responsibility carried by healthcare professionals.

d. Personal and Cultural Enrichment

This objective was fully met. Living and learning in Taiwan gave me the chance to appreciate its traditions, culture, and food. These cultural encounters went hand in hand with my clinical exposure, broadening my worldview and reinforcing the importance of understanding diversity in today’s globalized medical environment. On a personal level, I also learned to manage my time better, balance clinical duties with self-study, and reflect on my own growth as a medical student.

In summary: All four objectives of my elective posting were fulfilled. The experience gave me not only clinical exposure but also cultural understanding, professional growth, and personal enrichment. It has been a holistic journey that strengthened both my medical foundation and my vision of the kind of doctor I aspire to become.

2. What have you enjoyed or liked the most about the project?

What I enjoyed the most about this project was the opportunity to become more actively involved in clinical discussions and patient care as the weeks progressed. In the beginning, I was more reserved and mostly observed, but by Week 3 I found myself asking questions, sharing my thoughts during ward rounds, and even performing examinations under supervision. That sense of progression—from being unsure in Week 1, to gradually adapting in Week 2, and finally feeling confident and engaged in Week 3—was the most meaningful part of this journey. It showed me how much I had grown, not only in clinical knowledge but also in confidence, and it reinforced my passion for internal medicine as a field where learning never stops.

3. What have you done found challenging about this project ?( any part of the project you found hard to do )

What I found challenging about this project came in several forms, each pushing me out of my comfort zone and forcing me to grow.

Firstly, adapting to a new hospital environment was not easy in the beginning. In Week 1, I often felt unsure about the flow of ward rounds and hesitant to approach patients for clerking, as I did not yet fully understand the expectations or routines. It took me time to adjust, and I had to learn to observe carefully, ask politely, and slowly step into a more active role.

Secondly, building confidence in clinical discussions was another challenge. Early on, I was quiet during case presentations because I was worried about giving the wrong answer or asking questions that seemed too basic. For example, when we discussed UGI bleeding and diuretics, I sometimes understood the concepts but struggled to phrase my thoughts clearly in front of seniors. By Week 3, however, I noticed progress—I was able to ask more relevant questions and even contribute my perspective during ward rounds.

Lastly, understanding the weight of clinical responsibility was both challenging and eye-opening. Day 4 of Week 3, during the morbidity and mortality discussion, highlighted how even a small mistake by a healthcare worker could escalate into serious consequences for a patient. That discussion stayed with me—it was not just intellectually challenging, but also emotionally heavy, as I realised how much accountability the profession carries.

All these challenges were difficult at the time, but overcoming them gave me some of the most valuable lessons of my elective posting. Each hurdle became an opportunity for reflection, growth, and resilience.

4. What has really worked ? ( any part in the project that you thought worked well )

What has really worked well in this project was the way I gradually grew into the hospital environment and made the most out of the opportunities given to me.

Firstly, the structured lectures and teaching sessions were extremely effective. They gave me a strong theoretical foundation while also linking directly to clinical practice. For instance, the lecture on UGI bleeding not only explained diagnostic approaches but also helped me understand how to interpret cases I later encountered in the wards. Similarly, the lecture on gout with rare case examples made the learning more memorable and engaging.

Secondly, bedside teaching and direct patient interactions worked particularly well for me. Being able to clerk patients and then present to my seniors gave me both practice and immediate feedback. A highlight was performing an abdominal examination under Dr. Yang Zhi Hong’s supervision, where I detected a positive Murphy’s sign. This reinforced my confidence that I was applying what I had learned correctly.

Thirdly, the guidance and support from my supervising physician (SV) and seniors was invaluable. I felt that the one-to-one teaching moments—such as learning about the classes of diuretics and how to interpret abdominal ultrasounds—worked especially well, because the teaching was tailored to my level and directly relevant to clinical scenarios.

Lastly, my gradual involvement in ward rounds and case discussions was another part that worked well. In Week 1, I was mainly observing quietly, but by Week 3, I was more active in discussions and confident in asking questions. This progression showed me that the teaching environment truly encouraged participation and growth, which I really appreciated.

