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  1. The Theoretical Doctor @[email protected]

    An article regarding my Reflection of 2025.

    -

    #writing #doctor #malaysia #medicalofficer #houseofficer #2025 #reflection #blogging #healthcare

    theoreticaldoctor.com/2026/01/

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  2. The Theoretical Doctor @[email protected]

    12 Hours Shift – Counting Down My Hours Each Time At Work

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    How do you waste the most time every day?

    At the time of writing this article, which was back in June 2025, I was going through my 6th Rotation of my Housemanship which is in the Department of Emergency and Trauma. As a House Officer in the Emergency Department, we go by the 12-hours shift.

    This meant, our shift is from:

    • AM Shift: 7am till 7pm
    • PM Shift: 10am till 10pm
    • Night Shift: 10pm till 10am

    In this department, they are strict in regards to adhering to a minimum of 60 hours per week in total. Thus, in a week, our schedule is as follows;

    • A total of at least 4 daytime shifts (AM or PM Shifts)
    • One night shift
    • One off day

    That is provided one has off-tagged of course.

    Perhaps, it is the “last paper syndrome” that I was experiencing being in the 6th and final rotation, I would be counting down my hours each day at work. Thus, upon arrival at work, I would start my “12-hours countdown“ on my phone.

    On slow days, I made it a point to go to toilet every hour, technically my so-called “hourly break” whereas on busy days, the toilet break is the only time I could take a break. This is followed by ensuring I have at least one meal per day during my shift.

    Otherwise, the schedule in the emergency department is relatively better as compared to my previous rotations. Nevertheless, the tiredness is still there.

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  3. The Theoretical Doctor @[email protected]

    My First Day Of Locum And As A Medical Officer

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    A locum or locum tenens, is a person who temporarily fulfils the duties of another; the term is especially used for physicians or clergy.

    – Wikipedia.

    The first time I ever tasted or ventured into locum or a so-called “part-time doctor” was on the 3rd of August 2025.

    At that time, I was back in my hometown and on a 3-weeks-break post housemanship / internship at a small private clinic, yet to officially begin as a Medical Officer.

    While I was in medical school, I would occasionally hear this term “locum” from my fellow seniors or batch mates, lecturers, parents or even friends of my parents. However, in order to locum, one would need to be fully registered with the Malaysian Medical Council (MMC) and possess a valid Annual Practicing Certificate (APC). In short, I had to graduate medical school, finish my internship or housemanship first, then only am I able to dive into this.

    Thus, upon acquiring my full MMC and APC licence, I was looking forward to locum. Looking forward to it as well as nervous to dive into this. Thankfully, I had just completed my final rotation in the Emergency and Trauma Department.

    In the Emergency and Trauma Department, there are various zones in which the patients would be triaged into in terms of presenting complaints, severity and their vital signs. The least critical in severity would be triaged into Green zone. The Green zone is similar to a clinic setting, thus, it gave me some idea on the type of cases I would be expecting.

    My first locum was just 3 hours long, from 7pm till 10pm. I figured that since I am just starting at that time, it would be better to start with minimal hours in order to get used to it and also.. if I would enjoy it.

    The clinic was quaint and small but equipped with basic necessities and a scan machine. The only thing that it did not have, was an x-ray facility. The moment I sat down, the patients kept coming back-to-back. As soon as I was done with one, another came.

    For a first-timer, I felt it was equivalent to the Green Zone in General Hospital whereby the cases were always there but the patient load was manageable.

    However, I was extremely scared.

    Mainly afraid that I might accidentally jeopardise the patient’s safety in terms of mismanagement. Thankfully, by 9:30 pm, the clinic assistant stopped accepting new patients and prepared to close the clinic.

    For a first experience, it was a good one despite it being rather terrifying for me.

    But, we all have to start somewhere and build our confidence, don’t we?

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  4. The Theoretical Doctor @[email protected]

    My First Night Shift In Emergency & Trauma | Housemanship Diaries

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    Remember when I mentioned that I love the night shifts?

    No? Well, here are the articles advocating my love for that shift:

    Photo by Chauhan Dixant on Pexels.com

    My first night shift in this department was in the Red Zone and I was terrified.

    Thankfully, it was with a fellow Registrar who is rather patient, kind and one who loves to teach.

    The scary part however was that it is the Red Zone after all and on my first night!

    The Red Zone basically caters to patients who are unstable be it haemodynamically or in terms of their vital signs or that they are in a state of severe acidosis, on the verge of collapsing, you name it. Basically, how severe of a state a person must be in to end up in that zone.

    The night started off smoothly with cases coming in one at a time. Alright, I kept repeating to myself, “attend them, transfer them to another bed, vital signs, bloods, fill out forms, clerk and basically just listen to your superiors”.

    The night eventually turned into midnight and into the wee hours of the morning and finally the sun has risen. Before I knew it, it was 7am and the AM shift House Officer has arrived. I am not alone again.

    Time to prepare for handover rounds at 7:45am.

    It was better after that, having another person with me as it felt less intimidating.

    At 10am, I took off and headed home. Not a bad experience for the first night shift.

    The good thing about the night shift in the Emergency and Trauma is that we are not alone. There is always a team or at least your superiors are always there.

    However, I don’t quite prefer the night shift in this posting. Having actually completed this posting, at the time of writing this article, the daytime shift is definitely better.

    Nonetheless, in all the night shifts, albeit that it could be a terrifying one especially prior to the start of your shift, always remember that you are never completely alone even if it feels like it and that help is always nearby.

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  5. The Theoretical Doctor @[email protected]

    Life After Offtag In Emergency & Trauma | Housemanship Diaries

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    The tagging hours in the Department of Emergency & Trauma is from 7am till 10pm, for a total of 10 days and one off day per week. There are no assessments required to off-tag, only hours required to cash in.

    During our tagging season, we were not allocated for night shifts as well.

    For me, tagging in this posting felt like an eternity. I remembered counting down my days before I would finally “offtag” and be switched to regular working hours. I also remembered being extremely exhausted at the end of my shift, wondering how did my fellow colleagues managed to pull through.

    Tagging in this posting as compared to the other postings was considered less stressful as we were not required to arrive early for morning rounds. We merely had to arrive on time and upon the end of our shift, we leave, as compared to other postings where we would stay back almost every time, cash in “unpaid overtimes.”

    Finally after 10 days of tagging, I officially “off-tagged“.

    So how was life after that?

    Much better. Thankfully.

    Regular hours in the Emergency & Trauma Department meant working a 12-hours shift per day with an off day per week and a single night shift.

    Basically, we had to ensure that in total, we had to meet the total 60-hours shift per week.

    Thus are the timings for our respective shifts:

    • AM Shift: 7am – 7pm
    • PM Shift: 10am – 10pm
    • Night Shift: 10pm – 10am

    If you have read my articles on “The Joy Of Working The Night Shift As A House Officer” as well as “My Favourite Time Of The Day At Work“, I mentioned that I absolutely love the night shift. The disadvantage of working the night shift is that we are usually alone and the night shift can be rather unpredictable.

    However, it is not the same for me in this posting. Out of the shifts listed above, my favourite is the AM shift, 7am till 7pm. Initially, getting up for work at 7am is tough especially after working the PM shifts back-to-back. But after the initial morning sleepiness wears off, the day proceeds as usual and we return home at 7pm which is nice.

    Life after offtag in this department ensured that I had adequate rest prior to my shift starting. No doubt, it is a 12-hours shift every time, we usually arrive and leave work on time as compared to other postings.

    Nonetheless, I was still exhausted after every shift. Perhaps it was due to the accumulated mental and physical stress throughout the previous five postings that when I am finally blessed with extra rest, I am still tired.

    If you are still in the tagging phase, be it in this department or others, please stay strong. Remember that it doesn’t last forever, it is merely over a certain span of days or weeks.

    Keep showing up, keep doing the good work to the best of your strength and abilities and keep moving forward.

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  6. The Theoretical Doctor @[email protected]

    Day 1 Of My Final Posting – Day 647 Of Housemanship

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    My first day of my final posting, The Emergency & Trauma Department, commenced on the 11th of April 2025.

    Day 647, finally. Finally! I’ve pulled through and entered the last pit stop of my journey as a House Officer.

    In every posting, I have always looked forward to this posting. Prior to joining, I’ve always had mixed feelings and initially wanted to join Anaesthesiology. However, a few weeks prior to entering, the other postings such as Psychiatry, Klinik Kesihatan and Anaesthesiology were removed from our options and everyone had to rotate in the Emergency and Trauma Department.

    This is good. This meant more manpower.

    However, just as the previous postings, prior to joining any new department, I’ve always had this fear and mixed feelings because it is after a new environment.

