The 10 most important paperworks in Clinical Clerkship

Dear incoming Junior Intern/Clinical Clerk,

Now that you've seen your name posted on the registrar's office, I'd like to congratulate you for making it to JI-ship.

Junior Internship isn't just about roaming around the hospital, seeing patients, monitoring them, and seeing them either go home or die. The most important thing, the part and parcel of JI-ship, is the tons of paperwork that are in store for each and every JI out there. That is why JI's are officially called CLINICAL CLERKS. The second word explains everything.

Clerk, the master of paperworks.

So, in preparation for your JI-ship come April 1, here are 10 important documents that you should be familiar with starting day 1:

1. Initial Summary

• This is the first document that you should accomplish, because this should be clipped in the chart within 6 hours upon admission. You should write this on the "Intern's Notes" form, which you will definitely see on your first day. There you write your patient's history and PE, all in SOAP format. Because it's "initial," this is like a rough draft of your complete database, which is explained next.

2. Complete Database

• From the word itself, this contains the whole package of your history and PE. This consists of 2 parts: the history form and the physical exam form. You fill that up based on your initial summary, wherein you try to fill in or add answers to certain questions you might not have answered during your initial summary. This should be clipped in the chart within 24 hours upon admission. 

3. Case Discussion

• This is where "the patient is like a textbook" comes in. Clipped in the chart within 24-48 hours upon admission, this contains the case of your patient that you would like to report on. From definition to treatment and prognosis, this is where you try to unravel that human textbook of yours and make a paper about it. Originally computerised, some departments might require you to write your case discussion on your Intern's Notes form.

4. Drug Charting

• This goes hand-in-hand with your Case Discussion. Also clipped in the chart within 24-48 hours upon admission, this contains the drugs of your patient prescribed to him in the hospital. It's like how you did your formulary in pharmacology: you write down the generic name, class, mode of action, indications, adverse effects, and contraindications. You can add the half-life, peak plasma time, etc., if you so wish. Bahala ka magpakatoxic!

5. Lab Flow Sheet

• Some departments, especially when you're rotating in the charity wards, will require you to clip this on your chart the moment the first lab results come in. You update that form every time a new laboratory result arrives, or if a new imaging result comes. Some residents check that sheet, and if you don't even bother making one, well you can say hello to life's big bitch slap to the face, a.k.a. demerit.

6. Monitoring Sheet

• This is where you put in your patient's vital signs monitoring and intake/output monitoring. That is one of the most looked-at sheets, because you might not know about it, but even the consultant looks at what you write on the monitoring sheet to see how their patients are doing.

7. Referral Slip

• This is the slip that you will need whenever you will refer to a different department. Departments such as Medicine, Neurology, and Surgery are big users of this slip. Here, you write the SOAP format history and PE of your patient, and along with an attached Lab Flow Sheet, you have this slip signed by your Chief Resident, and have the receiving Chief Resident see it. Once they see it, be ready to present your case. And be sure to read before referring. You don't want to ruin your day because of poor referral, trust me on that.

8. Progress Notes

• A chart essential, especially when rotating in the charity wards, this contains what has happened to your patient or your group mate's patient throughout the 24-hour duty. This is written in SOAP format. Some departments are dead strict when it comes to this, so do not forget to update your Progress Notes everyday...unless you want to be bitch-slapped (if you know what I mean).

9. Endorsement/Take-Over Notes

• Aww, and it seems like you will be moving to a new department, or maybe a new sub-rotation. If so, then this is the form that you need to make before passing the baton to the incoming JI who'll be taking care of your patient. As the outgoing JI, you make Endorsement Notes in SOAP format, and if you're the incoming JI, the same goes with the Take-Over Notes. Residents check on this, too, so be on your toes with this one.

10. Discharge/Mortality Summary (DS/MS)

• And now your patient has to say good-bye to you, either dead or alive. If so, then this is the last form that you need to clip in the chart before the patient goes home or to the morgue. This contains the components of your Complete Database, plus all laboratory and imaging results, the course in the wards, and the take-home/discharge instructions. In the charity wards, you are required to give an extra copy of the DS (without the course in the wards) to your patient for follow-up purposes. You have to have this signed by your PGI and resident. Remember: you need to have at least 25 DS/MS in order for you to be cleared by the Records Section. But, because of the big number of your batch, I'm hoping that they will decrease the requirement to less than 25.

