My 4th year of MBBS course at NUMed

The 4th year of the MBBS course at Newcastle University Medicine (NUMed) Malaysia is known as Stage 4. Officially (de jure), Stage 4 lasted from 4 September 2017 to 3 August 2018, but in reality (de facto), Stage 4 lasted from 18 September 2017 to 7 June 2018. During Stage 4, I lived at Horizon Residences in Bukit Indah, Johor Bahru which is the accommodation managed by NUMed. Here, I am writing about my experience during Stage 4.

The 1st semester of Stage 4 consisted of Clinical Science & Investigative Medicine (CSIM), Clinical Pharmacology, Therapeutics & Prescribing (CPTP) and Patients, Doctors & Society (PDS). The teaching sessions were mostly lectures, seminars and Case Based Group Work sessions at the NUMed campus. The 2nd semester of Stage 4 consisted of three Student Selected Components (SSC) and two Electives. For each SSC and Elective, we could choose a topic that we would like to study. One of the SSC's could be non-clinical while the other two SSC's had to be clinical. SSC 3 and the Electives could be done either in Malaysia or in UK.

September 2017:

3 September was the last day of my summer break which lasted for 6.5 weeks. On that day, my parents drove me back to Johor Bahru, and I moved into Horizon Residences. Unlike the previous years, I didn't feel sad that the summer break was ending, instead I was actually looking forward to Stage 4. Stage 4 was supposed to begin on 4 September. On that morning, out of every student's expectation, the lecturers told us a bad news about the Stage 3 Single Best Answer (SBA) examination which we had taken and passed in July 2017. They declared the results of that examination invalid, because of a 'security breach' where some of the questions were leaked out before the examination. As a result, everyone in my batch had to resit for the examination on 14 and 15 September, while Stage 4 would begin on 18 September instead. The students who failed the examination in July would be resitting it as well. Most importantly, only those who pass the resit examination would be able to proceed to Stage 4, while those who fail would have to repeat Stage 3.

Immediately after the announcement was made, many students started complaining that it was very unfair. The lecturers' reply was that there was no way to find out exactly which students received the leaked questions, so everyone had to resit the examination. They said that they had known about it quite some time ago, but they had to wait until that day to inform us because that was the only way they could ensure all students would get the news at the same time. They also said that the resit examination couldn't be delayed any further because there wouldn't be enough time to complete the teaching in the 1st semester of Stage 4. In the end, nothing could be done to change the fact that we had to resit the examination. This definitely put me in a very difficult situation. I had worked very hard to pass the Stage 3 SBA examination in July, and now I had to go through that all over again. Throughout the summer break, I didn't study anything at all so I likely had forgotten a lot of what I had learnt in Stage 3. Having to revise the entire Stage 3 curriculum in just 10 days felt so much like an impossible task. I felt very angry, sad and stressed.

Later, someone attempted to create a petition for the postponement of the resit examination by 1 week. However, some students weren't quite supportive of the petition as they felt that it would be futile. In my opinion, the examination should be postponed by at least 2 weeks, as 1 week wouldn't be much of a difference. Nevertheless, I still signed the petition. After some analysis, I concluded that it was feasible for me to complete one full round of revision for the whole Stage 3 curriculum in 10 days, but this would mean the next 10 days would be extremely busy and stressful. On that afternoon, I began revising for the Stage 3 SBA resit examination. I started my revision with Internal Medicine which was the most important. Luckily, I still had significant memory of my Stage 3 knowledge, which enabled me to revise faster and easier compared to my revision for the examination in July. On 5 September, NUMed informed us that the examination dates of 14 and 15 September were final. After that, the student who created the petition told us that he had decided not to submit the petition due to the fact that only about 1/3 of the students in our batch signed it.

