Sunday, November 18, 2012

Clever ways to spend the money you earned in moonlighting (1st of 2 Parts)

To moonlight or not to moonlight, that used to be the question. A number of physicians these days find themselves saying yes to moonlighting, specially that it goes with the promise of a hefty pay. 

Photo by Shing Camps

Medical moonlighting in the Philippine setting basically means working as a doctor for pay, outside the requirements of a training program. Here in the Philippines, moonlighting is usually done by registered physicians, most of whom did not go through residency training yet, although there are also a handful who had a few years of residency under their belt but stopped training for a number of reasons. I personally have nothing against moonlighting. In fact, I am all for it.

I have been through that path myself. I spent four years doing moonlight job in the beautiful island of Bohol, after doing one year of residency training in Internal Medicine in Cebu City.

Physicians who choose the moonlighting pathway may actually have varied reasons for doing so. On top of these reasons is that they may still be undecided on which specialty to train for. Others may want to redeem themselves or their families from the financial pangs brought about by the high cost of medical education. It could also be that they want to build up a comfortable financial cushion before going into residency training. There are some who probably want a more or less relaxed and less stressful lifestyle as a doctor, with "relatively" easy money flowing in, money that is not in anyway associated with the horrors of residency training. The last reason is actually valid because saying that residency has its horrors is actually putting it mildly.

If ever you decide to go moonlighting, I believe there are two things that you should remember.

First and foremost, bear in mind that moonlighting is just a stopover.  

It is not the be-all of your medical career no matter how big the bucks you are raking in from going on 24H-duties everywhere.  Set a limit for yourself,  a duration of time time you would allow yourself to go moonlighting before finally submitting yourself to training.  One year is enough, with two years being the longest.  Do not be blinded by the money.  Residency might force you to tighten your belt a little, but as I have mentioned in my previous entry, just bear in mind that after proper medical training, the money will follow.  That was exactly what my boss in Bohol told me when I told him about my plans of re-entering residency - "Money will follow, Inday." By then you are already a consultant, a recognized expert in the field you have chosen. You would become the master of your own time and you will not anymore be an employee of the medical institution, unlike when you are moonlighting.  The owner of the hospital is not even your boss, but your business partner, because you bring in patients to their hospital thus making their venture prosper.


Friday, November 16, 2012

Another good news for coffee lovers like me: Caffeine found to boost positivity

If you are a coffee lover like me, you might just have to add another reason to your long list of reasons for drinking that taste of heaven in a cup.

A new research done by researchers from Ruhr University in Germany found out that caffeine may boost positivity and save one from the claws of negativity that abounds in this world.

Sixty-six subjects were part of the study, half of which took a lactose placebo pill and the other half took tablets containing 200 milligrams of caffeine, equivalent to about two or three cups of coffee, thirty minutes before the test.  The test comprised of making the subjects identify whether or not a string of letters flashing across a computer screen were real words or not.

The subjects who took in the caffeine pill were able to spot positive words such as "happy" more accurately than the negative or neutral words.  

Looks like this ability of caffeine to boost positivity further supports a study published last year in the Archives of Internal Medicine, which included 50,000 women who are drinkers of two or more cups of coffee daily.  The study found out that  those subjects who drink two or more cups of coffee a day are less likely to get depressed.  

According to the health website, LiveScience, prior studies have shown caffeine probably stimulates the central nervous system by increasing activity of the brain chemical dopamine, which is linked with rewards, creativity, impulsivity and addiction. Since caffeine seemed to boost the positivity advantage, these findings suggest the root of the positivity advantage may rest in dopamine.


How to get through the hell called internship in the Philippine setting

Lately I found myself in the teaching and tipster mode.  I realized that some unknown force have rekindled my love for teaching. 

It’s teaching in the clinics that I have learned to love this time.

I have nothing against teaching in the classroom because that is the foundation of all the basic knowledge we have about almost everything, of course aside from the basic learnings and values being taught to us by our folks at home.

Teaching in the clinics is unique.  We can even teach ourselves and reinforce our knowledge with the wisdom of our senior residents and medical consultants – wisdom that is invaluable because it backed up by experience. 

As for teaching the medical interns, I always try to emphasize that being in the clinics is way different from the environment they have been used to in the classroom.  In the clinics, it’s the real deal – we see patients, we delve deeper into their presenting complaints, we formulate our clinical impressions, and we work them up to arrive at the final and correct diagnosis.  Along the way, we verify our findings in our patients with what is written in our books, thus solidifying our clinical knowledge, and hopefully, sharpening our clinical acumen or what is fondly called the clinical eye.

