Main Objectives of the various postings

 

1.      E-clinics

§          You learn history taking and physical examination

§          By the end of the posting, you should know the questions to ask for each system (e.g. abdominal pain, bowel habits for GIT), and have your own smooth and fluid sequence of physical examination for each system (general appearance, then nails and hands, then eyes, then mouth… and the patient does not have to sit up and lie down, toss and turn too many times). Check the annex for my own personal example for GIT, for your reference.

 

Text Box: FAQ: Is it really important that I know history taking and physical exam very well?             Yes. The art of History taking and Physical Examination is largely what makes you unique as a doctor, and there is no better time to get a solid foundation than in the E-clinics posting. After this, you will simply be fine-tuning the same skills throughout your professional life.             Only after you’ve got the sequence at the back of your hand then can you recognize and remember the signs confidently. For example, during examination of your patient, if you keep thinking of “what’s next, what’s next…” it will be hard for you to remember and consolidate the findings.

 

 

 

 

 

 

 

 

§          Start to learn how to present cases well. Practise presenting to your peers. The best people to ask about this is probably M5 and above.

 

2.      General Medicine / General Surgery

§          I assume you have been given a CD on the core curriculum. This is also available online in http://mednet.nus.edu.sg/m3/m3.htm. At the start of every posting, look through the curriculum – the cases are classified as “Must see, Must know”, “Good to see, Must know”, “Good to see, Good to know”. Print out the table of cases for your own reference.

§          If you look through the logbook, you will realize that the cases printed in the logbook are “Must see, Must know” cases. Fill in other cases in the list provided at the back.

§          Strike a balance between seeing and knowing (aka studying) – we all know the Sir William Osler quote. To do that requires some discipline – that you try to study what you see on the same day. Try not to touch the weekends because they are precious for rest and relaxation, or “recreational reading” ;)

 

 

Text Box: FAQ: Why MUST I see? Why MUST I know? They are common, they are important (duh…), and they are most likely to appear in your exams, and if you’ve never seen it, you probably won’t recognize it well enough to help the patient (or yourself in the exam).   Do I know enough? Well… if you ask me, there’s nothing such as “know enough”. If you read around topics like you’d done in PBL, you can spend quite a bit of time on one disease or patient. However, it is also important that you stay focused and see a variety of cases, so a good guide is to follow objectives in the core curriculum. This should be the minimum you should know by the end of M5. For me, there’s no better time than NOW.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

§          Do not fill in the logbook just for the sake of filling it in. There are strong reasons why I’m warning you now. Strive to seek cases and see them, clerk properly and systematically and know the cases in the logbook. Record systematically in your own notebook. It should look like a mini-write-up.

 

Ø              Specifically for GS

Contrary to popular belief, GS is not totally about watching operations.

o         On one hand, you have to learn about basic surgical principles and familiarize yourself with basic surgical techniques.

o         On the other, you have to learn about the surgical diseases!

Text Box: FAQ: What makes a Surgical disease and what makes a Medical Disease? Well, this may be obvious to some, but perhaps not to me. At this point in time, this is how I see it... Surgical diseases usually require some form of surgical intervention for definitive treatment, e.g. gallstone cholescystitis. Medical diseases usually are treated without the scapel, e.g. rheumatoid arthritis. The distinction between the two is not so clear cut many a time. E.g. lung cancer may be a “medical’ disease but surgical lobectomy is required to treat it definitively. Hence the word “General”.  


 

 

 

 

 

 

 

 

 

Index    Overview of M3    Basics    General Hospital Layout    General pointers in clinical work   

Main Objectives of the various postings    Books      Case Write-ups    Presentations

On-line resources    General Tips for Exams    Ethics

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