    My fear was stumbling too badly on my first day. Thus, of course, I did my research and questioned the people I knew who were already in the posting.

    My First Day began on a Friday in the “Yellow Respi Zone“.

    The Yellow Respi Zone consists of patients who are unable to saturate well under room air, usually less than 90%. Having just completed the Medical Posting, the patients allocated there are primarily Medical patients or in particular, having respiratory issues such as patients developing acute pulmonary oedema or fluid overload secondary to non-compliance to their fluid restriction.

    Thankfully, I have just completed Medical. Thus, I am able to apply my knowledge learnt which was still fresh at that time.

    I arrived a little before 7am since the tagging shift is from 7am till 10pm, introduced myself to the medical officers and talked to a fellow friend who arrived and would be working in the same zone as well. I went through the triages and casenotes of the patients to see if there were any active cases or cases that were due tracing of bloods or referrals.

    The day started off rather quietly and it was manageable. I followed the morning handover rounds at 7:45am and after that attended to any new patients or refer if needed.

    Basically, when a patient comes in, especially to this zone where the patients’ chief complaint is “shortness of breath“, the first person who attends would usually auscultate or “listen” to the lungs and check the vital sigs prior to taking blood or doing a “full clerking” such as obtaining their past medical history or history of presenting illness.

    The next person that steps in usually helps with the bloods and fills the forms.

    Everyone worked together as a team and somehow indirectly we were communicating with one another without actually voicing it out. It seemed almost like a dance, or a workout.

    Afternoon came and afternoon handovers started at 2:45pm. I met a lovely medical officer who is a junior herself but one who was extremely upbeat and more than happy to guide me.

    I learnt a lot during my first day with her. She even encouraged me to consider joining this department during my floating period.

    The evenings became extremely busy to which I did not really realise. Maybe because it was my first day or maybe because I have just completed my Medical Posting (and it was much busier over there), or perhaps because I simply enjoyed working with my superior or team on that day.

    The day ended at 10pm and I walked back home. Thankfully, I lived within walking distance thus I saved time and did not have to worry regarding transportation or parking issues.

    My first day in my last posting or rotation started off well which is something I’m more than thankful for.

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  7. The Theoretical Doctor @[email protected]

    Surviving 10 Days Of Tagging | Emergency & Trauma Department

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    My tagging days in my sixth and final rotation, Emergency and Trauma Department, lasted for a total of 10 days which was from the 11th of April till the 23rd of April 2025. This is excluding our one “off day” for the week.

    Did I manage to last throughout the tagging days?

    Not quite.

    I did take a sick leave during my second week of tagging. The reason was that I was just extremely tired.

    Photo by Pixabay on Pexels.com

    The tagging hours in the Emergency and Trauma Department is from 7 am till 10pm, just in other postings.

    The good thing about this department is that we do not need to do morning reviews. Thus, coming way early prior to our shift is unheard of. We merely come and leave on time.

    However, considering that it is the Emergency Department, things are unpredictable whereby things could be quiet one moment and hectic the next.

    Hence, on days which burn, it can be extremely tiring. But, completing these tagging days are a must and so on slow days where the hours seem to pass by really slowly, I make it a point to have an “hourly toilet break“. On busy days, it may be the only time that I am given a chance to sit and breathe.

    On top of that, I made sure I took my lunch and dinner break. Not because I was hungry as I was used to having my meal for the day after work. It was merely my way of spending my time during my tagging days.

    At 10pm, the shift is over and I leave, even if the floor is busy because the following day my shift begins at 7am again.

    Finally after 10 days of “tagging“, I have finally off-tagged and shifted to “shift hours“.

    Photo by Andrey Grushnikov on Pexels.com

    There are no assessments in order to off-tag. as there were in other postings, which is a good thing. However, tagging in this posting felt long and seem to went on forever for me. Perhaps, this was because I was mainly tagging alone as I entered a month later than my fellow peers.

    Nonetheless, I was glad to be done with this schedule and shift back to a regular 12-hours shift.

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  8. The Theoretical Doctor @[email protected]

    Overcoming My Fear To Refer A Case I DO NOT KNOW | Housemanship Diaries

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    What fears have you overcome and how?

    At the moment of writing this article, I am in my sixth and final rotation which is in the Department of Emergency Medicine, pushing into my third month.

    One might think that as we become more senior in our current job, it gets easier or the fear fades.

    Well, the anxiety certainly reduces but that does not mean that it disappears.

    For me, the fear is still there as to who I would be working with or who I would be referring to and most of all, referring a case that I not know.

    I’m sure we’ve all been there before. Especially upon arrival to work and to be absolutely clueless about the patient and their case and progress and to not have anyone handover the case to you.

    Not that we won’t take the time to understand. It is just that, we will or at least I would take the time to digest the initial presentation, clinical examination and findings followed by the initial management of the patient and other teams as well as the current progress.

    Once I have finally understood the issue of the patient from A to Z, then I can confidently refer the patient for a simple thing.

    That’ll usually take me about 5-10 minutes, especially if there is just one too many writing. To others that may seem like an eternity.

    The thing is they will somewhat give me a template of what to say in regards to the patient but I am still absolutely clueless and wishes to kindly absorb the pages and information about the patient before I walk into the battlefield.

    This is because, one too many times, I will be asked about things totally irrelevant to the case of the patient which will take me some time and if I’m not so lucky, ended up being shouted at. I mean, that’s the worst that can happen right? Certainly reminds me of my early days of housemanship.

    Maybe it’s a form of childhood trauma or maybe not, but I need to at least have a reason to defend myself and the patient.

    It’s like a debate or a business deal which I find that I may need to fib or exaggerate myself in order to get a test approved or to refer, all for the sake of the patient or sometimes the superiors.

    It’s alright but at times it can be rather annoying especially when they want it done in a minutes time.

    The next that I have to actually open my mouth and communicate. Being an introvert, I can easily talk to people but I dislike being in groups, small talks or actually talking at times.

    I find it exhausting and thus upon the end of my shift, I just need time to recuperate.

    However, back to the question of this article, my fear, to refer to other departments, especially, if it is a case I do not know and to a tiger of a person who loves finding any fault just to reject the case is still present to this day and what have I done to overcome it? Nothing, really, just extreme patience.

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  9. The Theoretical Doctor @[email protected]

    My Last Shift As A House Officer in Medical | Housemanship Diaries

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    At the time of writing this article, I am no longer in my Fifth Rotation, Medical but already in my Sixth Rotation, The Emergency and Trauma Department and at the same time, due for my last shift in my Sixth rotation as well as being a House Officer.

    Looking back, my last shift in the Medical Department seemed ages ago.

    However, I remembered that I was night shift at that time and was at Male Medical Ward (MMW).

    My duration working in this ward was around 3 weeks. However, it was my least favourite as compared to Medical 3, Medical 4, the Infectious Disease (ID) Ward or being part of the Perimedical team. The superiors were alright but it was the vibe of the ward in general that I found unsettling that I can’t quite place my fingers on.

    The night shift in Medical is from 8pm till 9am. However, on that day, I recalled leaving home at 6:30pm to go to work as we were not allocated any “long day” shifts.

    “Long Day” or “LD” are those who work from 7am till 10pm. Thus from 6pm till 8pm, prior to the night shift person coming, there is a 2 hours gap which is filled by them.

    On that week, there were no “Long Day’s” and everyone had the opportunity to return home at 6pm. However, who would fill in the “2-hours gap”?

    Thus, I remembered me and my colleagues at that time coming into a mutual agreement and compromise that one person would stay till 7pm and the night shift person would arrive an hour earlier at 7pm.

    It was a good compromise except there would be nobody to accompany us till 10pm and usually their help is valuable. Those hours till 10pm can get rather hectic at times.

    I remembered arriving around 6:45pm and started receiving handover from the AM teams and was cautioned to lookout for a particular patient in the acute cubicle who was rather unstable.

    Upon finishing our handover, the Medical Officer on-call for that ward arrived and things started to go hectic.

    I can’t exactly remember what happened but I was on my feet the whole time and did not begin my “coming mornings” till 3am.

    Thankfully, I was still able to complete them before 5am and the morning bloods were out in the system on time.

    That morning during my post night shift, I was “summoned” for minimal bloods which I completed immediately. Usually during my post night shift, I would remain within the sights of the “AM team” and offer to help out where I could.

    But I remembered at that time that I was completely spent. I decided to rest in the House Officer’s room and take any bloods a little later prior to my shift ending, if there were any.

    Surprisingly there were none after that. I recalled seeing a junior taking the blood of a patient as I was exiting the ward and asked him as to why he did not just ask me.

