THE DISSECTION

THE PAIN

2011-12-25T09:41:00.000-08:00

Okay semi-short post.

Last week, I have been diagnosed with intervertebral disc prolapse (IVDP). Previously, my lecturer just suspected it as an “early stage of IVDP” based on my symptoms and clinical signs, but last week, I had a very severe lower back pain lasting about 2 weeks in duration, causing me difficulties to walk, bend down (especially for rukuk during prayers), sit, getting into the car. The pain travels along the course of the sciatic nerve, I could feel it. Last time, I even had numbness and pins-and-needles sensation at my right great toe, with loss of sensation around that area (thinking about L5 and S1 dermatomes huh?). It’s like I were 70 years old, when I’m actually just 24. I even asked my mom, “Mak, kalau la ni (sekarang ini) dah macam ni, Muna dah tua nanti macam mana?” So my mom suggested that I go to this private hospital in my hometown to get some medications, coz I ran out of the medications given by my lecturer – Celecoxib, Mecobalamin and Fastum (ketoprofen) gel. And of course, the doctor asked me to do MRI without even performing any basic tests e.g. SLRT (straight leg raising test) which costs my mom almost a thousand ringgit. I didn’t mind though, coz he was a good doctor, and he even asked me to describe my own X-ray and MRI (sigh, of course I screwed up, I was in pain okay =P) and I want to confirm the diagnosis and the cause of this terrible lower back pain which I have been suffering from since I was 14. To add to that, I have a strong family history of IVDP. Three of my close relatives have IVDP. One of them has mild scoliosis.

So these are the results:

You see, the L4-L5 disc is going into the spinal canal, almost consuming the space for the spinal cord, impinging the L5 nerve, explaining my numbness, prickling and loss of sensation at the great toe huh? It's going to the right, explaining the pain which travels through my right thigh downwards. Look at L5-S1 disc, my doc said it's degenerated!

According to my doc, the L4-L5 disc protrusion could have been due to a trauma where my body was twisted severely. I could only recall falling from a bicycle twice during my childhood years, and falling from a motorbike twice. Yeah, motorbike. Twice. During my teenage years. Once on the road in Batu Pahat town, and once on the highway from Batu Pahat to Seremban. I fell down hard to the ground. My ex broke his leg.

The L5-S1, according to my doc, was degenerated due to some genetic factor. Remember my strong family history?

The doctor recommended decompression surgery, which costs about RM10k-RM30k in that private hospital. I sent a text to my lecturer, he recommended surgery too, especially if I wanna do it in HTJ. Uh oh. My parents are thinking about asking second opinions. and I am thinking about... waiting. Waiting for the right time.

Surgery isn't scary, but the risks of anesthesia and the post-operative pain and complications are.

For the time being, I wanna try conservative method and traditional medications for symptomatic reliefs. What a medical student huh!

Ok. The next day, I attended an appointment for minor oral surgery (MOS) for tooth 38. Again. This is the second time I underwent that surgery, but this time is worse. The LA (local anesthetic) didn’t work perfectly! Previously I couldn’t feel anything but this time, the dentist said “pass me the blade!” to her nurse and I said “Uh oh” and there you go, I felt the blade incising my gum. Then she said “scissors!” and this part was the worst – I could feel the scissors cutting through my gum. Then I could feel the needle going into my gums while she sutured the wound T_T Multiple pokes of LA had been given, but it was still ineffective, I don’t know why. Then, my cheek was swollen. My face is asymmetrical (I’m too shamed to put my pic here, but I do look ugly now). I couldn’t eat properly, though I was very hungry. I have been eating porridge for days and I have gastritis, so my stomach decided it needs solid food so it stimulated my vomiting center in the brain and I have been vomiting after each intake of food. Even only a piece of chicken nugget.

So combine these:

Lower back pain 2⁰ to IVDP + post-operative dental pain + stomach pain and vomiting 2⁰ to gastritis = difficulty in mobility + difficulty in chewing food + difficulty in eating and accepting food

plus:

headache and migraine 2⁰to dental pain + vertigo and nausea 2⁰ to Tramal (given as painkillers for that post-MOS)

Do you think I’m enjoying my last days of holiday (I got 5 days of MC)?

Sigh.

So the important messages here are:

1) Ingat 5 perkara sebelum 5 perkara, especially sihat sebelum sakit.

2) Please be grateful with whatever you get to eat today because there are many people out there who are having difficulties not only to buy and get food, but to chew and swallow the food, no matter how delicious they are, they don’t matter anymore when you have tooth pain, dysphagia, odynophagia. Don’t complain.

Tomorrow ada follow-up with dentist. Tadi the sutures were broken, coz I brushed that area, and it bled. Uh oh.

Tolong doakan semua kesakitan saya cepat sembuh ya =(

P/S: Kalau nampak saya jalan macam tempang ke senget ke tonggek ke pelik ke apa kat IMU ke kat mana-mana ke, please la jangan kutuk, please ignore and excuse me. I’ve been having difficulties to walk properly, even long before I was diagnosed with IVDP. The pain started during my teenage years lagi dah. And one more thing, please excuse me if I pick things on the floor with my foot. Tak beradab, but it spares me the need to bend down so I could avoid the pain =P

Yeay, can’t wait to start major postings! =P

BOLA DAN INDONESIA

2011-11-24T23:54:00.000-08:00

Pertama kali.

Pertama kali saya menonton perlawanan bolasepak dan merasa berdebar-debar.

Pertama kali saya menunggu perlawanan bola sepak untuk bermula di depan kaca TV.

Pertama kali saya menonton perlawanan bola sepak dengan penuh fokus sehingga ke penghujungnya.

Pertama kali saya gembira dengan “goooollll!” dan mengutuk dengan “booooo!” semasa menonton sebuah perlawanan bolasepak.

Pertama kali saya mengenali dan mengingati nama-nama pemain pasukan bolasepak.

Pertama kali saya membaca akhbar bermula dari belakang, untuk mengetahui berita tentang perlawanan bolasepak sedangkan sebelum ini saya tidak pernah membaca bahagian Sukan.

Semuanya bermula apabila Syahrul Azwari menjaringkan gol dalam perlawanan separuh akhir menentang Indonesia itu. Entah kenapa, budak itu seolah-olah mempunyai aura menyuntik semangat saya untuk menanti dan mengikuti perlawanan seterusnya, sehinggakan perlawanan antara Malaysia dan Myanmar pun saya tonton hingga ke penamat, sedangkan Syahrul Azwari dikeluarkan selepas separuh masa kedua. Ya, saya saksikan bagaimana Fakri Saarani memberi tendangan ‘berbisa’ dan seterusnya menjaringkan gol tunggal pada 5 minit terakhir dalam perlawanan yang saya sangkakan tidak akan membuahkan apa-apa bagi Malaysia itu!

Tidak, bukan sebab kecomelan Syahrul Azwari. Tidak, bukan kerana Khairul Fahmi yang dikatakan ganteng banget itu. Walau bagaimanapun, tidak saya nafikan saya kagum dengan kehebatan, ketangkasan, kebijaksanaan, daya fokus dan kekuatan psikomotor Khairul Fahmi yang dapat menangkap bola dengan smooth setiap kali bola menerjah menghampiri gawang Malaysia.

Oh tapi mungkin juga kerana saya rasa Ong Kim Swee agak cute. Antara sebab saya bertahan menonton hingga ke minit akhir - saya ingin melihat senyuman Ong Kim Swee, yang sukar untuk dilihat melainkan pasukan Malaysia menjaringkan gol! Waktu lain ada dia senyum? Tak ada! Asyik berkerut dan nak marah-marah saja muka dia. Nampak berkaliber di situ. Saya pernah bertanya kepada ayah saya, "Abah, awat dia asyik pakai baju warna biru? Masuk ni dah 3 kali nampak dia pakai baju biru ni!"

Jawapannya, kerana rasa ingin tahu dan ingin saksikan sendiri gaya pemain kita menumpaskan pihak lawan! Pelik, tapi benar. Dulu, jika ada kawan perempuan yang menonton bolasepak, pasti akan saya katakana, “Eleh, mesti nak tengok pemain handsome! Mana ada perempuan teringin nak tengok bolasepak, kalau tak ada lelaki yang handsome.” Ternyata, tohmahan saya silap. Patritotisme misalnya, boleh menjadi penyebab utama sesiapa sahaja ingin menonton perlawanan itu hingga saat terakhir.

Maka berakhir sudah Sukan SEA di Indonesia, tapi kehangatan perlawanan bola sepak antara Garuda Muda dan Harimau Muda pada Isnin lalu masih lagi diperkatakan sehingga ke hari ini. Walaupun Malaysia tewas pada Syria dalam perlawanan kelayakan Sukan Olimpik, mata penyokong-penyokong Malaysia seolah-olah masih dikaburi, seolah-olah terpukau dan dibuai mimpi dek kemenangan negara tercinta di Stadium Gelora Bung Karno, di atas tanah negara seberang yang menjadi tuan rumah itu sendiri.

Bagi Indonesia, perlawanan dengan Malaysia dianggap sebagai kayu pengukur kehebatan pasukan mereka. Kemenangan ke atas Malaysia bagi mereka, adalah tiket untuk mendabik dada mengatakan mereka adalah pasukan bola sepak yang terhebat di Asia Tenggara.

Berlainan dengan negara kita Malaysia, perlawanan dengan Indonesia dianggap sebagai satu perlawanan yang cukup signifikan dan mendebarkan, kerana 3 perkara:

Pertama, kerana mereka jiran terdekat kita dan rata-rata masyarakat mereka adalah serumpun dengan kita. Susuk tubuh fizikal dan ketinggian mereka hampir-hampir sama dengan pemain-pemain kita (jika pemain import tidak diambil kira). Jadi, tiada alasan bahawa mereka lebih handal kerana kekuatan fizikal mereka.

Kedua, kerana rakyat Indonesia sudah banyak yang bertapak menumpang mencari rezeki di Malaysia, maka perlawanan Indonesia-Malaysia adalah perlawanan persaudaraan, yang boleh dibandingkan seperti dua orang kanak-kanak yang berlawan menyepak bola, satunya adik dan satunya abang.

