Sunday, March 30, 2008

Fei Yang Symphonic Band: Pirated Concert Videos?

Haha, these were listed on my band forum as "pirated", but hey, any public publicity on youtube goes a long way in the long run! Kudos to the unknown user who posted em :o)

These were from last year's concert (June 2007), u cant stop ppl from recordin ur concert, but what the heck, ur not chargin anywayz.

A medley of Carpenters songs, quite good with a few mistakes, we've played the song for like, the hundreth time edi, haha. Posted by the guest electric guitarist, a Soka friend who we invited from outside to join our concert.
http://www.youtube.com/watch?v=mtUhpHs1-80&feature=related

Chinese translation of the title is "Cute Rose" (Wo Ke Ai De Mei Kwey Hwa, i think). Cute piece that would always get the older generations swayin to the bass beat. Heheh, we basses get to play the first few sexy notes.
http://www.youtube.com/watch?v=Wt7CUqHbYAg

Our first debut of Pirates of the Carribean: Dead Man's Chest. Quite a tough piece, even for the bass parts. Even Mr.Lee din dare to conduct very fast, scard we cudnt catch up. Not a very good reception from the audience, but heck, we still love the song!
http://www.youtube.com/watch?v=-SIQnlJ7sCc

And further searches in YouTube revealed videos from a Penang Exchange, 2 years ago during the sem7 Paediatrics posting. Conducted by a famous maestro, kinda like the "consultant" equivalent of a conductor.

Beautiful piece of Colors of the Wind.
http://www.youtube.com/watch?v=DuCEfYLINWw&feature=related

Don Pedro, a mexican piece, i tink. Never really found out what the song was about.
http://www.youtube.com/watch?v=ep2kk9HLT-w&feature=related

And finally, an encore piece by an impromptu "conductor", a medley from the movie Lilo and Stitch, always our band favorite when it comes to blastin aimlessly :o)
http://www.youtube.com/watch?v=EY2ahzmqKPA&feature=related

And they keep tellin us at each concert, "No recording allowed!"

Enjoyz!

Friday, March 28, 2008

Medical Specialties - The Pays and Competiveness

1pm, lazy cloudy Friday. Today all the lecturers and staff at uni have gone to Shanghai for their annual holiday trip, so declared official holiday.

Just finished Surgery clinical exam yesterday. Got Mr.MTC for exam, wah, very bad if get academician for exam, cuz his basics are dem strong, can question u anything under the sun. Case was a perforated gastric (or mebe duodenal) ulcer, post-op with long laparotomic scar runnin down the middle of his six packs. Chinese gentleman, 44 year old, presented with acute and worsening epigastric pain. Couldnt speak english, me no understand chinese, tried to ask for pt change but was told to 'try' and clerk in Bahasa Melayu. So I stammered in mix of Mandarin, Cantonese, Malay and even abit of Hokkien. Very disabling to take history from pt who can only speak Chinese, some more in 20 minutes, den rush thru physical exam. Presented a poor history. Missed out alot on the investigations and post-op management/follow-up since wasnt given time to prepare b4 presenting. Totally stunned when Mr.MTC asked about stomach acid physiology, completely left dat behind in Bukit Jalil.

Mr.MTC invited us down to the cafeteria to breakfast with him after our class, the day b4 our exams. He mentioned about continuously developing urself as a doctor, which is why he came to our uni, but found dat there was not much development option for him here. I agree with dat. To become stagnant in ur medical education after uv qualified wud mean a boring life, so must continue to study. He also talked about getting into the masters program in Malaysia. Yup, British FRCS is still not recognised in Msia, so have to take local surgery training.

Acceptance into the local program at either UKM, UPM or UM (i think some are phasing out post-graduate programmes edi, couldnt remember what MCT mentioned) requires u to, in addition to passing an entrance exam, show alot of initiative in wanting to take up surgery. Electives, CMEs, psotings, doing well in exams, taking other degrees etc. all show ur interest. Dat, with a good letter of reference from ur senior consultants, would clinch ur entry into the 5-year program, but only after uv finished ur 2 year HO and 3 year MO in the ministry of hell (MOH), so by the time ur a surgeon, uv past ur 30s. Which is why in medicine and other fields, MOs quickly go for MRCP and their specialities abroad, which is recognised in Msia.