On 7 September, I finished revising Internal Medicine and proceeded with Mental Health. As there weren't many topics in Mental Health, I could finish revision for it on that day itself. I then revised Child Health. I finished revision for Child Health on 9 September and continued with Women's Health. On 11 September, I finished revising Women's Health and that marked the completion of my first round of revision for the entire Stage 3 curriculum. Over the next two days, I did a quick second round of revision for Internal Medicine. During that 10 days, I had to do revision for very long hours every day. I kept praying to God that I would pass the resit examination, and I promised that if I could enter Stage 4 successfully, I would show my fullest enthusiasm in Stage 4. To avoid wasting time, I stopped playing the game Clash of Clans temporarily. This resulted in the death of my clan in the game, as I was one of the only few active players in my clan. I had wanted to watch the iPhone 8 and iPhone X launch event live on 12 September, but I had to give up on that because of my revision. In the end, I was fairly well prepared for the Stage 3 SBA resit examination, but I was still quite worried that the questions would be difficult, which was the case for the examination in July. On 13 September, the selection for Student Selected Component (SSC) 1 was open.

On 14 September, it was Paper 1 of the resit examination. This paper was slightly easier than the examination in July, which made me feel more confident. Paper 2 of the examination was on 15 September. This paper was more difficult compared to Paper 1. I estimated that I would be able to score at least 58% in this examination. However, the problem was that the pass threshold of the Stage 3 SBA examination is often higher than 60%. In July 2017, it was as high as 64.3%. NUMed had stated that the pass threshold for this examination would be determined in the usual way. As a result, I was very worried of my examination results. On 17 September, I watched the movie Dunkirk online. However, the version I watched had poor video and audio quality, and I could not hear the dialogues in the movie at all. I had to watch it with subtitles, but the subtitles I downloaded was of poor quality too. This, in addition to the fact that I wasn't really in the mood of watching movies since the examination results would be released on the next day, I didn't enjoy the movie at all. On that night, I made the selection for the SSC 1. My top 3 selections were non-clinical topics. I had always wanted to do a non-clinical SSC, as I felt that it is important for medical students to have non-clinical knowledge as well. For SSC 2, only clinical topics would be available, and if I was to do SSC 3 in UK, there would be no non-clinical topics as well, so my best opportunity to do a non-clinical SSC was in SSC 1.

The results of the Stage 3 SBA resit examination was released at 8AM on 18 September. Just before the release of the results, I felt extremely nervous and my body was trembling. Then, I was so happy to know that I passed the examination. Out of my expectation, I scored 75.1% in this examination which was a huge improvement compared to the examination in July where I scored 67%. The pass threshold for this examination was 63.9%. With this, I finally could get into Stage 4 for real. After going through the whole ordeal where I nearly lost the opportunity to be in Stage 4, it made me value Stage 4 so much more. I was truly grateful that I could be in Stage 4, and I looked forward enthusiastically to what would be coming. Most importantly, I decided that I would make the most out of the opportunities I have in Stage 4. At 9AM on that day, there was a Stage 4 introductory lecture. That lecture was an emotional high point, as only students who passed the Stage 3 SBA resit examination would attend it. With the exception of one student, everyone in my batch passed. There were 8 students who originally failed the examination in July, but all of them passed the resit examination. They were definitely very lucky because in normal circumstances, there is no resit for the Stage 3 SBA and anyone who failed has to repeat Stage 3. Several of them are my close friends and I felt happy for them too.

Towards the end of the introductory lecture, the student group list for the 1st semester of Stage 4 was released. The lecturer told us in advance that the grouping had been finalised so no changes could be made. It turned out that this grouping was largely based on the Hospital-based Weeks in Stage 3 previously, although there were a bit of changes. I was allocated to Group 4, and most of my group mates were previously my group mates in Hospital-based Group (HBG) B1. Since I could reunite with my friends in HBG B1, I was very happy to be in Group 4. I was very grateful that I wasn't excluded from this group like what happened to my group allocation for the Essential Junior Rotations in Stage 3. Soon enough, someone in Group 4 created a WhatsApp group for us. At 11AM, there was a suturing session. We had never learnt suturing before, and this was our one and only opportunity to learn suturing in this semester. We had to perform suturing on a banana. I didn't bring a banana as I wasn't sure where to buy one, but one of my friends brought extra bananas so he gave me one. The lecturers thought us a few techniques of suturing. In the end, I was able to perform suturing fairly well. At 4PM, it was the first lecture for CSIM and I attended it enthusiastically. I considered that day to be a really great day, due to fact that I got into Stage 4 successfully and also got allocated to Group 4 which I really like.