    He claimed that upon arriving for his morning shift, I looked rather spent and after I left to take a short break in the House Officer’s room, he just did not want to disturb me. After all, he said, it was only one patient.

    I was touched and grateful. It was a small gesture. However, it’s small, simple things that sometimes touches you.

    After that, I clocked out for the last time as a House Officer in the Medical Department.

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  10. The Theoretical Doctor @[email protected]

    Jobs That I’ve Had

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    What jobs have you had?

    Teacher

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    My first job that I’ve ever had was as a Teacher.

    I had just completed my STPM which is a form of pre-university course in Malaysia, equivalent to that of the UK A-Levels and I was waiting for my results.

    At that time, I was on a holiday with my parents and was perusing through Facebook when I came across an advertisement on a job offer at a nearby language centre, looking for an English Language teacher.

    Without any expectations, I applied for it. At least, I’d have some exposure and regularity prior to entering Medical School in September that year.

    Shortly after I returned home, I received a call and an email responding to my application. I went for the interview session and was soon called back and offered a job to which I accepted.

    Barista

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    My second job, I was a barista at a coffee shop as well as worked at the cash register of a store, both at the same time during my first and second year of medical school after which I stopped and subsequently used to work as a waitress for an F&B company. That was my third job. My second and third jobs were jobs mainly to earn extra cash after classes amidst my free time.

    Looking back, I probably should’ve just focused on my writing.

    Junior Doctor

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    My fourth and current job is working as a junior doctor at Sarawak General Hospital. I still am one since I started practicing in 2023 and is currently going through my sixth and final rotation (at the time of writing this article) before finally receiving my full APC or license to practice independently both in government or private sector.

    Am I ready for it? Certainly not.

    However, somehow I haven’t quit and I kept pushing through. I don’t know how or why and before I knew it, 2 years has flown by.

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  11. The Theoretical Doctor @[email protected]

    Reflection – After Almost 2 Years Of Practicing As A Junior Doctor

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    “Would you want to return back to medical school?”

    No.

    I enjoyed my 5 years of medical school very much and I appreciate the memories formed throughout those years.

    However, after working as a junior doctor for 2 years, I would not consider turning back time, just to go through medical school all over again. I enjoyed studying and it was equally tough and fun. Besides that, I had the best study group, “The Impostors”.

    Going through the COVID-19 Pandemic season of social distancing and online classes made the journey easier. I remembered staying back in Kuala Lumpur and waking up in the morning prior to starting class just to set up my laptop and my connecting screen, sending the link earlier to the group, sharing the slides if needed and while the classes are on-going, I would go about cooking, cleaning or folding clothes.

    My coffee and tea would be on standby and everything was prim and proper. Besides that, breakfast, lunch and dinner would always be prepped by me, for me or my friend who lives upstairs. After that, I would proceed to study during the wee hours.

    I think the time I managed to complete reading various textbooks were during the COVID pandemic.

    Then, I graduated and started my housemanship. It was extremely tough at first and it’s still difficult now at times but I’ve grown to accept the fact that there will be difficult days as well as good days.

    Three months later after starting my housemanship journey, my first pay was banked in and subsequently, every month I received my monthly pay.

    Eventually as I become more and more senior, things became more and more familiar and easier and some things or procedures became a reflex, even the management plans.

    Thus, considering, the things that I’m doing now which I think is much easier as compared to my medical school days, would I want to turn back time?

    Nope. Medical school is important and equally tough. On top of that, I’m not getting paid. Instead, my parents had to pay for my medical school fees.

    So, no. I cherished those days as I said. But I certainly do not want to relieve them again.

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  12. The Theoretical Doctor @[email protected]

    Preparing For My Exit From The Medical Posting As A House Officer | Housemanship Diaries

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    Medical. My Fifth rotation.

    While I was in Medical School, my favourite rotation was the Medical Posting and I’ve always imagined myself being a Medical Officer in Medical.

    Thus, upon entering my Housemanship Journey, I did not choose to rotate in Medical as my first posting. Many people said that the Medical Posting is the most difficult posting of all the postings due to the patient load as well as the workload.

    Thus, I began in Orthopaedics and placed Medical as my Fifth Posting. Mainly, because I wanted to “enjoy” it. Enjoy it in the sense that I already knew the basics and knew how to function as a House Officer and would be able to learn how to manage the patients.

    However, albeit being a senior poster, some old habits retain. In the Medical posting, we were required to hand in our logbooks 2 weeks prior our End of Posting Date.

    However, I approached my mentor 5 weeks prior my exit. Unfortunately, my assigned mentor at that time was not available and asked me to approach my Specialist-in-charge of House Officers at that time to request for a new Mentor.

    I approached the Specialist-in-charge and was assigned a new mentor which happened to be someone I worked with multiple times while I was in Medical 3.

    The following week was a rather tensed week for me as I tried my best to cram as much as I could.

    I finally had my assessment with my first mentor who is a Medical Officer that Sunday. Thankfully, I passed.

    2 days later, I went for my assessment with my second mentor, my reassigned specialist, who passed me as well.

    The issue next was the completion of my 12 CMEs. CME stands for Continuous Medical Education which occurs once a week on Tuesdays. In other postings, only 5 CMEs were required in order to pass. Sadly, it is not the same for the Medical Posting.

    Unfortunately, CMEs done online were not acceptable even if there are certificate of attendance.

    Luckily, I had attended a Hospital CME some time ago and I was only looking for ONE more CME prior to my exit of this posting.

    Thus, I used that to my advantage and finally, I was able to hand in my logbook and officially exit the posting.

    Sadly, a few days prior to my exit, something occurred that led to the demise of a patient. But, that is a story for another article. Thankfully, that did not affect my exit from this posting and I exited, on time.

    If you are due to finish the Medical Posting or any posting in general, take it as a lesson from me and approach your assessors much earlier.

    Otherwise, all the very best!

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  13. The Theoretical Doctor @[email protected]

    Surviving The Night Shift As A House Officer In Medical 3 | Housemanship Diaries

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    The Medical 3 Ward of Hospital Umum Sarawak or “Sarawak General Hospital” is located on the 9th floor of the main building.

    Thankfully, being allocated as the Night House Officer, we only had to take care of one ward, unlike being allocated in Medical 4 / Medical 5 / Infectious Disease Ward or being in the Perimedical Team whereby we were always on the go.

    The Medical 3 Ward consists of three teams, which are General Medicine, Respiratory and Neuromedical.

    During the daytime, we have allocated House Officers for each team. However, during the night shift, we are in charge of the whole ward.

    The jobscope of the night shift House Officer in this ward is the same as in other wards and postings which are transferring in of new patients, attending to acute issues and most importantly, coming mornings.

    If you have read my previous article on Surviving The Night Shift In The Medical Posting In General, I mentioned that in this posting, upon my arrival to the ward for my night shift, I would begin taking my coming mornings.

    The same goes for Medical 3. However, unlike the night shift in Perimedical, I do not take my arterial blood gases with my coming mornings.

    I begin from the Respiratory cubicles which is located at the back of the ward and then move to the front cubicles before finally continuing at subacute and acute cubicles which are the beds located in the middle of the ward, in front of the nursing counter.

    If I were late for my coming mornings, then I would proceed with taking the arterial blood gases together. But if I finished early, I would take the blood gases much later.

    By 5:30am – 6am, I would start running my blood gases and paste them in the casenotes of the patients. Around 6am – 7am is when the morning team starts arriving to trace the bloods as well as begin their morning reviews.

    Thus, I wait to be summoned for my bloodtaking or certests.

    Finally, at 9am, I return home from my shift.

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  14. The Theoretical Doctor @[email protected]

    Surviving The Night Shift In The Medical Posting In General | Housemanship Diaries

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    The shift that I have always dreaded but enjoyed the most were the night shifts. I dreaded it because I knew that I would be alone most of the time and afraid that I would not be able to cope with the adrenaline rush or anxiety or the craziness that might ensue. However, I enjoyed it because that meant that I will be able to sleep in prior to going for my shift and the following day at 7am, the morning team will start arriving and I am not alone anymore.

    The Medical posting in general is a “heavy” posting because of the patient load. Almost all of the patients are so-called “Medical” patients once Surgical, Orthopaedic, Psychiatric or other causes have been ruled out, and it could stem from something as simple as electrolyte imbalance to myocardial infarction or stroke.

    Thus, imagine the amount of coming mornings.

    Prior to entering this posting, I’ve always enquired and listened to my fellow colleagues’ input and experiences. Most of them would say that “In the Medical posting, the rule of thumb for surviving the night shift is to start taking the bloods as soon as you arrive for the night shift”.