Ketiga - faktor yang paling penting: kerana sikap penyokong-penyokong mereka yang anti-Malaysia tanpa sebab-sebab yang munasabah, cukup hostile, kurang ajar dan boleh disifatkan seperti orang-orang yang datangnya dari negara yang tidak bertamadun, sedangkan Indonesia adalah sebuah negara yang penuh adat dan tatasusila, apatah lagi jika ingin kita bicarakan tentang adat Melayu yang masih mereka kekalkan dengan lebih baik daripada negara kita sendiri yang lebih banyak mengadaptasi budaya Barat dalam pelbagai aspek sekarang ini, sedangkan kedua-duanya ialah negara-negara Nusantara dari Rumpun Melayu yang sama.

Persoalannya, mengapa mereka terlalu bencikan Malaysia? Ada beberapa teori yang dapat saya simpulkan daripada beberapa pemerhatian dan pembacaan, yang mungkin menjadi faktor-faktor kebencian Indonesia terhadap Malaysia:

Pertama, mereka claimed that lagu Negaraku, yang sememangnya berirama sama dan diinspirasikan daripada lagu Terang Bulan, berasal dari Indonesia. Maka, mereka mengejek-ejek lagu Kebangsaan kita yang tiada originality itu. Sejauh mana kebenarannya, saya tidak pasti.

Kedua, banyak teori mengatakan mereka sebenarnya cemburu atau lebih tepat, envious dengan pembangunan dan kejayaan Malaysia. Perkara yang paling ketara? Matawang. Ringgit mempunyai nilai yang lebih tinggi daripada Rupiah. Bahkan, kecemburuan mereka hampir tidak berasas apabila mengatakan kejayaan yang dikecapi negara kita sekarang ini adalah disebabkan kaum bukan Melayu. Contohnya, syarikat-syarikat besar yang didominasi oleh Ananda Krishnan dan Tony Fernandes, Lee Chong Wei yang mengungguli arena badminton, Nicol David yang ternama dalam bidang squash. Ada benarnya, tetapi mereka bercakap seolah-olah negara mereka adalah negara total Melayu dan bukannya berbilang kaum!

Ketiga, mereka masih dilamun igauan yang diturunkan oleh nenek moyang mereka yang gagal dalam perjuangan mereka untuk menubuhkan Melayu Raya (sebuah negara Melayu yang dianggotai oleh Malaysia dan Indonesia), dan dengan itu, mereka masih ingin memperjuangkan Ganyang Malaysia. Rata-rata mereka tidak bersetuju apabila Tanah Melayu bergabung dengan Sabah dan Sarawak untuk membentuk Malaysia. Pada fikiran saya, bagus juga nenek moyang kita tidak merealisasikan Melayu Raya. Pertama, jika Melayu Raya menjadi realiti, mungkin negara itu masih lagi menjadi sebuah negara yang miskin dan bermatawang rendah disebabkan rakyat yang terlalu ramai. Kedua, jika sebegitulah sikap rakyat Indonesia yang sebenarnya, yang mengaku mereka adalah Melayu tetapi membuat rusuhan dan pembakaran di sana sini, maaf, saya tak rasa negara itu akan aman seperti Malaysia sekarang ini (ketepikan dahulu isu Bersih dan Seksualiti Merdeka yang dilatari individu bukan Melayu dan Melayu pengkhianat bangsa itu).

Keempat, tuntutan hakmilik dari segi kesenian. Mereka katakan batik itu kesenian Indonesia, mereka katakan lagu Rasa Sayang itu berasal dari Indonesia dan merupakan hakmilik mereka. Bagi saya, isu ini boleh diselesaikan dengan baik jika kita kembali kepada konsep rumpun Melayu. Berabad-abad dulu, nenek moyang kita semuanya Melayu, berdagang bersama-sama, jadi sudah pastilah ada pertukaran harta kesenian ini antara kedua-dua buah negara. Maka, apa salahnya berkongsi?

Kelima, isu pembantu rumah Indonesia yang asyik didera oleh majikan-majikan di Malaysia, yang masih belum ada penyelesaiannya.

Nak cakap pasal benda ni, sampai esok pun tak habis.

Dalam akhbar, ada rakyat Indonesia yang memberikan komen mengatakan mereka malu dengan sikap penyokong-penyokong Indonesia yang berkelakuan buruk dan tidak menghormati tetamu di tanahair mereka. Kata mereka, penyokong-penyokong itu rata-ratanya datang dari kampung (orang kampung), datang dari jauh, tanpa tiket. Baiklah, mungkin mereka itu kurang berpendidikan. Tapi untuk sebuah negara Islam, faktor kekurangan pendidikan akademik yang dijadikan alasan untuk kekurangan akhlak dan budi pekerti tidak dapat diterima akal sama sekali!

Apapun, satu sahaja yang ingin saya katakan.

Cuba anda pergi ke Indonesia. Perhatikan bagaimana layanan dan tingkahlaku mereka terhadap anda.

Sangat baik!

Berdasarkan pengalaman saya ke Jakarta dan Sumatera, Rakyat Indonesia sebenarnya (di luar padang, perlawanan bola, stadium), sangat baik, peramah, dan berbudi bahasa – jauh lebih baik dari rakyat Malaysia! Mereka sangat menghormati orang-orang Malaysia, sehinggakan saya berasa sangat malu apabila memikirkan layanan rakyat Malaysia terhadap mereka di negara kita, dan bagaimana rendahnya mereka pada pandangan kita.

Mereka tidak sombong. Apabila saya ke kedai, pekedai-pekedai mereka menyambut saya dengan senyuman. Malah, tauke-tauke Cina mereka juga sangat peramah, sangat fasih berbahasa Melayu sehinggakan saya tertipu dengan keindahan bahasa mereka, dan menyangka mereka adalah Melayu sebenar!

Apek: Kamu orang Maliysia ya?

Saya: Ya. Bagaimana kamu tahu?

Apek: Gaya pertuturannya lain.

Saya (ketawa kecil, malu kerana sudah sehabis baik cuba bertutur dengan gaya dialek Indonesia supaya dapat mengaburi mata mereka untuk memberi harga murah): Kamu? Orang sini ya?

Apek: Ya, saya orang Indonesia.

Saya (mengangguk dan teragak-agak, nak tanya ke taknak, kalau tanya kat Malaysia orang kata racist): Err... kamu ini Cina ya?

Apek: Ya! Mengapa ya?

Saya: Nggak apa-apa. Bahasa Melayu kamu baik banget, saya hampir-hampir ingat kamu Melayu.

Apek (ketawa): Jangan terkejut, kami di sini sangat pandai berbahasa Indunesia dong!

Saya: Sudah tentu!

Malah, apabila sampai ke Lapangan Terbang Sukarno Hatta di Jakarta, saya terdengar sekumpulan remaja Indonesia bercakap-cakap, dan seorang daripada mereka merakam percakapan itu menggunakan kamera video.

“Hai, kami sudah sampai di Lapangan Terbang Soekarno-Hatta, Jakarta. Sangat gembira kerana sudah kembali ke tanahair. Pengalaman bercuti di Kuala Lumpur tidak akan kami lupakan, tatapi Indonesia tetap di hati kami!”

Sambil mengambil beg di bahagian penyimpanan beg di atas kepala, saya berasa sangat kagum dengan semangat patriotisme mereka dan menoleh. “Omg, aku ingatkan Melayu tadi, fasihnya cakap Melayu!” bisik hati aku. Mereka semua rakyat Cina Indonesia! Kalau senario tadi berlaku di Malaysia, mesti saya sudah tampar-tampar pipi saya untuk memastikan saya bukan bermimpi. Kalau sekumpulan remaja Cina di Malaysia bercakap Melayu fasih sesama mereka dalam sebuah recording, tanpa seorang pun anggota mereka berbangsa Melayu, itu adalah ibarat igauan dalam mimpi.

Rakyat Indonesia rata-ratanya sangat miskin. Mereka sanggup buat apa saja untuk mencari rezeki. Saya benar-benar simpati dengan mereka. Ada yang cuba menjadi ‘polis trafik’ dan memberi isyarat kepada kereta-kereta lain supaya memberi laluan kepada kereta-kereta di kawasan berlampu isyarat dan diselekoh-selekoh yang pancit banget, dengan bayaran hanya beratus-ratus rupiah yang tiada langsung nilainya jika ditukarkan ke matawang Malaysia. Ada seorang budak lelaki yang mengejar saya sampai saya menaiki trem, hanya untuk memujuk saya membeli rantai buatan kayu (saya pernah memakai rantai ini di IMU, tapi dah hilang) dengan harga 5000 rupiah, kerana sebelum itu saya cuba bargain dengan dia 10,000 rupiah dapat 3 rantai (ridiculous kan, tapi waktu tu saya cuma ada wang yang sangat limited, jadi perlu berjimat) dan berlalu pergi apabila dia refused to sell with that price. 10,000 rupiah bersamaan lebih kurang 3 ringgit, jadi kalau saya minta 10,000 rupiah dapat 3 rantai memang kasihan pada budak tu, sebab dia akan kerugian besar, sedangkan rantainya elok buatannya. Saya rasa sangat simpati, jadi saya beli rantai itu dengan harga 5000 rupiah (seringgit lebih harga Malaysia), walaupun saya sangat pasti rantai itu dijual dengan harga RM10 di Malaysia (lebih daripada 30,000 rupiah).

Apabila mereka tahu kita rakyat Malaysia, mereka akan tunduk dan tersenyum dan menyapa “Pagi bu, pagi pak” dengan sangat mesra. Bagaimana pula layanan kita pada mereka di sini? Pada pembantu-pembantu rumah, buruh-buruh mereka?

