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It’s finally over. 4 months of O&G comes to an end this Sunday. With my end posting leave in effect, today is my official last day. Honestly, this department was a bitter sweet experience.

When I first started, I was extremely ticked off that you had to inform your seniors over every damn thing. Even on things that you obviously knew what to do. However, as I matured in the department, I realized the medicolegality of things, especially when shit hits the fan, and I understood the need to get someone senior to collaborate your findings. Anyways, coming from Medical, this was obviously a difficult change, because in Medical, you’re the first line, and you start treating the patient. In O&G, you’re quite often made to think you’re a clerk, but seriously, I just wouldn’t go with that.

As with all postings, it is my utmost desire to expose myself to all the procedures. I feel, to establish a good footing in any posting, it is first vital to observe, and if possible attempt all the relevant procedures. I must say that in O&G, theres always a procedure you’re gonna need, but luckily, colleagues are more than happy to switch the ward/OT/LR they are covering with you should you need a procedure from somewhere specific.

O&G started out exciting for me, but I was kept in the antenatal ward for 5 weeks. It was brutal, but I am thankful for it. I can honestly say, I became confident with my VE’s, S&S, Prostin Insertions because of the long stay in antenatal ward. I also learnt how to manage chicks and their labour. In HTAR, the general consensus is, 4 cm – ARM. 8 CM/9CM/Fully, then push to labour room. Sometimes, when you just observe the progress of a chick you’d know for sure if you are too generous with her os finding, go ahead with an ARM, that she is going to be diagnosed as prolonged labour and an unnecessary c-section would be done on her. I know it’s a cliché thing to say, but honestly, it does come with experience. As you go, you’ll just know how you should manage a specific patient, and can tailor the management, specifically for her.

Towards my last month, I was chucked in the Gynae/Onco ward. Whilst not as exciting as the other wards, It sure did give me a new outlook to life. Whilst here, I was given the opportunity to assist two great men. One specialist, who is the most humble man I’ve ever met. The first day I am meeting him, in the OT, I greet him and introduce myself, and he offers me his hands, shakes mine, and says, okay, lets get this TAHBSO done. After we’re done, he says, thank you very much for helping me, I appreciate it. When I heard a specialist speak like that, my heart figuratively sank. Wow. Another Consultant, was the nicest man you’d ever meet. He’s in charge of the Onco section of the gynae ward, and all his patients love him. He’s now in the private sector, but still makes time to come see his patients, and even goes as far as performing op on them. The best part about him is that he is extremely tall, in fact taller than me, which means I don’t have to end the day with a sore back after a 5 hour surgery.

All in all, O&G was a great experience. I must honestly say I now have new found respect for all women. I used to be really chauvinistic, but seriously, these 4 months has seriously changed me. I’ve seen what kind of assholes men can be towards their wives, I’ve seen how these women don’t have an ounce of independence, and how they are completely subservient to their husbands. I’ve seen women refuse oral contraception because the husband doesn’t allow it, because she’d gain weight. I’ve seen a woman dare not even talk about contraception without first asking the husband for “permission”. Seriously, are we still in the stone ages? If you get pregnant again, it’s not him who is going to face all the risks! These are just the tip of the iceberg, you’ll see it all later when you go through O&G.

In finishing, as I said earlier, to ensure that you get a holistic exposure to any department, you must observe, and at least attempt every procedure allowed. I’m happy I did.

Looks like the next department to go to is Paediatrics. Hopefully it will be a good journey into the unknown.

Cheers,

God bless.

So I’ve been in the OBGYN department for 3 weeks now, and boy has it been a journey. To be honest, the picture above pretty much sums up the department for me, and I’ll leave it to you to decipher.

Going into the department, I had mixed feelings on how things would be, so I went in with an open mind. Prior to going, I’ve heard tonnes from all the kids who were already in, and those who have completed the posting from various hospitals. Everyone had their own version, and it did nothing but cause anxiety, but luckily I had beer to quash that down.

The department had a mandatory tagging of 2 weeks, with a tag log to complete of various tasks. Decided to try my luck to off tag early after I completed my tag log, gave my assessment, and when I tried to show my tag log, I realized I lost it. EPIC. Luckily my mentor had seen the tag log prior to this and knew to an extent it was almost filled up. So I was tagging slightly over a week, I went off tag without knowing anything.

My off tag assessment wasn’t too bad. Basically about the progress of labour, the management of PIH, Eclampsia, GDM, Secondary Arrest, CTG interpretations, and parthograms. She asked me the dosage of Magnesium Sulphate, to which I proudly gave the Medical dose, and got laughed at. I had some issues with the doses they used, as in I wasn’t too familiar with them yet, such as Hydralazine and Labetolol at that point.

One of the more essential part of Obstetrics is the Vaginal Examination. It is a completely subjective thing, but it is pretty essential to identify the progress of labour (or the lack thereof).

The first few times I was trying it, I had no clue how to collaborate my findings. It was ridiculous. I’d attempt it, and declare, the os is fully open, the patient is bearing down, the staff nurse would have a go and declare, “Trololol, the OS is closed”

The first week at it, it was absolutely difficult, trying to visualize that which you are feeling. My friends, whilst genuine in their attempts, had the hardest time explaining the proper method. Anyways, I don’t blame them, cause today my VE are pretty decent, and I squeal a little on the inside when the Nurses findings are the same as mine. However, if you ask me to describe it to someone else, who is learning, I think I’d have the same difficulty explaining it because honestly it is just something that comes to you automatically after practice.

These days, I’m comfortable with my own findings without having a nurse validate them first, which to the excitement of nurses everywhere, allows them to release a sigh of relief. However, needed a Chaperone for everything is starting to tick me off. It’s not that the nurses aren’t helpful, it’s just, they are already busy with their own work, and my having to pull them off their work so they can just stand there whilst I perform an examination is just cruel.

One quick observation that I have made in OBGYN is that the nurses are really good. Anyone who starts as a first posting in OBGYN and goes to another posting, expecting to get the same level of competence, assistance, and teamwork they got from their OBGYN nursing staff is going to be sorely taught a lesson! However, I do wish they would stop writing my name on the BHT for everything. Here’s how their average reports look like.

“New case admitted into ward at 1300H. Patient accompanied by husband and family. ETC ETC ETC ETC ETC. Full clerking by DR. Karthik rqd – DR. Karthik noted.”

Anyways, I’m enjoying my OBGYN posting tremendously, and surprisingly, it is more fun than I had initially expected. I’m currently posted in the Obstetrics ward, but I am just waiting for my turn for the Labour Room and the OT. Why? Because the Labour room is where right after you bring the miracle of life into the world, you get to suture and repair the damage it has caused! The OT, well the OT is self-explanatory!

The most fun I had during tagging was when I was assisting the C-sections. When it was time to close, I decided to try my luck if the surgeon would teach me how to close. Surprisingly, he let me and as insignificant as it was to others, it felt like a stepping stone to me. Of course my sutures weren’t perfect, and my fisherman knot was laughable, but practice makes perfect, and I’m getting there bitches. It is my deepest hope that by the time I am done with O&G, I would have performed a ceaser, skin to skin. However, I’m not going to jump the gun, I’m going to learn closing the various layers before I even try to lead one. On top of that, I first need to learn it properly before I can convince my myself, let alone my MO’s to give me a shot.

Hell, if my homies in Sarawak are doing it, there’s no reason why I can’t.

Cheers bitches.