    True enough. That is something I have practiced since and even in other postings as you do not know just when something may happen and next thing you know, the sun is rising and your coming mornings are late and the morning team have arrived and the bloods are still pending or not in the system or yet to be taken and the medical officers and specialists have arrived.

    Sadly, when there is a delay in the blood investigations, there is a delay in management.

    Thus, it is a tachycardic moment for me. Prior to entering my shift, I would screen through the coming morning list and upon arriving, I would usually prep my trolley, ensure my coming mornings are divided and arranged according to their cubicles, ensure enough syringes and needles are set aside as well as the alcohol swabs and cotton swabs.

    Then, I will begin taking my coming mornings, usually working my way from the back of the ward then towards the front cubicle, subacute cubicle and finally, ending with the acute cubicle.

    Usually in between, something will occur, maybe a patient newly admitted into ward or a patient will suddenly be hypotensive or hypertensive or hypoglycaemic or starts throwing up or wants to have a small talk.

    Normally, I would not mind entertaining them. However, if I’m still due to complete my coming mornings, I would proceed to complete it and I usually will not rest until I do. At least I’ll be rest assured that should anything occur in between, I would not have to worry about the completion of my coming mornings.

    The night shifts can be rather unpredictable as one minute it can seem rather quiet and calm at first and hectic the next. At times, it can get overwhelming as well.

    However, have faith and know that help is always nearby and start taking your bloods as early as possible.

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  15. The Theoretical Doctor @[email protected]

    The Most Enjoyable and Tiring Day In Medical 3

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    I can’t remember which day it was but it was probably during the weekend or a public holiday as I remembered that I was allocated on call who was in charge of this ward.

    I was allocated to “General” on that day and was I was alone at that time. I remembered sitting at the other end of the ward at around 11am when one of my colleagues who was allocated to be covering the “Neuro” patients went to have lunch.

    The medical officer on call at that time, a rather “happy-go-lucky” and rather jovial person struts into the respiratory cubicle and asked if there were any house officers available?

    To which I responded, we’re right here and he came over. He asked for the person who was in charge of the front cubicles which happened to be my colleague who went for lunch. I asked what’s wrong, is there anything I can help with?

    He casually replied, nothing much, just walked in and saw a patient’s pulse oximeter reading 70% under room air. Then he laughed.

    Me and my friend who happened to be there at that time were shocked and rushed to the patient. True enough, the pulse oximeter reading was 70%, well, 68%. Oddly enough, the patient seemed rather comfortable and not tachypnoeic. In fact, he was surprised as we crowded around his bed, looking concerned.

    I asked him if he was having any difficulty breathing which he was not. Thus, our first instinct was probably the machine was faulty and proceeded to check with another vital signs machine.

    This time, it was 65%.

    I proceeded to take full set of bloods while my medical officer was writing his review and my friend attempted to call my colleague.

    I ran his arterial blood gas and it showed Type 1 Respiratory Failure. Considering he did not have a baseline during this admission, we do not know if this was near his baseline or a sudden deterioration.

    We called the Peri ICU team and referred the patient for non-invasive ventilatory support (NIV). Imagine, not knowing why this long stay patient was ever here in the first place to summarising the reason for admission down to his current progress. It turns out, he was due to be stepped down to a district hospital for continuation of antibiotics.

    Well now, he can’t.

    We transferred hum to the acute cubicle for closer monitoring while awaiting the Peri ICU team.

    While awaiting, my medical officer decided to check on a patient who was handover to him for afternoon reviews.

    This lady was in her 60’s and was admitted for left pleural abscess, meaning there’s pus in her lungs and for this patient, the whole left lung was completely filled. Clinically, she seemed well, speaking in full sentences and laughing to her family members as well in the morning.

    In fact. I was even taking her bloods that morning only to have it splashed all over me after attempting to fill the blood culture and sensitivity bottle.

    I recalled walking past her as I made my way to the front of the ward and she seemed alright. However, the moment me and my medical officer oncall stood in front of her. She desaturated an started being tachypnoeic.

    Well, here’s another one.

    There goes the next referral to the Peri ICU team for intubation and also Urology for emergency suprapubic catheter insertion as we attempted to insert a urinary catheter multiple times but failed.

    Now, all these events happened very fast but at the same time, time flew by fast. The second patient was intubated and we inserted a femoral venous catheter. My medical officer then wanted to excuse himself to settle the pending discharges in his other ward. However, the first patient wasn’t saturating well under NIV and needed to be intubated.

    There goes another intubation as well as another femoral venous catheter insertion. Finally, after all the chaos, things began to finally settle down.

    I proceeded to trace my coming mornings, considering that I was the only one in charge of “General” that day and nobody would be helping me. Finally, I proceeded to begin my oncall reviews. This was around 8pm by that time.

    After completing my in all reviews with intermittent disturbance in between. I proceeded to aid my friend in preparation of her coming mornings.

    It was close to 11pm, I was just clearing my stuffs and getting ready to go when a nurse informed me that a patient seemed rather tachypnoeic.

    Annoyed and tired, I attended STAT to find a patient sitting at the side of the bed with his BiPAP machine unlatched and hanging at the side of the bed. The patient beside him then told me, he removed it himself an hour ago.

    Boy… Why am I not surprised?

    This is another impending intubation.

    At this rate, I might as well not leave anymore.

    The day was busy enough. I sometimes wonder why is it that we feel guilty to even desire to return home on time? To walk out with the family members watching us finally ecstatic to return home for the day while their family members are stuck in the hospital?

    Back to that patient, I didn’t left him gasping on his own of course, I fixed back the BiPAP machine, took an arterial blood gas and alerted my night colleague and medical officer oncall to which they attended STAT.

    Thankfully, the following day, I was allocated as night shift. Thus, despite returning home late, I was able to sleep in and recuperate a little before returning back to work that night.

    It was a busy day but considerably a rather fun one considering that I happened to work with a rather jovial medical officer oncall and my colleague stayed back to accompany me despite her shift being till 6pm.

    Working with certain people definitely helps alleviate some of the pressure of the day.

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  16. The Theoretical Doctor @[email protected]

    My Next 6 Months (Post Housemanship)

    What is the biggest challenge you will face in the next six months?

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    At the time of writing this article, it is the 8th of April 2025, Day 644 of my Housemanship Journey. I have just completed my Fifth Posting in Medical and is currently on leave as well as due to begin my 6th and Final Posting in Emergency Medicine on the 11th of April 2025.

    One posting or rotation lasts for a total of 4 months if there is no extension, for House Officers.

    Thus, it’s safe to say that for the upcoming 4 months, my focus would be on leaving and enjoying my final posting and the challenges I would most probably face then would be the completion of my logbook, preparing my presentation for CME and preparing for my end of posting assessments.

    But how about for the subsequent 2 months after that?

    That’s a grey area for me.

    First of all, I do not know myself on the department that I would want to serve in as a Medical Officer as I enjoyed every posting that I have ever rotated in.

    Next, the state or hospital that I would be interested in practicing in for at least the next few years. Currently, I am practicing in Hospital Umum Sarawak, otherwise known as Sarawak General Hospital or “SGH”, in Kuching, Sarawak.

    Personally, I would like to stay back over here and serve here rather than to go back as I absolutely love it here and feel like this is where I am meant to be.

    However, things might change in the future considering that I would want to get married and my partner is living in Peninsular Malaysia. That’s one as well as the consideration of my parents, having grown up as an only child.

    Thus, a grey area for me, nevertheless. Me, being comfortable with procrastination has pushed this thought to the back of my head and refused to entertain since I have to submit my full MMC application by the 13th of April 2025.

    This means, I have to set my mind on a department as well as my choice of state (location) or hospitals of choice.

    Oh dear…

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  17. The Theoretical Doctor @[email protected]

    My Grocery List As A Junior Doctor – While I Was In My Vegetarian Phase

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    Being a Junior Doctor or a House Officer, we are located the lowest in the hierarchy of medical personnels. That is because we have just started practicing which means there is still a lot for us to learn on top of learning how to be a safe doctor as well as the simple management of the patients’ condition down to their tailored management. Thus, this automatically translates into long hours at work, a mentally and physically tiring journey as well as a reduction in our total night’s sleep.

    Are we married to our work? In a way yes and also no.

    Not that we want to or that we are workaholics but being in this field, it is an unspoken expectation which seems to have befallen us.

    Thus, our so-called “work-life balance” is almost always in disequilibrium and we try our best to destress in whatever way suits us best.

    For me, it is cooking and recently, I have embarked on a vegetarian journey for the Lenten season (at the time of writing this article, it was during Lent), as well as a way of trying to be a pinch healthier to my already unhealthy lifestyle.

