Med Board Exam: It's that time of the year again!

This coming weekend, thousands of young doctors (yes, they are doctors, they have already earned their degrees) would be taking one of the most important exams in their professional lives.  The Physicians Licensure Exams are fast approaching.  Many are doing last minute cram sessions, and most are on the verge of a nervous breakdown.  Quite understandable, when your future depends on the result of this exam.

I was fortunate enough to pass the boards some years ago.  But I will never forget how I felt during the three months of cramming (yes, cramming and not studying) prior and the emotional roller coaster I experienced during the actual 2-week period.  Many of my former interns and clerks have approached me, texted/vibered/IMed and called me to solicit some advice on preparing and taking the boards.  Here are some tips/advice for those about to take the boards this coming weekend:

1. Get some rest.  You have been studying/cramming for several months.  Pahinga ka muna.  Stop cramming.  You should just be checking your notes at this time.  Baka maguluhan ka lang lalo kung bigla ka pa mag-cram ngayon.  Be sure to get a good night's sleep the day prior.  You don't want to be late for the exam.
2. Eat.  Have breakfast before the exam.  Bring baon for during the exam (or in-between exams).  You'll need the energy to go through the grueling exam.  
3. Pray.  There is nothing wrong in asking for Divine Guidance.  (Hindi intervention.  Tandaan, nasa Diyos ang Awa, nasa tao ang gawa.)
4. Keep calm.  Many of the horror stories regarding the boards are caused by one panicking.   Shaded the wrong number, taking too long on a particular question, etc can all be avoided if you just keep calm.  And don't forget to breathe.
5. Read carefully.  Beware of the words NOT and EXCEPT, as well as double negatives like ARE NOT UNCOMMON, NOT INFREQUENT, etc.  
6. Skip.  If you are unsure of your answer to a particular question, don't take too long on it.  Skip ahead.  Quite often, there are questions that are repeated (as in verbatim ha?) or essentially repeated (binago lang yung phrasing), and sometimes the answer to the previous question is given in the other question.
7. Erasures are allowed.  Urban myth ang bawal magbura.  You can do so as long as you do it neatly.  Huwag mo namang punitin ang answer sheet sa kakabura, ok?
8. Pace yourself.  You alone know your speed/comfort level when answering exams.  Do not be rattled when someone finishes answering their exams way ahead of you.  Again, item number 4.  Use up as much time as you need, as long as you are able to answer the exam in the allotted time then walang kaso.  Pwede ka pang magpalit ng sagot habang nag-eexam, pero pag inabot mo na yung answer sheet mo wala ng bawian.  Touch move na.
9. Do not do anything that the proctor would deem as suspicious behavior.  If you drop your pencil, leave it be.  That's why you have a spare.  Baka yung aktong pagpulot ng lapis pa eh paghinalaan ka pa ng proctor.  Mahirap na, baka ma-invalidate pa yung exam mo. 
10. Do not cheat.  You are a professional.  Like what Doc Ronibats said, kung kelangan mo mandaya para maging doktor, panahon na para maghanap ng ibang hanap-buhay.  Remember: you may look down in desperation, you may look up for inspiration, but never to the left or right for information.
11. Get some rest.  Yes, I intentionally repeated this.  I don't believe that you could study/cram for the exam during the inbetween week.  Magugulo ka lang. Magpahinga ka na lang.  But if you must, then just skim through your notes.  And do not even attempt to try and look up answers to the previous tests.  Wala ka nang magagawa dun.
12. There is nothing wrong in following pamahiins.  Magbaon ng chicken empanada from Red Ribbon, magsuot ng pula, etc.  Sundin mo man o hindi, walang kaso dun.  Do whatever would make you at ease.
13. Keep your spirits up.  If you feel like you didn't do as well in one exam, don't allow it to let you down.  You did what you could.  If you dwell too much on it, it might affect how you take the subsequent subjects.

I'm sure that you've done everything in your power to prepare for the exams.  Just hope for the best, that what you've studied comes out in the exam.

With that, I wish all those who will be taking the board exams the very best of luck!

Knock out

Last night I attended the wedding of my kabarkada's sister, ate Mariz Umali.  First off, I'd like to congratulate her and her husband Raffy Tima.  It was a beautiful wedding.  And I had fun at the reception.  May God bless your union with so much blessings.