Lebih kurang 3 minggu lepas, sewaktu makan tengahari dengan mak di Papa Rich Sunway Pyramid, ada sekeluarga Cina datang duduk di sebelah meja kami. Keluarga itu ada 2 anak kecil, dan ada seorang pembantu rumah warga Indonesia bersama mereka. Mereka menempah nasi lemak ayam yang sama setiap seorang, termasuk pembantu rumah itu. Apa yang mengejutkan saya, sebaik sahaja makanan sampai, wanita cina itu terus mangambil ketulan ayam (satu-satunya ketulan ayam) daripada pinggan pembantu rumahnya dan memasukkan ke pinggannya, yang juga sudah ada seketul ayam, menjadikan jumlah ketulan ayam di pinggannya 2 ketul. Pembantu rumah itu nampak terpinga-pinga kerana ketulan ayamnya sudah diambil, dan apa yang tinggal di pinggannya hanyalah nasi lemak biasa. Saya sangat bersimpati dengan pembantu rumah itu. Rasa simpati dan malu menjadi rakyat Malaysia yang berkelakuan begitu, walaupun pembantu rumah itu adalah pekerja yang dibayar gajinya. Langsung tidak beretika!

Kesimpulan yang ingin saya ketengahkan di sini – hormatilah mereka, kerana mereka sebenarnya amat menghormati kita. Berbudi-bahasalah setakat yang kita mampu.

Namun, jika difikirkan kembali sikap pemain-pemain mereka yang menjampi-jampi di tiang gol, sikap penyokong-penyokong mereka yang tidak bangun dan mengejek-ejek lagu Negaraku sewaktu ia dimainkan, sikap mereka yang mengganggu pemain-pemain kita sehingga tidak dapat masuk dan keluar dari stadium dengan aman sehingga perlu menaiki Barracuda – mungkin kekalahan itu perlu bagi mereka sebagai pengajaran. Namun, adakah mereka akan mengambil kekalahan itu sebagai pengajaran? Pada fikir saya, kekalahan yang boleh dikatakan hampir-hampir disebabkan nasib itu (penalti adalah perjudian nasib, sepakan Baddrol yang dramatic umpama magis, walaupun ketangkasan dan fokus Khairul Fahmi patut dipuji) akan menyemarakkan lagi api kebencian dan fahaman anti-Malaysia mereka, dan pemain-pemain kita kemungkinan akan berdepan dengan dugaan yang lebih hebat lagi selepas ini. Saya khuatir, selepas ini mereka akan menjampi dan mencuba sesuatu agar Khairul Fahmi, aset penting pasukan kita, tercedera dan dikeluarkan. Berapa kali penyerang-penyerang kita diberi kad kuning pada hari itu, oleh pengadil yang juga kelihatan seperti berat sebelah?

Sukan SEA dilihat gagal menyatukan negara-negara ASEAN kerana sikap pentingkan diri negara penganjur!

Apapun, saya suka makan Nasi Padang. Oh Sari Ratu!

P/S: Can anyone enlighten me, why does Harimau Muda have to play against Syria and Bahrain, when they just played in Sukan SEA? Where’s the Harimau Malaya team – Safee Sali, Zaquan, Zafuan? What are the senior players doing? Why didn’t they let the above-23 team to play for the Olympic qualification match? I’m just curious, cuz Harimau Muda looked exhausted last Wednesday.

JUST A FEW LITTLE WORDS

2011-11-23T05:15:00.000-08:00

From MotivateUs.com:

It only takes a few little words to cause much pain,
and it only takes a few words to cause much happiness.
It only takes a few words to crush a heart,
and it only takes a few words to give a heart joy.

It only takes a few words to alienate a friendship,
and it only takes a few words to make a friendship blossom.
It only takes a few words to cause someone to go astray,
and it only takes a few words to help them find their way back again.

It only takes a few words to destroy someone's hopes and dreams,
and it only takes a few words to give a person reason to hope and dream again.

It only takes a few words to make someone cry,
and it only takes a few words to take their tears away.
It only takes a few words to make someone's day sad and dreary,
and it only takes a few words to make someone's day happy and cheery.

It only takes a few words to cause dark clouds to appear,
and it only takes a few words to chase all those dark clouds away.
Just a few little words can comfort one in grief, can soothe a broken heart,
can bring one back from the brink of despair.

Just a few little words can help someone cope,
can help someone lonely feel not so alone.
Just a few words can calm someone's fears,
and ease someone's troubled thoughts.

Just a few little words can brighten someone's day,
and make their road in life easier to travel.
Just a few little words can lift someone's burdens,
and help them make it through the day.

Motivating Moments, LLC
1085 Shady Ln.
Waterford, Michigan 48327 USA
http://www.MotivateUs.com

SELF-MOTIVATION

2011-11-15T21:52:00.000-08:00

You can find this article on Medscape. I like it and I decided to share it with you.

How to Motivate Yourself

Can't Be Bothered to Write That Essay?

Anita Houghton

Introduction

Life is full of things that need to be done, and medical student life is fuller than most. There are essays to write, lectures to attend, patients to see, skills to sign off, and exams to revise for. And there are also parties to go to, friends to be with, drinks to be enjoyed, sports to be played, music to be listened to, and fun to be had. How do you fit it all in?

Planners v Last Minuters

When it comes to getting things done there are two main camps. There are the type that consider work, however unappealing, should be done before play.^[1]

These people like to get things done in plenty of time, and they like to plan. They do not like finding themselves with a substantial amount of work and only a short time to do it.

All these people need to get motivated is a job that has to be done. The problem arises for them when there are jobs that don't have to be done, or at least not by a particular time, and which they find unappealing. With these they procrastinate, just like anybody else. The other problem that this type may experience is never getting to the fun. Let's call this type the Planners.

The other camp have a rather different philosophy—life is meant to be fun, why spoil it with work unless and until you absolutely have to? In fact, work itself should be fun, shouldn't it?

These are the easy going and flexible people in life. What these people need to get motivated is a job that has to be done right now. That's because when the last minute approaches this type get a sudden surge of energy which renders them extraordinarily efficient.

Entire modules can be learnt overnight. An essay can be written in an evening. Three month projects can be completed in a few days, or a week anyway, or perhaps a fortnight, or maybe a bit longer. And this is the trap that this type are in danger of falling into—not knowing when the last minute begins.

They wait for that surge and then they know it is time to start—but what if the surge doesn't come at the right time? What if it arrives two weeks before finals, when there is actually at least three months' worth of revision to do? What if their gut instinct isn't all that good at making these crucial estimates? Let's call this type the Last Minuters.

To maximise motivation, Planners need to have more fun, because fun lightens the spirit and renews energy. The Last Minuters need to estimate carefully how long their projects will take. Both types need to plan.

What Works in Self Motivation?

A few years ago Richard Wiseman, professor for the public understanding of psychology, did a study of 5000 people from all over the world who wanted to achieve something in their lives: pass exams, lose weight, progress their career, and so on. He monitored their methods and their achievements, and from the data he gathered he identified the techniques which were associated with success, and those which were not.^[2]

These were the techniques that were consistently associated with success:

(1) Making a plan consisting of small, achievable steps to be achieved within a specific time frame
(2) Rewarding yourself when each step is completed
(3) Telling others about your plan
(4) Reminding yourself of the benefits of completing your plan
(5) Keeping a written record of your plans and your progress.

Let's see how this could work for you in preparing for exams.

First write down every area that you need to prepare or revise. Everything from clinical scenarios and system examinations for objective structured clinical exams and vivas, to learning the differential diagnosis of ankle oedema or the microscopic features of a cirrhotic liver.
For each area, write down what resources you will need (books, lecture notes, papers, and so on) and estimate how long you will need to spend on it, bearing in mind that you will want to revise subjects more than once. Add up the hours you need to spend revising, including the time it will take to assemble all your resources. Experience suggests that you should add at least 50% to your total hours to allow for underestimates.
Look at the time available between now and your exams and calculate the number of hours you need to work each day, allowing for rest periods/days. Draw up a timetable.
Tell your friends or family, or both, about your plan. You may like to stick it up on the wall where you work or put it on your Facebook page.
Each day, plan yourself a reward for each step. You might plan a cup of coffee and a brief chat with a friend for mid-morning, a nice lunch at midday, and some exercise or a television programme in the evening.
Write down the benefits of keeping to your plan, and each day remind yourself why it is you want to work effectively, and how much you want to do well (see below for turning "shoulds" into "wants").
Keep a daily written record of your progress.

Other Ways to Get Motivated

Start, even if only for a few minutes—A Russian psychology graduate in the 1920s, Bluma Zeigarnik, found that once someone starts a task, a kind of psychic anxiety is produced which stays until the task is complete.^[2] In other words, if you wait for motivation you might wait for a long time, but if you start the task, even if only for a few minutes, motivation arises.

Do it with someone—Challenges are less daunting if they are tackled with a friend.^[2]

Combine optimism with realism—Simply visualising success not only doesn't work but can actually result in reduced effort and lower levels of achievement. Similarly, focusing on difficulties and obstacles is demotivating and unlikely to result in success. Gabriele Oettingen, from the University of Pennsylvania, did a study where participants were asked to identify the benefits of achieving their goal, and also to identify likely difficulties along the way. She found that people were more likely to achieve their goal if they combined optimism about achieving it with careful assessment of obstacles and how they will deal with them.^[2]

The Least Appealing Tasks

Consider the following example. You don't like tidying your desk or putting your notes in order, but you know your work will be easier and more efficient if you do.

Remind Yourself Why You Want to Do It

Tasks that you need to do but don't want to do are always shrouded in "shoulds," "oughts," and "musts." I should tidy my desk. I ought to put my notes in order. I must start my revision today. I really should go to the library and research that essay. I should lose weight, take exercise, drink less, eat more healthily, ring my parents, do my laundry, get my hair cut, and so on.

These words are a remnant of our childhood, a time when we wanted to play but our parents and teachers wanted us to work. You wanted to play on your PlayStation, chat with your friends, or watch television, but all you ever heard was: "Do your homework," "stop talking and concentrate," "tidy your bedroom," "go and practise your piano/violin/trumpet."

All of us imbibe these admonishments until such time our parents and teachers become redundant because we carry their voices inside our heads. If you listen to yourself carefully you will hear these voices, and if you check your body you will find that the feeling that you have when you tear yourself away from doing what you want to do, to do what you should do, is exactly the same today as it was back then.

