#ummc

bc I obviously have nothing to do with my life I was scrolling through the ummc Instagram and scroll to like the last minute, sloot and allie are scooping confetti off the ground and throwing it at each other, it’s actually so cute

Over the summer, I had the unique opportunity to shadow Dr.Mohd Rusdi bin Draman, a fantastic Orthopaedic surgeon of the Orthopedic Surgery Specialists in PPUM KL. I had the opportunity to shadow everything he did: running operations, making ward rounds in the hospital, and interacting with patients in the clinic.

It was so much fun, and I learned not just about orthopedics but the qualities of a good doctor.

I still remember the first day I was here:

That day, I had arrived at the hospital early, But, due to some confusion on who I was supposed to be assigned to, I was kept waiting for a few hours.

To say I was worried is an understatement; I thought that my plan to shadow an orthopedic surgeon would not happen. After a while,  the staff finally gave me this phone number and wanted me to contact the doctor to check for his availability. So, I texted and waited for his response. At this point, I had so many thoughts in my head: “what if the doctor wasn’t open to students shadowing him?”,  “what if my schedule couldn’t fit his?”,   “what if he doesn’t reply to me, how long more do I need to wait here?”

My thoughts were put to a stop because suddenly, I had received the doctor’s reply saying that he wanted me to meet him in his office at 1 pm. I looked at the time and it was just 11:30 am. So I continued to wait until I unknowingly fell asleep on the couch. When I woke up at 1230pm, I discovered that the doctor had already phoned me 3 times. He texted, wanting to see me in his office now. I quickly got up, rushed to his office and wondered why my phone didn’t ring.

I knocked on the door and  a man in his 30’s came to answer.“Hi, is Dr Rusdi here?”, I asked and was surprised that the man in front of me is him! He looked different from what I was expecting, he was so much younger, so much friendlier and amiable! Before this, I had always thought that a surgeon is someone who is quite arrogant, or always in a malicious mood due to their busy schedule. But after our first meeting, I don’t think so anymore.

I introduced myself and thought that later Dr. Rusdi might shoot me with some questions on the musculoskeletal system. I was back to being scared as I had come unprepared, and honestly, the musculoskeletal module is my weakness. But that is the main reason I came - so that I can learn more! But at that moment, I was more afraid of getting exposed of my weakness and thrown out of his department. Shockingly, Dr. Rus didn’t ask me on anything related to the musculoskeletal and instead,  he slowly explained to me about his department and allowed me to tag under his trauma team, Dr. Rus even showed me around the department.

The very first thing that I learned about this field is that there is more specialization than I previously realized. Orthopaedic surgery is a specialty of general surgery and the types of surgeons who are Orthopaedic surgeons can specialize even further. in the hand and upper extremities, spine, lower extremity, sports medicine or joints.

While showing me around, he asked me why I had not picked up the phone earlier. I had come to the conclusion that using a foreign number had most likely been the root cause of why my phone didn’t ring and I explained it to him. Dr. Rus responded that to be a doctor, the first thing I should be is contactable at any time and at any place. Doctors are responsible for the patient’s life and anything could go wrong at any time. Thus, it is important to make sure we are always reachable by the others.

Over the week,  I was lucky to follow everywhere Dr. Rusdi went. He would always provide a running commentary about what I’m observing. When the day is slow for him, he would arrange another doctor for me to shadow so that my experience is as fruitful as possible.

Every day except on the weekends, I needed to be in the wards by 7 am. Every morning, they will have passovers and ward rounds. This usually lasted for an hour to an hour and a half. The team in charge often involved different leaders, houseman officers, medical officers, chief resident, consultant and more.

The Houseman in charge will present the cases and bring the team to the patient for reviewing and assessing of the inpatient’s clinical state. The team would further discuss future plans and management and also communicate their findings with the patient and their relatives or caretakers. On the other hand, the houseman on ED duty will need to pass over the cases encountered the day before in the ED to the team through a powerpoint.