There are still other forms that are not discussed here, but for now, these are the essential ones that you must know once you step inside the halls of the hospital.

Good luck!

The 10 things a Clinical Clerk should know

Dear incoming Junior Intern/Clinical Clerk (JI/CC),

It's about 10 days to go before your "normal" life takes a twisted turn.

I'm sure that most, if not all, are anxious on how JI or CC life, as how some of us call it, is like. The life of a junior intern, also known as a clinical clerk, is not as daunting as you might expect, and it is not as wonderful as you might imagine.

To go straight to the point, let me share to you 10 things you need to carry on once you start wandering the hallways of the hospital and start becoming the future doctor that you are:

1. Love what you do

• You will be scattered throughout the corridors of your hospital for the next 365 days. Loving what you do will give you the motivation to work hard and do your best. Do not perform tasks with a heavy heart. There will be times that you will regret doing what you are doing every single day. Just remember: loving your work is like loving your patient, and also loving yourself. So show some heart and work that ass off!

2. Learn from each patient

• When you are decked with a patient, treat each patient with utmost care, like how you would like to take care of your loved ones. But, most importantly, learn from them, like you're reading a textbook. Each patient carries a unique case that you might have read from your previous years. Internship is the time to reinforce those tiring coffeehouse sessions with real-life scenarios.

3. Take criticisms in a constructive way

• Being a JI/CC isn't all glitz and glamour. There will always come a time when you will be subjected to criticism and embarrassment. When that inevitable moment comes, try not to frown. Though it is human nature to be sad, just do so for a while. Then, when you get back to your senses, take it as a means to improve yourself. Almost all of us went through that phase, so don't think that you're alone.

4. Be nice to everybody

• Like what I've said, you will be scattered throughout the corridors of your hospital for the next 365 days. And with that comes a good attitude. Remember to be nice to everybody: from your friendly janitor up until your terror consultant. Show some love to your co-JI's, residents, nurses med techs, and a whole lot more. Your attitude will speak of how you will be seen by everybody for one whole year, so don't risk being a jerk and acting like one.

5. Treat demerits as life's painful lessons

• When life gives you accolades, it also gives you heartbreaks. That is how it goes with demerits. A demerit is life's big bitch slap to your face, telling you to man up and do better next time. Don't sulk over a demerit, because you WILL have to serve them eventually. Take it with a grain of salt: don't take it literally. Instead, learn from it, and let it teach you to become a better doctor.

6. Do not be late

• Gone were the days when we can go to class 30 minutes before it ends, and get away with it smooth and clean. It NEVER works that way in JI-ship. When attendance is at 7:00AM, do come earlier than that. Trust me, you won't like being crossed out. Three (3) strikes is equals to a 24-hour demerit. Succeeding lates is tantamount to additional 24 hours. Ain't that a bitch.

7. Know your role, and stick to it

• When you are given a role, or a certain function, live with it, and don't go overboard. When they tell you to monitor a certain patient, don't go doing other stuff not related to your assigned task. Going overboard incurs certain consequences that, mind you, you do not want to face. Know your job description, do it, and if they give you another task to do, make sure it is justifiable, and do it. Don't work on something that will implicate you into something bad. 'nuf said.

8. Know what to prioritise

• Patients are always first priority, no doubt about that. But in between patients, there will always be a #1 priority. Know who and what to prioritise. Identify tasks that are needed to be done immediately, and know which patient needs closer monitoring. It helps you save time and effort despite the unbearable load of patients that you will be having.

9. Share what you know, and learn what you don't know

• There will always be rounds with either residents or consultants. Stay alert: if you know something, and the senior asks something about it, share it with everybody. It will not make you less of a person if you get it wrong. If you don't know what is being asked, don't let it slip through your head. Learn what is lacking, and take it as a golden opportunity to learn something new.

10. Treat every single day as a blessing

• JI-ship is a roller-coaster ride. There will be days that you will love what you're doing, and there will be days that you would wish you would've quit while you still can. Take each day in JI-ship carpe diem: seize each day and treat it as a blessing. Don't treat each day as a "this again?!" moment. Each day is a blessing, so never forget to thank God for each and every day that you will live as a JI, because as a day passes by with you feeling fine, there will always be someone who's life is on the thinnest line.