Let me mark this tipster/teaching mode with a list of tips for the interns on how to get through the hell called internship.  It might be too late now, considering that they are halfway beyond their internship, but I believe these tips will come in handy for incoming interns.  I hope these tips will shed light to an intern who chances to find this entry.  I don’t actually promote my blog, and only a few know that I have one.  If an intern happens to drop by my blog and read this entry, I hope he or she finds it worthy to stumble upon.

1.    First and foremost, accept your situation.  Internship is your fate.  It is your destiny.  Internship is you’re here and now.   You have worked hard for it for three years, and hey, don’t forget to include the three to four years you spent studying for your pre-medical course.  That makes it seven to eight years of toil before finally becoming a medical intern.  A lot of people are actually dying to be in your place right now.  You are actually on your way to fulfilling your dreams (or your parents and relatives’ dreams) of becoming a doctor.  Acceptance is the first key to success.  Accept internship as a blessing.  There is a song that goes, “Count your blessings, name them one by one/ Count your blessings see what God has done.”  Accept and name internship as one of your blessings, and thank God for getting you through the academic part towards internship.

2.    Cultivate diligence and hardwork.  Ward work, scut work, dirty work, those are the tasks laid on your shoulder as an intern.  You are at the bottom of the food chain.  Somebody’s got to start somewhere.  That bigwig consultant was once an intern.  Make that as your inspiration, and focus on the doughnut, not the hole.  

Think of internship as your initiation, your rite of passage, into the medical circle.  While you have the chance to perform procedures, go ahead.  Refrain from complaining, and aim towards achieving mastery in performing procedures like IV insertion, NGT and FBC insertion, etc.  

Read as much as you can about your cases while you are on duty.  You are more likely to sleep when you are not on 24-hour duty so you might as well read what you can, complete whateven paperwork you need to finish while you can and while you are still wide awake. 

Be early.  A Filipino adage goes, “Daig ng maaga ang masipag,“ but of course it would be better if you are both bright and always on time. 

3.    Practice the virtue of patience.  You may want to want each day to spin fast forward to your last month of internship but that will never ever be the case.  Take each day as it comes, and make the most out of each day.  Do what you can while you can still do it.  Aside from the fulfillment of helping to save a life, try to make it a point to have another reason to pat yourself on the back like, a new learning or a new skill or a completed task.    As much as possible avoid procrastination especially in your paperwork.

                Patience is a job requirement in the medical profession.  In almost every step of your career, you will meet a number of characters, and will find yourself in a situation, who will, and where your patience will be tested.  Internship is just the beginning of it all and it does not even come close to the tip of the iceberg.

4.    Get enough rest.  Interns are sleep deprived.  Sleep deprivation is that sinking feeling trying to swim over a sea of thick chocolate.  Take your vitamins.  Eat healthy food.  What you miss out in sleep you make up with intake of a lot of  good and healthy food.  Drink a lot of water. 

5.    Learn to unwind.  You have to find ways to be happy inspite of your situation. 

6.    Maintain an enthusiasm for learning.  Read and do all you can while you’re on duty.  Also, make it a point to have complete medical tools required in your rotation.

7.    Maintain a positive attitude.  Need I say more?  This too shall pass.  A positive attitude will also help you maintain a good rapport and relationship with your superiors and your fellow interns.  Nobody wants to be around someone who’s always grumpy, someone who always complains, and radiates nothing but negative vibes.

8.    Anticipate.  A resident loves an intern who anticipates what’s next to be done and down the line.  A clever intern who’s full of initiative that right after the resident successfully inserts the IV catheter, he would need a plaster to secure it.  It would speak a lot about you as an intern when you wouldn’t even give the resident the chance to ask for something like the plaster because you are handing it already to him.  The resident would know through that that the intern knows what he or she is doing and is not just a mere errand girl or errand boy.  This for me is actually the secret of internship so you wouldn’t be reprimanded or lectured upon by the stressed resident.

9.    Stop keeping track of the tasks you have done for your groupmates.  If there is one sure formula for a group’s downfall and for a group member to be really disliked by the whole group is to keeping count of the tasks you have done for your group.  As much as you can, go out of your way for the group’s sake.  Any task left undone by a groupmate will tarnish the whole group’s reputation.  It would also help that from the start the group agree on a consensus to help each other and cover up for each other’s asses no matter what.