Around that time, I made the decision to do the SSC 3 in UK. In the past, I was reluctant to go to UK for the SSC 3 and Elective as I was worried that I couldn't adapt to the life in UK. But now, since I wanted to make the most out of Stage 4, I felt that it would only be right if I do the SSC 3 in UK. The fact that many of my friends were also planning to go to UK made me even more convinced to do so. However, I decided not to do the Elective in UK. Since there would only be a short 3 week break after the Elective, I wanted to have more time at home by doing the Elective in my hometown. On 19 September, there was an introductory Case-based Group Work session. Case-based Group Work sessions are a unique feature of Stage 4. In each session, every group would be presented with clinical cases where the group members had to discuss and work together to come out with the answers for the questions in the case. The introductory session was quite simple and was just meant to make me and my group mates in Group 4 know each other better. At the end of the session, the lecturers provided us with some costumes of superheroes, which we wore and took group photos together. After that, we went for lunch together at MH Beriani Tindih in Gelang Patah.

On 20 September, it was the first Case-based Group Work session, which was about multisystem disease. For each session, someone had to take the lead. I and my group mates in Group 4 decided to take turns for that. I resumed playing the game Clash of Clans around that time. I tried reviving my dead clan, but I wasn't successful as all other active players had left the clan. As a result, I switched to my friend's clan. On 25 September, a few students started discussing about the annual health camp. The health camp had never been something that I am interested in. Worse still, they seemed to imply that the health camp was compulsory for everyone in my batch. This gave me a bad impression about the health camp, and I decided not to participate in it at all. On 26 September, there was a disabilities field trip. I didn't want to attend it as I felt it was just a waste of time, but since it was compulsory for all Stage 4 students, I had no choice but to attend. We went to the Handicapped and Mentally Disabled Children Association in Saleng. Towards the end of the field trip, two teenagers at the association started fighting with each other. Some of my friends intervened and managed to keep the situation under control until the trainer came and stopped the fight.

Due to the fact that the start date of this semester was delayed from 4 September to 18 September, the timetable throughout the semester was very packed, with long hours of classes every day. On 28 September, the allocation for Student Selected Component (SSC) 1 was out. I got allocated my 3rd choice which was 'Basic Statistics in Medical Research', a non-clinical SSC done at the NUMed campus. I was the only student in this SSC, even though there were places for 4 students. I wasn't quite happy about having to do this SSC alone, but I understood that it was because most students wanted to do clinical SSC's instead. Later on that day, it was the official discussion session for the health camp. At that time, the lecturer clarified that it wasn't compulsory for us to participate in the health camp. My perception towards the health camp improved as a result, but I still didn't want to participate. I joined the discussion session, but only as an 'observer' without offering any of my opinion.

October 2017:

The 3rd week of this semester began on 2 October. For this week, we learnt about cardiovascular diseases. Unlike the past 2 weeks where the topics were relatively easy, the topics in this week were much more difficult. To make matters worse, there was a lecturer who had the habit of using a particular design in his lecture slides which in my opinion was really ugly, and there would be many lectures by him throughout the week. Annoyed by that, I chose to skip one of his lectures. But later, I thought of my desire to make the most out of Stage 4. I realised that I shouldn't skip a single lecture, even though most Stage 4 lectures weren't compulsory. Then, I found a better solution. Since that lecturer would usually upload his lecture slides to the learning support website one day in advance, I could just download the slides to my iPad and change the design beforehand. I would then view the modified slides on my iPad during his lectures. This enabled me to attend all his other lectures while avoiding the annoyance of the design of his slides. On 3 October, there was a forensics field trip to Hospital Sultan Ismail. There, a surgeon performed dissection on the body of a man who had experienced sudden death, and we had the opportunity to observe the whole process. The surgeon also showed us various organs of the body after removing them.