Our batch's run throughout this whole JI-ship thing has been unforgettable. It taught us how to become better than what we were before. We started out as zombies, knowing nothing and treating everything as hieroglyphics. Now, we can say that we are confident to be exposed to the world of the sick and suffering. We do hope that you will become better JI's than we are. It's just a mix of a good attitude and positive outlook that will take you to better places in the near future.

Good luck, incoming JI/CC. See you in a few days! :)

Medicine: 4 years later

Four years...

How fast time flies...

It was back in 2009 when college life ended for me. It was a time when the dreams of becoming a medical student was a fresh one. It was a time when I left the comfort of my hometown to venture into another city to reach a dream some people say only a few can achieve...

To become a Doctor of Medicine..

It was the first two weeks of medical school when I first tasted the reality of medical school, that it was more hard than college life. Later, there was that temptation of quitting. For the first time in my life, I felt sad because I entered medical school without looking at how hard it was to become a doctor. My parents were very supportive of me, even encouraging me to just have fun in medical school, and quit if I cannot take it anymore.

I guess I had to give it a try. So I began to walk the road less traveled back in..

First year.

First year medicine was memorable, for it was a time that I gained new friends and gained new knowledge beyond the bounds of Nursing. There were those usual ups and downs, such as failing examinations, being involved in misunderstandings with friends, arguing with group mates, and a lot more. But, it was in freshman year that I learned that medical school can fly so fast. So fast that in a few months time, I entered...

Second year.

Second year medicine was the most chill of the 3 year levels except 4th year. It was true when our preceptor said that it was the easier than the 1st and 3rd year. I met new friends, who would later become my buddies until now. It was that year when I learned the basic skills of the physician. It was similar to Nursing, but it was more in-depth. What made it memorable was that t was in second year where I met a simple, down-to-earth girl, wherein I became so much comfortable with her, my emotions couldn't control my rationality. Our friendship eventually led to a better friendship, but it later ended up in a sad turn. That of which happened during...

Third year.

Before I even talk about that, third year was the most stressful because it was the preparation for Junior Internship/Clinical Clerkship, or fourth year. It was then when I felt so stressed, that there were times that I would have bouts of mental and emotional breakdowns, up to the point of entertaining thoughts of quitting again. My solace that time was teaching kids Bible stories on Sundays, and most especially, spending time with the girl I met back in second year. About her, she was just the comfort from the stress, the happiness that made me smile despite the sea of sadness. It was that year, during that cold November evening, when my college past caught up with me, and our friendship got strained completely. It was a emotional downward spiral for me, in which the thoughts of her keep on catching up with me until internship.

But enough of that. Third year was a bumpy ride, wherein I thought I would fail some subjects, that I wouldn't be able to make it into internship. The months that ensued during third year had my anxiety levels increase to insurmountable levels because of the uncertainty of becoming an intern. But, during that chilly March evening, I learned the greatest news: I was promoted to...

Fourth year.

I have to admit, fourth year, or Junior Internship (JI)/Clinical Clerkship (CC), has been the BEST thing that has happened to me. It was this year that I felt like a doctor. Admit it or not, this is the year where we start from the bottom of the medical totem pole. It's true about what someone told me before, that internship unleashes the 'natural' in you. It was here that I learned about the true nature of people, the 'real' them in the face of reality. On the bright side, it was in internship that differences were settled, and friendships rekindled. It was here where the textbook learnings sprung to life. It was here where we learned to keep our emotions to ourselves whenever someone dies right in front of our eyes. It was here where we were given demerits, where were learned the pains of being scolded at and being embarrassed in front of a lot of people. It was here where we met new people in the form of friendly residents and staff members. It was here where I met new people. It was here where....

Okay, enough of that.

After so many years, it all boils down to the last few weeks of internship. Much as I want to tell my medical school story in detail, it will not be enough for 1 post to share it all.

I just wanna graduate.

I really want to become a doctor.

It'll almost be over. It's just these eyes on the prize.