An appreciable change in this one pattern will make more difference to your motivation than any other single course of action. The way to do it is to substitute "I should" with "I want": I want to tidy my desk so that I have a clear space to work. I want to get my notes in order so I don't have to waste valuable revision time looking for the right ones. I want go to the library today and get what I need to start my essay. I want to drink less and eat more healthily this week so that my head is clearer and I feel better.

Do it Little and Often

Putting off tasks will result in them getting bigger and bigger, until you need not just an hour or two, but a whole week to do them. Do them regularly and in small steps.

Do it at Your Best Time of Day

You wouldn't start tidying your desk late in the evening after a few drinks and a heavy meal, would you?

Make it Fun

How could you make it fun? Put some music on, think about how great you'll feel when it's all tidy, develop a new and brilliant filing system, have a competition with a friend to see who can do the best job in the least time. If you're stuck for how to make it fun, ask one of your Last Minuter friends for some tips.

A medical student's prayer: May I turn my "shoulds" into "wants," my tasks into plans, my obstacles into action, and my drudgery into fun.

THE BEGINNING

2011-11-03T08:46:00.000-07:00

Sudah lama rasanya tidakku jenguk laman blog kepunyaanku ini. Kali ini, aku memilih untuk menulis dalam Bahasa Melayu, bahasa ibunda negara tercinta tanah airku, Malaysia. Kekok rasanya setelah lama tidak menulis dalam bahasa ini. Sudah lama kutinggalkan mata pena yang mengalirkan darah kemelayuanku. Bahasa Inggeris, bahasa penjajah negaraku tidaklah kukuasai sesempurna mana, namun aku berasa bertanggungjawab untuk bersama-sama memainkan peranan, walau kecil, untuk memartabatkan semula bahasa ini kerana sejak akhir-akhir ini, kecenderungan generasi baru negaraku untuk bercakap dalam bahasa Inggeris di mana-mana tempat awam dan bertambahnya jumlah rakyat negaraku sendiri yang tidak fasih berbahasa Melayu amat membimbangkan.

And my Malay language is not perfect either. I chose to write in Malay language this time, though I knew I’d shy away my non-Malay-speaking readers. I said non-Malay-speakers, not non-Malays, and that includes you if you’re a Malay but you can’t read and speak Malay and you’ve mentioned one of these: “I sound awkward/serious/funny when I speak in Malay” or “Sorry but my Malay is not good”. Yeah, these kind of Malays are growing in number, mind you, though most of them actually know how to eat sambal belacan or suck and eat the contents of siput sedut masak lemak cili api when they go to Malay restaurants. Back to the main topic.

Banyak yang berlaku dalam hidupku dalam masa 5 bulan yang lalu (sejak entry terakhirku). Apa yang paling penting, aku telah pun lulus dalam peperiksaan akhir semester 7. Sesuatu yang tidak kusangka-sangka, kerana persediaan yang sangat sedikit dan ilmu yang sangat cetek.

Sebenarnya, banyak yang ingin aku tulis, namun bukan pada malam ini. Ada tugasan lebih penting yang harus aku siapkan. Pada tahun ini, aku hanya akan menyambut hari raya Aidiladha di Kuala Lumpur, tidak meriah seperti tahun-tahun sebelumnya dengan daging korban yang dimasak beramai-ramai untuk dijadikan kari dan sup.

Aku menulis entry ini di Hotel Grand Dorsett, Subang. Hotel ini sudah menjadi rumah keduaku pada waktu ini memandangkan rumah kami di Denai Alam masih dalam proses pengubahsuaian dan penambahbaikan. Abah baru sahaja dibenarkan keluar dari wad semalam. Selama seminggu dia terlantar di Pusat Perubatan Sime Darby (SDMC), Subang ini untuk pembedahan bagi membuang ketumbuhan dalam otak yang dikesan melalui MRI minggu lalu. Alhamdulillah, pembedahan itu berjaya dan ketumbuhan itu adalah meningioma yang dikesan pada peringkat awal walaupun saiznya hampir mencecah 3.0 x 2.8 x 2.8 sentimeter. Ia adalah ketumbuhan yang datangnya dari sel-sel arachnoid villi yang terdapat di dalam lapisan meninges yang melindungi otak. Ketumbuhan ini bukanlah kanser (benign) namun ianya berpotensi menjadi kanser (malignant) jika tidak dirawat.

Sekadar gambar hiasan

Alhamdulillah, simptom yang abah hadapi sebelum ketumbuhan itu dikesan hanyalah sakit kepala. Sekiranya ia lambat diketahui, mungkin ketumbuhan itu akan menjadi bertambah besar dan mengakibatkan komplikasi seperti sawan, kesukaran bercakap, kelemahan dalam menggerakan anggota badan, dan strok.

Banyak yang ingin aku tulis dan perkatakan, tetapi hanya setakat ini dahulu untuk hari ini sebagai permulaan. Terima kasih kerana membaca entry kosong yang tidak ada apa-apa kandungan dan mesej ini.

P/S:

Kepada rakan-rakan sekerja, sahabat-handai, saudara-mara, kenalan-kenalan dan semua staff Sime Darby Plantations amnya; yang datang melawat di hospital mahupun di hotel, yang menghantarkan jambangan bunga, kad dan buah-buahan, atau yang menelefon dan menanyakan khabar mahupun yang menghantar mesej di Facebook; saya bagi pihak Haji Ghoz sekeluarga ingin mengucapkan ribuan terima kasih atas ingatan tulus ikhlas dan doa anda semua.

Semoga kita semua sentiasa beringat-ingat untuk menghargai waktu sihat sebelum datangnya sakit dan senantiasa dilimpahkan nikmat kesihatan yang baik oleh Allah s.w.t. Aamiin.

JAUNDICE IN OSCE

2011-08-03T00:38:00.001-07:00

This is my own complication. Thanks for reading.

JAUNDICE OSCE

HISTORY

HOPI

1. Onset of jaundice

2. Nature

a. fluctuating - carcinoma of ampulla of Vater

b. fluctuating but increases with stress – Dubin Johnson syndrome

c. prolonged attacks – cholestasis

d. mild-moderate – Laennec’s cirrhosis

3. Associated symptoms:

a. pruritus (pancreatic cancer, cholelithiasis, carcinoma of ampulla of Vater, cholestasis, Laennec’s cirrhosis)

i. worsens at bedtime – primary biliary cirrhosis

b. dark-coloured urine (hepatitis)

c. clay-coloured stools (cholelithiasis, cholelstasis, hepatitis)

4. Prior episodes of jaundice

Systemic Review

1. Fever (hepatic cancer, pancreatic cancer, cholangitis, cholelithiasis, rapid hemolysis in acquired haemolytic anaemia, hepatic abscess, hepatitis, Weil’s diseases of severe leptospirosis, sickle cell anaemia)

2. Chills (cholangitis, cholecystitis, cholelithiasis, rapid hemolysis in acquired haemolytic anaemia, hepatic abscess, Weil’s diseases of severe leptospirosis, sickle cell anaemia)

3. Cough (hepatitis)

4. Sore throat/pharyngitis (hepatitis

5. Fatigue (pancreatic cancer, cholestasis, primary biliary cirrhosis, acquired haemolytic anaemia, hepatitis, severe hemolysis in sickle cell anaemia)

6. Weakness (pancreatic cancer, Laennec’s cirrhosis, primary biliary cirrhosis, severe hemolysis in sickle cell anaemia, increased in sickle cell crisis)

7. Shortness of breaths (G6PD, heart failure, acquired haemolytic anaemia, severe hemolysis in sickle cell anaemia – on exertion, sickle cell crisis)

8. Palpitations (acquired haemolytic anaemia)

9. Chest pain (sickle cell anaemia, heart failure)

10. Headache (rapid hemolysis in acquired haemolytic anaemia, hepatitis, frontal in Weil’s diseases of severe leptospirosis)

11. Sweating (hepatic abscess)

a. profuse in cholecystitis, severe acute pancreatitis

12. Bleeding tendencies (Laennec’s cirrhosis, Weil’s diseases of severe leptospirosis)

a. bruises, petechiae, purpura, epistaxis, hematemesis, haemoptysis, melaena

13. Haematuria (severe hemolysis in sickle cell anaemia)

14. GI symptoms

a. Anorexia (pancreatic cancer, cholestasis, Laennec’s cirrhosis, hepatic abscess, hepatitis)

b. Weight loss (carcinoma, cholestasis, Laennec’s cirrhosis, primary biliary cirrhosis, icteric phase of hepatitis)

c. Abdominal pain (rapid hemolysis in acquired haemolytic anaemia, Weil’s diseases of severe leptospirosis)

i. site

· RUQ (cholelithiasis, hepatic cancer, cholangitis, cholestasis, Laennec’s cirrhosis, hepatic abscess, icteric phase of hepatitis, Weil’s diseases of severe leptospirosis)

· epigastrium (cholelithiasis, hepatic abscess, acute pancreatitis

o relieved by lying with knees flexed to chest or sitting up and leaning forward = acute pancreatitis

ii. radiation

· right shoulder/scapula (cholelithiasis, hepatic abscess, acute pancreatitis)

· back (pancreatic cancer)

d. Back pain (carcinoma of ampulla of Vater)

e. Nausea (pancreatic cancer, cholelithiasis, cholestasis, Laennec’s cirrhosis, heart failure, hepatic abscess, Weil’s diseases of severe leptospirosis, acute pancreatitis)

f. Vomiting (pancreatic cancer, cholelithiasis, Laennec’s cirrhosis, heart failure Weil’s diseases of severe leptospirosis, acute pancreatitis – persistent)

i. hematemesis (primary biliary cirrhosis, hepatic abscess, hepatitis)

g. Dyspepsia/abdominal discomfort after taking fatty food (cholelithiasis)

h. Steatorrhoea (pancreatic cancer, primary biliary cirrhosis)

i. Diarrhoea (Laennec’s cirrhosis, primary biliary cirrhosis)