Overall, what worked best in this project was the combination of structured teaching, hands-on learning, supportive mentorship, and a safe space for progressive involvement—all of which allowed me to learn and grow steadily throughout the three weeks.

5. What can be improved in this project?

What can be improved in this project is the opportunity for more structured, hands-on clinical exposure. While I gained a lot from observing and discussing cases, I felt that there could have been more chances for students to practice basic clinical skills under supervision, such as physical examinations or simple procedures. For example, I only managed to perform an abdominal examination once during Week 3. If the program allowed more scheduled bedside teaching sessions or allocated specific patients for clerking, it would have further strengthened my confidence and practical learning. Another area that could be improved is the availability of English resources, such as lecture slides or summaries, since some of the discussions were conducted in Mandarin, and it sometimes made it challenging to fully capture every detail.

What I can improve myself is my own initiative and confidence in clinical settings. In the first week, I was mostly quiet and hesitant to ask questions because I did not want to interrupt or take up too much of the doctors’ time. Looking back, I realize that I could have gained more if I had been more proactive from the start. By Week 3, I became more comfortable and started engaging more actively in ward rounds and discussions, but I know I can still work on speaking up earlier and contributing my thoughts. Another personal area for improvement is consolidating my learning daily. Sometimes I was too tired after long days in the hospital and postponed my note-writing or case review. If I had kept a more consistent study habit, I could have deepened my understanding more effectively.

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Week 4: Reflection in Linkou Chang Gung Memorial Hospital, Taiwan

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Week 4: Reflection in Linkou Chang Gung Memorial Hospital, Taiwan

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Name: Marcus Chin Yi Khai

Matric number: A196073

Date: 01/09/2025

1. Were the objectives of the project fulfilled?

Yes, I feel that the objectives of this elective posting were fulfilled. From the start, I wanted to gain more understanding in internal medicine for the geriatric population, and along the way I managed to see how elderly patients are cared for not only medically, but also in terms of their functional status and overall quality of life. Through ward rounds and case discussions, I got to follow how doctors reason through complex cases with multiple comorbidities, and this really helped me improve my own way of thinking.

Another objective I set for myself was to improve my communication skills with elderly patients. At first I found it a bit challenging, but gradually I became more comfortable by adjusting the way I spoke, being patient, and making sure they felt heard. I also learned a lot from watching how the multidisciplinary team works together, which gave me a clearer picture of holistic care.

Overall, I think the posting gave me what I hoped for. It helped me gain more knowledge, but more importantly, it also taught me to be more patient, empathetic, and adaptable in handling different situations.

2. What have you enjoyed or liked the most about the project?

What I enjoyed the most about this elective posting was the opportunity to interact with elderly patients and listen to their stories. Many of them were very open in sharing about their health struggles as well as their life experiences, and I found these conversations meaningful. It reminded me that medicine is not just about treating diseases, but also about understanding the person behind the illness.

I also really liked observing how the team approached patient care in such a holistic way. Seeing doctors, nurses, physiotherapists, and other allied health staff working together made me appreciate how important teamwork is in geriatric medicine. Being part of the ward rounds and case discussions also gave me a sense of involvement and made me feel like I was learning something practical each day.

Overall, what I enjoyed most was the balance between clinical learning and human connection. This experience made the posting both educational and personally fulfilling.

3. What have you found challenging about this project?

One of the main challenges I faced during this posting was trying to follow the complexity of cases in geriatric medicine. Many patients had multiple comorbidities, and it was sometimes difficult to fully understand the reasoning behind certain management decisions. I realised that treating elderly patients is not always straightforward, as the doctors also have to consider the patient’s functional status, social background, and even their personal wishes.

Another challenge was communication. Some patients had hearing difficulties or mild cognitive impairment, which made history-taking less smooth. I had to learn to be patient, repeat myself when needed, and sometimes rely on family members or the healthcare team to help clarify details.