After the reception, my girlfriend and I decided to go out since we were already dressed anyway.  We went to Rocket Room to knock down a few drinks.

She had a glass of Reisling white wine while i had the Scandinavian over homemade steak fries and dip.

Today I woke up to the news that Manny Pacquiao lost via KO to Juan Manuel Marquez in the 6th round of their fight.  I searched the internet for news items, pictures and videos of how it ended.  It was a vicious counter by JMM, he really connected on that one.

JMM is a good fighter, let's not take it away from him.  He's fought in many great fights and has landed countless good punches.  That counter was one of his best.  Too bad Manny was on the receiving end of that brutal counter.  He got decked really hard, and for his safety the referee did the right thing and called for the end of the match.

I know we all wanted a Pacquiao win.  But that's boxing.  Both had the ability to knock each other cold.  It only takes one punch to do it.  Unfortunately for us, JMM landed it first.  Watching it reminded me of how Manny decked out Ricky Hatton in the 2nd round of their fight.  It was a punch that Hatton didn't see coming.  And that counter was a puch Manny didn't see coming from JMM.  Great fight for both fighters.  Hats off to both these great warriors.

Unfortunately, that KO loss might also spell the end of what could have been a mega fight between Mayweather and Pacquiao.  That fight should have been fought 2 years ago when both were 1-2 in the rankings.  Both were the biggest draw in boxing at that time (and may still be today) and they would have commanded a big payday for both.  Unfortunately negotiations were always ended due to some thing or the other.  First it was the drug testing issue.  When finally Manny agreed to what Mayweather was insisting, the issue became the purse for the fight.  I don't care if one or the other thinks he is the bigger name, but both should have just agreed to split it evenly and fought.

Fans would still want to see them fight, but it's not going to be the same anymore.  Yes, the revenue would be big, but it could have been bigger had they fought a couple of years ago.

JMM not only knocked out MP in their fight, but he may have also knocked out what could have been the biggest fight ever between Pacquiao and Mayweather.

Manny, we still believe in you.  You fought well, attacking until the end.  You went down fighting.  You will still be our champion.

Mech Vent

July 17, 2006

1:40am
sa loob ng CCU ng uerm

tahimik lahat.  tulog na ang mga pasyente.  wow benign sa ccu.  wala akong magawa.  sa mga ganitong pagkakataon madalas lumipad ang aking isipan.  napapaisip ako ng kung anu-ano.  "is the world round?"  joke lang.  seryoso na.  napaisip ako kung ano itong ginagawa ko.

syet alarm ng mech vent.
(tayo sandali, suction ng endotracheal tube)

minsan na ring sumagi sa isipan ko ang tanong na "bakit ba ako nag-med?"
noong bata pa ako, engineer talaga ang gusto kong kunin.  ika nga nila, like father like son.  eh pucha, marami palang math sa engineering.  sa lahat nga ayaw ko, eh yung math.  bakit di na lang architecture o fine arts?  mahilig naman ako mag-drawing.  pwede.  pero bakit med?

nagustuhan ko kasi yung idea na astig ang itsura ng doktor.  may nakasabit na stethoscope na mamahalin, na tipong gamitin lang sa pasyente eh alam mo na yung diperensya sa kanya.  tapos nakasuot ng puting coat.  maangas.  and of course, i want to help others.  idealistic.  eto lang masasabi ko sa sarili ko ngayon: tanga.

ang hirap pala ng pinasok ko.  from 1st year to 3rd year pukpok sa aral.  foundation daw ito para sa oras na tumapak na ako sa ospital.  tapos nung 4th year (medical clerkship o junior intern kung tawagin sa ue) wasakan.  duty every other day.  kami lang ata ang med school na ganito.  di birong trabaho.  doctor-in-the-making ka na, minsan sideline pa ng trabaho ng nurse at nurse aide (no offense sa nurses at nurse aides).  taga-gawa ka na ng sandamukmok na paperworks ng pasyente, ikaw pa din ang taga-monitor, pati ba naman pagtakal ng ihi at pagtimbang ng diapers eh trabaho mo pa din.  tapos sobrang bangag ka na sa dami ng trabaho na di mo na magawang mag-aral pa.  biglang may rounds, tapos di ka makasagot dahil nga di ka na nakapag-aral.  napagalitan ka na, may sp ka pa.  wow.  one hell year.

