matric number:A194600

date: 25 July 2025

2. Your progress so far

I have progressed to assisting doctors with procedures such as wound dressing and blood draws, always under supervision to ensure patient safety. I also administered nebulisation to patients, and was given the opportunity to insert suppositories for paediatric patients. These experiences helped me understand the correct techniques, infection control practices, and how to communicate effectively with patients, especially children who uncooperative.

This hands-on exposure has been valuable not only for technical skills but also for developing my confidence and ability to remain calm and focused during procedures.

Overall, I feel like I’ve made meaningful progress from being a passive observer to actively contributing to patient care under supervision.

3. Your feelings and thoughts

I feel more engaged and motivated as I’m now more involved in patient care. At first, I was a bit nervous about performing procedures, especially on children, but with proper supervision and support from the clinic staff, I’ve become more comfortable. It’s been fulfilling to see myself progressing and contributing .

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

In Week 1, while working as an admin, I learned to make quick decisions when verifying patient IDs, checking panel eligibility, and handling claim submissions especially when there are some issues in claiming the panel such as patient need to copay

In Week 2, at the dispensing counter, I had to ensure the right medications were given to the right patients, checking prescriptions carefully and clarifying with the doctor when needed.

By Week 3, when I began assisting in clinical procedures decision making became even more important such as preparing the correct materials, assessing patient comfort, and knowing when to act or ask for help.

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

I managed my time by setting daily goals based on the clinical schedule and prioritising tasks that could provide the most learning opportunities. I made sure to be proactive , volunteering to assist whenever possible, while also setting aside time after sessions to review and reflect on what I’ve learned.

6. Your plan for next week (Week 4)

For Week 4, my plan is to take an overall role by performing a variety of tasks that clinic assistants usually do, rather than focusing on just one area. This includes continuing with hands-on procedures and assisting. I also plan to help with front-desk duties like patient registration and claim processing, as well as assist in the pharmacy by preparing and dispensing medications. By rotating through these roles, I hope to better understand the workflow of the clinic, improve my multitasking and adaptability, and develop a more complete picture of how different roles support patient care.

Nursakinah Hayati binti Azhar

A191966

18/8 - 20/8

2. Progress so far
As I planned for week 3 in my last journal, this week I focused more on dentures – from taking moulds (acuan gigi), recording patients’ bites, sending them to the lab, and eventually making a complete denture!

Basically, here are the steps for dentures:

1. First visit: Primary & Secondary impression
   The dentist first takes a quick mould using alginate (yellow powder). This is just to get the general shape of the gums, teeth, and ridges. Then comes the secondary impression using a special tray with silicone (purple powder). This one is more accurate, capturing fine details like soft tissue and margins, so the denture fits comfortably without gaps.

2. Second visit: Bite registration
   The dentist uses wax blocks to record how the upper and lower jaws meet. This sets the bite height and midline so the teeth look and function naturally.

3. Third visit: Try-in stage
   (The doctor said this is the most critical stage – extra caution needed!)
   The lab makes a trial denture in wax with teeth, and the patient comes in to try it. The dentist checks the fit, bite, speech, and smile. Adjustments are done here before the final stage.

4. Final visit: Denture delivery
   The lab sends the final denture in acrylic. The dentist fits it, checks comfort and bite, and gives the patient instructions on how to care for it.

Other than dentures, I also got the trust to assist the dental surgeon independently for scaling and tooth fillings. For fillings, they use a material called composite to fill cavities. There are many shades available to match the patient’s natural teeth. Now I can even guess my own tooth shade in “dental language” hahaha.

3. Feelings and thoughts
I feel grateful that I can help the staff with simple procedures. Even though they look easy, you really need experience to know where and how to place instruments so they align with the dentist’s work.

I was also really shocked to discover that one of the dental surgeons at the clinic is actually my senior from high school! “What a small world,” I thought. Since my school was a boarding school far from home, it’s rare for me to bump into old schoolmates. We ended up talking a lot about school, teachers, and his journey to becoming a dental surgeon. That conversation really helped me build a better connection with him too.