    Since I enjoy making my own meals, I rarely eat outside. Thus, the idea that vegetarian food is a little bit difficult to be obtained or ordered online, does not really bother me.

    A bright side to this is that, I’m lacto-ovo-vegetarian, meaning I consume egg amidst being vegetarian as well as dairy products and throughout my vegetarian season, I did not reduce my food portion (which may be bad). Rather, I simply changed my food choices from non-vegetarian to vegetarian and from ordering take-outs to consuming more home prepared meals.

    Thus, what are the grocery items that I ensure I stock up on a regular basis?

    1. Tofu

    Photo by Polina Tankilevitch on Pexels.com

    I absolutely CANNOT live without tofu. It is extremely versatile as I could make any kind of dish with it. Most of the time, I would simply dice it and marinade with some spices and air fry it.

    At times, when I’m feeling fancy, I would use it as a burger patty as well.

    2. Mushrooms

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    This is another versatile ingredient. From enoki mushrooms to crab mushrooms, oyster mushrooms or button mushrooms, you name it. I’m a big fan.

    I try my best to stock up on fresh mushrooms. However, since I go through it pretty fast, I would usually fall back to dried mushrooms since it is readily available in the mart of my residential area.

    3. Eggs

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    Luckily, I chose to be lacto-ovo-vegetarian, meaning if I ran out of ingredients, I could pretty much add egg, be it just cracking them into my broth or frying them.

    4. Bird’s Eye Chilli

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    Bird’s eye chilli or “cili padi” as we call it in Malaysia.

    I am a big fan of spicy food and since I go through chilli powder pretty fast, I started incorporating them into my dishes.

    Be warned though, if you’re not a fan of spicy dishes, adding one too many may render the dish unconsumable.

    5. Rolled Oats

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    This usually takes some time before it finishes.

    Since I am a “heavy eater”, I started substituting my rice with rolled oats instead, which is something I started doing 2 years ago.

    I’m not a big fan of having my oats with milk as I find it rather sweet or sometimes just bland for my palate. Instead, I prefer savoury dishes and the oats complements most of the dishes well.

    6. Curry Leaves

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    This does not really serve any purpose except I merely enjoy the aroma emitting when I sizzle it with oil, adding a nice aroma to my dishes.

    7. Random Vegetables – Cabbage, Leafy Vegetables, Potatoes, Cabbage

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    I started eating greens again.

    I have always loved eating vegetables. However, it is not easily obtained since I do not have a car, I rarely go out and the nearby residential mart does not sell them.

    Thus, I order online, I usually have a few fallback vegetables which I would add to my cart which are cabbages, any leafy vegetables, potatoes and aubergines.

    Photo by Laker on Pexels.com

    Cabbage is another versatile vegetable as I could add it to my curry dishes and it does not wilt immediately, as an extra ingredient in my stir fried noodles as well as when I cook “okonomiyaki”.

    These are my food grocery list by default. I’m not exactly a health conscious person despite being a doctor myself nor do I reduce my food portion. It is merely a step for me to try and be a little bit healthier which is sustainable for me and hopefully in time, it deems fruitful.

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  18. The Theoretical Doctor @[email protected]

    Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward

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    The Peri Medical House Officer Team takes care of:

    1. The Emergency Department
      • Green zone
      • Yellow zone
      • Yellow respiratory zone
      • Green-Yellow zone
      • Asthma Bay
      • Red Zone I
      • Red Zone II
      • Decon
      • CSSD
      • EDOU
    2. Main Building
    3. Side Building
    4. Infectious Disease Ward
    5. SDC (Surgical Daycare)

    In this article, I will be sharing my experiences as a Perimedical House Officer covering main building, side building, SDC as well as the Infectious Disease (ID) ward.

    As I previously mentioned in my previous article, the work begins from 7am till 6pm (short days), 7am till 10pm (long days) and 8am till 9am (night shifts).

    Covering this part of the hospital meant taking care of “stranded patients” which are medical patients who are lodging in other department wards as there are no space or beds available in the main medical wards. Usually, patients like these are somewhat stable enough to be left on their own without constant supervision. Those that do require, are usually left in the Emergency Department or transferred straight to medical wards.

    The Main Building

    Taking care of the Main Building meant that one would have to cover:

    On some days, there would not be any perimedical patients in certain wards. Thus, there are days that we do not have to go to these wards. On bad days, there are perimedical patients on every floor and the patient count will be extremely high.

    During my time serving in the main building, I was blessed enough to have a partner. Thus, despite the high volume of patients, it felt manageable.

    Upon my arrival, I usually begin from the highest floor and work my way down. Thus, I begin from the 7th floor by checking with the TL or Team Leader to identify new cases and update the list followed by tracing the blood investigations.

    This is to ensure that the patients are not missed during rounds.

    I proceed with doing this in the wards of every floor till I am done prior to beginning my morning reviews.

    Usually by then, the Medical Officers have arrived and are proceeding with their morning reviews.

    Sometimes, we join in and sometimes, we are asked to review the other patients and on our own until the specialist arrives.

    Upon the specialist’s arrival, we would all meet up at one place to begin out rounds.

    Rounds in perimedical is similar to that in the ward. The only difference is that rounds are once daily and the patients are all around the place.

    In between, there would be new transfer ins, attending to acute issues of which the nurses from other wards would call or inform the House Officers from other departments.

    After that, it is followed by preparation of the coming morning bloods. The wards and bed numbers are labelled on top of the forms and kept in the ETD for the night House Officers to take.

    The Side Building

    The Side Building is less hectic than main building and that meant we had to cover:

    As usual, upon my arrival, I would begin at the topmost floor and check for any new patients as well as to trace the bloods.

    After all of it is done, I begin my review in the ICU Extension 2 Ward. The ICU Extension 2 ward consists of unstable, intubated patients of various departments.

    Usually by the time I begin my morning review, the specialist would have just arrived and we begin our rounds.

    After the ICU Extension 2 is followed by Neurosurgical Ward since they are located at the same place, then Neurosurgical HDU.

    Upon completion of morning rounds is followed by carrying out the active joblists, discharges and requesting for radiological scans.

    Similar to Main Building, the coming morning bloods are prepped and kept at the Emergency Department for the night house officers to collect.

    SDC – Surgical Day Care

    SDC is the Surgical Day Care as per the name. Usually patients who are admitted here come in on the day of the procedure itself and is discharged in the evening.

    However, when the wards are fully occupied and the Emergency Department is overflowing with stranded patients, the SDC converts temporarily to host the stranded patients.

    At max, the patient load is only two cubicles full and the patients being admitted there are usually relatively stable.

    Similar to main building and side building, I begin my day with tracing the bloods, x-rays or any relevant radiologist reports before beginning my review and rounds with the medical officer and specialists.

    The Infectious Disease Ward

    The Infectious Disease Ward or “ID Ward” is located in a building separate from the main or side building.

    Previously, it used to be the House Officer’s Accommodation. However, it was subsequently converted into a ward.

    The ward consists of two floors with each floor containing 6 isolation rooms for each floor. Upon entering the ward itself, one has to change into the hospital scrubs and prior entering the ward isolation rooms, one has to don apron, shower cap and gloves, the standard PPE.

    The casenotes are not allowed to be brought in, thus all reviews are written outside.

    What do I do if I were stationed to at the Infectious Disease Ward?

    The house officer allocated to the ID ward are those from the Peri Pool, meaning our shift is from 7am till 6pm for short days.

    Thus, upon my arrival, I would change into the hospital scrubs. Then, I would proceed to trace the bloods. The bloods sent from the ID ward are usually late. Thus. It would either be pending in the system or yet to be in the system.

    Next, I will begin my reviews, first to the newly transferred in patients followed by the rest while awaiting the medical officer.

    There is a whiteboard consisting of the names of the patients in the isolation rooms. Usually in the morning prior to entering the isolation rooms, we would have a short round and presentation with the ID consultant with the whiteboard.

    Thus, during my time there, I would constantly update and personalise it according to my style which would be easier for me during my presentation with the ward consultant.

    After that, we will all proceed to the isolation room. As House Officers, we are the scribe and assistants of the medical officers. Since, we are not allowed to bring the casenotes into the isolation room, thus we will type everything inside our phone and transfer it onto paper after our grand rounds with the patients.

    Rounds at the Infectious Disease Ward is only once daily.

    After the completion of rounds, just like any ward is the completion of active joblist.

    Personally, I enjoyed my time in the Infectious Disease Ward a lot, mainly because I was given the autonomy to customise the board as I liked, present to the consultant myself and was asked multiple questions during rounds and having discussions which I find rather stimulating and enjoyable.