Borrowed the Lange medical specialty book. It's based on US statistic, but i think they would reflect the medical scene here abit. They call post-gradutate training in the US as residency if im not mistaken, and HO training as internship.

Here are the competitiveness of getting into a residency program based on the rejection ("unmatched") rates (in % of applications) in the US in 2002. Cant find the latest one online. It shows the difficultness of matching into that programme, oso reflects the number of doctors rushing for it.

Extremely Competitive
Plastic Surgery - 23.5
Opthalmology - 22.0
Urology - 20.0
Radiation Oncology - 17.9
Dermatology - 16.1

Very Competitive
Neurosurgery - 15.0
ENT - 15.0
Orthopedic surgery - 14.9
Radiology - 11.1
AnE - 6.5

Competitive
General surgery - 5.4
Anesthesiology - 5.2
OnG - 4.3
Psychiatry - 4.3
Neurology - 3.0

Less Competitive
Rehabilitation - 2.7
Pathology - 2.1
Family medicine - 1.9 (wah, so not competitive meh...)
Internal medicine - 1.6
Pediatrics - 1.3

Everyone loves to know how much a specialty earns (money makes the world go around), so I've oso extracted the median compensation (which i assume is the annual average salary in US dollars, since its the only money thingy of each chapter) for each specialty based on 2002 statistics and re-arranged em.

But remember, medicine in the Us is mostly a private thingy, whereas in Msia, everyone in the government gets about the same amount of pay. If u want to earn this salary, go into private practice. Oso, they got more plastic surgeons over there than here, so of course, the pay here could be much higher. And this is US pay, not directly proportionate to Msian pay, which explains why med students abroad dun wan to come back after qualifying.

I din include some really sub-specialties (retinal surgery, endocinologic gynecology etc.) cuz i dun tink they exist in Msia yet, but their pay is much higher than what the general specialty gets.

Spinal Surgery
$420,660.

Cardiothoracic Surgery
$401,440.

Joint Replacement Orthopedic Surgery
$400,017.

Neurosurgery
$391,250.

Interventional Radiology
$356,000

Orthopedic Surgery
$324,754.

Radiation Oncology
$303,750

Diagnostic Radiology
$302,704

Cardiology
$287,163

Vascular Surgery
$286,286

Plastic and Reconstructive Surgery
$282,825

Anesthesiology
$278,964


Urology
$276,798

GI Surgery
$277,441.

Pediatric Surgery
$270,593.

General Surgery
$255,304.

ENT
$253, 971.

GI
$246,663.

Opththalmology
$240,265.

OnG
$230,804.

Pathology
$221,242

Dermatology
$220,766.

Pulmonary Medicine/Critical Care
$213,483.

Hematology/Oncology
$210,000.

Nephrology
$205,000.

AnE
$204,519.

Neonatology
$201,702.

Neurology
$181,689.

Child Psychiatry
$172,107.

Rehabilitation Medicine
$171,549

Rheumatology
$167,007.

Endocrinology
$166,929

Infectious Disease
$166,156.

Psychiatry
$158,275

Geriatrics
$152,260

General Internal Medicine (i tink its with ur basic MRCP)
$150,534.

Pediatrics
$149,429

Family Medicine
$145,675.

Msia government pay doctors based on their U levels. HO start off at U41, which is about RM2,800 and add all the on-call and some weird allowances (entertainment allowance?), it totals to about RM4,000. MOs now get RM6,000 based on recent news. Specialists go to U48, whereas consultants are at U52 and HODs at U54. Highest u can go is around RM10,000 i tink, with extra pay if ur datuk, do extra admin work, research and etc.

Thus everyone gets about the same pay in the gov, whether ur a cardiothoracic surgeon who's half-dead in the OT at the middle of god-knows what time in the morning, or a radiologist sleeping with the cardiothoracic surgeon's wife in the on-call rooms in the opposite block.

Not very attractive when u know that an ortho surgeon in private practice can earn around RM120,000 a month. Even a "retarded" one can earn about RM80,000.

But i think in the end, it depends on where ur interest lies. U can be making millions a year and giving the tax-collectors a field day, but if u hate ur job, u can be the unhappiest person on this planet. The list is to show u whether u think the job is worth the amount of effort u put in, which u must then applaud the doctors who stay back in the government to work for the sake of the patients who cannot afford private medical care.