4. Decision-making skills in EP
In a clinic setting, the best way to learn decision-making is through hands-on experience. Observing others is important, but doing it yourself helps you get into the clinical rhythm. Usually, I watch once to understand the flow, then try it myself the next time. If I’m unsure, I quickly ask or double-check. As I get more confident, I try to think one step ahead to better assist the dentist.

5. Time management in EP
During week 1, I felt really tired working 9 AM–5 PM, and I usually did research on instruments and procedures at night before bed. But by week 2 and 3, I found a better strategy: I started asking questions directly to the staff and doing my research on the spot at the clinic whenever there were no patients. I also typed quick notes into my phone so I didn’t need to revise everything again at home.

After 5 PM, my evenings are now just for rest, Netflix, and sleep. I also worked on fixing my sleep schedule — since I need to wake up early, I now go to bed earlier. Honestly, this change has been life-changing because I feel much more energetic in the mornings.

6. Plan for next week (Week 4)
Since it’s my final week, I plan to observe the last step of dental care: cleaning and sterilising the used instruments. I also want to say goodbye to the staff and dentists properly… by baking them a chocolate banana cake myself. Stay tuned!

Shade *ABCD

• Reddish-brownish: A1 - A2 - A3 - A3,5 - A4

• Reddish-yellowish : B1 - B2 - B3 - B4

• Greyish : C1 - C2 - C3 - C4

• Reddish-grey : D2 - D3 - D4

Brightness *the numbers

Within these shades, either A, B, C or D, the shades are classified by a number from the lightest, 1, to the darkest and most intense, 4. Thus, a shade A1 will be a reddish-brown shade, just like shade A2, but the latter will be darker.

FOMEMA is Malaysia’s mandatory medical screening for foreign workers, carried out by registered panel clinics, labs, and radiology centers. The goal is to ensure workers are medically fit for employment and to detect important communicable conditions according to the current guidelines.

2. Progress so far

   In my third week of elective posting with the Dietitian Department, the focus shifted more toward clinical dietetics, particularly in outpatient care. I was attached to various clinics, with most of my time spent observing and participating in the obesity clinic.

   
   

   This was one of the most insightful weeks so far, as I gained firsthand experience of dietitian and patient consultations. I observed how dietitians conducted 24 hour dietary recalls, asked open-ended questions to assess food intake, and tailored individualized diet plans based on the patient's current lifestyle, comorbidities, and nutritional goals.

   
   

   A significant portion of the consultation process involved calculation of the patient’s daily calorie needs, which was followed by discussions on weight reduction strategies, meal portioning, carbohydrate intake, and diabetic friendly meal plans. We also saw a wide range of patients, which gave me a deeper understanding of how to adapt advice depending on patient background, education level, and motivation

   
   

   Additionally, I had the opportunity to take part in a community outreach program at Institut Pendidikan Guru (IPG) Cheras. This was the second phase of an ongoing program aimed at managing and reducing overweight prevalence among students. We helped assess the students’ progress since the initial intervention by weighing their weight. I also had the opportunity explaining to them a little bit about their BMI and body fat mass. Top 5 students who showed the most improvement were awarded prizes (money), it is a great example of using motivation to promote health.

   
   

   We also conducted nutritional screenings in the ward, which allowed me to interact more with inpatients. I learned how to initiate sensitive conversations, ask the right questions respectfully, and build rapport with patients while assessing their nutritional risks.

   
   

3. Feelings & Thoughts

   This week was both enlightening and humbling. I saw how dietitians operate on the frontlines of patient care, not just from a medical standpoint, but from a behavioral and emotional perspective as well. Many patients struggle with food choices, not due to lack of knowledge, but due to environmental, cultural, and psychological factors. Watching the dietitians navigate these complex interactions with empathy, patience, and clarity was eye opening.

   
   

   Being in the obesity clinic also highlighted the real world impact of Malaysia's growing non communicable disease burden. Seeing the high volume of patients needing nutritional intervention reminded me of the importance of prevention in public health. Nutrition is clearly not a secondary issue, it is a central to long term health outcomes.

