My Year 5 or Final Year or Senior Year of Bachelor of Medicine & Bachelor of Surgery (MBBS) at MAHSA University commenced somewhere around late October of 2021 and ended early November of 2022, after our Final Professional Exam (Final Pro).
Before I dive into the main purpose of this article, I am from Batch 9 (2017-2022) and one of the batch who had majority of our classes during clinical years (Year 3 – Year 5) online.
Alright, back to the main topic.
The Year 5 of my batch was divided into two segments, Part A and Part B. Part A commenced from late October of 2021 till mid-January of 2022. This was followed by Part B which was from mid-January of 2022 till the end.
A) PART A
Part A focuses on the theory component with very little exposure towards clinical skills.
The duration for each postings in Part A lasted for 2 weeks. It was very quick, aimed at getting the theory component out of the way.
The classes were conducted physically and since it was during the time when lockdown was newly lifted, every time somebody was declared “Covid-19 positive”, classes would be suspended immediately followed by total disinfection of the place. If you happened to be from the particular subgroup whom the said person was from, classes will be switched online for a few days.
Admittedly, those were good times. At the end of the second week, we would sit for our end-posting examination (EOP) which were usually conducted on the university’s e-learning portal (LMS).
B) PART B
Part B of my Year 5 focused mainly on the clinical aspect, whereby we had Bedside Teachings (BSTs), Clinical Skills Practice (CSL) on mannequins at the Clinical Skill Lab at Bandar Saujana Putra.
We started having classes in the hospital again where we would take a focused history on the patients and even perform focused physical examination just like it was pre-pandemic.
OBSTETRICS & GYNAECOLOGY (O&G)
For O&G posting, it was at Hospital Tunku Azizah. We would have 2-3 BSTs in a week, with each session lasting for about an hour. On some days, we would be placed in the O&G clinics whereby we were able to observe procedures. At the end of 6 weeks, we had our End-Posting Examination which comprised of a Modified Long Case (MLC) and 3 Interactive-OSCE Stations.
As for MLC, we had to take a focused history from our respective lecturers who will be acting as the simulated patients as well and perform a focused physical examination on the dummy.
These were all conducted in Clinical Skills Lab in MAHSA University.
ORTHOPAEDIC & PSYCHIATRY
We were divided into half whereby the other half will go through Orthopaedic posting and the other half, Psychiatry posting for a duration of 3 weeks.
After a duration of 3 weeks, we will be switched whereby the subgroup that had undergone Orthopaedic posting will now undergo Psychiatry posting and vice versa.
In Orthopaedic Posting, our Bedside Teachings were relatively short, maximising around an hour for each BST. Thus, 30 minutes focused history and focused physical examination followed by 30 minutes presentation and discussion with the lecturers.
Similarly, in Psychiatry posting, we had to clerk a patient from the Psychiatric ward, during Bedside Teachings. Of course, since it is a Psychiatric ward, entry and exit were well-controlled and we weren’t allowed to exit or enter as we please. Besides that, we always had to have a lecturer accompanying us when we enter the wards.
It was a rather interesting posting to have underwent.
The theory component which consisted of Multiple Choice Questions (MCQs) and Modified Essay Questions (MEQs) were conducted together at the end of 6 weeks (Yes 6, not 3, which is the end of the second sub-posting). Meanwhile, the Modified Long Case (MLQ) and I-OSCE for each posting were conducted at the end of 3 weeks of each posting.
For MLC in Orthopaedic, it was conducted in the hospital, on a real patient and I-OSCE was conducted in Menara Teo Chew. Whereas in Psychiatry, we did not have MLC. Instead, we had 6 stations of I-OSCE.
INTERNAL MEDICINE
Internal Medicine. The mos condensed and concentrated posting of all.
We had BSTs almost everyday except on a Friday and it was dispersed to several locations:
- Institut Perubatan Respiratori
- Main Building of Hospital Kuala Lumpur
- Old wards near the Paediatric Institute, HKL
We will usually start off with classes in the morning followed by BSTs in the hospital and return for classes again in the afternoon.
By the end of the posting, we had our End-Posting Exam of course. Modified Essay Questions (MEQs), Modified Long Case (MLC) which was not performed on a real patient but on the lecturers and as for Focused Physical Examination, we had to verbally explain the procedure and findings, I-OSCEs, were conducted at the end of the 6-weeks posting period.
SURGERY
The Surgery Posting consisted of General Surgery whereby we had BSTs in the main building of Hospital Kuala Lumpur and clerked “Thyroid”, “Breast”, “Abdomen” and “Vascular” patients. This is followed by a week of Neurosurgery, mainly led by adjunct lecturers.
Our Modified Long Case was conducted at the end of 6 weeks on real patients at HKL. The theoretical component (MCQs & MEQs) and I-OSCEs were conducted in Menara Teo Chew.
PAEDIATRICS
The BSTs for Paediatric posting were conducted in the same hospital as the Obstetric & Gynaecology posting, Hospital Tunku Azizah (HTA) otherwise known as The Women’s and Children’s Hospital.
Clerking usually involved talking or obtaining the history from the parent of guardian rather than the patients themselves.
Since, the wards are guarded, entry and exiting is controlled. Hence, we are not allowed to enter as freely as we please and usually require us to be accompanied by a lecturer.
This posting was also the only posting which my group (Group 4) went for an “on-call”. As we progressed throughout Part B in Year 5, O&G posting introduced “on-call” in their curriculum. Sadly, my group weren’t privilege enough to go through that as it was during a time when the Standard Operating Procedures (SOPs) were much stricter in the hospital.
In Paediatrics, “on-call” basically means going to a particular ward, 10A, usually, from 7pm-9pm. Then, we were required to inquire from the staff nurses regarding the total number of patients in the ward, the number of new admissions, cases, transferred-in cases from emergency department, high-dependancy unit (HDU) and intensive care unit (ICU), transferred-out cases as well as the number of patients discharged.
In all of the postings in Part B, we were required to submit our LogBooks as well as our case write-up by the end of 6 weeks.
Besides that, we had lots of “Case-Based Discussions (CBDs)” where we had to find a case, preferably a real case of course or obtain one from the internet and talk about:
- Full history of the patient
- Full physical examination findings
- Summary
- Investigations performed and results
- Treatment for this patient
- Short theoretical component on the case
In addition to that, we also had adjunct lecturers who would facilitate our bedside teachings in the hospital or some of our CBDs as in Orthopaedic, Internal Medicine, Surgery and Paediatrics.
We basically completed our Year 5 by the end our fifth rotation somewhere around late September 2022, after the end-posting examination, of course.
This is followed by submission of our Portfolio which consisted of compiled case write-ups from all the postings in Year 5 as well as PPD essay and Patient Safety Project, at the end of August 2022.
Our evaluation for the Portfolio and Patient Safety Project were conducted on early October 2022. However, that is a separate post for itself, so do check that out!
Finally, the exam study weeks followed by the Final Professional Exam (Final Pro) which commenced from 26th of October 2022 till the 4th of November 2022.
Do read my posts on it!
The Theoretical Doctor 