ngayon senior intern (post-grad intern sa labas) na ako.  more responsibilities.  dahil ngayon ang turing na sa akin doktor na talaga.  may degree na nga naman ako, wala nga lang lisensya.  pero kahit na, tingin ng lahat sayo - mapa-nurses, residents, pati consultants, and especially the patients - doktor ka na.  bigat.  eto na yung pinangarap ko simula't sapul.  may MD na sa ID ko.  nakasuot na rin ako ng white coat.  bakit lost pa din ako?  bakit ba ako nag-med.

alarm ng mech vent, syet.

after 10 minutes, eto na uli ako.  galing ako sa cubicle ni mommy catherine.  naoperahan siya nung isang araw.  dumating siya na parang wala ng pag-asa ang lagay niya.  ngayon gising na at nagpipilit na tanggalin ang kanyang et.  sa tapat ko kita ko si daddy pedro.  wala si mommy, yung asawa niya.  umuwi, nagpahinga.  nangako nga pala akong sa cubicle niya ako tatambay, ako ang bantay niya ngayong gabi.
bakit ako nag-med?

kasi ito ang nakita kong paraan na sa tingin ko makakatulong ako.  no stir.

(anak ng tinapa.  yung title ko pang maalaala mo kaya haha!)

Another 365 days

I didn't announce it to the press, but I just celebrated my birthday some time ago this month.  No, I will not say when, nor will I divulge which year I was born.  I stopped counting my age at 28.

It is mandatory that I celebrate my birthday.  Everyone else does right?  It's always the usual - eat out and invite almost everyone in the clan.  It did cause a significant drop in my bank account, but it was worth it.

Vikings buffet was packed that day, despite the ugly weather.  I refused to have the staff sing to me at our table.  I hate that.

So another year has passed.  A lot of things have happened in the span of 1 year.  I graduated from residency.  I passed the diplomate boards and am now a certified radiologist.  I started my fellowship training in CT-MRI a few months back.  Life went by like a blur.

I'd like to say that I've learned something in the past year.  Yes, maybe I did.  But nothing really life altering.  I guess most of the valuable lessons in life I have already learned.

It's the start of another year.  May this one be a good one as well.

Missing Sunday

I'm tired.

Sundays are days when one can relax, spend quality time with family and friends. But for someone in my profession, even Sundays are not spared.

When I was a kid I looked forward to Sundays. We usually spend Sunday mornings at the PICC complex. Dad would go jogging, us kids would go biking or join dad in his jogging, and mom stays at a shaded place with the younger kids while preparing a sort of picnic for when we finish our jog. I remember waiting for the vendor who sells Magnolia chocolait, the ones in the glass bottles. It tasted better back then.

We'd go home after and mom cooks us a sumptuous lunch. It would always be one of our favorites, and we'd end up eating a lot.

Sunday afternoons are spent going out to the mall where we play in the arcades. I remember using up all my tokens worth Php200 (back then that would mean a lot of tokens) on this one first-person shooting game, trying to defeat the last boss character. If we didn't go out we'd stay at home and just chill. Dad would order Shakey's thin crust itallian sausage pizza, a family favorite, for merienda. Mom would make halo-halo. Us kids would be out in the garden playing. Me and kuya would be playing with our G.I. Joes playing make-believe war, while the younger brothers watch and play with the fallen heroes of our little war games.

Sunday evenings are always reserved for Mass. After Mass, we'd either eat out or mom would prepare a feast for dinner.

I always liked Sundays.

Those Sundays are now a distant memory.

When dad moved to the US so that he can augment the family income, we cut down on the time we spend going to PICC complex for our morning jogs. Lunch and dinner feasts were still there. And of course Sunday mass.

When I entered medschool I try to go home every Sunday if I can. But when I started to have hospital duties, even Sundays were not spared. I'd spend Sundays at the hospital looking after patients, sometimes forgetting to eat due to the amount of work needed to be accomplished. Sundays were no longer happy days.

On the rare occasion that I was not on duty on a Sunday, I'd spend it sleeping. Weekends off were the only days when I can catch up on sleep. If not sleeping I'd be studying. Gone were the happy Sundays.