   
   

4. Decision Making Skills

   Throughout this journey, decision-making has been essential even as a student. I learned how dietitians make informed decisions by combining patient history, clinical indicators, anthropometric data, and lifestyle factors to form a realistic and individualized care plan.

   
   

   From my side, I had to decide how best to spend my time during clinic hours: whether to observe silently or engage more actively by asking questions. I also made personal learning decisions, like reviewing calculation methods for basal metabolic rate (BMR) and total daily energy expenditure (TDEE) in my free time to better understand the rationale behind the dietitian’s choices.

   
   

   In the community program, decision-making was crucial when determining how to communicate with students of different ages and educational backgrounds ensuring the message was both motivating and age-appropriate

   
   

5. Time Management

   Balancing clinical observations, note-taking, self-study, and participation in community events required effective time management. I made a habit of jotting down important points during consultations, then summarizing them at night. This helped reinforce learning and keep a structured record of key concepts.

   
   

   I also planned ahead for community events by reviewing our itinerary and familiarizing myself with the screening tools beforehand. I’ve found that using a simple to-do list each morning helped me stay organized and make the most of each day without feeling overwhelmed.

   
   

6. Plan for week 4

   For my final week, we need to do a presentation regarding nutritional screening that we had done in the ward. I’m also planning to compile and review everything I’ve learned so far, from enteral nutrition, food service management, to outpatient care and reflect on how I can apply these lessons as a future medical doctor.

   
   

   
   

Name: Muhammad Adam bin Romzi

Matric No: A194734

Date: 13th to 17th July 2025

2. Your progress so far

On the third week, again we went to Taman Jubli for Kelas Warga Emas. It was nice to see the familiar faces of the aunties and they were so welcoming of us interns. The class was done as per usual, with walk around the park, simple exercises and cooling down.

We also travelled all the way to Merbok for the Kelas Warga Emas. When we got there, we immediately started the chairobic with the elderly. Turns out it wasn’t just an ordinary Kelas Warga Emas, they were actually doing pot luck! With that in mind, we cut the exercise short to 45 minutes as we were invited to eat. This was my favourite part of the internship so far because I felt a close sense of community with them. Before we feast, we did the same thing as last week, which was a survey regarding general health of the elderly.

Other than that, we went to MPSP hall for their staff IFitEr programme. However, this time there were higher attendance compared to last week. Maybe because they didn’t have to travel to the park. As usual, my task was taking attendance, playing background music and taking survey responses. I was trying my best to contribute to the team as best as I could. Observing my supervisor instructing the programme made me realize I don’t have the same stamina as them.

Lastly, we travelled to Merdeka Beach for a gotong-royong programme under Agenda Nasional Malaysia Sihat (ANMS) initiative. We opened a booth there whereby participants can perform challenges such as showing their step counts, push up challenge, football game to win prizes. My task was to explain the challenges to the participants and handing them the gifts. Later we stopped by a local restaurant and I had the best Nasi Goreng Udang of my life.

3. Your feelings and thoughts 

This week was very fun and meaningful. I really enjoyed meeting the elderly again at Taman Jubli and Merbok. The potluck especially made me feel like part of their community, not just an outsider. I also realized how much effort the Wellness Hub team puts into these activities, because it takes a lot of energy to lead the programmes. The ANMS gotong-royong was also something different and I liked how creative the challenges were to attract people.

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

During the surveys and booth activities, I had to make small decisions like how to approach participants, when to explain things, and how to encourage them without being pushy. I also decided to take on tasks that I could handle better with my ankle condition, for example focusing on attendance, music, and explaining challenges instead of physical activities. I realized that a part of decision making skill was to consider what I can do best in regards to my current capability.

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

So far, time management has been about following the team’s schedule because every day is different. Some days we spend the whole morning at a programme, other days we travel far like to Merbok or Merdeka Beach. I try to manage my time by arriving early to the office before heading off to programmes (usually morning), and using time at work with meaningful activities.