Saturday, March 22, 2008

Tiring Week

11pm, damp outside after the rain, crickets chirping peacefully. Back from practice, played Summon the Heroes during clarient sectional, tho we were 5 bars from ending b4 everyone gave up :o)

Given the script for next week's wedding. YMD with Thai girl (not SGI member). Small ceremony at home, at nite have to rush back after practice for wedding dinner. Not much to say as emcee, wonder how i can spruce up the celebration? Hmm...

Rushed back on Thurs after class with Dr.C, dat day wuz Prophet Muhammad's bday, dem weird have class on public holiday. Dem good surgeon-lecturer, like Dr.Y, both oso from the same uni. Hmm, that uni must produce very good doctors-teachers.

Quickly organised clarinet gathering two days b4 after found out Fri no class. Managed abt 55% attendance. 9 clarinetist, 1 bass clarinetist, 1 basoonist, 1 oboeist, and even 1 french horner (sounds really wrong). Others could not make it on such a short notice. Tidied up house, went out to get pizzaz and junk food, and played host for the rest of the nite. Lotsa of peanuts eaten, lotsa tissue used up when things got emotional. Half the box i tink. Problem is, things got emotional at 10pm, ah, wished it started earlier, den dun have to leave so late to fetch sum of the members back to Ampang. Reached home by 12.45am, after 1 hour 45 minz on the road. Tidied up a bit, bathed, den dropped dead in bed.

Its true, u have to come down to grassroot level and hear what members have to say, totally different world for me. I live in a comfortable world, got functional (if rusty) family, can study at (bloodi expensive) medical uni, got car etc. Others are not so fortunate, yet at practice, u see them smile and work hard for kosenrufu, and yet not know a thing abt whats goin on in their lives. There are many things in life that we take for granted. Must listen more to members, dialogue with them. Time to brush up my Mandarin seriously.

Gave the short Gosho preview i wuz supposed to give 3 weeks ago. Wish i could share the actual Gosho with the members, tell them that to practice Buddhism is hard, but not to give up. Winter always turns to spring.

Tmrw got L1 seminar, need to get up early. 2 weeks time got Student Division Exchange Camp with Malacca SD members. 4 weeks time got exchange with Klang band members and Music Instructors Band (MIB), i tink its called Rakan Muda Orchestra or sumthin. Dats Mr. Lee's band, i tink.

Weds, stayed back with * and her friends till 12am. Took her around the wards, learnt from her, as her from I. Muz learn from her semangat, dem hardworking. We helped out in a few MVA cases, blood all over the place, she and i took turns bagging, and holding the damned pen torch cuz wards dem dark and HO tryin his best to suture meat back to victim's face. Victim screamin in pain, max dose of pethidine given.

I volunteered to catheterize my 1st pt, messed up big time, not same as when practice on fake model. Totally not sterile, used up 4 sterile gloves since everytime contaminated. Well, patient din scream or anythin as i pushed the catheter in, mebe cuz he already fainted from extreme pain, imagine gettin ur face sewed back. Sweat like mad cuz urine took so long to finally come out, i tot i punctured the bladder or ruptured the urethra.

By the time i walked home, reached at 12.45am. Jalan Rasah quiet and peaceful at night, ppl watchin wrestlin at mamak shops, few sundry shops open, 7-eleven only shop lighted up at its row, ppl singin karaoke loudly at Teo Chew association building.

Examz next week, Tues and Thurs. Haiz, life is not a box of chocolates, it's one big, bloody exam. After Thurs, gonna come home and kill lotsa ppl. In Unreal Tourney. Long time din make killing. Wahaha!

Sleepz now, dem tired. ZZZ...

Saturday, March 15, 2008

Bananas, DAP, Japanese Friends

10pm, outside wet after the rain. Love the smell u get after a rain.

Listenin to the John Williams' version of "Summon the Heroes", whush, they play the bass parts dem kann chiong. Just back from band practice, din play 'Heroes today, sniff.


Found a version of the actual 1996 Atlanta Olympics performance, conducted by John Williams' himself, dem cool, check it out:

http://www.youtube.com/watch?v=10SWNWzGq1U



Caught Macha eating while a cat was waiting patiently behind a pillar for him to leave, so that it could come and grub in. Managed to snap one pic b4 Macha saw me, got excited and ran to me. Cat ran in, grabbed a bone b4 Macha came tearin back after it and chased it away.