15. Malaise (hepatitis)

16. Arthralgia (hepatitis, sickle cell anaemia)

17. Myalgia (hepatitis, Weil’s diseases of severe leptospirosis – lumbar and thigh area, severe hemolysis in sickle cell anaemia, severe in sickle cell crisis)

18. Photophobia (hepatitis)

19. Paraesthesia (hypocalcemia in severe acute pancreatitis)

20. Tetany (hypocalcemia in severe acute pancreatitis)

21. Bone pain/osteomalacia (sickle cell anaemia, severe in sickle cell crisis, primary biliary cirrhosis)

Past Medical History

1. Admissions/surgery/allergies

2. Drug history

3. Medical conditions – hepatitis, gallstones, liver/pancreatic diseases

4. Mentsrual irregularities (Laennec’s cirrhosis)

Family History

1. Jaundice

2. Cancer – liver, gallbladder

3. Medical conditions – hepatitis, gallstones, liver/pancreatic diseases

PHYSICAL EXAMINATION

1. Restlessness (cholelithiasis, extreme in severe acute pancreatitis)

2. Tachypnoea

3. Tetany (hypocalcemia in severe acute pancreatitis)

4. Temperature: fever (hepatic cancer, cholangitis - high fever, hepatitis – low grade, Weil’s diseases of severe leptospirosis – rapidly rising, acute pancreatitis, sickle cell crisis – low grade)

5. Hands

a. Cold (severe acute pancreatitis)

b. Diaphoresis (severe acute pancreatitis)

c. Pallor

d. Cyanosis (heart failure)

e. Hyperpigmentation

f. Xanthomas – palm (primary biliary cirrhosis)

g. Dupuytren’s contracture (Laennec’s cirrhosis)

h. Palmar erythema (Laennec’s cirrhosis)

i. Finger clubbing (Laennec’s cirrhosis, heart failure)

j. Asterixis (flapping tremor) - Laennec’s cirrhosis

k. Radial pulse

i. tachycardia (cholelithiasis, G6PD, heart failure, acquired haemolytic anaemia, acute pancreatitis, severe hemolysis in sickle cell anaemia)

6. Arms

a. Hyperpigmentations (primary biliary cirrhosis)

b. Diaphoresis (severe acute pancreatitis)

c. Spider naevi (Laennec’s cirrhosis)

d. Pruritus/excoriations (primary biliary cirrhosis)

e. Petechiae

f. Purpura (primary biliary cirrhosis

g. Xanthoma – elbow (primary biliary cirrhosis)

h. Armpit: hair loss (Laennec’s cirrhosis)

7. Face

a. facial skin color

b. Xanthelasma (primary biliary cirrhosis)

c. conjunctiva

i. pallor (G6PD, acquired haemolytic anaemia, severe hemolysis in sickle cell anaemia)

ii. suffusion (Weil’s diseases of severe leptospirosis)

d. sclera – jaundice

e. parotid gland enlargement (Laennec’s cirrhosis)

8. Mouth

a. lips/tongue – cyanosis (heart failure)

b. Fetor hepaticus (Laennec’s cirrhosis)

c. Hard palate

d. Frenulum

9. Neck

a. lymph nodes

b. jugular vein distension (heart failure)

10. Chest

a. Spider naevia (Laennec’s cirrhosis)

b. Loss of chest hair (Laennec’s cirrhosis)

c. Gynaecomastia (Laennec’s cirrhosis)

d. Auscultate: murmurs, gallop rhythm – heart failure, lung crackles

11. Abdomen

a. inspection

i. distended – (hepatic cancer, cholecystitis Laennec’s cirrhosis, heart failure late sign, hepatic abscess, acute pancreatitis)

ii. Grey Turner’s sign (acute pancreatitis)

iii. Cullen’s sign (acute pancreatitis)

b. palpation

i. tenderness/pain (hepatic cancer, cholelithiasis, acute pancreatitis)

ii. rigidity (cholecystitis, acute pancreatitis)

iii. hepatomegaly (Laennec’s cirrhosis, hepatic cancer, primary biliary cirrhosis, G6PD, heart failure, hepatic abscess, icteric phase of hepatitis, Weil’s diseases of severe leptospirosis)

· irregular, firm, nodular – hepatic cancer

iv. splenomegaly (G6PD, severe hemolysis in sickle cell anaemia)

v. Murphy’s sign (acute cholecystitis)

vi. Boa’s sign (acute cholecystitis)

c. Percussion

i. resonance

ii. liver span - hepatomegaly

iii. splenomegaly

iv. shifting dullness

v. fluid thrill

d. Auscultation

i. bowel sounds (hypoactive in acute pancreatitis)

ii. crackles (acute pancreatitis

iii. bruits

· liver bruits (hepatic cancer)

12. Legs

a. peripheral oedema (hepatic cancer, Laennec’s cirrhosis, heart failure)

b. purpura

c. petechiae

d. diaphoresis (severe acute pancreatitis)

e. xanthoma – soles (primary biliary cirrhosis)

f. ulcers (sickle cell anaemia

13. Altered mental status (Laennec’s cirrhosis, heart failure)

14. Testicular atrophy (Laennec’s cirrhosis)

INVESTIGATIONS

Lab

1. Serum direct and indirect bilirubin

2. LFT

3. Urine bilirubin and urobilinogen

a. bilirubinuria in hepatocellular/cholestatic jaundice

b. urobilinogenuria in haemolytic/prehepatic jaundice

4. FBC

a. high reticulocyte count, low Hb - haemolytic jaundice

5. Electrolytes

a. Hypocalcemia – severe pancreatitis

6. Peripheral blood film

7. Coomb’s test

8. Hemoglobin electrophoresis

9. Hepatitis surface antigen screen

10. Autoimmune screen

a. ANF

b. anti-smooth muscles

c. anti-LKM Ab

11. Liver biopsy

12. Foecal occult blood test – Carcinoma of ampulla of Vater

13. Urinalysis – proteinuria, pyuria, hematuria (Weil’s diseases of severe leptospirosis)

Imaging

1. Ultrasound

2. ERCP/MRCP

3. CT scan

4. Cholangiography

5. Cholecystogram

6. HIDA (hydroxy iminodiacetic acid) scan

SPM IS NOT THE END

2011-05-22T07:47:00.000-07:00

Now allow me to discuss this in the form of a Problem-Based Learning (PBL).

Case 1

Julia got straight 10As in SPM 2010 and recently, she was offered a MARA scholarship to do a preparatory course - International Baccalaureate Diploma Program in Kolej Mara Seremban, before flying to Ireland to study Medicine, provided that she passes the required points in the preparatory course. She has never heard of International Baccalaureate (IB) before and doesn’t even know how to pronounce it. However, she was determined to accept the offer as flying overseas to study Medicine has always been her dream. Her best friend, Fatimah, was also offered a MARA scholarship to do a preparatory course in Kolej Mara Seremban, but she got to do A-Levels instead of IB.

Learning Issues:

1. What is International Baccalaureate Diploma (IB)?

2. A-Levels or IB? What are the differences?

3. IB and A-Levels in Kolej Mara Seremban

4. MARA – is it a loan or a scholarship?

Answers:

1. What is International Baccalaureate Diploma (IB)?

The International Baccalaureate Diploma Programme (IBDP) is a two-year educational programme that provides an internationally accepted qualification for entry into higher education, and is recognised by universities worldwide. In order to participate in the IBDP, students must attend an IB school. IBDP students complete assessments in six subjects from the six different subject groups, and complete three core requirements. Subjects are assessed using both internal and external assessments, and courses finish with an externally assessed series of examinations, usually consisting of two or three timed written examinations. Internal assessment varies by subject (there may be oral presentations, practical work, or written works) and in most cases is initially graded by the classroom teacher, whose grades are then verified or modified, as necessary, by an appointed, external moderator. Generally the IBDP has been well-received. It has been commended for introducing interdisciplinary thinking to students. The United Kingdom regards the IBDP as "more academically challenging and broader than three or four A-levels”. To be awarded an IB Diploma, a candidate must fulfill three core requirements, in addition to passing his or her subject examinations:

§ Extended essay (EE). Candidates must write an independent research essay of up to 4,000 wordsin a subject from the list of approved EE subjects. The candidate may choose to investigate a topic within a subject they are currently studying, although this is not required. The EE may not be written on an interdisciplinary topic.

§ Theory of knowledge (TOK). This course introduces students to theories about the nature and limitations of knowledge (basic epistemology) and provides practice in determining the meaning and validity of knowledge (critical thinking). It is claimed to be a "flagship element" of the Diploma Programme, and is the one course that all diploma candidates are required to take. TOK requires 100 hours of instruction, the completion of an externally assessed essay of 1,200–1,600 words (from a choice of ten titles prescribed by the IB), and an internally assessed presentation on the candidate's chosen topic.

§ Creativity, action, service (CAS). CAS aims to provide students with opportunities for personal growth, self-reflection, intellectual, physical and creative challenges, and awareness of themselves as responsible members of their communities through participation in social or community work (service), athletics or other physical activities (action), and creative activities (creativity). The guideline for the minimum amount of CAS activity over the two-year Diploma programme is approximately 3–4 hours per week, though "hour counting” is not encouraged.

Students who pursue the IB Diploma must take six subjects, one from each of subject groups 1–5, and either one from group 6 or a permitted substitute from one of the other groups, as described below. Either three or four subjects must be taken at Higher level (HL) and the rest at Standard level (SL). The IB recommends a minimum of 240 hours of instructional time for HL courses and 150 hours for SL courses.

While the IB encourages students to pursue the full IB diploma, the "substantial workload require a great deal of commitment, organization, and initiative". If they wish, students may instead choose to register for one or more individual IB subjects, without the core requirements. The six IBDP subject groups and course offerings are summarised below. More information about the subject groups and individual courses can be found at the respective subject group articles:

§ Group 1: Language A1. Taken at either SL or HL, this is generally the student's native language, with over 80 different languages available. Students may choose to take a second language A1 in lieu of studying a second language as a Group 2 subject.