    On top of that, I even had time to return home for a quick lunch every time I was stationed at this ward.

    In the afternoon, some patients on high oxygen support may need arterial blood gases (ABGs) at certain time. If not, it is the preparation of coming morning bloods and transfer ins of any new patients.

    Being in charge of the other places is considerably less hectic than being allocated in the Yellow Zone which can get rather crazy at times as there is massive movement of patients constantly. It actually feels like as if I am at KL Sentral during peak hours.

    However, do not fear if you are allocated into the Peri Medical Pool. The workload can get extremely hectic and it can be rather messy. But, always try your best to learn as much as you can during your period serving there and to enjoy your journey.

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  19. The Theoretical Doctor @[email protected]

    Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department

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    Upon entering the Medical Posting, I was stationed into the “Peri-Medical Pool”. My “birthplace”, so-called.

    Prior to entering the Medical Posting, many of my colleagues commented that the Peri-Medical pool is probably one of the worst place to enter considering that it is rather hectic, busy and messy, not to mention the joblist is never ending.

    The working shift for a Medical House Officer is as such:

    • Short Day (SD): 7am till 6pm
    • Long Day (LD): 7am till 10pm
    • Night Shift (ON): 8pm till 9am

    The Emergency Department in Hospital Umum Sarawak is rather huge and consists of:

    • Green Zone
    • EDAU
    • CSSD
    • Yellow Zone
    • Yellow Respi Zone
    • Green Yellow Zone
    • Red Zone I
    • Res Zone II
    • Decon

    Usually a House Officer is allocated to take care of more than one zones.

    For example:

    • Green Zone / EDAY / CSSD
    • Yellow Zone / Green Yellow Zone
    • Red Zone I / Red Zone II / Yellow Respi Zone

    When the amount of manpower is high, the job gets done quickly and keeping track of the patients is easier.

    However, in days where we are stretched thin it is rather difficult.

    The Day Shift

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    Since I entered the Peri Medical Pool on my Day 1 of tagging in the Medical Posting, my working hours were from 7am till 10pm every day till I offtagged.

    I begin my day by first tracing the casenotes of the patients in the zone I am allocated to, snap pictures of the chest x-rays, any relevant radiological reports as well as to trace their bloods.

    If bloods were not taken or not in the system, we would then proceed to “summon” the post-night team for help with their bloods.

    After all the patients have been traced and the Google Lists have been updated (this is to aid us during our rounds as well as following up on their location later, to ensure that they are not being missed), then I would proceed with my morning reviews.

    The morning reviews are just as usual as any morning ward reviews, rounds with the Medical Officer and Specialists and finally carrying out any active joblists.

    Since we are in the emergency department, there is usually no afternoon reviews. It depends on the medical officer. Most of the time, rounds are just once daily.

    After we are done with our morning joblists, we have to actively screen through the patients in our allocated zones as there is constant movement of the patients in both in and out of the emergency department.

    Thus, this means assisting the current on-call team for the day with any STAT bloods or STAT radiological requests as well as updating their progress.

    On most days, it is manageable despite the chaos. However, on days where we are lacking in manpower, the difficulty sets in.

    The Night Shift

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    The night shift begins at 8pm till 9am the following day or until we are done with our “summons”.

    I was blessed enough to have gone through perimedical with a partner. Thus, there were two House Officers allocated for the night shift.

    As night House Officers in Peri-Medical. We are expected to continue screening through all the casenotes for any new joblist or patients in all the zones in the Emergency Department as well as to assist in any procedures, take STAT bloods or request STAT radiological procedures.

    In addition to that, we also have to cover the main building and the side building. This means, if there are any medical patients lodging in non-medical wards, we are in charge of them as well. Most of the time, it is just new transfer ins, sometimes, it is attending to any acute issues.

    This is then followed by taking the “coming mornings” or bloods of the stranded patients in the Emergency Department of the lodging patients.

    The amount of patients in the Medical Department is extremely high and thus, the medical patients can be stranded up to days in the Emergency Department which can even last till they are being discharged.

    Thus, this ensures that the patients are being continued on their treatment irregardless of their location within the hospital.

    The night shift as a perimedical house officer can get rather hectic if there are back-to-back influx of new patients in the Emergency Department, tons of coming mornings as well as acute issues in the ward.

    In the morning, the “summoned” list can get rather extensive and chaotic as well and can be rather endless.

    Hence, on top of the constant walking about the whole hospital, it can get rather tiring. But like I said, it is doable and manageable.

    In fact, I enjoyed life as a perimedical house officer a lot.

    If you are due to join Peri-Medical, fret not. Keep yourselves equipped with necessary forms and just work quick and as fast as you can.

    On some days, one might get lost in the sea of chaos. However, stay strong and know that help is always within reach and that you are not alone.

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  20. The Theoretical Doctor @[email protected]

    An article regarding my Evening Routine while I was serving as a House Officer in my Fifth Posting, the Department of Medical.

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    theoreticaldoctor.com/2025/04/

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  21. The Theoretical Doctor @[email protected]

    My Evening Routine In The Medical Posting | Housemanship Diaries

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    On most days in the Medical Posting, at least in the hospital that I’m practicing in, we are allocated to work the “Short Day” or “SD” shifts.

    “Short Days” last till 6pm. Occasionally, we would have to work the “Long Day” shift or “LD” which lasts till 10pm or “on-night” which is the night shift.

    On days where I’m allocated to work the short day shift, I try to leave work by 6pm. Most of the time, it is feasible while on some days, it is not so.

    However, my evening routine is pretty much the same upon returning home irregardless of the time I leave work.

    1. Preparing My Dinner

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    I love to cook. However, considering I live alone, the meals that I prepare are usually many for one person. Thus, I would keep the extra, rendering me an extra meal prepped for a day or two.

    Depending on my mood as well, should I be working the morning shift the following morning and I’m just too exhausted after work and there is no food, I would go for my regular comfort food, instant noodles.

    My version of instant noodles involves sautéing chopped onions, curry leaves, mushrooms and diced chilli before adding the water and mixing the instant sachet powders into the broth. I usually add additional curry powder as I like the broth of my instant noodles to be extra soupy and not dry. Once it has come to a boil, I would crack two eggs into the gravy and boil it for a minute or two before adding “half” of the instant noodles and finally topping with some leafy vegetables.

    Yes, that’s right, I only consume half. My instant noodles are extra soupy and has less noodles.

    Partly because I love adding rolled oats into my broth, thus the whole meal would be too heavy for me if I were to eat all the noodles.

    What do I do with the other half of the uncooked noodles?

    I keep it and usually comes in handy if I were to cook stir fried noodles.

    Photo by Amar Preciado on Pexels.com

    Then, there are evenings where I’m filled with energy and the following day happened to be an allocated off day or my night shift, allowing me to cook something different.

    Nevertheless, irregardless of my dish of choice for the evening, I would always prepare a set of chopped tofu and mushrooms which I would marinade with some oil, salt, crushed black peppers, diced chilli, slides garlic, curry leaves and some curry powder or chilli powder prior to air frying it.

    Thus, by the end of 10 minutes, my dinner would usually be ready.

    2. Resetting My Room

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    I don’t go through a major spring cleaning in the evenings, just simple tiny actions to reset my room back to an “acceptable” state.

    This includes folding my clothes and keeping them back in my cupboard and their designated places, taking out the trash and vacuuming.

    Considering I wash my hair every morning prior going to work, there would be strands of hairs on the floor after drying my hair and dusts and tiny debris begins to gather. Thus, I would vacuum almost every evening.

    Since I live in a studio apartment, this action is merely a 5 minute job.

    3. Preparation For The Next Day

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    “Your morning begins the night before.”

    I’ve forgotten where I’ve heard this but it’s what I’ve been practicing since I was a kid. Usually the night before, I would know of the set of clothes that I would be wearing the following day.

    Next, I would prepare my jars of cold coffee. I usually save up spaghetti glass bottles or jam bottles to keep my tea or coffees or sometimes to be even used as drinking glasses.

    I usually carry two 1.5L of flasks to work, one of it contains green tea and the other, my special prepped coffee.

    After all of that is done, next would be…

    4. Unwinding for the Day

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    This begins with me pampering myself with a hot long bath to wash myself of the stench and tiredness of the day, followed by donning myself in a soft, flowy night dress and going about my self-care nighttime routine.

    Only after that would I have dinner as I usually fall into a state of food coma after eating.

    This is then followed by me clearing the dishes for the last time and finally, heading to bed, which on some days, would be as early as 8pm. However, on average, it is usually around 9-10pm.