10.   Dress appropriately.  Observe good hygiene.  No matter the situation you are in right now, you are still a doctor, even if you are still one or two steps away from it.  Make it a point to freshen up yourself at least twice a day or as often as you can, especially when you feel that your face is as oily as a frying pan already.  Brush your teeth ever after meals and please, comb your hair, and at least apply deodorant or spray on some fragrant body mist.  Maybe try to disguise with all that scent and aura that you didn’t have the time to take a shower at all .

          Internship is the only way to go.  Take each day as it comes is the favorite mantra.  But as long as you do everything well and according to the rules, you will only be an intern once.  This is only one of the many hurdles of being a doctor.  But once you reach the finish line of internship and finally walk on the graduation aisle, the exhilaration and the sense of fulfillment is beyond words.  You never want to go back to internship again but each time you look back, you dig through a big bag full of happy and maybe some unpleasant memories, and you say proudly to yourself, “I did it!”

Sunday, November 4, 2012

My vision of how medical practice would be like in the future

I was having my meals at the hospital kitchen when I found myself engaged in a conversation with my fellow residents about how medical practice would be like in the future.  Considering the amazing rate at which technological advances are surfacing in the field of communication and information access through the internet, it is not impossible that medical practice will experience ripples from modern technology.

            These days, going through the daily grind at the wards, I think at least one in ten medical interns owns an Ipad (or any tablet for that matter).  Although probably, most of the time, they might use it as an easy access to watch their downloaded movies or television series, they most likely have saved medical electronic books in those gadgets. 

            In this light, I was thinking, that probably in the future, all medical practitioners will own a tablet through which they can access all the data regarding their patients, particularly those who are admitted at the hospital.

            Picture this:  A resident admits a patient under the service of an attending physician.  The resident physician calls the attending about the admission, tells him or her about the presenting complaint of the patient, the resident’s primary clinical impression, and the laboratory tests which the resident plans to order.  The attending physician agrees to the resident’s plans, then before terminating the call, the physician asks the resident to send through text message the name, age, and room number of the patient, and the access code.

            Now what is this access code?

            It will be a code with five characters, which may be composed by numbers or letters or a mix of those, and it will be through this code by which the attending would access the general data of the patient as well as the laboratory results for this admission.  Additional access codes may be requested for hospital records from previous hospitalizations in the same institution.

            The access code will be convenient to both the attending and the resident physician.  The resident would not be bugging the people at the laboratory if the results of the tests are already available.  It will save the resident a lot of time from waiting for the final report to be sent to the ward. Aside from this, the physician could clarify the laboratory results for himself, in case he or she needs to.  

            I was also thinking of access codes so that the attending physician could see the patient through a CCTV installed in the patient’s room.  However I instantly developed aversion to this idea since I think installing a CCTV inside the patient’s room would go beyond the line of patient’s privacy.  

            I could not anymore recall why we started that conversation on how medical practice would be like in the future.  This vision may come true, it may not, but who knows? Now I remember, so crystal clear, that during my childhood days, I used to play telephone and I wished we only had to bring the handset itself - no bulky receivers or tangled telephone wires.  I must have had the first vision, the original idea, that gave birth to the mobile phone.  The mobile companies owe me big time then, if that's the case.  But then your sarcastic laugh brings me back instantly to reality.  It's time to go back to work and go back to the hospital ward.  (My laughter inserted here.)


Sunday, September 30, 2012

Choose Philippines! -- El Gamma Penumbra makes me proud to be a Filipino

Last Saturday night on the X Factor Philippines, El Gamma Penumbra gave a breathtaking performance on the show, and danced and shadow-played to the tune of Choose Philippines.

The crowd, and I - while witnessing the performance on television, could only scream in amazement.  I had goosebumps all over my body, and it has been quite a while since I had those.  The group, which I believe I first saw perform on ABS-CBN's Showtime, makes me proud to be a Filipino.  

Choose Philippines! Always. 

X Factor PH Update: Top 3 Finalists at last!

Allen Jane Sta. Maria has just been booted out of the greatest musical event in the country this year, The X Factor Philippines.

That leaves the following on the Top 3 slots:  KZ Tandingan, who this time, surprisingly found her way on the bottom 2, Gabriel Maturan, and Daddy's Home.

All roads lead to the PAGCOR Grand Theater in Paranaque next week for the Grand Finals of the 1st Season of X Factor Philippines.  

Good luck, Finalists!

To us viewers, another musical experience to look forward to. 