§ Group 2: Second language. An additional language, taken at the following levels: Language A2 (SL or HL), Language B (SL or HL), or Language ab initio (SL only). Latin and Classical Greek are also offered and may be taken at SL or HL.

§ Group 3: Individuals and societies. Humanities and social sciences courses offered at both SL and HL: Business and management, Economics, Geography, History, Information technology in a global society (ITGS), Islamic history, Philosophy, Psychology, and Social and cultural anthropology.^[26]

§ Group 4: Experimental sciences. Four courses are offered at both SL and HL: Chemistry, Biology, Physics, and Design Technology. One course, Environmental systems and Societies, is offered at SL only.^[27]

§ Group 5: Mathematics and computer science. In order of increasing difficulty, the courses offered are Mathematical Studies SL, Mathematics SL and HL, and Further Mathematics SL, as well as two elective courses, Computer science SL and HL.^[28]

§ Group 6: The arts. Courses offered at both SL and HL: Music, Theatre, Visual Arts, and Film. In lieu of taking a Group 6 course, students may choose to take an additional course from Groups 1–4 or either Further Mathematics SL (if already studying Mathematics HL) a Computer science course from Group 5, or a school-based syllabus course approved by IB.

All subjects (with the exception of CAS) are assessed using both internal and external assessors. The externally assessed examinations are given worldwide in May and in November. Each exam usually consists of two or three papers, generally written on the same or successive weekdays. The different papers may have different forms of questions, or they may focus on different areas of the subject syllabus. For example, in Chemistry SL, paper 1 has multiple choice questions, paper 2 has extended response questions, and paper 3 focuses on the "Option(s)" selected by the teacher. The grading of all external assessments is done by independent examiners appointed by the IB.

The nature of the internal assessment (IA) varies by subject. There may be oral presentations (used in languages), practical work (in experimental sciences and performing arts), or written works. Internal assessment accounts for 20 to 50 percent of the mark awarded for each subject and is marked by a teacher in the school. A sample of at least five per subject at each level will also be graded by a moderator appointed by the IB, in a process called external moderation of internal assessment.

Points are awarded from 1 to 7. Up to three additional points are awarded depending on the grades achieved in the extended essay and theory of knowledge, so the maximum possible point total in the IBDP is 45. The global pass rate for the IB diploma is approximately 80%. In order to receive an IB diploma, candidates must receive a minimum of 24 points or an average of four out of a possible seven points for six subjects. Candidates must also receive a minimum of 12 points from their Higher Level subjects and a minimum of 9 points from their Standard Level subjects. Additionally, candidates must complete all of the requirements for the EE, CAS and TOK. Failing conditions which will prevent a student from being awarded a diploma, regardless of points received, are non-completion of CAS, more than three scores of 3 or below, not meeting the specific points required for Higher Level or Standard Level subjects, or plagiarism.

Candidates who successfully complete all the requirements of the IB Diploma Programme and one or more of the following combinations are eligible to receive a bilingual diploma: two languages A1, a language A1 taken with a language A2, a group 3 or 4 subject taken in a language other than the candidate's language A1, or an extended essay in a group 3 or group 4 subject written in a language other than the candidate's language A1. IB certificates are issued to indicate completion of diploma courses and exams for non-diploma candidate students.

(from Wikipedia)

2. A-Levels or IB? What are the differences?

I will talk about this from my own knowledge, experience and views:

· A-Level requires you to pass 3-4 subjects, but IB requires you to pass 6 subjects plus Theory of Knowledge as an additional subject (that makes it 7 in total) plus a 4000-word mini-thesis (refer to Extended Essay or EE in the text above) and a couple of hundreds of hours for Community, Action, Service program which requires you to take part in sports, creative/arts classes/programs, and community service works – and they are ALL COMPULSORY in order for you to pass IB and graduate with an IB Diploma. A-Level is all about studying, while IB is about molding you to become a well-rounded critical thinker.

· Easy. A-Level is easy, IB is extremely difficult. Studying for A-Level is casual, studying for IB requires sleepless nights, extreme determination, strength and confidence, a little bit of talent, and HARD WORK. You’ll hear the word “stress” everywhere. A-Level students have more time to hang out, while IB students will be grateful enough to have a 5-hour of deep, restful sleep.

· A-Levels can be as short as 1-1 ½ year, but IB is a compulsory 2-year course. A very time-consuming pre-university course. You usually will graduate later than your fellow ex-schoolmates who are opting for government matriculation, Ausmat (Australian Matriculation), SAM (South Australian Matriculation). However, you wouldn’t be able to buy the experiences you’ll get during your IB course anywhere, for any cost at all. IB experiences are a lifetime experience, they are priceless and too valuable to be traded for.

· Both are pre-university courses, but IB is a diploma which you can’t really use to work. However, I have once been offered to work as a Nutrition Assessment Trainee by a milk-selling company (Anmum) during the holidays, after I graduated from IB (while waiting to fly to NZ / enrolling in IMU). Not bad at all. You graduate with a ‘diploma’ in your hands by going through 2 years of extreme hard work instead of 3 years of a casual diploma course.

3. IB and A-Levels in Kolej Mara Seremban

History

As I was one of the 95 students enrolled for the first batch IB program in Kolej Mara Seremban (KMS), my life there was a memorable one. As far as I’m concerned, KMS is a very old college, starting by being an MRSM in the 1970s, and turned to a matriculation college several years ago. It was quite recent that Mara decided to turn the college into an IB World School (it required intense preparation and thorough work for application of this status and logo, I believe.)

We only have a few IB Schools in Malaysia, (about 5 or less I think?). They started with A-Levels first, and after that they decided to start IB (in 2005, my batch!) Previously there were only TESL, Engineering and Teaching students doing A-Levels there. Engineering students got to go to UK, Australia and New Zealand (NZ) while TESL and Teaching students got to go to New Zealand (University of Auckland and Victoria University of Wellington). After that, they started taking IB students bound for India, for either a twinning course of 1 ½ year at Manipal University and 1 ½ year at Melaka Manipal Medical College (MMMC) and graduate with a degree from MMMC; or a full course in MS Ramaiah Medical College and graduate with a degree by IMS-MSU (International Medical School-Management & Science University). During my time, the cut-off point to get you to FLY was 13 for A-Levels and 35 for IB. However, those who got 10-13 (AL) and 33-35 (IB) could make appeals and usually they got through and managed to fly. However, that happened only for my IB batch because we were the first batch (trial version / lab rats/ test subjects). Those who got below 35 points were IB students taking Physics (Physics is hard) and a lot of them failed Physics or got low point for that subject, and that brought their total points down. I heard they have increased the “flying-pass point” for IB to 38, but I am not certain about it. During my time, only 3 IB students did NOT fly, 2 did not manage to fly overseas due to below requirements (their “flying-pass point” was below 30) but they are currently studying Food Science in MSU and Engineering in UNITEN respectively, while 1 graduated IB with flying colours but chose/opted to not fly and instead changed course from Teaching Chemistry to Medicine. She is currently studying Medicine locally in IMU. And she is... ME! (For the full story, read further below). Not to forget, one student who was bound for a medical course in India opted to fly to Indonesia instead, for a twinning program in Padjadjaran University – University Kebangsaan Malaysia (UKM).

Subjects

During my time, Engineering A-Level students took up Physics, Chemistry and Maths while TESL learned some English Literature and Social Sciences subjects which I am not certain about. During my time, these are the IB subjects which we had to take. (SL = standard level, HL= higher level, as it sounds, higher level subjects you are taking are the advanced/further/higher version of the core subjects, which means they are more/very difficult). In KMS, we took 3 SL subjects and 3 HL subjects.

1) Group 1: Malay A1 (SL)

2) Group 2: English B (SL)

3) Group 3: Business & Management (SL) – now they are offering ITGS (Informations Technology in a Global Society). They depends on your class.

4) Group 4: Chemistry, Biology, Physics (HL) – Chemistry is compulsory for everyone, Biology is compulsory for medical students, and Physics is a choice for Teaching students. Teaching students have to take compulsory Chemistry and chooses either Biology or Physics. Biology is easier, Physics is a killer).

5) Group 5: Mathematics (HL)

6) Group 6: none in KMS (you have to take two group 4 subjects instead)

Points/Marks

In IB, there is no ABC for grading. I’m not sure about the grading system in A-Levels, I’m sorry. So I’ll talk about IB. The highest grade for every subject is 7 (7=A, 6=B, 5=C) and a pass is a 4. That means if you get 3 in Mathematics, you already failed that subject. However, MARA, for flying purpose, and most universities, require you to get 5 and above for all HL subjects. That means you have to get at least 5 points for Mathematics, Physics, Biology and Chemistry, although the passing point is 4.

Besides, you can get additional 3 points from CAS, EE (extended essay) and TOK (Theory of Knowledge, a compulsory additional subject). TOK can be graded as ABC. For example, if you get A for TOK and A for EE, and you completed total hours for CAS activities, you already secured 3 points. There are ways to count this, I can’t really remember. Contact your IB coordinator for clarification.

The passing points for IB is 24. That means you will not graduate with an IB diploma if you get 23 points in total. The total points you can get (yes, there’s a limit) is 45. That means, a top student in school would get 7 points in each of the 6 subjects taken, an A in TOK, A in EE (secured 3 points) and completed CAS, so 7X6 + 3 = 45 points. If you get 6 points in 2 subjects, 7 points in 2 subjects, and 5 in 2 subjects, with 2 points for TOK and EE, you will get = 6x2 + 7x2 + 5 x2 + 2 = 37. The flying-pass point required by MARA during my time was 35 points, so you can successfully FLY overseas with 37 points. However, if it is true that they have raised the total required points to 38, and you scored only 37 points - even 1 point short, that means you passed the IB program, graduated with a diploma, but you wouldn’t be able to fly overseas. Most probably you will be sponsored to study locally, unless your appeal is successful. During my time, the highest score in my batch was 43.

