You are now in 3rd week of your EP journey! Good job on your progress so far!

Please share your experience with your friends. You can write, upload lots of pictures & videos. Do comment and give a like on your friends’ posts too =)

1. Your name, matric number, date

2. Your progress so far

3. Your feelings and thoughts

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

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

6. Your plan for next week (Week 4)

Name: Eng Gui Wen

Matric Number: A187846

Date: 18 August 2024

2. Your progress so far

• This week, my shop was officially launched! I decided to open my shop on instagram instead of Shopee because the commission rate and transaction fee rate of Shopee has increased since 1 August. The total commission and transaction fee rate for my business category is 13.5% in which I believe it is not worth it. I started to set up my Instagram page by taking photos and video for my products and uploaded them with clear measurement and pricing. I realised that determining the price for handmade products is not as easy as I thought because it involves not only accounting for the product’s cost but also the time invested and I need to set a reasonable price that the public can accept. In order to drive traffic to my instagram profile, I created a account in a platform known as ‘Xiao Hong Shu’ to promote my products. There’s a few orders after my shop has launched and it is also my first time shipping parcel as a seller so I was quite worrying about any problems that I didn’t expect. At the end of this week, I started to plan my new product for next week with my own design and tried to come out with a sample after multiple redo.

3. Your feelings and thoughts

• Excited and nervous as my products are finally available for sale. It’s a thrilling milestone, but there’s also an underlying anxiety about how the market will respond. I also feel blessed seeing people surrounding me support my business at this initial stage and this is an opportunity to help in building up my shop’s reputation.

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

• Decision-making has been crucial throughout my journey. For instance, choosing Instagram over Shopee required analyzing the costs and benefits of each platform. I weighed the increased commission rates against the potential customer reach and decided that Instagram offered a better deal for my business at this stage. This experience reinforced the importance of evaluating options carefully and making informed decisions based on both data and intuition.

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

• I organized my plans according to weeks, ensuring that I allocated sufficient time for each preparation phase. This approach helped me avoid rushing and allowed for a more balanced and structured workflow. I made sure to set realistic goals and deadlines, which kept me on track and reduced stress.

6. Your plan for next week (Week 4)

• I plan to increase my product range with different designs and explore different types of yarn. Expanding my product variety will cater to a broader audience and experimenting with different yarns can lead to discovering new textures and qualities that enhance my creations.

Lim Quan Pin, A180861, 13/8/2024-16/8/2024

2. Your progress so far

On my second week of posting at gastroenterology department, I met my new partner from Taiwan. together we observe several procedure together such as endoscopic mucosal dissection (EMD) and ERCP. We also met Dr Kabemura, a nice dr who willing to explain how they perform procedure to patient even though he was busy on that day.

Other than that, I manage to go to the simulation lab to try the Da Vinci Simulation during my free time. It was a nice experience whereby I managed to try the tutorial and practical of some procedure such as blood vessel ligation and suturing.

However, my second week did not went well as on my last day at Juntendo University (16/8), I receive typhoon notification from university site which makes me unable to attend the program at my last day. Fortunately, I am able to go to the international center early before the schedule typhoon to get my certification of completion and also submit all the necessary documents for the program before ending my posting. Then I manage to get back to my hotel safely before the typhoon reached.

3. Your feelings and thoughts

I feel that I am lucky to get the opportunity to try the Da Vinci simulation which I had never tried before and I had practice a lot on how to operate the machine there. Yet at the same time I realize that I am still lack of skills to operate such machine especially when I saw how the medical student there operate the machine. I would have to practice more on that whenever I have opportunity. On the other hand, I was a little disappointed for my last day there whereby I couldnt able to watch the procedure on the last day due to the scheduled typhoon. I am not able to meet my supervisor in person to thank her for the guidance throughout the two weeks in Juntendo University. I am only able to thank her through Whatsapp as without her guidance I will be so lost throughout my posting there.

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

On my last day in Juntendo University, there was a typhoon schedule to hit Japan around 10am. Upon received email from university site, I was struggling whether or not to go hospital to complete my posting. I was afraid that I am not able to return all my ID and access card to university site in time and receive my certificate but at the same time I am also worried that if I choose to complete my final day in hospital, I am not able to get back to my hotel if the typhoon hits before I reach my hotel. Therefore, I decided to inform my supervisor there that I will be at the hospital site early to submit all my documents and will not be able to join gastroenterology department procedure on that day. Luckily, after I explain my situation to my supervisor, she is able to understand my situation and allow me for not attending on the last day.