Today is a Sunday. I'm here at the hospital waiting for the next patient. I'd probably end up working through lunch again. My brother and his family are going to visit home, and as usual I am the absentee.

In a few years, after I'm done with training I might get the chance to spend Sundays at home again. I'm hoping to try and get back those missed Sundays. To spend it with my family like I used to. Then probably Sundays would be fun days again.

More fun in the Philippines

 

 

 

 

 

from point then to point now

it's 3:05 AM.  i can't sleep.  i've been trying to read this thick textbook on my desk, preparing and studying for my next in-service exam.  who knew that in residency we still had to take exams?  as a sort of diversion, i started opening folders here in my files.  i have files from med school, about time i deleted them right?  i started looking at pictures too.  scrolling through, i saw pictures from all the way back (scanned) as well as the most recent ones.  what particularly drew my attention were the pictures from med school.  yes, med school.  that time of my life really is one of the most significant chapter in my life.  it got me thinking of how i managed to survive it all, of how i managed to be where i am now.

it all started in 1996.  i was still in second year highschool then.  before that all i ever wanted was to be an engineer.  dad was an engineer, so i wanted to emulate him.  but i was never really good at math.  up until that point i never really appreciated how good i was at my science subjects.  it was because of my biology teacher that i started thinking about a career in medicine.  she had started med school but had to stop because of financial reasons.  she took up a teaching post in out school in order to earn and save for her med school tuition.  she told us stories of her med school days, of how fun it was and how fulfilling.  that got me thinking, hey maybe i can do that instead.  after that i was gearing up for a career in medicine.  i told my parents and they were very supportive.  (oh, and my teacher was able to go back to med school after that.)

i took up bs public health in college.  in my application form for UP, i chose bs fine arts and bs biology for up diliman and bs public health and bs biology for up manila.  3 pre-med courses and one course that totally has nothing to do with medicine.  also checked the box for intarmed (7-year straight medicine program of UP), who knows right?  i decided taking up a 4 year course for my pre-med even if another great opportunity was presented to me.  had one of the best 4 years of my life.  and it very well prepared me for med school.  we took up subjects that would also be taken up in med school (anatomy, histology, physiology, biochemistry, pathology, etc) as well as having a strong background in microbiology and parasitology.  got decent NMAT grades, good enough i guess to flaunt to the medical schools i applied to.  at that point in my life, i was excitedly shouting, "med school here i come!"

i was at a fork in the road to becoming a doctor.  which med school to go to?  it was a choice of going to UST, where majority of my friends were going, or to UERM where i got accepted first, had an innovative teaching style (problem-based learning), and not to mention where all my doctors are.  i decided to apply to UERM since i was assured of a spot, only having confirmation of my acceptance to UST after about a few days after enrolling.  even after then i was presented with another option: UP med has just recalled me.  an opening came up about a week after classes started.  after weighing my options, i decided to stay.  looking back, i think i made the right decision.  i benefited from the teaching style of problem-based learning.  making good friends and having a great time while i was there were bonuses.  i was able to pass med school, clawed my way through the hell year that was medical clerkship and survived the grueling internship year.  all that was left was to pass the board exam.

it was a rough three months.  studying, or rather cramming for the boards was all i did from morning until early morning, only sleeping a couple of hours before repeating the cycle.  i did get to have a vacation of some sort, having spent a week in boracay a month prior to the board exams.  i said to myself that had i failed the exam, this trip was to blame.  a lame excuse, i know.  but lucky for me, i passed the boards on my first take.  finally, all the hard work paid off.

looking through the pictures again, i began to scroll through my pictures during residency.  time has really flown.  from pictures during pre-residency, to first year and now to my fourth and final year, a lot has happened.  a lot has changed.  back then i was so unsure of the future.  back then all i was hoping for was for this hospital to accept me into their training program.  and after that, all i ever thought of was to survive first year residency.  i have had my fair share of mistakes since then.  from forgetting to check the patient's bleeding parameters resulting to a postponed procedure, to missing out findings in imaging studies, i've experienced them all.  those experiences have taught me well.  better to make mistakes now during training than to make mistakes in my private practice.

a little less than 6 months from now, i will have finished my residency training.  this toxic year would be over.  i will be relinquishing my duties as chief resident.  next step: diplomate board exams.  but that's looking at the future.