To Shiawase: Sigh, sumtimes proud to be a banana, sumtimes sad to be a banana. Speakin of blenders, mango shakes sellin very well at Chapati Corner, must suggest to Aunty to make banana shake...ewww...dat sounds bad (and obscene at the same time), on 2nd thoughts, nevermind. Do take us again thru paedz wards nxt week ya!

Havin second thoughts on emcee-ing for the wedding. Yikes, i'd be nervous as hell. Dun wan2 mess up sumone's wedding.



Haha, after many years of voting for the Opposition, PJ has finally come under the Rocket! We were mostly cheerin dat Samy Vellu lost the election, can hear the whole SS3 shouting in unison when his results were shown on RTM1.

Surgery goin smoothly. Not practicin enuf of my physical examination skills, very weak.
New juniorz finally came in to surgical wards, brought a few around, some presented cases to me, realised how much i've grown in knowledge and maturity, especially in history takin. Could not believe i once clerked history as a sem6 junior. Stayed back a few times just to bring juniors around, haha, its more fun when ur teaching, forced to read up beforehand so dun look stoopid in front of juniors.

One patient at bed C13 complained of abdominal pain and constipation. I showed the abdominal xray to a group of juniors, showed off my xray interpretation skills, i suspected intestinal obstruction, couldnt really see dilated bowels tho. Juniors questioned back, me as senior ego super big, junior not allowed to question senior, just accept wat we teach u, even tho xray looked quite funny. Suspicious bladder stone noted by one junior, i brushed it off as a phlebolith (calcified vein, incidental finding in old ppl, but pt was only 36 yrs old...). I gave my provisional diagnosis: TB of the ileum. Fuyoh...super-rare disease. Dun noe till dis day how i came up with that differential.

When everybody left, i checked the name on the xray. Wrong xray, supposed to be bed C13, i took for bed 13. Turns out patient in bed 13 was being investigated for blood in the urine, doctor's differential: bladder stone. Bed C13 just had an appendicitis. -_-"""

This week, IMU had 3 Japanese elective students. We had the honor of having one of em onboard in Surgery. His name is T. I was jealous dat Japanese medical students could keep long hair, dem cool. Could only speak halting English, lotsa medical terms he could not understand for they studied medicine in pure Japanese over in Japan, even his textbooks were in Japanese. He learnt the English terms himself with the aid of his translating device. I played unofficial host to him and his friend, R, a Japanese girl who likes anime (its pronounced a-nime in Japan, not ani-meh) and Queen rock music. T spends his time in the labs doin lung cancer research over the weekends. Wow, so hardworkin.

Showed T around the hospital, translated for him during case presentations. A lot of things he couldnt understand. He tended to nod ALOT. Haha, me too, mebe its built into all things Japanese. It was like, at 10Hz per sentence said to him. He nodded to alot of ppl in the hospital as well, everyone thought he was a Japanese specialist, since he had a very matured look. Everyone nodded back at the same frequency until they became giddy.

On Wed I went to endoscopy room with T. Everytime im the only Chinese in a room, i prayed hard dat no Chinese pt would come in, cuz then i wud be called to translate. My bad luck dat day.

I was tested to the limits of my chinese language when a Chinese pt with the whole family (picture this: pt in wheelchair, daughter, son-in-law, 2 children, grandma and brother) came to endoscopy room. All could not speak Malay or English, or refused to speak it, i tink.

Their CT forms and blood forms got mixed up, so i had to take em all the way to MOPD and ask for an appointment. Due to damned beuracracy (godz, how do u spell dat damned word), i was sent on a long walk back to the endoscopy room.

Naturally, all the family members asked me a lot of questions, even their little girl. They were worried about their grandpa having lung cancer. I saw the chest xray, a huge opaque lesion at the left upper lobe. Scope on TV showed an ugly lesion infiltrating the left upper bronchus, doc took a sample. Din dare to show the family members the chest xray.

Didnt know how to pharse it properly, just kept tellin them to wait for biopsy results to come back. Their questions became more complex, from what i usually expected. I switched rapidly from what little vocabulary i knew in Mandarin and Cantonese, and finally a desperate attempt to Hokkien, b4 i admitted defeat and told em i din know how to speak proper Chinese.

Even then, they kept asking. Shows how same races lean on each other in times of need, they refused to converse with the doctors and nurses, only turned to a fellow Chinese. Makes u feel proud to be a Chinese.