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

I have my timetable form gastroenterology department throughout my posting for 2 weeks at Juntendo University. I usually get myself ready at 7am and be at hospital around 8am. I will be at hospital until 12pm whereby I will be having my lunch with my friends there. After lunch, I will continue to observe procedure until 5pm before I went back to the hotel. I will enjoy my free time until 10pm and after that, I will do some notes and pre read some materials to prepare myself for the next day.

6. Your plan for next week (Week 4)

For next week I would like to enjoy the rest of my days in Japan by going to visit some of the famous travel site at Japan before travelling back to Malaysia.

2.Your progress so far

• During the third phase of my elective posting, I transitioned from the Hepatobiliary surgery department to the Cardiac Surgery department. This change was a new experience for me since I did not have a cardiac surgery rotation during my five years of medical school at UKM.

• To prepare, I did some self-study to review the knowledge from my Year 2 cardiovascular module. Although this wasn't comprehensive, it still helped me understand the surgeries better. Similar to my previous department, I was placed in a group with students from Juntendo University who guided me throughout my time in the department.

• Sometimes, when there are multiple surgeries happening simultaneously, we are separated. In these situations, I observe the surgery alone and use translation apps like Papago to help me understand the patient's background better.

3. Your feelings and thoughts

• At the beginning of this rotation, I felt a bit lost and worried about my performance since I didn't always know the answers to the surgeons' questions. However, an experienced surgeon advised me not to worry because this isn't a familiar area for me, and it takes time to learn. He reminded me that "Rome wasn’t built in a day," which made me feel more reassured and motivated to keep learning at my own pace.

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

• As I rotate through different surgery departments, decision-making is a crucial skill, as any mistakes during surgery can have serious consequences for the patient. The surgeons often advise me to carefully consider the potential outcomes and consequences of any decision, aiming to minimize any possible negative effects on the patient.

• As a medical student, I apply this advice by being attentive during surgeries, observing how the surgeons make decisions, and asking questions about their thought process. I make an effort to understand the rationale behind each choice and consider how I would handle similar situations. This helps me develop a deeper understanding of the importance of careful decision-making in surgery.

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

• I always strive for a work-life balance. During weekdays, I focus on clinical duties and studying, while on weekends, I take the opportunity to explore Tokyo. There are several surgeries each day from 8 a.m. to 5 p.m., so I use my lunch breaks and the time when patients are preparing for anesthesia to review what I've learned and take notes.

• I will also make sure that i finished the syllabus according to my to-do-list goals and deadlines as well as before the particular surgery

6. My plan for next week (Phase 4)

• Next week will be my final few days at Juntendo University. I plan to make the most of this time by learning as much as I can. To end my trip to Japan, I also plan to visit Tokyo Disneyland.

Tan Jia You, A188027, 18 August 2024

2. Your progress so far

Next week, my program attendance is limited to three days due to a public holiday on Monday and a university closure on Friday because of an approaching typhoon. Although photography is strictly prohibited in the hospital, making it difficult to record my progress, I’m thrilled to be joining the Hepatobiliary Pancreatic Surgery Department. On my first day, I attended a conference in the department meeting room, where I was warmly welcomed by the doctors. They not only briefed me extensively about hospital procedures but also inquired about my experiences in Japan and provided guidance on what to explore in both the hospital and the city. My supervisor gave me a detailed and systematic timetable for observing surgeries throughout the week, which has been immensely helpful. With my improved language skills and the doctors’ greater fluency in English, the language barrier has lessened significantly. This week, I observed intricate procedures such as endoscopic pancreatoduodenectomy and liver biopsy, and gained valuable insights into the staging of liver cancer and the assessment of metastasis. The week ended on a high note with a delightful trip to Tokyo, where I visited iconic attractions like Disneyland, Shinjuku, Shibuya, and Asakusa, adding a memorable cultural experience to my professional journey.

3. Your feelings and thoughts

This week has been a rollercoaster of emotions and experiences. Despite the frustration of being unable to photograph my progress due to strict hospital policies and the challenge of a shortened schedule because of the holiday and typhoon, I felt genuinely welcomed and supported in the Hepatobiliary Pancreatic Surgery Department. The friendly and thorough briefings from the doctors made me feel more at ease and excited about my learning opportunities. I was particularly relieved to find that the language barrier was less daunting this time, thanks to my improved Japanese and the doctors' better English. Observing complex surgeries like endoscopic pancreatoduodenectomy and liver biopsy deepened my understanding and sparked a genuine interest in liver cancer treatment. The week wrapped up beautifully with a fun trip to Tokyo’s vibrant attractions, which provided a refreshing contrast and a sense of adventure, making this week both professionally enriching and personally fulfilling.

