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      Medical Students' Column

"The Elementary Clinics Experience - A New Journey"


New course

This year’s Elementary Clinics for pre-clinical students, renamed Clinical Skills Foundation Course, lasted 8 weeks from late April to early June. Apart from the traditional laying down of groundwork for history-taking and physical examination, the course offered us the chance to be the pioneer batch to learn clinical procedures such as venepuncture and urinary catheterization on simulated models and wound suturing.

As my classmates arrived in the LT for introductory lectures, I guessed from their pleasant disposition and that oh-so-subtle spring in the footsteps that we were all thrilled to embark on this, perhaps our greatest journey yet. Taking that giant leap into the wards is an event that every medical student looks forward to, not just for the academic opportunities, but for entering the wards is symbolic of the acceptance of a student to the closely-knitted fraternity of doctors.

So it was with immeasurable pride that I donned my white coat (freshly pressed, of course) emblazoned with my name-tag, adorned my neck with my stethoscope (the way I’d seen the seniors do) and marched in with my tutor and clinical group-mates to meet our first patients. I remember some of them vividly: the lady huddled under her blanket, clutching a rosary, her eyes closed in a silent battle to overcome her pain; the gentleman propped in bed by cushions, struggling for each breath, coaxing the life-force from a thin mask moulded to his eburnean countenance.

I had been living a near-ethereal existence from the day I received my letter of acceptance into the Faculty. I treasured the honour of being a medical student, delighted in knowing gems of information like the 4 developmental anomalies of a Tetralogy of Fallot and that femoral hernias are more common in females than in males. But much of this had been plain information committed to memory, without my having any inkling of the repercussions of a disease on a patient.



The true gravity of my present and future responsibilities emerged from that first day at the wards.

Over the weeks that we were assigned to NUH and TTSH, my group-mates and I took history from and examined over 60 patients _ 60 complete strangers who willingly answered our questions that probed into their lives and permitted us to lay our hands on them. I remember more of our patients: the grizzled faces that were glowing at the end of the conversation and the tearful mother who took comfort in our simple reassurances. I could never have anticipated the immensity of the privilege that we had been given or the trust that a patient can award us. In the movie Restoration, a young doctor, in speaking of his patients, confesses,

"I am frightened by their faith ... and my ignorance."

How many a time have I echoed this sentiment exactly? We’d only had 2 years of pre-clinical studies and still a long road remains before us. It has become my fervent hope since that the years ahead will see me develop to become the competent doctor that I should be.


The joy of doctoring

For me, the whole E. Clinics experience is very aptly described by Shakespeare’s Sonnet 25,

"Let those who are in favour with their stars
Of public honour and proud titles boast,
Whilst I whom fortune in such triumph bars,
Unlooked for joy in that I honour most"

Most of my friends are in universities in Singapore or elsewhere in the world _ many on prestigious scholarships, some have made it to the Dean’s List and during vacation, they may take ski trip holidays or surfing lessons _ they have attained their honour and titles. But I have found my joy.

As I explore the SGH wards now for my Surgery posting, I find inspiring role-models among my teachers and discover camaraderie among my colleagues. I know that the life-force may ebb for the gentleman and may one day cease to flow, but I take heart in knowing too that the lady may conquer her pain. At that moment, the faces that glow and the tears that subside will be honour and title enough for me.

"Then happy I, that love and am beloved

That I may not remove, nor be removed"