The Battle for the Top 3: Road to the Grand Finals of X Factor PH

It's been a while since I wrote a review about the X Factor Philippines.  

Inspite of my silence, I continued to watch the show, and silently rejoiced when I knew that finally, Kedebon Colim was given the boot.  (A sigh of relief inserted here.)  A great relief at that because in a popularity show like this where twists are inherent - just like any other popularity show -  the balance could tip in favor of Kedebon and he could have been the First Grand Winner of X Factor Philippines.  Everybody would know that if that happened, I mean Kedebon winning the grand prize, the X Factor that he has would not necessarily be the talent of singing which is the major quality being searched for in this contest.  It could be something else other than that and I leave that to you.  (Evil laugh inserted here.) 

Now it's down to the Top 4.  Owning the Top 4 spots are (in random order): KZ Tandingan, Daddy's Home, Allen, and Gabriel Maturan.  KZ and Allen are both Charice's mentorees, Daddy's Home is Gary V's only surviving group, and Gab is Martin Nievera's last man standing among his boys.

Last night's Performance Night was the most crucial since it leads the road to the Grand Finals of X Factor Philippines which will be next week, also to be held at the PAGCOR Grand Theater in Paranaque.

As for the performances last night, one could tell that the competition has gone even more tough, with each contestant giving his or her or their all.

KZ Tandingan sang Chris Brown's Forever.  It was something new for this favorite especially that this time, she had to dance and do rap, aside from her usual chore of singing.  As a rookie in this department of talent combo's, KZ did satisfactorily.  I could feel she had to go out of her way to maintain her breath and I saw that the power of her voice was diminished in some way since she had to move around while she danced.  The rapping part was also new to her I guess and although it was a breath of fresh air both for her and the viewers, it was evident that, yes, it was new for her.  Inspite of that, KZ still remains to be my best bet to be this first season's Grand Winner.  

Daddy's Home sang Open Arms, a hit by Journey.  Surely they are the masters of voice blending and they also have a say when it comes to belting.  They are entertaining enough, yes, but I almost have enough of these guy's style.  Surely they have a lot of potential to become  the prime male singing group of the country more likely after the show ends this season, in line with respected male groups such as The Tux, NeoColours, to name a few but I'm about to say ho-humm.  It's the same singing style every night and it would have been better if they showed the audience something new last night, something they don't usually do.  In that department, where all the other finalists really worked hard for -- thinking out of the box and stepping out of their comfort zone -- this group failed.  A strong contender for the Top 3 and even for the Grand Winner, this group will still have a chance on Grand Performance Night.  I hope they make the most of that chance, if they indeed grab a spot in the Top 3.

Allen, the youngest among the finalist sang Willow Smith's Whip My Hair.  For her age range market, it was quite a performance but for young adults and for those who belong to the older age bracket the song may be forgettable and not really a strong weapon to make her grab a slot in the Top 3.  This girl has more than enough raw potential, with some parts really ripe for the taking.  If she is mentored more, and longer, and very well at that, this girl could go to places.  

Gabriel Maturan or Gab as he is fondly called on the show, surprised everyone when he sang his own version of Justin Bieber's Boyfriend.  Gab said he considers Bieber as his musical hero and I could see that he did his best to give justice to Bieber's hit.  I agree with Martin when he said that this is Gab's best performance yet.

My fearless forecast, Allen Sta. Maria should go.  However this young lady maintains a strong following from her fans and so, if she does survives the axe, it is time for Daddy's Home to go home.  It is very possible that the voters will send out the older guys leaving the younger ones behind.  In that case, it will be more fun I guess.  Raw talent, raging hormones, nurtured dreams yet to be embattled, and convictions at their strongest -- all those will come into play on the grand finals night, if the young ones will be left behind to fight for the crown.  Actually, that's not bad at all.  That's for sure.



Sunday, September 23, 2012

I Want It That Way by the ABS-CBN News Anchors

I'm sharing this just in case you haven't bitten by the bug that caused this viral video

It's quite entertaining and refreshing at the same time to see our news anchors share their wacky side, even for just a few seconds.



Thursday, September 6, 2012

Joan Da Survives the Axe: X Factor PH 5th Performance Night and Results Show

For those who have been waiting for my review of the 5th Performance Night and Results Show of the X Factor Philippines, please excuse the slight delay.

But still, better late than never, so here it goes.