Exams

A-Level has two important exams – AS and A2, plus IELTS (International English Language Test System), which is an English proficiency exam, a requirement for A-Level students to apply for foreign universities. In contrast, IB students do not have to take IELTS. IB students,only have one exam in their total 2-year course, and that determines everything. The external exam is taken at the end of the course, usually held in May in KMS. The papers will be marked by external examiners. However, there are internal exams for every semester, held by KMS itself. They are to monitor your performance, your level of preparation and studies. There’s also a trial exam, just like STPM, because you only have one chance and if you let go of it, it’s gone. However, there are internal assignments which you have to do during the 2 years and that will contribute / will be counted/added to your external papers marks. In Kolej Mara Banting, your Semester 2 and 3 exams will be the parameters which will be looked for by the universities you are applying to. They make a difference - whether you will be able to go to the top universities or just a "normal" university, in the country you are bound for.

Life in KMS

In KMS, A-Level students are “free-er”, have more time to “chillax”. Classes begin at 8am, and usually end at 2-3 pm. During my time, the college management have tried to fill up our free evening time with some reading program, but we objected it. It ended up as additional classes or personal study time, but I can’t really remember. During my time, Thursdays/Fridays were CAS days, that means we spent half of the day/ the whole day for a community service program – going to an old-folks home or a handicap school, or spent half of the day doing club activities – mine were Cooking Club in Year 1 and Theatre Club in Year 2 so we learned cooking some common recipes and perform some plays! Other clubs during my time were Film Club, Dance Club etc. etc. In the evening, on any day of the weekdays, there would be a time for sports/physical acitivity, and that is compulsory for you to attend in order for you to fill up your CAS hours. Mine was Aerobic club.

KMS is located at Jalan Aminuddin Baki, just opposite Klana Resort, in the peaceful area of Seremban Lake Gardens. You can chillax and exercise every day, because a playground is located just opposite the hostel area! You can go out from 5pm-7pm every day, and you can go home during the weekends. The hostel is usually calm and almost empty during the weekends. Food is provided to you for free at Dewan Selera (DS). Food provided were quite nice during my time, I used to like them very much (maybe because I’m a kampung girl). When IB real exam was just around the corner, you would be pampered with very healthy and nice food. A-Level students were lucky to enjoy them too even though they were not having exams at the time. Besides, the college management decided to supply us free breads, raisins and honey to boost up our energy and concentration level during the period of one month before the actual IB exam.
In addition, you will get RM50 monthly allowance (not sure whether they have increased the amount but you get free food anyway, so what’s the fuss?) There’s a koperasi next to the DS, selling some common stuff that you would need. There were people selling fried food at night during my time, if you feel like not eating DS food for the day, and I loved the wantan mee! Miss it very much! You can also order fast food and they will deliver the food in front of the hostel gate (not to your doorstep!). You can’t bring a vehicle there, because the college is just 3 minutes walk from the hostel. The only mode of transport to the city is by cab. It costs you about RM7 during my time, to go to Terminal One, and RM 10 to go to Jusco Seremban 2. But, you can go to Seremban Centrepoint by walking, it has Pizza Hut, Marrybrown, The Store, ATM Machines, Hot Market! These places are within walking distance (Yes, my friends and I had actually WALKED to these places!):

· Lake Gardens (10 minutes walk)

· Allson Klana Resort (5 minutes walk)

· Medan Selera Penghulu Cantik (7 minutes walk)

· Seremban Plaza (10 minutes walk)

· Seremban Centre Point (10 minutes walk)

· A&W (20 minutes walk)

· Seremban Parade (25 minutes walk)

· Terminal One (35 minutes walk)

· Masjid Negeri (30 minutes walk)

· Pasar Malam Ampangan (45 minutes walk? I’ve never tried) – on Tuesdays and Saturdays

Seremban best giler! And if you get really bored, you can go to KL by bus/KTM Komuter. It will cost you only RM 6.00 to go to Midvalley Megamall or KL Sentral by Komuter (1 hour travel) and about more or less than that by bus (45 minutes travel).

Places you should check out if you want to chillax:

· Jusco Seremban 2 (the best mall in Seremban) – Pizza Hut, KFC, McD, Starbucks, Big Apple Donuts, Johnny’s, TGV Cinema, Popular and MPH Bookstores, Al-Ikhsan, Guardian, Watsons, Secret Recipe, Old Town, Chicken Rice Shop, Bowling, Karaoke

· Terminal One – GSC Cinema, Pizza Hut, KFC, McD, Dunkin Donuts, Giant, Parkson, Watsons, Guardia

· Terminal 2 – MBO Cinema

· Seremban Parade – Parkson Grand, Kenny Rogers, Chicken Rice Shop, Bowling, McD, Pizza Hut, Watsons

· Seremban Centrepoint – The Store, Pizza Hut, Marrybrown, Station Kopitiam, Hot Market

· Domino’s Pizza in town

· Giant Ampangan/Senawang

· Senawang – got EVERYTHING in the world – Domino’s, 24-hours McD, Secret Recipe, Haji Samuri satay, big Giant, RM2 shop

· Tesco Extra Seremban 2 –KFC and Cool Blog

· Carrefour Senawang – KFC and Cool Blog

Great makan places:

· Satay Haji Samuri in Senawang

· Satay R&K in Jalan Sg. Ujong

· Man Tomyam at Jalan Jelebu

· Nasi Arab Damsyik in Senawang

· Ayam Panggang Kenyalang at Jalan Jelebu
and more - Windmill, Oriental Chinese Muslim restaurant etc. etc.

My life in KMS was worthwhile. It was motivational and inspirational for my own personal development. Until now, if I want some inspiration, I would just drive pass KMS and feel the nostalgic inspiring moments.

5. MARA – is it a loan or a scholarship?

As far as I know, as a MARA scholar, MARA is a loan. But, the amount you pay back depends on the course you are taking and the loan scheme given to you. Mine is Skim Pelajar Cemerlang (SPC), which means I have to pay back only 1% from the total cost of my studies. For example, the total cost of studying medicine in IMU RM400,000 including tuition fees, RM 3000 computer loan, RM 770 month allowances, and RM 1000 annual books allowances and annual RM 200 stationery allowances. So, I only have to pay back RM 4000. This was told by a teacher of mine, who was a MARA scholar too. I’m sorry if I’m wrong. Now can you guess where all the government’s money is drained to? To you! For your future. So be responsible. It’s inappropriate to support the Opposition when the food you are eating right now and the books you are reading now are paid using the government’s money. Plus, being a MARA scholar I don’t have to serve the government for 10 years unlike JPA scholars. I only have to work in the government hospital for the compulsory 5 years which include the compulsory housemanship training.

However, my friend of mine, who did not manage to get enough points to fly during her A-Level course, was offered Skim Pinjaman Terbuka (SPT) instead. The differences are, the RM 3000 computer loan is not included in her loan and she would have to pay back 10% (RM40,000) of the total cost later when she works. Correct me if I’m wrong, but these have been told to us many times.

On the other hand, my brother, who is a pilot, was a MARA scholar of Skim Pinjaman Terbuka (SPT). The course he took, Diploma in Aviation and Commercial Pilot License, is not a critical course. Therefore he will have to pay back MARA in total of RM250,000 of his tuition fees and allowances. He does not have to serve the government or MARA at all. Among courses which are deemed as “critical courses” are medicine, pharmacy, and dentistry etc. etc.

Furthermore, a Teaching student who is sponsored by MARA to study overseas would have to sign a contract with MARA, agreeing that she has to serve MARA as an MRSM teacher for 5 years, once she graduates. She does not have to pay any single sen from the total cost of RM450,000 study in New Zealand, provided that she completed the total 5 years of service. By any chance, if she breaches the contract, she would have to pay back the total RM450,000 to MARA.

I’m not sure about other courses, but I’m sure that you can apply for “Borang Pengurangan Bayaran Balik Pinjaman” from MARA once you graduate, especially if you achieved good grades in your exams during your studies.

Now be grateful and thankful for being a part of MARA family.

Case 2

Diana got 6As in SPM 2010, wants to be a Mechanical Engineer and was recently offered a pre-university course at Kolej Matrikulasi Gopeng, Perak. However, she was also offered to do to do a Diploma in Mechanical Engineering in University Teknologi Mara (UiTM). At the same time, her boyfriend, Daniel, who got 7As in SPM 2010, was recently offered a foundation course in Engineering by the International Islamic University Malaysia (IIUM/UIA) and his application for a foundation course in Engineering to Universiti Tenaga Nasional was also successful.

The learning issues:

1. Government matriculation or IPTA foundation/diploma course?

Answers

1. Government matriculation or IPTA foundation course?

It depends on you. For some people, going for government matriculation is like dealing with a poker game. You can be a very bright student, got CGPA of 4.0 but yet you are not successful in your application for UPU medical courses in the public universities. Instead of becoming a doctor, you are forced to become a pharmacist or a dentist instead due to limited places for medical program. You could have been a very bright student at school but yet you got CGPA of 3.8 in matrics and still are not successful in your application for UPU pharmacy courses in the public universities. Thus, you are forced to take up engineering, physiotherapy or other courses which you have never thought of. By enrolling into government matriculation, you have to accept, with an open heart, the fact that your future is decided and determined 99% by UPU and 1% by luck. Unless you are still clueless of what to become and you do not mind having any types of career in the future. I’m not saying you can’t go to government matriculation or I’m having negative perception towards government matriculation, but this is the reality behind it – I’ve seen my friends, who used to be bright in school, stumbling and tumbling for their future because they did not get the course they’ve always dreamt for. If you have no other choices and are opting for government matriculation, just remember this, WORK VERY VERY HARD. No a second of wasted time. And, PRAY, PRAY HARD. By putting up huge effort, deep prayers and tawakkal, there is always a possibility that you can succeed and get what you want. Be positive!

However, if you are standing in front of two roads – government matriculation/ IPTA foundation/ diploma courses, I advise you to take up that foundation or diploma courses, if you like the course. For example, I would advise Diana to go for the Diploma course instead of the matriculation course. If she went for matriculation, scored 3.0, couldn’t get a place for Engineering in IPTA, and instead offered Degree in Computer Science, that would be the biggest regret in her life. She would have been a step closer to becoming an engineer, had she gone for the Diploma course in UiTM.