Almost there

For the past 10 months now, my life has been living on a series of events which I can vividly enumerate:

1. Wake up before 6AM, even before the alarm hits.
2. Reset the alarm and sleep for another 5 minutes.
3. Wake up feeling so frustrated, begging for another round of sleep.
4. Prepare for half an hour (breakfast included), then head off to the hospital.
5. Drive for 20-25 minutes through the bustling traffic.
6. Make it to the hospital, work my bum off for 10-34 hours, depending on the schedule.
7. Go home, driving another 20-25 minutes feeling all groggy and sleepy.
8. Make it home, use whatever time is left for myself (surf the net, watch a movie, read notes, etc.)
9. Sleep for 5-6 hours, depending on what time I doze off.
10. Repeat.

Yes, repeat.

That is how my life as a Junior Intern/Clinical Clerk has been going. It has been like this for such a long time, I sometimes forget what day of the week it is.

It makes me reminisce how much I miss the life of the classroom: its ambiance, listening or sleeping through lectures, going home and study, and even going out.

Back then, I was in command of my time. I almost had every minute for fun.

When the calendar struck April 1, that life became a thing of the past.

Everyday has been a struggle. The sight of patients and staff, and the sound of endorsements greeted me every morning as I arrived at the hospital. My day would run monitoring patients, referring left and right to different departments, doing chart rounds, attending conferences, and sometimes get my bum kicked for some incursions. That would end as the sun begins to set, sometimes leaving the hospital at night because of unfinished tasks.

I then sometimes become envious of other people, who get to enjoy their lives, having control of their own time. I couldn't help but wonder how I can use up the remaining hours of the day to make my own day worth it.

It's a sad thought, to be honest. But it is a reality that I chose to live. For me, it's a blessing to be in the hospital, despite the hardship. It's a moment for me to realize and appreciate the importance of life and health.

What makes a day in the hospital worth the hard work is when a patient says "Thank you" with a smile on his/her face. Those 2 words and that nice expression never fails to erase a day's worth of stress.

It's almost 50 days to go before this present life of mine draws to a temporary close. I can't wait for vacation to come, to have time for myself, my family, and loved ones (friends included).

Most especially, I cannot wait to graduate.

"Almost there." That is what is on my mind right now.

Clinical Clerkship: Medicine Life

So, I'm back using this blog again. Hello world, we meet again!

It's almost 60 days since we entered another world in medical school called Junior Internship. It's more known as Clinical Clerkship nowadays, just to keep us in check with the modern trends. Clerkship is considered the last stage (4th year Med) in medical school before graduation. Students in this level now assume the position of a clerk, whose tasks include interviewing and diagnosing patients, formulating diagnostic and treatment plans, perform various procedures that not everybody can do, and especially, monitor. Oh yes! Sounds a lot? You haven't seen anything yet.

Our group started out clerkship with the Medicine rotation, which is considered by majority of people that I've asked as the most "toxic," or more commonly, the hardest of all rotations. This is where 3 years of Patient-Doctor come into play.

If you ask what a Medicine Clinical Clerk does everyday in the hospital, well...

You initiate rapport with patients, handle them, and deal with them, especially the relatives. You learn how to do the "diskarte" factor when it comes to patient care, wherein you try to maximise your time handling more than just 1 or 2 patients. You also learn how to refer to different departments, where medicine is most of the time the starting point for all referrals. You also attend teaching rounds and subspecialty conferences to enhance your knowledge in certain areas of medicine. You answer to codes and either do chest pumping (for males) or ambu-bagging (for females) of the patient who's life is as thin as  a strand of hair, in short, at the brink of death. Much more, you learn how to THINK. Yes, THINK. To use the brain, to think, to analyze, that's how we do it. 

There's more to what medicine can offer to clerks, it's just up to you to discover.

This rotation of ours, which is set to end in a few days' time, is for me the best rotation...yet. There's a lot of learning in the Department of Medicine. Interns rotating outside of Medicine say that rotating in this department is hard, taxing, and most of all, "toxic." Yes it is, but learning is abundant because of the fountain of cases that can be found in the pay and charity wards, and don't forget the out-patient department. Rotating in the department has been a memorable experience, especially because of the friendly residents and consultants who are more than willing to teach what interns need to know. There are no dull moments with the house staff because they make you feel at home, despite the toxicity. The coolness of this department makes me think of pursuing Internal Medicine as a specialty in 2 years' time.