6. Your plan for next week (Week 4)

Next week, apart from the usual programmes, we will be going to a secondary school to lead a senamrobik. Other than that, because it’s the last week, I want to get involved more with the survey process.

Thaqif Bin Tabian

A191739

23/8/2025 (End of week 3 of local elective posting)

2. Your progress so far (also skin cancer CME)

For my week 3 of elective posting, I focused a lot on the pharmacy side of the clinic which includes both pharmacological and non-pharmacological management aspects of dermatology related conditions. However, in our clinic, there are no designated pharmacists hence we do not compound any creams or other topical medications. We solely depend on oral/topical medications and creams that are sold from external companies such as Ceradan and TDF-Derma. Other products such as steroid creams, antibiotics, supplements, biologic agents are also externally sourced - medical sales representatives are in charge of bringing in different products useful to the clinic. Thus, all medications are also fully prescribed by the resident doctors only. If the medications are out of stock or not available, we would need to prepare and write a prescription note as supervised by our resident doctor. In order to fulfill a complete prescription note, we would include the following components: patient’s full name, date, IC/passport number, name of medication and dosage, quantity and indication, and finally the doctor's signature and chop. 

I also got an insight on how to pharmacologically manage both acne and atopic dermatitis patients. Firstly, for acne patients, they were categorised into 3 different categories: mild, moderate and severe where all 3 receive different courses of medications:-

• Mild (few comedones and/or papules) = topical agents such as topical retinoids or topical antibiotics are used.

• Moderate (multiple comedones, papules and/or pustules - nodular acne might also be present) = a combination of topical agents and oral antibiotics such as azithromycin/doxycycline are used. 

• Severe (multiple painful nodular acne, multiple pustules and acne scars and marks) = oral accutane is indicated. A renal and liver function test is also ordered before starting and during treatment for continuous monitoring and surveillance. 

• With all categories, non-pharmacological intervention is also needed such as changing their skincare regime. This includes facewash, facial moisturiser as well as sunscreen.

For the atopic dermatitis patients, they were typically prescribed with a rich emollient/moisturising cream to help create the protective skin barrier. If severe, they were also prescribed a topical steroid cream such as Elosone and/or non-steroidal topical creams such as Elidel. 

Additionally, this week we had a CME session on skin cancer. We got insights in how to detect and screen for different skin cancers such as melanomas and squamous cell carcinoma. Pre-cancerous lesions such as actinic keratosis were also discussed. With this, they also come with different treatment regimes. Some can be removed via liquid nitrogen or cryotherapy, however some need to be fully excised and be sent to the laboratory for a full histopathology report. With this, I also learned how to interpret a histopathology report. As clinic assistants, we had to scan these reports to send to the patients via messaging as well. 

3. Your feelings and thoughts 

I feel like in week 3, my confidence in handling the patients prescriptions was much better. Even my social skills have improved as the weeks have passed by - I did not feel as nervous when communicating with the patients now as I did during my first week. I also felt like I moved more efficiently this week which improved clinic workflow, whether it was helping with prescriptions or preparing the sterile sets for excision biopsies which I am proud of myself for. I am happy to see how much more contributions I can make towards the clinic as a clinic assistant. 

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

In order to learn and improve my decision making skills, I had to put myself out there and volunteer doing as much clinic work, consultations and procedures as possible. This way, I knew how to gather my thoughts well and actually apply them towards my working tasks. I also learnt that this is much better than just solely just observing my doctors, medical assistants and admin staff doing their work. This taught me to think fast as well in any urgent situations, whether it is clinical or non-clinical. For example, what to do when patient bookings are accidentally overlapped or when patients get increasingly anxious before their minor surgery. It is all about experience and getting comfortable with the uncomfortable overtime. 

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

Throughout the EP, I managed my time with my own notability calendar on my iPad. Each week, I would write down the days I am expected to come into work and the working hours. Then, for each of the days, I would write down the amount of patients expected to come in for a consult, and jot down any important procedures if any such as mole mapping, excision biopsies (as ExBx), electrosurgeries (as Ed+c), suture removals (as STO) and more. This way I got a clear idea of what my day would potentially look like (hour wise as well) and to prepare myself mentally. 