Even though these challenges were not easy at first, I think they were valuable learning points. They pushed me to improve my observation skills, to listen more carefully, and to be more empathetic towards the limitations that elderly patients face.

4. What has really worked?

I think what really worked during this posting was keeping an open mind and being proactive in learning. Whenever I joined ward rounds or case discussions, I made the effort to listen carefully and jot down points that I did not fully understand, then reviewed them afterwards. This helped me gradually make more sense of the complex cases we encountered.

Another thing that worked was trying to build rapport with patients, even in small ways. Simple gestures like greeting them warmly, speaking slowly, or just sitting by their bedside for a short chat made the patients more comfortable, and it also made me feel more connected to them. These small steps made communication smoother and more meaningful.

Lastly, learning from the multidisciplinary team also worked really well for me. Observing how doctors collaborated with nurses, physiotherapists, and dietitians gave me insights into areas beyond pure medical management. It made the whole learning experience more holistic and practical.

5. What can be improved in this project?

One area that I think could be improved is having more structured teaching sessions during the posting. While I learned a lot from observing and participating in ward rounds, sometimes the pace was quite fast and it was hard to fully follow the thought process behind certain decisions. Short, focused teaching sessions on common geriatric issues would have helped me consolidate my learning better.

Another improvement could be giving students more hands-on opportunities, such as practicing basic clinical skills under supervision or being more involved in patient assessments. This would make the experience even more engaging and interactive.

Lastly, I feel that having clearer objectives set at the beginning of the posting, with a chance to review them midway, would help students track their progress more effectively. Overall, the posting was very valuable, but these small adjustments could make it even more beneficial for future students.

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Week 4: Reflection in Linkou Chang Gung Memorial Hospital, Taiwan

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Week 4: Reflection in Linkou Chang Gung Memorial Hospital, Taiwan

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Name: Briand Wong Teng Ming

Matric number: A195901

Date: 01/09/2025

1. Were the objectives of the project fulfilled?
Yes, the objectives of the project were fulfilled. My main aim was to gain hands-on exposure to clinical practice in plastic surgery while learning from experienced surgeons and interacting with peers from diverse backgrounds. During the attachment, I managed to observe various surgical cases, from reconstructive to microsurgery, and this broadened my perspective of the field. The experience not only deepened my medical knowledge but also enhanced my understanding of the patient journey, from preoperative assessment to postoperative care.

2. What have you enjoyed or liked the most about the project?
What I enjoyed most was being able to observe and learn directly from experts in the field of plastic surgery. It was fascinating to see how delicate techniques, such as free flap reconstruction, were performed with such precision. Another highlight was the chance to interact with international colleagues and exchange perspectives on healthcare systems, training, and clinical practices. This created meaningful friendships and gave me fresh insights that I would not have gained from textbooks alone.

3. What have you found challenging about this project?
One of the main challenges was adapting quickly to the fast-paced clinical environment. Sometimes I found it overwhelming to keep up with the medical terms, surgical techniques, and the flow of the operating theatre. Time management was another challenge, as the days were often long and packed with activities. However, these challenges pushed me out of my comfort zone and made me more resilient, resourceful, and determined to keep improving.

4. What has really worked?
The teamwork and guidance provided by the supervising surgeons and staff worked really well. They were approachable, willing to teach, and encouraged us to ask questions. This created a very supportive learning environment. Additionally, the exchange of ideas with international peers made the project even more enriching, as we could learn from each other’s experiences and perspectives. The combination of structured teaching and informal discussions ensured that I gained knowledge in both technical and professional aspects.

5. What can be improved in this project?
The project could be improved by incorporating more cultural exchange and social bonding activities with international peers. While the hospital exposure was very valuable, I feel that structured opportunities to interact outside the clinical setting would make the experience more well-rounded. Activities such as cultural nights, group sharing sessions, or simple outings would help us build stronger friendships and create lasting memories beyond the hospital walls.

These interactions would also give us a chance to learn how medicine is practiced in different countries, as every participant brings unique perspectives shaped by their own healthcare system. Understanding these differences not only broadens our knowledge but also encourages us to reflect on our own practices and values. In the long run, this type of cultural and social exchange helps us grow into more empathetic, open-minded, and globally aware future doctors.