Friday nite I took T and R to our variety nite, orientation ended this week. Gave them a dose of IMU orientation nite group performances, yeah, obscenity and IMCCs' included. They could not believe me (they're Asian eyes became American eyes) when I told em, "That girl is a boy... yes, SHE is a HE... yes, its water balloons and a wig...". After dat, their cameras were flashin away.


They were impressed dat Malaysia was such a multi-cultural society. The plays, musicals and songs alternated between shouting bad words in Hokkien, singin the TV3 Ah Long of Bukit Beruntung song in Malay, to lotsa Bollywood music and dancing. An Indian junior was asked to translate one bangra music, the results: "Boy asks girl, 'U look like apple. What is ur name, apple?'" Tamil translation did not come well into English, T looked quite bemused. R and T also laughed alot, even though they couldnt understand the jokes. Most amused by every IMCC dat came on stage. Ah, what is an IMU orientation without our IMCCs? The IMU tradition to be most proud of.


Probably take em photos back to Japan, and showed it to the deans and the whole university during a cultural exchange presentation or sumthin.

"This is what Malaysian students usually do in medical universities."

(Hundreds of stunned Japanese faces)

"...soh des kah...".



Oh, well lotsa things to do b4 Sat nite ends. Nitez...


Saturday, March 8, 2008

A Short Post

2am, silent air outside, kenny g music playin softly from speakerz.

They say if u step out of ur comfort zone, a whole new world opens up to u. Well, I was surprised to find ppl's blogs so short dat i thought, why not me too? It goes easy on the eyes as well.

Din study whole day. Nagging guilt. Spent whole day runnin around preparin for clarinet gathering tmrw (or rather, today). Buyin stuff, tryin to bring down costs, thinkin of entertainment. Suddenly advised NOT to have gathering tmrw. Cuz after practice, voting results will be announced, mebe streets not safe. Sigh, whole day wasted. Oh well, quite a few cant make it tmrw anywayz.

Main purpose wan2 target 1 junior. I see her very sad in band, dun mix well with others, she english-speakin surrounded by chinese-speakin ppl. I understand how she feels, i spent 9 years in a band whom i dun reli understand as well. Gets kinda lonely sumtimes, not understandin pplz jokes. But slowly, u mix with them, ur sense of humor oso blend with them, ah , u feel part of the band, whether u banana or mango. Very hard to "kacau" her, she dun respond dat well, so shy all the time. Mebe in this gatherin, other juniors will mix with her as well. If not, can lose a potential band player. Must establish the sense of belonging.

Tmrw end practice early, 5.30pm. Yeah, we're playin Summon the Heroes, dem cool olympics theme song, dem loud timpanis banging away, and i get a few solo parts! Well, its more of a "play-the-rhythm-while-band-goes-silent" parts. But its still dem cool to hear a bass clarinet playing like a lone beating heart beating away in the expansive silence of a huge universe.

Voting day tmrw. Forgot to register, so cant vote. Wait another 4 yearz. Dat time no time to even register, probably.

Just finished watchin Stardust with bro and sis on tv. Haha, dem funny show, Robert De Niro dem funny. Cool photography and angles, wish i could do stuff like dat. Romantic movie, ah, its a work of escapism. Makes u all wishy-washy. What would it be like to fall in love with a star?

Midz of surgery, Sunday have to go back early and clerk case. New lecturer wants to have case presentation at 7.15am in the morning on Monday. Crazy, patient oso havent wake up yet. Means i have to start walkin at 6.45am, or i drive the car.

Sigh, sem9 here so fast. 5 months to go, time flies while ur in medical school. Must enjoy times with friends, afterwards all go back to their individual states, rarely cross paths with them. Play futsal perhaps? Sigh, dun noe why i hate sports so much. Got two left legs. Just love a good book (and lotsa peanuts or kuaci), or just crapping with friends. I got no sport spirit...

2 weeks time have to emcee a wedding ceremony. SGM member from our chapter marryin a Thai girl. Haha, wonder how to do it. "We gather here today on this very aussipi... auspisios... aupsipicous...(bah) ...beautiful day...". Must make a memorable day for them.

Last week opened a stone exhibition with our recital piece, Mozart's Wind Quintet in Eb. As usual, no one in the audience could make out the mistake. Thats classical music for u there.

Oh well, time to sleep, my circadian rhythm probably all screwed up by now.

Nitez.