As the 1st chapter of our 12-month journey to graduation draws to a close, I'm proud to say that I've survived one of the most "toxic" areas of the hospital. What makes me a proud intern, a soon-to-be-physician, is that what was complex has been made simple because of experience. At the end of the day, the fund of knowledge is filled with new information and knowledge that is waiting to be shared to everybody who needs assurance from a person who knows health better than the layman does.

As seen in a Twitter user that I've been following for quite some time:

"When the complex becomes simple, it's pretty amazing."

Two months down, 10 months to go.

Looking Back at Nursing: the social 'trend,' training hospital issue and salary problems

(This is an unfinished post from last year, which I just finished now.)

It has been 3 years since I graduated from my pre-med course. Since then, much has changed within the atmosphere of nursing: the decline in enrollment rates, the appeal of AYNLA on nurses' rights, the still-uncertain future for nurses who are just left working in non-nursing jobs, and recently, based on FB posts, the nurses who keep pushing for the imposition of the salary grade of nurses stipulated in RA 9173 or the Nursing Law. Despite being on the other side of the fence for 3 years, I keep on looking back, even for just a sneak peek on what has happened in nursing since I jumped ship. It must have been a tumultuous road for nursing in the country, and I must say, the problems that have burdened the profession I was once a part of, but until now I still cherish and love, is somewhat overwhelming.

Nursing has been the course of so many people who believe that this course is the easiest way to a better life. Most parents entice or prod their children to take up Nursing so that these children will be the ones who will put food on the table of their parents and siblings once they have fulfilled their obligation to achieve the profession. Because of this humongous trend, a lot of  so-called Nursing schools have sprouted left and right, front and back, and lure students to achieve a Bachelor of Science degree and become certified Board passers in the near future. It turns out, instead of promoting the improvement of Nursing in this country, the overemphasized trend of Nursing as a "way to escape poverty" has backfired in ways unimaginable. Think about it: because of the increasing number of Nursing graduates who couldn't land a sure ball job as a nurse, there has been a surplus of nurses of unthinkable proportions. According to the Board of Nursing, there are hundreds of thousands of licensed nurses who still don't have a decent job as a nurse in a hospital. To curb that problem, the Department of Health has launched their pro-nursing campaign of letting fresh board passers to work in the community and gain experience.

On the other side, hospitals would launch their own "pro-nursing" campaign of hiring nurses and letting them train in hospitals, but for a certain price. These nurses pay training fees, and train without the certainty of landing a job. Because of this, in January 2011, the Association of Young Nurses, Leaders and Advocates International, Inc., or AYNLA, has been called in Senate hearings about this commotion between nurses and training hospitals. With this commotion, training hospitals became more stringent with their training criteria, and now would barely accept nurses for training. Despite that patriotic move from AYNLA, what they did, instead of helping nurses land better jobs, taking their complaints to the Senate made it worse because hospitals became more strict and impeded the flow of nurses who are supposedly to train. The thing about the hospitals is that they shouldn't be exploiting the number of nursing graduates and let them train for a hefty price with a big void of landing a stable job. It's also inappropriate for hospitals to become more strict with letting nurses train. AYNLA just wanted for proper nurses' rights in terms of training. Either way, there was no winner or loser in this case. AYNLA was a winner because they took their grievances to the Senate, but lost in terms that nurses now found it kind of hard to train in hospitals and land good jobs. The hospitals, on the other hand, won because the move by AYNLA made them more stringent in letting nurses train, which would save them more money in the long run. They lost in this case because they just let the trust and confidence of nurses down in their potentials to become great nurses someday.

Another issue is the appeal of nurses to uphold the salary grade of 15, amounting to PHP20,000 a month. If you work at a government hospital, it is a possibility to gain such salary. But, despite such law implementing such a salary grade, it's just a dream that is left unfulfilled for most, if not all, hard-working nurses. What's with the promise of a better life if the hospital that you're working for is not even abiding to the law that stipulates the implementation of salary grades? Earning 10k a month in a private hospital won't suffice to put a month's worth of food on your family's table, that's for sure.