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My Journey in Kaohsiung Chang Gung Memorial Hospital

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My Journey in Kaohsiung Chang Gung Memorial Hospital

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NAME: YONG WEI EU

MATRIC NUMBER: A196878

DATE: 31 AUGUST 2025

1. Were the objectives of the project fulfilled?

Yes, I believe the objectives of this project were fully met. Over the three weeks at Kaohsiung Chang Gung Memorial Hospital, I gained valuable exposure to both outpatient and inpatient care. In the clinics, I observed how doctors conducted consultations efficiently while maintaining good rapport with patients.

My clinical knowledge and reasoning were strengthened. Every day brought new opportunities to discuss cases with the doctors and observe how they approached diagnosis and management. These real-life cases helped me apply what I’ve learned in class and understand how clinical reasoning is used in actual practice.

One of the most valuable aspects was learning about the structure of Taiwan’s healthcare system. I compared this with Malaysia’s system and realized both the strengths and challenges of each. I was especially impressed by Taiwan’s efficiency, advanced infrastructure, and organized workflow, which I believe offer that Malaysia could learn from to strengthen its own system.

2. What have you enjoyed or liked the most about the project?

I really enjoyed the hands-on learning experience throughout my elective posting in CGMH. Spending time in both the clinics and the wards gave me so many chances to learn in a real setting. I liked how I could follow the journey of some patients from their admission to the hospital to their treatment and recovery in the wards. This made me understand the whole process of care much better. I also enjoyed the moments when I could watch doctors perform procedures and assist with simple tasks under their guidance. These experiences helped me build more confidence and made me realize what it feels like to be part of the clinical team.

I also truly appreciated the kind and supportive environment created by the doctors, nurses, and other healthcare staff. Even though I was only a visiting student, they always treated me with warmth and respect. Many of them took the time to explain cases in detail, answer my questions, and share their tips on how to talk to patients or think through a diagnosis. This made me feel very comfortable and encouraged to join in discussions during rounds. Their kindness and guidance made the whole experience not only educational but also very enjoyable.

3. What have you found challenging about this project? (any part of the project you found hard to do)

One of the main challenges I faced during this elective posting was adapting to the different healthcare system and communication style in Taiwan. The workflow in the hospital was not the same as in Malaysia. The ward rounds were faster and the doctors expected students to be proactive in asking questions or sharing opinions. At first, I felt a bit lost and unsure of when to speak up. Over time, I observed how the team interacted and slowly adjusted my approach. This experience taught me the importance of being adaptable and open-minded when working in a new environment.

Lastly, I found it challenging to apply my clinical knowledge to real-life situations. It was very different to see how theories from textbooks were used in managing real patients. Sometimes, I struggled to understand the reasoning behind certain decisions, especially in complex cases. To overcome this, I started asking more questions during discussions and reviewing cases afterward. This helped me improve my clinical reasoning and see how knowledge connects to practice.

4. What has really worked? (any part in the project that you thought worked well)

One thing that really worked well during this elective posting was my ability to adapt to the new environment quickly. Even though the healthcare system and communication style in Taiwan were quite different from what I was used to in Malaysia, I made an effort to observe, listen, and learn from the doctors, nurses, and even other medical students. This helped me understand their workflow better and allowed me to adjust to their routines more smoothly, which made my experience much more productive.

At the start of my posting, I was quite quiet because I didn’t know what to ask or how to join the discussions. Most of the time, I just listened and tried to understand what was going on during the ward rounds. As days passed and I became more used to the routine, I started to feel more confident. My supervisor also encouraged me to speak up and reminded me that it’s okay to ask even simple questions. Slowly, I learned how to ask better questions and share my thoughts. Whenever I asked something, my supervisor would answer patiently and explain things clearly. This made me feel more comfortable and supported. Over time, I became more active during discussions and understood the cases much better, which really helped me build my confidence.