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

Throughout the program, I gained valuable insights into decision-making processes in surgery and patient care. Observing surgeons during complex procedures like endoscopic pancreatoduodenectomy and liver biopsy, I saw firsthand how they make real-time decisions based on the patient’s condition, adapt their techniques, and address unforeseen challenges to achieve optimal outcomes. I also learned about the critical aspects of treatment planning and patient consent, where decisions are made by weighing the benefits and risks of different options and ensuring that patients are fully informed and comfortable with their choices. This exposure underscored the importance of critical thinking, adaptability, and clear communication in both surgical and clinical settings.

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

Managing my time this week required careful planning and flexibility. With only three days available due to the public holiday and typhoon, I prioritized key activities by focusing on essential observations and interactions. I used alarms to ensure I woke up on time to attend the program and adhered to the detailed timetable provided by my supervisor, which was crucial for ensuring I observed all the scheduled surgeries. I also allocated time for language practice and clarification of complex procedures to effectively overcome the language barrier. Additionally, I balanced my professional duties with personal exploration, making sure to enjoy Tokyo’s attractions while managing my schedule efficiently. This structured approach allowed me to maximize both my clinical learning and cultural experiences.

6. Your plan for next week

I only have few days left for me to enjoy in Japan before returning back to Malaysia as my clinical observationship ended in the second week. I planned to go to the attraction in Japan as many as I can to get deepen into the culture, tradition and people of Japan. Hopefully my trip can be running smoothly without any disaster especially raining and else.

Name: THESIGAN GANESAN

Matrics Number: A188895

Date: 17 Aug 2024

2. Your progress so far

After a day trip to Jaipur, last weekend, I did some studying in the weekend about the common diseases in India. On the next morning, I continued to join the clinic around 9am. We had a short tour around the slum, which was organized by the clinic doctor. He showed us around and explained about the population of the slum, their water resources,  jobs, and its drainage systems.

There are almost 80 to 100 families staying in the slum which is about 3 acres. All the land and houses are government owned and will be chased away if their government have any urbanizing plans in that area. Most of them work as help in the metropolitan nearby, some work as contract workers and most of them are unemployed. The slum is not well maintained with no proper sewage and drainage system. This really made me think that it’s really a high-risk area for infections and many other infectious diseases.

Then I continued my day at the clinic. All the cases we attended to in that week were almost the same as the previous week. But, there were really some interesting cases that caught my attention. First, a 5-year old boy with syndromic features as the doctor suspects. He is still undiagnosed and the parents have not been guided and educated about their child’s health condition. The doctor explained that they do not have much medical literacy and are in denial even if the measures have been explained to them, hence the doctor just gave vitamins for the patient.

I was thought and guided to do wound dressing on a patient. He had a wound on his right ankle. I managed to do the dressing in that very non-sterile setting. It was really a learning experience as it’s very different from a hospital setting which is very sterile and hygienic. As there were no gloves in the previous week, one of the volunteers donated some gloves that they brought from their country.

A patient with TB, post her 6-month regimen visited the clinic for her follow-up. We studied her X-ray scans and blood investigations. I advised her to always wear a mask to prevent the spread. The doctor also thought us neuro examination on a patient who had limb weakness for 2 days. Interestingly, there was a kid who came to the clinic with an injury on her ankle which was wrapped with a hot chapati and a cloth. This was interesting as it was very unusual of treating patients with hot chapati as it’s actually a famous dish in India. Apparently, it’s a home remedy which has been practiced in that country for many years.

I also checked the vital signs and random blood sugar for diabetic patients. We had to use the medical equipments and dispense medicine mindfully as we had to serve many every single day.

On 15th August, it was a public holiday, India’s 78th Independence day. I visited the free slum school where they had flag hoisting ceremony, dance performances and lunch. On Friday, the clinic was also closed due to the unavailability of the doctor, I volunteered to teach at the local school for the kids who were really interested in learning. They had a small farewell party for us in the school. We were sent off very well and they really wished for us to visit again.

3. Your feelings and thoughts

I really had a good experience while volunteering in the clinic throughout this week. It was an experience I would really cherish forever. When helping the kids that come to the clinic, I could only pray that they be provided with good food, proper clothes, better healthcare and most importantly adequate education for a brighter future.

Again, I really felt grateful that I was born in Malaysia, as we have a better healthcare system, eat healthy food and wear good clothes. This is actually the basic need for a person. However, the Indian leader are lacking in providing this mere basic need for their citizens while being a rich country.

I also felt really happy meeting new people there and spending lots of time together. We really became one family by the end of the trip. We decided to keep in touch and prolong this great friendship we formed here. On the last day, the doctor bid his farewell to me and gave me a hug which really surprised me. It was really kind of him to do so.