Nursing is a noble profession, but, the issues that nurses handle in this ever-worsening society makes it losen its nobility because of necessity: hefty paychecks and a taste of the good life. What happened to nursing as a caring profession, a profession that doesn't crave for money, but instead for the respect of society? It's up to the nurses in this country to set the mindset of everyone that nursing is not a money-making profession and a way out of poverty. Rather, it is a profession that leans on care and trust towards the client/patient.

Think about it.

Intern's Log

Watch out for a blog page about life as a Junior Intern a.k.a. the lowest life-form in the hierarchy that is MEDICINE.

Onward to Junior Internship!

Deep reflections: on leaving Med and pursuing the different road

Moments ago, a friend of mine decided that she will quit from studying Medicine. It was a tough semester for everybody, especially for her. I deeply wondered how a wunderkind who had such a strong work ethic eventually surrendered the long haul. That decision of hers made me think very deeply on how I felt about what she did. The pressure was just very great, so it seems, for her to decide to quit. But nonetheless, I thought at first that it was kinda unnecessary for her to do that, given that she has high grades and a passion for learning.

I was unconsciously getting a grip of myself as I learned of her decision. She said it was final, and it was just sad for me to know about it firsthand. I was starting to feel the sadness inside, that I was about to lose a close confidant, where I found comfort and happiness despite living inside the hellhole that was really keen on consuming my sanity.

Weeks have passed since we talked about this. I persuaded her to think about what she was planning to do. I convinced her to take the road less traveled even if it meant sacrificing mind and body just to achieve such purpose. I belted out almost all of the persuasion tactics I knew of just for her to reconsider. It was a big effort for me, to go and push her to continue on with studying. I always knew that she had it in her, that she can do things that would make even the most hardworking student green with envy. I couldn't accept the fact that she wanted to quit. She was really adamant about her decision to surrender. The good thing was, she eventually decided to move on and continue on with it. I thought it would be the end of painstaking convincing, but now I guess I was wrong.

For the first time, someone close to me has decided to leave the dream only a blessed few would even dare to take, a dream that she used to share to me even before she entered the halls of Med school. I understand how her pain felt, because I also went through that same ordeal years ago. Now that I'm sitting on my study table and making this blog, her decision has made me reflect deeply on my situation in Med school. Her eventual decision to quit made me rethink about how my life in Medicine has been. Sure, that my life inside Med was tough, that it had its ups and downs. But, the question is: am I really happy with this? Am I happy with some classmates hating me and some classmates liking me? Am I happy interviewing patients from time to time? Am I happy making paperworks and study every evening until my brain cells deplete to zero? Am I happy that I get to pass my subjects? Am I even happy being inside Medical school?

These are the questions that are now reentering my mind. I've been through these questions before, but why of all things would these questions visit me again, when I'm already a few months away from Junior Internship? It's hard for me to reflect on these, but as the minutes linger, these voids are slightly devouring me up to the point my emotions and thinking start to run empty. 

A while ago, I started looking at websites of flying schools. My dream of becoming a pilot was slowly creeping back into me. I began considering skipping JI-ship, enter flying school and maybe try it out for a change. My mind was even thinking about entering flying school after finishing JI-ship, without the possibility of taking Senior Internship or even the Physician Board Exam. My passion of flight and flying was slowly coming back. It was a dream I have already shared to my parents, but my Mom wouldn't let me because of its risks. Other than flying, my mind was slowly entering a void of uncertainty: a mindset that was making me feel empty and sad, just like how it felt when I was considering quitting Medicine back 2009.

I know Medicine is hard, and that enduring this course really entails the full potential of the mind, body and spirit. But, it is true that sometimes, we should just know when to give up. It is not forever that we can continue on not being ourselves. Most Med students would say they want to be doctors, but along the way, a few would quit. It is not because that they are weak, but because they do not see themselves as doctors anyway. If one seems to surrender despite all the painstaking efforts to continue, then there is nothing wrong in taking a different path. There will be people who will think that quitting Medicine is a stupid thing to do, but one thing I've realized is that if one is not happy in what he/she does, then why continue on? It will be sad for me to see her leave, but there will always a tinge of happiness deep inside because she will be able to follow what really interests her. In the end, doing things that we can't see ourselves to be in the future is like wearing a shirt that isn't your size. It is the pursuit of the inside passion that is important to follow. One should not force himself/herself into something he/she is not. Live life and be free, and wherever God will take you, for sure He will take care of the rest.