Admittedly, it is a bit frustrating that the finalists whom we think have the X Factor are actually those who find themselves in the bottom of the list and are threatened to be kicked out from the show.  Probably that is one of the reasons why I dilly-dallied in writing this entry.  Well, again, we all  have to keep on reminding ourselves that that is the way the show goes and we all must have the fluidity to go with the flow.

The unexpected twists are both sources of thrill and at the same time, disappointment, actually not an unusual combination at all, but something that does not really leave a pleasant taste in the mouth. 

For the second time around, Joan Da, found herself in the bottom two along with boy band-wanna be, Take Off.  She had to sing again for survival, this time with her version of Bruno Mars' Grenade, and had to prove her worth, that she deserves to stay in the show, more than the male group does.  Indeed, she proved it.


The 5th Performance Night was dedicated to Original Pilipino Music (OPM) and Joan Da sang Join the Club's Nobela.  Though the song was only a little familiar to me, I could say still that her performance was superb.  The voice was great.  It sounded like an original to me, actually the challenge that she had to beat when she chose this song.  This may be a cliche but if you compare the original version, you might even say, Joan's version is better.  Joan Da did it again, and injected her own personality and style into the song.  


Nobela by Join the Club, now beginning to be one of my new OPM favorites.

I realized that Joan Da's talent could actually match that of KZ's.  KZ's edge is that her being at home on the performance stage is so palpable that you could almost touch it on your television screen.  

Still, Joan Da is one of my bets for the Top 3 along with KZ Tandingan.   I believe she will stay longer on the show if she goes on taking time and caution in choosing her songs ( I observed that her chosen pieces suffer from popularity, a big determinant for the voters to trust the finalist with their votes), and if she strives to boost her confidence on the stage every time. 

The all male group, Take Off sang an APO Classic, Yakap sa Dilim.  How can one go wrong with a song by the APO Hiking Society? I could say that was the group's best performance yet since the start of this premiere season.  I loved the vintage feel of the whole performance and I just loved those suspenders! Apparently the vintage effect and the suspenders were not enough, I found myself shortchanged, I wanted the boys to show to give the audience something more particularly in their singing.  Still, I commend them for having the best among their performances so far, before taking a bow and leaving the show.  Their last performance made me smile, cradled me for a while, and for a second made me wish they never had to go.


Again there was a deadlock of votes among the mentor judges, 2 favoring Joan Da to stay, and the other 2  wanting Take Off to stay.  The text votes results were opened this time favoring Joan to stay on the show.  I particulary appreciated how Charice explained her choice.  She wanted Take Off to leave the show, considering that this is the third time that the group is on the bottom too and it was only right this time to heed the clamor of the text votes and let the group go.  Judge Mentor Pilita, Joan Da's mentor, did what she was expected this time, unlike what she did last week when she voted against her own mentoree, Mang Modesto.  Gary Valenciano and Martin Nievera both wanted Take Off to stay, saying they can do a lot with a group of boys rather than with a solo singing act.  Short of saying there is strength in numbers, but I dont think that's where the strength lies in right now.  A group of boys just trying to nail some notes, and banking on their appeal is not actually a match to a solo act with real talent.

Daddy's Home (see video above) again did well that night, singing Smokey Mountain's Paraiso, and tagging along their kids with them. 

KZ Tandingan expectedly blew the house down with her version of the well loved classic, Eraserheads'  Ang Huling El Bimbo.  To say that  I was in awe while watching her sing is definitely an understatement.  KZ is on the verge of mastering her craft at such a young age.  She is totally off the roof when it comes to performance.  This lass from Digos City indeed knows how to build momentum in her performance, she knows how to tease the audience a little bit by not really giving what they expected but giving them something pleasantly outrageous,  thus leaving all of us wanting for more.  You can only shake your head in amazement.  I was practically screaming!  What a performance!

Her outfit however had residues of the past week's rock theme and she looked like Amy Winehouse who came home in the morning after partying all night long.  But that does not really tarnish the wonder that is KZ Tandingan.


I think I already know what you will say next.  Yes, Kedebon is still in!  And, yes, after murdering Gary Valenciano's Kaliangan Kita, it was almost like a massacre openly shown on Philippine television.  If I were Gary V., I would have already covered my face with my two hands out of shame and disgust. 

C'mon this is the X Factor, guys, and the show does not need anybody's (most especially Kedebon's) monkey antics to keep the ratings up.  A talent show that truly showcases talent,  will itself attract the viewers to stay glued to the television during weekend nights, will keep the advertisers flowing in, and will make the ratings soar higher.  

So Kedebon, be careful, your time on X Factor PH is almost up.                   

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