6. Your plan for next week (Week 4)

My plan for week 4 is to hopefully be able to assist in more excision biopsies and blood taking procedures as well. I would also like to learn about and run the surgical instrument autoclaving process with the autoclaving machine to complete my full experience as a clinic assistant. 

1. Your name, matric number, date

Name: Nur Afiqah Binti Anwar Iqbal

Matric no. :A194988

Date: 18/8-24/8/25

2. Your progress so far

In Week 3, I managed to upload a few items for sale and, surprisingly, people have already started placing orders from the pages that I created. This was a very motivating experience, and I am grateful for the guidance given by my supervisor. I also continued with my usual task, which is preparing items to be shipped out.

One additional skill I learned this week was how to create ads to attract buyers. As we all know, customers love promotions, and creating ads is an important way to increase sales.

The process starts with clicking the “Create New Ads” button. Then, I can choose the type of ad I want to create, whether it is Product Ads (to promote specific products), Shop Ads (to advertise the entire shop), or Discovery Ads (to promote products across different locations in Shopee).

Next, I learned to set the basic ad settings, including the budget and duration of the campaign. The budget can either be total or daily, and I can also decide the start and end dates. I then need to choose the landing page, which can be a product page, the shop page, or a product collection page. For Shop Ads, I also have to create a catchy tagline and select a relevant image to attract buyers.

The following step involves selecting the products or keywords. For Product Ads, I can either let Shopee automatically choose the best-performing products or manually select specific items from my shop. For Shop Ads, I can use Shopee-suggested keywords or add my own to target the right buyers. Meanwhile, for Discovery Ads, I should focus on products with high sales potential and enough stock.

After that, I learned how to set the bidding price, which is the maximum amount I am willing to pay each time a customer clicks on the ad.For this,my supervisor helped me to set the required amount. Finally, once all the settings are complete, the ad can be published to start attracting buyers and promoting products effectively.

Overall, Week 3 has been very exciting because I not only continued my usual tasks but also gained a new skill in digital marketing through Shopee ads. This knowledge is valuable because I now understand how promotions, vouchers, and ads play a big role in attracting customers and boosting sales.

3. Your feelings and thoughts

This week, I felt more accomplished and motivated because I could see the results of my work when customers placed orders from the pages I created. I also felt proud that I was trusted with a new responsibility, which was learning how to create ads to attract buyers. At the same time, I felt a sense of curiosity and eagerness to explore more strategies that could improve sales and customer engagement.

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

I learned decision-making by having to choose the right approach when uploading items or creating ads. For example, I had to decide which product photos looked the most attractive, what keywords to include in the title, and which items were suitable for promotions or ads. I applied this skill by carefully considering the advice from my supervisor, observing how experienced colleagues did their work, and then making my own choices based on what I had learned. This helped me build confidence in making small but important decisions that directly affected customer interest and sales.

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

I managed my time by following a routine and prioritizing my tasks. For instance, I set aside specific times for uploading new products, preparing items for shipping, and learning new skills such as ad creation. When unexpected tasks came up, I tried to complete the urgent ones first while planning the less urgent ones for later. I also made sure to ask for guidance whenever I was unsure, which saved me from wasting time making mistakes. This helped me stay organized and complete my tasks efficiently.

6. Your plan for next week (Week 4)

• Check the stock in the warehouse and arrange the items neatly.

• Make sure that there are enough items available to be sold.

1. Your name, matric number, date

Hani Sakinah binti Shaiful Azmi

A192250

18/8 - 22/8/2025

2. Your progress so far

This week marked the start of my paediatric cardiology posting, and I entered it with a mix of excitement and nerves as I transitioned from adult cardiology into a completely new field. Since I have not yet done paediatrics in university, my knowledge in this area was very limited, but I was eager to learn and be exposed to congenital heart diseases. On Monday morning, I reported to the Paediatric & Congenital Heart Centre (PCHC), where I was introduced to my supervisor, Dr. Leong Ming Chern. He gave us a brief overview of what to expect over the next two weeks, and without delay, I was invited to join a pre-operative discussion with the paediatric cardiology team. At first, I felt a little lost in following the discussion, but once I reviewed the echocardiogram images, I began to appreciate the cases better.