Google launched the Pixel 2 phone and Pixelbook on 4 October. I watched the launch event live online. I really liked the Pixel 2, but unfortunately it wouldn't be available in Malaysia. On 6 October, I happened to walk to a part of the NUMed campus which I was rather unfamiliar with. I came across a flight of stairs. After walking up the stairs, I arrived at a room with the words 'Welcome Centre' on its entrance. I was rather surprised as I had never known about its existence even though I had been studying at NUMed for more than 3 years and the NUMed campus is actually pretty small. Around that time, I began my revision for the Stage 4 Single Best Answer (SBA) examination which would be in December 2017. Since I scored 75% for the Stage 3 SBA resit examination, I hoped to maintain the same level of performance in the Stage 4 SBA examination, so I aimed for a score of 75%. I believed that early revision would be the key to achieving this aim. Most importantly, I had to at least pass the Stage 4 SBA examination. Any student who fail the examination would be required to resit it after the SSC's and Electives in the 2nd semester, which would be very stressful as the revision for the resit examination would be hampered by the SSC's and Elective.

On 9 October, there was an interpreters workshop and a prescribing workshop. The interpreters workshop was supposed to be quite interesting, but the lecturers involved didn't manage the session well, so the session ended up being rather disorganised. Then during the prescribing workshop, the lecturer was not at all enthusiastic when teaching us. As a result, I felt that I didn't learn anything in both of the workshops. On the following day, there was a session on telephone consultations. Compared to the workshops in the previous day, the lecturers managed this session much better. On 11 October, it was the Case-based Group Work session on infections. It was my turn to lead the session on that day. As this session was rather easy, I and my Group 4 group mates finished the discussions earlier than expected. We then decided to go to YouTube to watch some movie trailers. One of the trailers was for the movie Happy Death Day. This movie seemed really good and I planned to watch it when it is released. There was a cancer quiz on 19 October. Although I didn't do much preparation for the quiz, I was able to get a score of 61% and I was quite satisfied with that. On 20 October, this blog reached a total of 1 million pageviews. It was a significant milestone for this blog, and I felt really proud of it.

I used to have a negative perception towards the Elective in the 2nd semester of Stage 4. This was because I didn't know what the Elective actually is, and I had the impression that it is some form of a 'pre-housemanship programme' which would be quite stressful. As such, I thought of skipping the Elective entirely. Around that time, I read through the NUMed Elective study guide and found out that students who don't attend the Elective satisfactorily wouldn't be permitted to proceed to Stage 5, which made me feel disappointed. However, I later came to understand the truth that the Elective is actually just like the SSC's, which I knew would be very enjoyable. Since then, I no longer disliked the Elective and I embrace it as an essential part of Stage 4. I planned to do the Elective at a private clinic located near my house in Subang Jaya. There was 6 days of study break from 24 October to 29 October. On 24 October, I took a flight back to Subang Jaya. When I was in Subang Jaya, I made preliminary contact with the private clinic and they agreed to let me do my Elective there. Throughout the study break, I mostly spent my time revising for the upcoming Stage 4 SBA examination. I then flew back to Johor Bahru on 29 October. I met one of my friend on the flight. She had travelled to Kuala Lumpur to attend her friend's graduation.

After arriving Horizon Residences, I found out that my access card wasn't working. I went to the NUMed accommodation office to report the problem. They then gave me a replacement card which seemed to work properly. But on the next day, I was unable to exit the car park using the replacement card. I had to report to NUMed once again. Eventually, they returned to me the original access card which they had repaired, and there were no more problems since then. On 31 October, there was a group discussion session on health systems. For this session, NUMed reallocated all students to different groups, and I was placed in Group 11. We had to create a public health plan and present it during the health systems group presentations a few days later. Initially, I was happy with Group 11, as a few of my friends were in this group as well. Then out of sudden, a distressing thought came to my mind. Was NUMed planning to make Group 11 my permanent group for the remainder of this semester? Group 4 had always been my group for this semester and I loved Group 4 since the first day. I definitely wouldn't condone any attempt by NUMed to separate me and my group mates in Group 4. As a result, I refused to recognise Group 11 as my group and I didn't contribute any ideas throughout the session.