    This is my evening routine in my Fifth Posting, the Department of Medical, as a House Officer thus far.

    I often get questioned by my fellow colleagues as to why I would even consider cooking considering that there are a lot of steps or effort that goes into the process.

    However, I do not find it tiring at all as it is my version of de-stressing.

    Nothing calms my mind more than listening to music or putting a good show on Netflix while going about my dinner preparations with my phone in “Do Not Disturb” or “Sleep” mode.

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  22. The Theoretical Doctor @[email protected]

    Working on New Year’s Day (2025)

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    This will be the second year in a row that I’ve chosen to work on New Year’s Day. If you’ve read my previous similar article last year, I’ve mentioned how my father has this tradition of working on New Year’s Day every year, ever since he started working at the age of 18. It is something that I’ve adapted as well.

    This year, I began my year in the Department of Medical which is my Fifth Posting in my Housemanship Journey. I entered this department on the 11th of December last year.

    Having just off-tagged the week before, I was still allocated in my first pool which is the Perimedical Pool.

    Looking back as it is currently April 2025, at the time of writing this article, I do not quite remember where I was allocated to. I think that I was most probably taking care of the stranded Medical patients in the main building.

    Thankfully, I remembered it not being a hectic day and I was allocated the “short day” shift, meaning that I had the opportunity to return home at 6pm.

    Considering it was New Year’s Day which is a Public Holiday here, things were rather slow and tuned down.

    Thus, it was a rather slowed down and uneventful day, ending with me returning home on time and unwinding early.

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  23. The Theoretical Doctor @[email protected]

    A short article written in March 2025 on my reflection towards 2024.

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  24. The Theoretical Doctor @[email protected]

    A short article regarding the time I officially off-tagged just in time to celebrate Christmas with my parents in my Fifth Posting of Housemanship.

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    theoreticaldoctor.com/2025/04/

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  25. The Theoretical Doctor @[email protected]

    An article regarding my first day of tagging in my fifth posting, Medical, as a House Officer.

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    theoreticaldoctor.com/2025/03/

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  26. The Theoretical Doctor @[email protected]

    The House Officer’s Dilemma | Housemanship Diaries

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    While growing up, when I was asked regarding what I looked forward towards in the future, I always had the answer.

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    The answer was simply, I wanted to be a Doctor (coz that’s what I knew my whole life and indirectly working towards albeit having other interests).

    Thus, from primary school, next would be high school, moving towards science stream in school and pre-university in a course which would serves as a prerequisite into entering medical school. 

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    In medical school, my focus was always on the exams, completing that particular posting, completing that year, completing preclinicals and moving onto clinicals, studying for the grand finals, completing medical school and graduating.

    Upon graduation, applying for housemanship to start practicing. I always knew that I wanted to practice in Sarawak General Hospital. Thus, that didn’t require much thinking. Working my way there, and finally, starting housemanship.

    Now that I’m a House Officer, completing each posting, working towards completing a year, now focusing on completing the whole journey.

    But after that? I feel lost and aimless.

    Previously, when asked regarding my need to have a family, I would brush it off. Not that I didn’t want to but I’ve yet to meet the person that I would want to spend the rest of my life with and build a family.

    My aim was mainly catered towards my parents. But they’re doing just fine on their own. Thank God for that. I don’t see my purpose anymore actually.

    In regard to post-housemanship, I have no idea of which speciality I would like to dive into. In terms of being surgical based or medical based, the thing I learnt over this past 1 year is that I’m definitely a surgical based person. Though, I have enjoyed paediatrics very much (which I supposed is a very much toned down version of the chaotic medical posting).

    I wouldn’t know, as upon writing this article, I’ve yet to complete my medical posting.

    The medical field is not just tied to 6 different postings. As a House Officer in Malaysia, we are required to rotate to 6 different postings throughout our 2-year-duration in housemanship which are, Surgery, Medical, Orthopaedics, Obstetrics and Gynaecology and Paediatrics. The sixth posting, we have the privilege to choose among Emergency Department (ETD / ED), Anaesthesia, Klinik Kesihatan (Community Clinics) and Psychiatry.

    However, in reality, the clinical field is vast and there are other specialities that we as House Officers have yet to enter. In terms of non-clinical field, it is another vast category.

    Which of it am I?

    At times I wished that I always knew of what I wanted to be, such as a Cardiologist or a Surgeon but after assisting in the operating theatres and working as a junior doctor, none of it appeals to me 100%. Sure it is interesting but is it something I would want to be doing for the rest of my life?

    Having completed a year of housemanship, I thought that the answer would be clear to me by now. Yet, I’m still as unsure as I had been before. I’ve approached multiple seniors, medical officers and specialists and talked to various doctors from different fields regarding their experience. I seem to have the information but my heart was not fully captured by any of it. 

    Everything seems nice and interesting. I hope that in time to come, the answer would be clearer. The least I could do at the moment is to put my best foot forward in whatever department or sector that I go through.

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  27. The Theoretical Doctor @[email protected]

    My Top 5 Grocery Store Items

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    Daily writing prompt List your top 5 grocery store items. View all responses

    Working as a House Officer, I do not go out to eat much. Mainly because our days are mainly occupied with work and after work, we would be drained. Well, most of the time.

    Thus, if I were to really go out, it would be during my long breaks which is when I apply for leaves.

    In terms of acquiring groceries, I rarely go to the grocery store myself as I do not have a car of my own in Sarawak. I am extremely dependent on Grab and overtime can be expensive as well.

    Hence, I make do with the convenience store downstairs at my apartment which doesn’t really have much in terms of fresh foods or ordering online.

    Here are my Top 5 must haves in my grocery list which is available in the convenience store if I were to just shop there.

    1. Coffee

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    As I mentioned in some of my previous articles before. It is a must have drug in my system. Personally I think I have grown rather immune to the effects of caffeine over the years from overconsumption. Thus, if I’m unable to get my grounded coffee beans, usually I’ll make do with some freeze dried coffee or a regular black coffee powder.

    2. Oats

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    I replace rice for rolled oats when I’m living alone. Back at home, my mother would always cook rice as my parents love rice. However, I noticed that I easily crash or get sleepy easily after consuming rice. Thus, I substitute it for rolled oats and usually I would cook soups or curries and pour the oats over it and consume it just like regular rice.

    3. Eggs

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    It is easily available. When there is nothing else stored in my pantry and everything else is closed, eggs go about well with almost everything. 

    4. Noodles

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    Well, I’m not exactly healthy per se all the time, and I do enjoy my occasional instant noodles. Especially after work and not having a meal the whole day, I’ll just whip up a quick dish of curry instant noodles with eggs.

    5. Sausages

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    Personally, I prefer chicken over sausages and as mentioned before, I rarely go out for my groceries. Hence, I’d go for sausage since it is easily available at the convenience store downstairs. In addition to that, I can be versatile with cooking them.

    Thus, if I had to list 5 of the hat, these are my top 5 that I would shop for in any grocery stores amidst working as a House Officer.

    Again, sadly, it lacks nutrition. But, oh well.

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  28. The Theoretical Doctor @[email protected]

    Reflection of the Paediatrics Posting

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    Paediatrics Posting. The posting of tiny human beings.

    Looking back, I feared entering into the Paediatrics posting. I think I say that for almost every posting.

    However, it was one that I fell in love with before I even off-tagged, as mentioned in one of my articles previously.

    The stress level was not as bad as it was in other postings mainly because we were dealing with children. Not to say that treating them is easier, in fact it isn’t as they tend to fight back, scream or cry a lot.

    I mean they’re just children.

    But perhaps when I do come to work, the smile on their cute faces were enough to alleviate some of the stress and checking them clinically involves a skill as they are easily triggered. 

    I would find myself playing with them or calming them down. Most of the time if I were to auscultate them, they would either start playing with it, swat it away or start crying.

    The Paediatrics posting is the place I started eating again amidst the stress. Irregardless of the amount of patients and work to do, there is always time for lunch or at least our superiors will make sure of that. 

    It was also the place where I enjoyed the long rounds in the morning and afternoon as well as I would present to specialists. 

    I made a good friend with a medical officer who I still keep contact with albeit having left the posting. I enjoyed the days where I would be allocated to work with him. 

    Having worked both in the general ward and nursery ward, the experiences were different but enjoyable nonetheless.

    If there is a posting I wouldn’t mind repeating, it is the Paediatric Posting and I hope you do or will or had enjoyed this posting just as much as I did.

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  29. The Theoretical Doctor @[email protected]

    Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries

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    I tagged for almost a month here.

    The tagging timing in the Surgical Posting is from 7am till 10pm which is same as with other postings, except Obstetrics & Gynaecology (O&G).