5. What can be improved in this project?

One thing I really feel I can improve on is my confidence and how actively I participate. At the start of the posting, I was quite passive because I didn’t want to say the wrong thing or ask questions that might sound silly. I mostly just observed quietly and tried to learn by watching. Over time, as I got used to the environment, I started to feel more comfortable and slowly became more active during rounds and discussions. I think there’s still room for me to push myself to speak up earlier and share my thoughts more often.

Another thing I think I can work on is catching up faster with what is going on in the ward. In the first week, I often felt a little lost when the doctors discussed cases quickly or when they used medical terms I wasn’t fully familiar with. It took me some time to understand the flow and figure out how everything worked. By the second week, I started reviewing the patient charts on my own and asking the staff or my supervisor for clarification, which helped a lot. But I still think I need to improve on processing information faster so that I can keep up better with the pace of the ward and contribute more during discussions.

Lastly, I realized that my decision-making and analytical skills need to be developed further. There were times when my supervisor asked me what I would do for a certain patient or how I would interpret the findings, and I hesitated because I wasn’t confident in my reasoning. Sometimes my answers were too general or lacked clear structure. I want to train myself to think more critically and logically, so that I can make more confident decisions when discussing cases. I believe with more exposure and guidance, I can get better in this area and become more prepared for my future clinical years.

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Week 4 : Farewell in Kaohsiung Chang Gung Memorial Hospital

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Week 4 : Farewell in Kaohsiung Chang Gung Memorial Hospital

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Name : Yap Sin Yin

Matric no : A195900

Date :25/9/2025 -29/9/2025

1. Were the objectives of the project fulfilled?
Yes, the objectives were fulfilled. During my attachment, I significantly enhanced my technical knowledge by observing complex hepatobiliary and liver transplant surgeries, including preoperative planning, intraoperative techniques such as vascular anastomosis, and meticulous postoperative management. I gained hands-on insight into patient care throughout the perioperative period, including monitoring immunosuppressive therapy, identifying and managing complications like acute cellular rejection, and supporting patient recovery. Additionally, I developed a comprehensive understanding of multidisciplinary teamwork, witnessing how surgeons, anesthetists, oncologists, interventional radiologists, nuclear medicine specialists, and nurses collaborate seamlessly to optimize patient outcomes, ensure procedural safety, and provide holistic care. This experience not only strengthened my clinical knowledge but also deepened my appreciation for the essential role of nursing and allied health professionals in complex medical settings.

2. What have you enjoyed or liked the most about the project?
What I enjoyed the most was the professor’s clinic attachment. I saw patients from many different countries such as the Philippines, Malaysia, Indonesia, and Japan who came to Taiwan for liver transplant. This showed me the international reputation of Chang Gung Memorial Hospital in this field. I learned a lot in the clinic, especially about post-transplant follow-up and how drug adjustments are made based on liver function tests and creatinine to monitor for acute cellular rejection. Each patient’s treatment plan was individualized, which was very impressive. I also enjoyed the chance to interact with the surgical team, who were supportive and willing to answer questions. Their explanations helped me connect theory with practice. Outside of the hospital, I appreciated having weekends free to travel and explore Taiwan. Since this was my first time overseas, it was very eye-opening to experience life in another country.

3. What have you found challenging about this project?
One challenge I faced was during ward rounds, as many discussions were in Mandarin or dialect. At first, it was hard for me to understand, especially since most of the medical terms I had learned were in English. However, I treated it as a learning opportunity, and after listening many times, I started to pick up certain words and could roughly follow the discussion.

4. What has really worked?
The most valuable part was being able to observe liver transplant surgery, which is not common in Malaysia. I saw a living donor liver transplant, where both the donor and the recipient underwent surgery at the same time. Even though the surgery was very complex, the surgeon explained the steps during the procedure, which helped us understand better. I also appreciated being taught how to interpret intraoperative cholangiography. What worked especially well was the structured balance between operating room observation, ward rounds, and research discussions, which gave me a more complete picture of the transplant process. The teamwork and communication among the surgical team and allied health professionals also stood out — it showed me how collaboration is key to achieving good outcomes.