Later that day, I joined the clinic and encountered several fascinating cases of congenital heart disease, conditions I had only briefly read about but never seen in real life. From cyanotic heart disease to septal defects, each case expanded my understanding and gave me a glimpse into the complexity of paediatric cardiology. Although I could not answer most of the questions asked, I did not feel discouraged. Instead, I saw it as motivation to prepare more thoroughly so that I could contribute in the coming days.

As the week progressed, I grew more confident. During clinics, I was encouraged to examine patients and listen to heart sounds. Initially, I struggled to differentiate murmurs, but repeated practice and guidance from my supervisor made it easier to appreciate the subtle differences. I also began preparing in advance by reading about cases, which helped me respond better when asked. A particularly memorable moment was seeing a young child with Tetralogy of Fallot. Observing the child’s bluish lips and clubbed fingers brought textbook descriptions to life.

Although I cannot directly compare my progress to Week 2 since this is a brand new posting, I feel that I am gradually improving in recognising the presentations of congenital heart diseases. More importantly, my curiosity and eagerness to learn are growing stronger each day.

3. Your feelings and thoughts

At the beginning of the week, I felt both excited and nervous about entering paediatric cardiology, a specialty I had no formal exposure to yet. Seeing congenital heart cases in real life for the first time was eye-opening and highlighted how complex yet fascinating this field is. While I often felt lost during case discussions, I chose not to see this negatively. Instead, it motivated me to read more and prepare better. I also felt inspired by the doctors, who not only demonstrated deep medical knowledge but also showed compassion in explaining conditions to children and their families. Overall, I feel humbled by how much I still have to learn, but also encouraged to keep pushing myself in this journey.

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

During this elective posting, I realised that decision making in medicine is not about always having the answers, but about using available information, applying clinical reasoning, and knowing when to seek guidance. In paediatric cardiology, many cases were completely new to me, so I started by making small decisions such as how to approach reading echocardiograms, which heart sounds to focus on during examinations, and what differentials to consider when a child presented with cyanosis.

I also learned a lot from observing my supervisors make decisions during pre-operative discussions, where every choice involved balancing risks and benefits for young patients. This showed me that medical decision making requires teamwork, evidence-based knowledge, and clear communication.

For my own learning, I applied this skill by deciding what topics to prioritise based on the cases I saw. For example, after seeing a child with Tetralogy of Fallot, I chose to study cyanotic congenital heart diseases in detail so that I could engage more meaningfully in discussions the following day. This helped me feel more prepared and confident.

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

Time management became an important focus during this posting. The schedule at Institut Jantung Negara was packed with ward rounds, clinics, procedures in the Invasive Catheter Lab, and departmental meetings. To keep up, I learned to plan my day carefully. For instance, after clinical hours, I set aside short but consistent study sessions each evening to review the cases I had seen. This reinforced my learning and kept me on track. I also made a conscious effort to balance my time between observing procedures and participating in clinics so I could gain a broad range of experiences.

6. Your plan for next week (Week 4)

As I approach the final week of my elective, my goal is to maximise every learning opportunity in the paediatric cardiology department. I want to deepen my understanding of complex congenital heart diseases such as transposition of the great arteries, truncus arteriosus, and hypoplastic left heart syndrome. I plan to be more proactive during ward rounds and clinics by asking questions, even when I am unsure, as this will help me clarify my doubts and learn more directly from my supervisor. I also want to spend more time observing how doctors communicate with children and their families, since effective counselling in paediatrics requires extra empathy and clarity. Finally, I intend to use this last week to reflect on everything I have learned in both adult and paediatric cardiology, and to integrate these experiences into my overall medical knowledge. My aim is to leave IJN with not just greater knowledge, but also more confidence, curiosity, and appreciation for the field of cardiology.