At the ward, I got to see patients suffering from poly-trauma, DFU, NF, thrombophlebitis, pt referred from emergency on-call team, pre-opt patient and many more. I also got to observe some common procedures such as bandaging, wound sloughing, and traction. I find that ward rounds are the most fundamental activity of medical professionals worldwide and it is the thing that I enjoyed most.  The ward rounds here is very structured and organised. Not only did I get a chance to witness how the team worked with each other but also between different medical teams caring for the same patient.

I like the ward rounds most because it is an opportunity to offer patients a high standard of integrated multidisciplinary care. Moreover, they also provide a platform for medical professionals to demonstrate to the patients that there is multidisciplinary communication and collaboration. Since senior doctors are difficult to contact at other times, ward rounds are sometimes the only chance for patients to communicate with them.  In conclusion, I’m sure that ward rounds are the most important thing to improve patient outcomes.

Every Tuesday and Thursday after the ward rounds, I got to follow Dr. Rusdi to the orthopaedic follow-up clinic. In the clinic, I observed hundreds of different patients: post-op patients and patients who suffer from chronic pain, such as osteoarthritis, diabetic foot ulcer, etc.  Here, I learned how doctors communicate with their patients, as well as how they carried out examinations and assessments.  Some consultation can be brief and short, especially with patients that only need an X-ray or a physiotherapy session; while others can be long, especially when a patient requires surgery and they become more concerned and ask more questions.

After a few weeks of shadowing Dr.Rusdi, I had become more familiar with diagnoses, and eventually, I was able to recognize some orthopedic problems simply by looking at x-rays. I became to realise that in orthopaedics, the doctors have the ability to truly “fix” their patients’ problem, unlike other specialties. This is something I started to enjoy.

I also got a chance to shadow in the ED with the MO or HO-on call for the day. In the ED, I got to see some common emergency procedure, such as POP, backslab, arm sling, buddy tape splinting, and even pulling the broken wrist back into its position and more!  Dr. Rusdi also brought me into the OT with him. As it was my first time entering the OT, and I couldn't be more than excited and grateful! I stood at the side, quietly observing and absorbing everything around me.  I thought it was the absolute coolest thing I had ever seen. I couldn’t stop talking about it to my parents and all of my friends and couldn’t understand why they were grossed out!

The surgery that I remember the most is an open reduction surgery for a capitulum fracture. I carefully looked on as the surgeons put in k wires and drilled in screws. I’m really fascinated by how these simple little tools can fix a fracture and regain the limb’s function, and most importantly, the independence of the patient!

I also learned that in orthopaedic surgery, the medical device representative (device reps) is an integral part of the operating theatre. The device reps are responsible for ensuring that all components in the implant system needed for the surgery are on-hand. Throughout the surgery, the device reps will be there to guide the surgeon on using the techs, and also troubleshoot problems that arose during the surgery. I noticed that the device reps will answer the surgeons when question are imposed on them but otherwise, the device reps will just remain silent and keep a safe distance away from the surgeons’ activities. In conclusion, surgeons and device reps share a close working relationship that is necessary for the desired positive outcome of the surgery,

Besides that, Dr. Rusdi also brought me to his NTC workshop, a trauma workshop targeted for master students. Even though it was far too advanced for me, I did have lots of fun there! It was there where I got a chance to try using the tools used in orthopaedics surgery like power drills and saws!!! Orthopaedics seems like a good specialty if you are keen on aggression. I got to try locking the interlocking screw onto the locking plate for the first time. Maybe to any other person, it looks like what a mechanic does every day but the feeling of drilling something into a bone and into a wooden plank is a whole different thing!

Of course, at this point, anyone would think that the life of a surgeon is all about surgeries and patients, which is not quite true. During this shadowing period, I  followed Dr. Rusdi to meet up with his master students to discuss their thesis and research projects. He teaches degree and undergraduate students as well. Overall, He’s more than just a surgeon, but also an educator and researcher.

All and all, I think that although Orthopedic surgery can be an exciting career with personal and financial rewards, it can also be extremely stressful. The day in the life of a surgeon can be extremely long and physically draining. However if it is what someone is interested in, the job can be very rewarding and fulfilling.