Strongest: weird, introverted, but still cool

Think of this: you're someone who is very introverted. You don't talk that much to other people, stutter a lot, become clumsy at times, and would either go alone or go with a bunch of people. You also try your luck in PC games, but to somewhat no avail or little improvement, if any. You're also this type of person who would come to class with a gadget and would have a knack for a sleep-wake cycle within lectures. Because of your unique personality, you gain haters and friends. Haters who hate you because you're "special," and friends who accept you for who you really are. Despite this kind of behavior, deep inside, you have a wonderful mind filled with creative ideas that you can only express online. Despite all of this, you are a very hardworking person who knows how to dedicate work to the highest level.

Think about it.

This is about a classmate of mine, a friend and a group mate who I've been with since day 1 of Med school. Name withheld, but for sure any reader who's a classmate of mine will have the biggest idea on who this person is based on my seemingly obvious description above. Personally, with no sugarcoating, he is a weird guy with a kinda weird demeanor. Some people, especially those who know him well, would diss him because of his personality. Despite this, only a few accept him for who he really is. He is considered within our circle as a person who should be loved and treated like any ordinary human being. Sometimes, I admit, I kinda bully the guy, but I personally like him because of his real deal, no shit dedication to any work that is being given to him.

I met him back during stress management session, when we were all strangers to each other. The moment I saw him, from the way he stood up, the way he looks, and up to the way he talks, I knew that this guy is not any ordinary person. I saw him as someone who is "special": not the mentally retarded-type ones, but as a person who looks endowed with a potential to bring color to a class of people with different origins. When I first talked to him, I could barely understand a word he was saying because he kept on stuttering. But as time passed by, I started to get used to his stuttering way of communicating. I understand he has this stuttering problem, but nonetheless, he can still communicate. I was with him when we were with our 1st clique. We hung on there until the day I left the old gang because my old friends started to become distant. He was left all alone there, trying to struggle and keep up with what he had back then. I felt bad for him because despite the barrage of bad words against his clumsiness and his weird ways, he never seemed to fight back. He took all of the blows in stride. Define STRONGEST, and I'm dead sure that all of the synonymous words of languages around the world all point to him. With a new set of friends, he seems so comfortable being with the new gang. He found solace in playing PC games (despite his slow progress for improvement), in hanging out with people who really know how to have fun based on his preferences, and in being accepted for who he really is. 

In terms of communicating, he seems not to be the extroverted type. He's active in the online realm: he posts announcements more like any active member in our class. His activeness online is the almost entire opposite of him in the real world. He seems kinda distant to others, but not to the present gang who took him and treated him like a man deserving of respect. His dedication to work is also unparalleled. Give him something to do, and he will not hesitate to work on it. Because of this, I knew that what our classmates see everyday is only a shell of the man he really is. Only a few can notice his importance and worth, and because of this, our friends agreed upon protecting him from any hater that would pose a threat to him.

I posted this blog about him not because I'm bored, but because I just wanted to show to you, the reader, how cool this person is. His being a weird dude doesn't mean people can treat him like shit. His not being able to defend himself doesn't mean people can just diss him and make fun of him. I may be one of those pricks who would sometimes diss him, but despite that, I still accept him for who he is. I would get reprimanded by one of our friends because of that. Haha. Nonetheless, this person who I'm pertaining to has a very beautiful heart and mind that only a few can see: only those with pure hearts who know kindness more than hatred.

To those who still mock him for his shortcomings, I just appeal that instead of making fun of the person and putting out a mischievous smile behind his back whenever he'd say something that would maybe be weird, let's just remind him of his mistakes in a straightforward way. Like what some of us would do (especially me), if he would commit a mistake, we would tell him that he did a mistake and that he should not do it again. But despite that, what is important is acceptance. People should just accept him as to who he is, not mock him and shit. If moralists taught us to love the mentally-challenged ones, why can't we love a person who is just plain introverted, definitely not schizoid, but nonetheless game for anything that is given to him? This goes all to those who have been bad to him, especially the ones who have know him very well. We can say jokes about him, but not mock him entirely, strip him of his humanity and make him feel so down and degraded. He's a human being, just like the rest of us.