    In the Surgical Posting, we all have to complete a compulsory 14-Day-Tagging period irregardless of having “off-tagged”. Entering the Surgical Department as a senior or fourth poster, we are allocated to special shifts such as night shifts in ward or night shifts in ethe emergency department (ETD).

    This serves as an advantage to us seniors as we do not have to work the morning shift for one week straight prior to having an off day. It is also better as it allows us to recuperate in between by not having to go to work extremely early.

    However, the disadvantage is that our tagging period is somewhat extended.

    As I mentioned before, we are required to complete a 14-Day-Tagging period. The night shift is not counted. Hence, the tagging duration can go up to 3 weeks.

    For me, it extended up to 4 weeks due to my medical leaves (MC).

    During my first week of tagging, I took a day of medical leave due to extreme fatigue and in the second week, I took 3 days of medical leaves due to extreme fatigue and COVID-19.

    At the time of writing this article, I am on a 6 weeks medical leave due to my ATFL injury.

    Sometimes I wonder, if I will ever exit this posting and proceed with my last which is medical.

    Back to the tagging part, thus my tagging period lasted for a month.

    Going to work as a tagger, I would leave home around 5:45am – 6am. Partly because I’m just tired and felt like I needed more rest because there will always be an active issue in ward and I am only able to return home at 10pm.

    In the evening around 7pm, I would go for dinner after handing over to the night colleagues and completing my tasks and on-call reviews for the day. Most of the time, it would be our first meal of the day.

    Some days, we would be done by 8-9pm and on some days, earlier. Most of us, upon completing, would head for dinner and head home or to just head home straightaway.

    This is wrong of course but we were simply exhausted and burnt-out during the tagging period. Thus, we grab the opportunity while we could.

    Towards the end of my tagging period, I started bringing packed dinner boxes and reheating them as work prior going back.

    Surviving the tagging period in the Surgical Posting was hard and tiring but eventually, it did came to an end.

    Thus, if you have yet to enter the Surgical Posting, the tagging period is indeed tiring as with any posting. However, try to learn as much as you can and take comfort in the fact that it does come to an end.

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  30. The Theoretical Doctor @[email protected]

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    “You Guys Are Angels”

    This may be a biased statement and it differs according to the individual’s experience. Thus, although I do know of the controversies I may ignite. I am merely saying this out of my own firsthand experiences and as mentioned before, each person’s experience differs greatly.

    MOs, short for Medical Officers.

    First of all, I don’t know how do you guys (medical officers) do it, pulling through an oncall shift, just to return for another oncall duty the following day after postcall. Perhaps it is because during my current batch, we have shifted fully to the “shift system”. Thus, we have yet to experience the “oncall” system which was experienced by the older house officer batches. 

    I am in awe and I appreciate the determination and discipline that goes with it. Most of the time when an oncall medical officer is on duty, they solely handle the referrals from emergency or ward and sometimes both. This goes on from the start of that day till the following morning and after which they would have to help out in clinics during their postcall, wards or even in operating theatres (OT).

    Most of the time, they are alone unless they are lucky enough to have a “tagger”. Thus it is them, the house officer, the registrar and the specialist that forms the oncall team.

    That is if they are oncall. In the wards, they rely on the house officers to carry out the active joblists, to take the bloods, request necessary scans, to resuscitate the patient first and inform if there are any acute issues and to carry out the morning, evening and oncall reviews while they are in the clinics or operating theatres or helping out in other places.

    I used to think that once we have completed housemanship, life will be better. However, after observing my medical officers and registrars, it does not actually get better, the stress is on another level, the responsibilities increases yet they pull through it with jokes and smiles. I used to think that, perhaps they have gotten used to it. On the other hand, I’m still struggling. 

    Medical Officers are in charge of the House Officers as well. Thus, if any pitfalls were to occur, of course we do get scolded but they are the ones who get reprimanded as well. I’ve lost count of the times when the medical officers have backed me up. Although I do know that, that is their duty but albeit the responsibilities and the stress, I’ve experienced it first hand multiple times when they would take the fall instead when it comes to answering the specialists.

    There are times when I do feel their anger were uncalled for. However, most of the time I understand that it mainly stems from tiredness. The patience really wears thin and snaps easily when there is lack of proper rest. 

    A lot is expected of them from the specialists and on top of that, taking care of us, House Officers too and teaching us what we do not know while trusting the patient’s care into our hands while they are off to help out in a different place. They are always a call away even if we are placed in the night shift. Thus, should there be any issues, they are always nearby and there.

    Yet, after work, after the tiring day and issues that occur in ward, they return home to their families and loved ones and try to go about their life, only to return and repeat it again the following day.

    Some might say, well, it is their duty isn’t it? I’ve heard it before.

    It is true and personally I feel that we as House Officers, although we are tired, and on top of that being tested emotionally, they are even more tired. 

    Thus, if there is anything at all that stems from this article, it is my deep and heartfelt gratitude and appreciation towards the Medical Officers, which are rarely said.

    My dear readers, if you are beginning your journey as a House Officer or is currently going through your housemanship or internship journey, have faith, patience and to always remember to be kind. Remember that as House Officers, we serve to ease the burdens of the Medical Officers on top of learning on the job, for we will one day take their place. 

    A fellow colleague always mentions this sentence while I’m in my Surgical Posting, “Don’t do unto others what you don’t want them to do unto you”.

    This wise line by Confucius has a special place in my heart and I hope it does for you as well. As you become more senior and familiar with the work at hand as well as build good relationships with your superiors, always remember to be humble and kind.

    Do not let cockiness overcome you nor be easily angered when a fellow junior makes a mistake or asks for guidance. 

    We were all once in their shoes as well.

    Always remember to take care of yourselves first, so you can serve others best.

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  31. The Theoretical Doctor @[email protected]

    Being The ANSC (Antenatal Specialist Clinic) House Officer – Housemanship Diaries

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    In my previous article, I have talked about my experience as an EPAU (Early Pregnancy Assessment Unit) House Officer.

    The ANSC (Antenatal Specialist Clinic) is a separate clinic of its own. Usually patients with other underlying issues comes in for follow up here and most of the time, it is combined with the Medical team. The operating hours are on weekdays from 9am till 12pm and 2pm till 5pm.

    The joblists for ANSC is similar to that of EPAU. The patients over here will come in for scan and the medical officers are in charge of screening and scanning the patients. After which, the patients will go to their allocated specialists.

    The job of the House Officer?

    Our job is merely to record down scan findings or to call the patients or to take their blood or fill up blood requests forms if needed. There are instances whereby we need to request certain radiological tests or to get an outpatient appointment.

    But that’s about it actually. The good thing about EPAU and ANSC is that we do get lunch breaks. Thus, it is something I always looked forward to.

    Usually in the afternoon, it is a different clinic. Most of the time I would stay behind. Mainly because once we are done with the clinics, we are expected to return to Labour Ward and help out since our working hours are till 7pm. Thus, I try my best to delay my return to the labour ward for as long as possible.

    My experience as a House Officer in both the EPAU and ANSC were both enjoyable and fun.

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  32. The Theoretical Doctor @[email protected]

    Being the EPAU (Early Pregnancy Assessment Unit) House Officer – Housemanship Diaries

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    EPAU of the Early Pregnancy Assessment Unit is like working in a clinic. Before I begin, allow me to express how much I absolutely love it when I am allocated as the “EPAU House Officer” for the day.

    The hospital that I am practicing in is Hospital Umum Sarawak otherwise known as Sarawak General Hospital.

    The working hours as an EPAU HO is from 8am till 5pm, with a lunch break from 12pm till 2pm. This is then followed by the continuation of work from 2pm till about 5pm.

    Most of the cases seen here are patients who go for follow up most likely due to foetal growth restriction (FGR) or cases referred from Klinik Kesihatan. There are some cases whereby the gestation is yet to be seen in utero likely because it is too early but the pregnancy test appears positive, hence they are on follow up for scan of gestational viability after a week or two. In terms of gynae cases, most of the patients that come in are impending miscarriages or patients who have miscarriage but are on follow up to check on their B-hCG.

    As an EPAU house officer, our duty is to first screen through the cases that comes in. As I mentioned before, some cases are referred while some are on follow-up.

    Thus, we will screen through by writing their age followed by their gestation and parity and finally, any relevant antenatal history.

    After we are done screening, we help out with writing the scan findings, calling the patients or helping to take bloods.

    There’s not much that needs to be done actually but on certain days whereby the patient load is tremendous, it can get extremely busy.

    However, being an EPAU house officer is a good experience and a good change of scene especially if you’ve been allocated to the ward always.

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