As I reached the end of the trip, I was saddened by the thought of leaving this beautiful country with many memories. It was really a great trip and I promised myself to return there when I could.

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

When it was my 2nd week in the clinic, there was a situation where we had a conflict with the IVHQ New Delhi’s PIC. The reason being we saw the condition of the clinic and was curious on whether our money that we have paid was misused for their own personal reasons. The clinic was not well maintained, it was not clean, dusty, floods when it rains, inadequate medical equipments and many other problems.

When my fellow volunteers asked whether we should proceed to question the PIC. We had the discussion because by informing the PIC, they could get offended and stop this free clinic for the public. As one previous volunteer quoted on her FB post that they stopped the programme for 2 months as she complained to them about it. But when she came back the condition was still the same.

This people needed the help but we wanted to seriously address this issue to the PIC. So I learned that we can handle and address it by not offending the PIC. I also learned that I can avoid any conflict if I talked to him with the right tone, right words and in a way that he would understand.

Hence, I decided to talk to him on Tuesday that week. He also visited the clinic saying that I wanted to provide some funds to renovate the clinic as it was in a very bad condition and it needed lots of work done. This was only to provide the slum residents with better healthcare. I communicated well with him and it was a good discussion. We understood the problem and I thanked him for spending his time to answer my concerns. He was happy that I approached him instead of spreading rumors on social media.

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

I managed my time very well throughout this EP journey. It was really easy to manage as we had a routine everyday. I would wake up around 8am, have breakfast and go to the clinic. We will be back around 1am. I would rest for a while before having lunch with the other volunteers. We would talk about our day and the interesting events that happened. Then we would plan on what to do for the rest of the day. On some days, we went out and the other we would attend yoga classes in the centre nearby. We would be back by 10-11 pm and call it a day.

Having the same routine everyday really helped me to manage my time there very well. Since we managed it well, we were able to have impromptu outings as there were extra time to spare. Planning the day earlier with the other volunteers really helped to connect us more, be on time, rest well and also have fun.

6. Your plan for next week (Week 4)

My plan is to go back home and unpack my travel bags. Write up my reflective writing and also create the video for my EP presentation. Also, I would like to visit my friends, to pass them the souvenirs that I got for them from Indian. Share the desserts and snacks I bought for my family members on the weekend. I really hope to have a smooth journey back.

Healing in the heart of India 🇮🇳: Medical Volunteering in New Delhi

2. Your progress so far

   In the third week, I have joined the Internal Medicine department. It is because our person in charge has allowed us to join any department that we wish to. In the morning, I went to the Internal department; upon reaching, I met a friendly MO, and she has directed me to a consultant (Team A). The consultant has asked me to join the meeting for discussion of cases covered in Team A. After that, I joined the ward round. I also have an opportunity to join the cardiology outpatient clinic. I walked into the clinic and introduced myself to Dr. He told me that today has no patient (and I was shocked internally by how little the patient has in SQUH!!). However, I still stay inside the clinic, and Dr. was so nice to teach me a lot of cardio knowledge. I also took the chance to ask the bunch of questions about which I was curious previously. It was a nice 1-to-1 Q&A session at the end. I was also able to join the hematology department. I was so excited to meet some Malaysian nurses there!! They have worked here for around 10 years and have told us how Oman is a slowly developed country. However, the healthcare workers here have the most work-life balance jobs! They have taken care well for us during the journey. They brought us outside and treated us to food such as camel, Turkish food, and fits. It was really a pleasure and gratitute to have them on the journey.

   
   

3. Your feelings and thoughts

   I am feeling fruitful and productive during this week.I always feel lucky again to have a lot of kind people around. This reminds me that we always need to help each other in foreign countries. I will remember the kindness of the nurses and everyone here and do the same to the others that need my help in the future.

   
   

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

   For me, decision-making skills are needed throughout the journey. It is because we need to take care of our own in another country, which I am not familiar with. In the purchasing part, I have a limited budget, so I need to have a well-planned trip and think twice before spending the money to make sure I can still have money before I return to Malaysia. I also learned I need to take responsibility for my own learning process. I need to make good decisions to be motivated to search for opportunities (when there is less of a spoon-feeding teaching session) to make sure the exchange is a meaningful one.

   
   

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

   Besides every morning going to the hospital, I lead a work-life balance lifestyle here. In the afternoon and weekend, I will hang out with other friends to explore the beauty of Oman! Every weekend, we will have an overnight social program. It was exhausted, yet it was enjoying.

   
   

6. Your plan for next week

   Continue staying in Internal Medicine department. Join the lecture by my supervisor if there is any.