5. What can be improved in this project?
The project could be improved by providing more support for international students in terms of language. Since most discussions in Taiwan are conducted in Mandarin or dialect, it can sometimes be confusing for students who are more familiar with English medical terms. Offering short English summaries, handouts, or occasional translation during rounds would make it easier to follow along and maximize learning.

Another area for improvement would be to include more hands-on opportunities under supervision, such as basic suturing practice or assisting in minor procedures. This would complement the observation sessions and allow students to gain practical skills alongside theoretical knowledge.

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Week 4 Reflection – Chang Gung Memorial Hospital

Name : Teoh June Jern

Matriks no : A195158

1. Were the objectives of the project fulfilled?

During this fourth week of my attachment at Chang Gung Memorial Hospital, I feel that the objectives of my project were largely fulfilled. My primary goals included observing advanced surgical procedures, particularly in liver transplantation, understanding the workflow of a high-volume transplant center, and clinical decision-making. I had the opportunity to witness complex surgeries under the guidance of world-renowned surgeons such as Professor Chao-Long Chen, gaining insight into both the technical aspects of liver transplantation and the meticulous preparation involved before, during, and after surgery. Furthermore, I was able to participate in rounds, observe patient management discussions, and engage with multidisciplinary teams, which allowed me to better understand the coordination required for successful transplant outcomes. Overall, the experience has significantly deepened my knowledge and fulfilled my learning objectives for this rotation.

2. What have you enjoyed or liked the most about the project?

One of the aspects I enjoyed the most was being able to witness the precision, teamwork, and dedication involved in liver transplant surgeries. Observing Professor Chao-Long Chen perform procedures that have saved thousands of lives was truly inspiring. I was fascinated not only by the technical skill but also by the meticulous planning, anticipation of potential complications, and the calm, confident approach he demonstrated even in high-pressure situations. Additionally, I enjoyed the opportunity to interact with the team members, including Dr. Chee Chien Yong, whose research contributions in living-donor liver transplantation were enlightening. Learning about both the clinical and research aspects of transplantation, and seeing how evidence-based practice is integrated into patient care, gave me a comprehensive understanding of the field. The supportive learning environment, where I could ask questions and receive explanations without hesitation, also made this experience very rewarding.

3. What have you found challenging about this project?

Despite the many positive experiences, I did encounter several challenges. The most notable was the steep learning curve in understanding the surgical anatomy and techniques involved in liver transplantation. While observing surgeries, I found it difficult at first to follow the sequence of complex steps, especially when it involved detailed vascular and biliary reconstructions. Additionally, the fast pace and intensity of the operating room environment were initially overwhelming. Another challenge was synthesizing large amounts of clinical information during rounds, particularly when discussing postoperative complications and long-term management plans. Nevertheless, these challenges ultimately enhanced my learning and made me more resilient in a high-pressure clinical setting.

4. What has really worked?

Several aspects of the project worked exceptionally well. Firstly, the structured schedule that included operating room observation, clinical rounds, and research discussions provided a balanced and immersive learning experience. Being able to follow a patient’s journey from preoperative assessment to postoperative care allowed me to see the continuity of care in a transplant center. Secondly, the mentorship and guidance from Professor Chao-Long Chen and Dr. Chee Chien Yong were invaluable; their willingness to explain complex procedures and answer questions helped bridge the gap between theoretical knowledge and practical application. Additionally, the collaborative environment among the surgical team and allied health professionals worked well to demonstrate the importance of communication, precision, and teamwork in achieving successful patient outcomes.

5. What can be improved in this project?

While the project was highly beneficial, there are areas that could be improved for future students. Area for enhancement could be allocating more time for hands-on practice under supervision, such as suturing techniques or assisting in minor procedures, to complement observation with practical skill development. Finally, incorporating short debriefing sessions after surgeries or rounds could allow students to consolidate learning, discuss questions, and reflect on critical aspects of patient management, thereby maximizing the educational value of each experience