November 2017:

On 1 November, there were theme overview and case review lectures on asthma and COPD. In total, the lectures were supposed to last 2 hours and there were close to 300 slides. But surprisingly, the lecturer just rushed through the lecture slides while giving very little explanation, and he finished the lectures within 20 minutes. Some students obviously weren't happy about that. There was a Case-based Group Work session on chest medicine on 2 November. I was once again with Group 4 for this session. Strangely, this session was not held at the usual seminar rooms, instead it was held at one of the simulation rooms in the clinical skills laboratory. On that day, it was my turn to lead the session. One of my group mate's birthday was on that day, so we decided to celebrate it with her. We surprised her with a birthday cake and sang the birthday song during the session. On 3 November, it was the health systems group presentations. My refusal to contribute my ideas during the group discussion with Group 11 a few days ago had caused resentment among the other students in Group 11, so they proceeded with the presentation without me. I too wasn't planning to participate in that presentation. At that point, it was clear that Group 11 was just a one-off group allocation and I would get to continue to be in Group 4, which made me feel quite relieved.

Later on that afternoon, there was a careers session. During the session, NUMed told us that it is now possible for NUMed graduates to get into the UK Foundation Programme, but the situation could still change in the future. We were also told that NUMed graduates who complete house officer training at 7 approved hospitals in Malaysia can now gain full registration with the UK General Medical Council. The 2nd prescribing workshop was on 6 November. The lecturer involved in this workshop was the same lecturer involved in the previous prescribing workshop in October. But unlike the previous workshop, the lecturer was much more enthusiastic this time and she was able to teach us quite well. Then on 7 November, there was a session on shared decision making. During the session, I role-played as a doctor while my friend role-played as a patient with pharyngitis who was requesting for antibiotics. Since the patient fulfilled the 'Centor criteria' which indicated that the pharyngitis was likely to be bacterial, I decided to give the antibiotics as requested. However, the lecturer then explained that even though the 'Centor criteria' was fulfilled, I shouldn't have given the antibiotics as it is unlikely to bring any significant benefit to the patient.

On 10 November, it was the NUMed F&B Night 2017. I chose not to attend it, due to the fact that I was busy with my revision for the Stage 4 SBA examination and that I had never attended in the previous years. Out of my expectation, many of my friends in Group 4 attended it, and they took many nice photos together. Consequently, I really regretted not attending the F&B Night. This was one of my greatest regrets in 2017. On 11 November, when I went shopping at AEON Bukit Indah, I saw Taiwanese beef noodles on sale. I had tried Taiwanese beef noodles before when I went to Taiwan many years ago, and I really liked it. Therefore, I bought the beef noodle, even though it was quite expensive. I then had it for my lunch. On that night, I happened to check the NUMed assessment feedback website. Much to my surprise, the results of the Stage 3 SBA resit examination in September had been removed from the website. I began to feel quite worried. Was there another 'security breach'? Would we be required to resit the Stage 3 SBA once again? I told my friend about that and he was worried too.

The health camp was on 12 November. Vast majority of the students in Stage 4 participated in it, but I maintained my decision not to participate. Although my friends told me that the health camp was very fun, I didn't feel regret for not joining, because it really wasn't my kind of thing. On 13 November, NUMed sent us an e-mail to inform that they had concluded the investigation regarding the 'security breach' of the Stage 3 SBA examination in July and that they had taken necessary actions towards those who were involved in it. They had also determined the students who got the Merit award based on the Stage 3 SBA resit examination in September, and the results on the assessment feedback website had been updated to reflect that. That was the reason why the results got removed temporarily a few days ago. I was so relieved that we didn't have to resit the examination once again. Then, the selection for Student Selected Component (SSC) 2 was open on 15 November. All the selections I made for SSC 2 were topics related to Primary Care, because I find Primary Care really interesting.