What if we have children who are born just like him, what would you feel if your child's classmate would treat your child like a douchebag?

This is dedicated to you buddy, just in case you get to read this. I'm sorry if I was such a prick towards you. I was just like that because I just want you to improve and become a better man. I made this into a blog so that not only the people who know you would get to read this, but also the entire world who can maybe relate to what you have and what you are experiencing as of this present.

How I wish I can post a picture, but this blog goes out to the public eye as well. Kaya wag muna. Haha!

You deserve a blog that the whole world should read.

Words of wisdom for this: Let's love each other like how God taught us to love Him. Love God and your neighbor. It may not be a common fact, but it sure is a general rule.

Medicine: 2 1/2 years later

It has been a while since I last blogged about how life in Med school was. Because of the tight schedules we have been experiencing in 3rd year, the time that has been spent on using the computer for blogging has been overshadowed by the tons of paper work, reading, and other academic priorities.

It has been already one semester (actually, 3 days to go before the end of the sem) and it feels like time has flown so fast. It felt like it was just yesterday when we returned to the halls of our school (now on a revamped look) and hurdle another year in Med school. It felt like it was months since we endured 2nd year, and it felt like almost a year since we narrowly passed 1st year. 

Looking back and comparing 3rd year with the past 2 years, this year has been the most mentally toxic of all the year levels. It's true what our preceptor back in 2nd year said: that 2nd year was the easiest. I guess she's right: 2nd year was the easiest, but only the easiest in terms of the schedule and light workload. Back then, we had more time for ourselves, though in 1st year we had the most time because of the few subjects that we took during those times. It is in 3rd year where we soon found out that the demands of academics and clinical work were somewhat overwhelming. 

Entering 3rd year was like adding another weight to the already heavy load students have been carrying since the 1st day we entered Med. Third year, the year before Junior Internship, required us to become more adept into the clinical analysis and application of what we have learned from the 2 years in school. I personally admit that not all of what I learned from 1st to 2nd year came back immediately whenever we had preceptor sessions, but they slowly reappeared and were put into good use as time passed. Despite that lofty advantage, there has been a lot of difficulty in terms of meeting the demands of clinicians and professors. In 3rd year, we are required to think and act like doctors: we interview patients, examine them, and later on form a diagnosis from the findings. Not only that, we were made to submit paper works every week for each patient we checked up on. We have 3 to 4 preceptor sessions, and each session required us to submit a paper case per week. It's like working 3 to 4 papers weekly on top of the interviewing and examining of patients. It is a definitely heavy load for junior Med students. At first, the rigors of it were too overwhelming. The time spent on adjusting to the demands of clinical practice made us get used to these rigorous tasks. Truth be told, because of the loads of paper works, patient interactions, and lectures with exams, time really flew so fast. We thought that life would be so slow in 3rd year. Turns out, it kinda wasn't.

What's new in UERM is that the school has made quite a face lift of their classrooms. Five new classrooms were added to accommodate new and old students. The classrooms are quite nice: they have movie house seats, cozy atmosphere, and an environment that is really conducive to studying or sleeping (pick one). We have a new Skills Laboratory, which replaced the old rooms of the 2nd floor of the JMC building, which is really nice and clean-looking. In terms of student population, the 1st year batch was divided into 3 sections because of the enormous number of students who wish to try their luck in passing 1st year. Also new to the mix is the requirement of some classes to have an arranged seating for students, and a mandatory attendance sheet for strict monitoring of who's attending and who's not. It wasn't like that in the past. It just happened that most students tend not to attend lectures, that's why they made attendance mandatory. There's nothing wrong with it, as long as this is included in the grading system of the student. 

Much as I want to say more to this, I just feel sleepy right now. It has been a long week for me because of the exams, and my mind is still exhausted from all the studying and mentally preparing for this past week.

It'll be a few more months before we become Junior Interns. I just hope that the remaining months would be so gentle to us so that we can be one step nearer to become the future doctors we have been molding to become.