Case 3

Siti, who stays in a rural area in Kokdiang, Kedah, comes from a poor family. She got 7As in SPM 2010 and was recently offered to do Diploma in Pharmacy by University Teknologi Mara (UiTM). However, her ambition was actually to be a doctor and she wants to study Medicine. Her best friend, Zakiah, who got 3As in SPM, was offered Diploma Pengurusan Maklumat by UiTM. Yesterday, Zakiah called Siti to express her disappointment and regrets for herself, not doing well in SPM. She was thankful to receive the offer by UiTM but she wishes she can study Accountancy as being an accountant has always been her ambition. Zakiah told Siti that her cousin, Shakira, who is now studying Medicine in Monash University Malaysia campus, had the same ordeal as theirs. Shakira wanted to study Medicine but she passed SPM 2005 only with 5As, which did not qualify her to be admitted to public universities for foundation in Medicine. Therefore, her father decided to send her to Taylors University College to study A-Levels. She passed A-Levels with flying colours and that was the turning point that changed her life forever. She is now studying the course that she wanted, and is going to work in a profession she has always dreamt to be.

Learning Issues

1. I didn’t get government matriculation. What to do for pre-university? Which college? Public or private?

2. I don’t think my father can afford paying my studies in a private college, but I really want to take a course that I like. What should I do?

3. Private medical schools in Malaysia – which one should I choose?

4. What are the entry requirements for private medical schools in Malaysia, which has the lowest entry requirement?

5. Which medical schools in Malaysia have the lowest cost (tuition fees)?

Answers

1. I didn’t get a place for the government matriculation program. What should I do for pre-university? Which college should I choose? Public or private?

Putting government matriculation and community colleges aside, there are many ways you can utilize private colleges. Some of them have high reputations and offer quality, employable courses. If you want to graduate early and start working at a young age, I advise you to opt for South Australian Matriculation (SAM) in colleges such as Sunway UC and Taylors UC, as its duration is only 8 months. However, you may not be prepared with enough knowledge for your degree. For example, things I learned during my first semester of medical degree were quite easy, as they were actually repetitions of things I have learned in Biology in my 2 years of IB, but my colleagues who took SAM complained that things were difficult to learn because they were new to them. Plus, I am very used to writing long reports that I could finish my reports in 2-3 hours when my colleagues take the whole day to prepare them (and we scored the same marks). Not to brag, but because of EE and internal assessments, IB graduates are very good in writing citations/references/bibliography in reports.

However, I don’t advise you to take IB if you’re going to private colleges. It is very tough, expensive (one exam paper can cost you $200) and time-consuming. The best choices are A-Levels and SAM. Just make do of them. However, if you want challenges of IB, go ahead. After all, IB is the best pre-university/preparatory course on earth.

If you have the money and you ask me, I would recommend you to do A-Levels in KYUEM (Kolej Yayasan UEM) in Lembah Beringin. Many of their graduates managed to get places at top foreign universities, such as Oxbridge (Oxford and Cambridge). Plus, the study environment is very conducive. However, the cost of studies is very high. If you want to cut cost, you can apply for Sunway, Taylors or SEGI etc. etc. After that, you can apply to foreign universities or top local universities such as Curtin, Monash and IMU. You can also apply to public universities but I believe you have to compete and reserve the seats for diploma graduates and government matriculation students.

Private universities such as Monash and IMU, have higher reputation than some of the local public universities. So, it is not a wrong choice if you opt for private universities. But if you can’t afford it, what should you do?

2. My father can't afford to finance my studies in a private college, but I really want to pursue a course which I like. What should I do?

There are loans, baby! First, make sure that your college is approved by MQA (Malaysian Qualifying Agency) and covered by PTPTN. Like IMU, once you receive the offer letter confirming that you are accepted for admission into IMU, you can apply for MARA if you’re a Bumiputra. You don’t even have to go for an interview if it’s a critical course you’re applying for. If you have good grades in your A-Levels/IB, there’s a high probability that you will get the sponsorhip. On the other hand, you can apply for PTPTN or in some colleges, Petronas convertible loan. There’ll always be a way, so don’t let money deter you from reaching for the dreams.

If you have any questions, don’t hesitate to drop a comment below.

*Learning Issues number 2, 3 and 4 will be discussed in the next entry, titled “WHAT MALAYSIAN MEDICAL STUDENTS AND MUSHROOMS HAVE IN COMMON”

If you are interested to study medicine but did not get good SPM results / were not successful in JPA or MARA sponsorship to study medicine overseas / were not successful in UPU application to foundation courses in Asasi Perubatan UIA or Tamhidi Perubatan USIM / do not want to gamble your future by enrolling into government matriculation courses, check out my next blog entry. It is VERY important to do an in-depth research about the medical school you are applying to, regardless of whether you are looking for the “value-for-money”, “low-cost” or “high reputation” universities. Choosing a good medical degree from a good medical school determines the quality of a doctor you are going to become, and the perception and impressions you are going to receive from your future colleagues, bosses and co-workers.

MY SIDE OF STORY

My SPM 2004 result was just satisfactory, I wouldn't say it's excellent. I was eligible for all UPU courses, but I didn’t get UIA’s Foundation in Medicine and Tamhidi Perubatan USIM as I wanted. I wanted to do medicine, but I was not eligible to apply for the overseas medical program. The only courses I could apply for overseas programs were TESL and Sciences (Mathematics, Physics, Chemistry or Biology majors). So, I applied for Degree in Science (Chemistry) and I got a MARA sponsorship for it, bound for New Zealand. Little did I know that it was a teaching course because it was not specified in the application guidelines. So, I enrolled in IB in KMS. Almost gave up – working very hard just to be a teacher? Oh no! But then, I gathered my strength, I knew I needed to graduate IB with more than 35 points, as a reward not for myself, but for KMS teachers who had been my fathers and mothers during my tough IB times, who had helped me a lot during those difficult moments. So, I graduated IB with 38 points, with an A for TOK (not to brag but it’s hard to get an A for TOK and students seldom get A for it! Plus your papers are marked by those Caucasian external examiners!) more than enough for me to further my studies overseas. I was more than eligible to apply for a medical degree in a foreign university in UK, Ireland, Australia or NZ - I could have if I wanted to, but then I knew no one was going to pay for the tuition fees. I could not change my course, Mara wouldn't allow me to do so, and my father would not be able to afford RM 1 million to finance my total medical degree cost. However, I really thought that it was “now or never” – it was either I went to NZ and become a teacher, or made a turn and become a doctor. So, with my parents’ approval, I met MARA officials and asked them to stop my sponsorship, and apologized - I wrote a very dramatic and poetic letter of apology to them. So, I applied to IMU but I was worried about the cost of the studies – RM40,000 per semester! How was my family going to eat if my father was going to pay that amount plus my living costs? Allah is Great. A Sponsorship Executive in IMU advised me to start from scratch, fill up MARA form again, asked a supporting letter from the Dean, and God is Great – my application was approved. I was and am, again - a part of MARA family.

However, the decision I made to not fly to New Zealand was not an easy one. Mind you, it was VERY DIFFICULT and TORMENTING, with my grandparents already spreading the words to the village people that their granddaughter was going to fly overseas, and my parents were being excited to buy me a huge luggage bag and planning to visit me in New Zealand some time for vacation. Plus, with my relatives asking this and that, guessing that maybe I actually did not pass IB well and did not get the grades to fly. At that point of time, I only knew one thing. This is my future, my life, and I was not going to jeopardize it.

Until now, I still have to face my village people and relatives bragging about their granddaughters studying medicine in Indonesia with government sponsorships, unaware that I am studying under MARA sponsorship. I didn’t want to brag, because it is Allah’s gift for me. I only answered if they asked, and I usually said “it’s a loan”. I still face people who said “Oh so it’s a private university. Kita tak main la university swasta ni, kita mau biasiswa kerajaan”, not knowing that JPA (PSD) and MARA are actually sending many medical and pharmacy students to IMU for IMU-foreign universities twinning programs to cut costs.

The most important part, I did it and went through it ALL ALONE. I didn’t have relatives working in MARA to persuade them to sponsor me again. My parents are not influential/famous people, we are just commoners. But I believe in determination, confidence and strong will.

From my story, I want you to learn 3 lessons:

· Private universities are not as bad as you think they are. Some of them are even better than some public universities. They are not the “last resort”.

· Don’t be afraid to enrol in private colleges/universities, you can always apply for loans/scholarships. Go for what you want, just do it.

· Hold on to your dreams and never give up, because nothing is impossible.

Alhamdulillah.

Syukran (thank you) for reading.

And oh, if you are going to KMS this July for IB, send my regards to these teachers who taught me during my IB years. I love them and I miss them very much (I’ve been very busy to visit KMS even though it’s just a few minutes away).

· Puan Azizah – Malay A1 SL

· Puan Hindun – English B SL

· Puan Kamilah – Business and Management SL

· Puan Hamimah – Mathematics HL

· Puan Zolbidah – Chemistry HL

· Puan Juriah – Biology HL

· Mr. Azlan – Theory of Knowledge

· Puan Rohana – IB Coordinator

and other teachers who did not teach me but might know me:

· Puan Noraini – English B SL

· Puan Kartina – Business and Management SL

· Puan Azian – Mathematics HL

Life is a miracle. Allah is Great.

Nothing can deter you from reaching your dreams - unless it is the end of your soul and life or the end of the world.

* Sorry if I talked more about IB, because I'm an IB graduate. =)

All the best, and good luck!

THE FIRST POST

2011-05-21T10:28:00.000-07:00

Now let me begin by Bismillahirrahmanirrahim.

Hooray to a new blog, and the first entry.

I decided to put up a picture for this entry, so take a look.

This picture was taken a few months ago after an operation to remove a stomach tumor in a 72 year-old man. It was a gastric carcinoma, and the part that you are seeing now is the fundus of his stomach (refer to the picture of the anatomy of the stomach below), which was resected earlier. The rest of the stomach was yet to be (until that point of time) invaded by the malignancy.