At night on 19 November, I slept unusually early at 12AM because I felt very tired. I woke up at 4:30AM, when I heard a strange high-pitched sound. I then heard the same sound again and again every few minutes. The sound clearly came from within my room, but it wasn't from my phone or iPad, and I couldn't think of anything else in my room that could be making the sound. This made me feel very scared. Was my room haunted? Or was I having auditory hallucinations? Then, after searching on Google, I came across a disease known as Exploding Head Syndrome (EHS). According to Wikipedia, people with EHS would hear an imaginary high-pitched sound when falling asleep or waking up from sleep. EHS seems to be more common in people who are deprived of sleep, and there is no effective treatment for it. I thought that I must be having EHS. The sound continued until the next morning, but it stopped completely after I got up from bed. I hoped that I was just having a single episode of EHS. However, I kept hearing the same sound on the following nights. Strangely, I never heard the sound whenever I took naps in the afternoon. This definitely made me feel quite depressed, and I was worried that the EHS would be permanent. I tried sleeping earlier every night to get enough sleep, hoping to get rid of the EHS that way, but nothing changed.

On 21 November, there was a lecture about SSC 3 and Electives in UK. The lecturer explained to us the procedures we had to follow if we wish to go to UK for the SSC 3 and Electives. In the past, I had always thought that there is just a single Elective which lasts for 8 weeks, but at that time, I found out the truth that there are actually two Electives where each lasts for 4 weeks. Some students planned to do the Elective 1 in UK and Elective 2 in Malaysia, which I felt was quite a good idea. However, I had already made plans to do 8 weeks of Elective at the private clinic in Subang Jaya and I didn't see a great need to change that, so I maintained my decision to go to UK only for SSC 3. On that week, we learnt about haematological disorders, and the topics were very difficult. On 22 November, the allocation for SSC 2 was out. I got allocated my 1st choice which was 'Explorations into Primary Care', but much to my disappointment, I was the only student in this SSC, just like the SSC 1. The fact that I would be doing both SSC 1 and SSC 2 on my own made me feel extremely unhappy, because the SSC's won't be enjoyable without any friends. I then tried requesting for a switch to my 2nd or 3rd choice which still had available places, but NUMed rejected my request because the SSC allocations were final. Worse still, since I would be doing the Electives on my own in Subang Jaya, this would mean that with the exception of SSC 3 which I would do in UK, I would be alone for the entirety of the 2nd semester of Stage 4. To overcome this problem, I considered the possibility of doing the Elective 1 in UK. At that time, the Stage 4 SBA examination was approaching, so I had to revise even harder. This, in addition to the SSC allocation and my Exploding Head Syndrome (EHS), made me feel extremely stressed and depressed.

On 24 November, there was a lecture on critical illness and multi-organ failure. The lecture was supposed to last 2 and a half hours, but the lecturer explained everything in so much detail that the lecture was eventually extended to 3 hours. Immediately after that, there was another 1 hour lecture on principles of IV therapy by the same lecturer. In total, we attended her lecture for 4 hours continuously. Then on that afternoon, it was the NUMed Cultural Fest 2017 and I attended it. Many of my friends were there as well. There, many food stalls were set up by students where each stall represented a particular culture. Students from the neighbouring University of Southampton Malaysia Campus joined the NUMed Cultural Fest as well, and they set up one of the stalls which represented Chinese culture. I bought food from some of the stalls and the food was quite tasty. After returning to Horizon Residences on that afternoon, I decided to turn on the air-conditioner in my room. Usually, I only used the air-conditioner at night. Half an hour later, I suddenly heard the same sound again. This was the first time I heard the sound in the afternoon and while being fully awake. I then noticed the smoke detector located near the air-conditioner. Then, at the moment when I heard the sound again, the smoke detector emitted a red light. This meant that the sound was actually from the smoke detector. I was so relieved to know that I wasn't really having EHS. I then made a report to NUMed about that and they sent someone to replace the battery of the smoke detector. The fact was that, the battery of the smoke detector was low, and whenever my room was very cold after the air-conditioner had been on for some time, it caused the battery level to fall even lower, so the smoke detector gave the warning sound.

