Sunday, October 22, 2006


It's been a rough week.

Am I entitled to be PO-ed when one of my MOs can't differentiate between an upper and a lower motor neuron facial nerve palsy?

And I quote: "Dr. spacefan, LMN 7th should SPARE the forehead right?"


An MO who's been with us for 6 months, whom I assume has attended our many tutorials ( which include ENT and neurology modules )?

I've had medical students who can diagnose a Bell's palsy from across the room.

And I'm told that this particular MO is a trainee, no less ( but not in emergency medicine, thank goodness ).

Never mind all that -- s/he also failed to perform an otoscopy to exclude Ramsay-Hunt.

And is notorious for going AWOL during shifts. I personally caught this person hiding in the MO room a couple of times. ( And there's another one who pulls the same stunt regularly. )

Let me just say a few things:

1. I wonder how the STC chooses trainees.

2. An MO who cannot diagnose Bell's palsy -- especially after 6 months in the A&E -- should repeat the posting as punishment ( but of course, none of us wants to be saddled with this person so it's better to let him/her go ).

3. From now on, anyone I catch slacking off during busy shifts will get blasted.

Is it just my opinion, or are our juniors becoming more complacent nowadays?

When I was a house officer, I didn't even dare to bother my MO unless my patient was on the brink of death. I skipped meals and toilet breaks to clerk cases and finish changes. Unlike current trends where MOs are kind enough to help do discharge summaries, summarize old notes, see new admissions on their own and even set plugs.

In my day, I knew of NO-ONE who had the audacity to switch off their pagers / phones while at work.

Imagine my horror when, during an Internal Med posting in 2003, I encountered a few HOs did just that, with one fellow remaining completely uncontactable ( and physically missing from all the usual call rooms ) while covering MICU ( I was the unfortunate MO that night ).

That was the first ( and so far the last ) time I ever yelled at a junior, in addition to lodging formal complaints with his supervisor and the consultant in charge of HO matters.

Don't make me do it again.

On the upside, we received 3 new MOs last week -- 1 HO-turned-MO who's out-of-phase, and 2 who just finished NS. If you're reading, let me just say that you're all excellent, and doing very well despite being so new.

Am hoping to recruit at least one of them as an emergency medicine BST. :)

Not in the best of moods right now, for various reasons. Thought I could catch The Prestige, but couldn't find the time. A colleague from the ward formed erroneous opinions about a case I managed, then refused to hear my side of the story when I gently attempted to explain.

Hello, I had 2 cardio cases to admit -- one of whom went to high dependency; the incident occurred during a shift changeover; I resuscitated the guy, ordered the necessary bloods and x-rays and reviewed them, contacted the relevant specialties, then handed the case to my colleague and informed the nurse in charge. There were 3 senior doctors ( non-A&E ) swarming all over the patient, and I'm told there was "insufficient support"?

Of course I tried to relay all this information across, but alas, I was interrupted within the first few seconds, and decided to give up and give in.

Time to move on. Chris Botti awaits. :)

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