On 25 November, it was the NUMed Diwali Night 2017, and there was an online vote for the person with the best dress during the event. I didn't attend the event, but I participated in the vote by voting for one of my friend. She ended up getting the highest number of votes. On 28 November, there was a Case-based Group Work session on overdose and poisoning. This was the last Case-based Group Work session ever, so I took photos with my group mates in Group 4 at the end of the session. Later on that day, NUMed informed us that they had to perform a reallocation for SSC 1 due to a new ruling. Consequently, someone would be doing 'Basic Statistics in Medical Research' with me. I was so happy that I would no longer be alone for SSC 1. With that, I no longer wanted to do the Elective 1 in UK. Then, there was an simulation session on 29 November. During the session, I had to provide care to a simulated patient who was in a critical condition. Due to my lack of experience in that, I didn't perform very well. That was my last day with Group 4 and I felt sad that we would be separated after that. We once again took photos together on that day. On 30 November, there was an examination briefing lecture. That was the last lecture in the 1st semester of Stage 4. Technically, it was also my last lecture in the MBBS course, as there wouldn't be any lectures in the 2nd semester or in Stage 5.

December 2017:

There were no classes from 1 December to 11 December. During that period of time, I was busy doing revision for the Stage 4 SBA examination and I felt rather stressed. After doing so much revision, I felt that I was well prepared for the examination. However, many had described this examination as being the most difficult examination in the entire NUMed MBBS course, so I was worried that the questions would be difficult. On 12 December, it was Paper 1 of the Stage 4 SBA examination. This paper was not too difficult and there were in fact some easy questions, except for the last 10 questions, all of which I couldn't answer. After Paper 1 ended, I received an e-mail from NUMed which stated that there was a major power outage in Bukit Indah including Horizon Residences and that the power supply would be restored by midnight. I wanted to go for dinner in Bukit Indah, but there was a very bad traffic congestion as the traffic lights weren't functioning. As a result, I had to go to Taman Perling instead, and I bought my dinner at KFC by drive-thru. I returned to Horizon Residences at 7PM. After having dinner, the sky had turned dark and the power supply still had not been restored. I then telephoned TNB to ask about the power outage. TNB told me that they had no idea when the power outage could be repaired and that they would supply Horizon Residences with backup power later.

As such, I decided not to wait for the power supply to be restored and I went to the NUMed library instead. Many of my friends who lived in Horizon Residences were also at the library. For a few hours, I did revision in the library. Around 12AM, many of my friends returned to Horizon Residences even though the power supply was still not restored, but I decided to spend the night in the library. There were several sleeping bags in the library and I slept on one of those. After waking up on the next morning, I had breakfast at the NUMed cafeteria and then continued with my revision. Paper 2 of the examination was on that afternoon. This paper was slightly easier compared to Paper 1. Overall, the examination was easier than what I had expected. I estimated that I could be able to score at least 54% in the Stage 4 SBA examination, while the pass threshold for this examination is usually around 52%. Therefore, I was very confident of passing the examination. After Paper 2 ended, I went to the NUMed library to scan my CAS application form which had just been signed by the Dean of NUMed and send it to Newcastle University UK. The CAS was needed in order for me to apply for my visa to go to UK. When I returned to Horizon Residences on that night, the power supply had been restored.

There was 2.5 weeks of winter break from 14 December to 2 January. On 14 December, I took a flight back to Subang Jaya. On that day, NUMed told us they had decided that it is no longer possible for us to do the Elective 1 in UK and Elective 2 in Malaysia. We had to either do both Electives in UK or not at all. Many students complained about that. Since I would only be doing the SSC 3 in UK, I wasn't affected by this. On that night, in response to the complaints, NUMed informed us that we once again could do Elective 1 in UK and Elective 2 in Malaysia. However, they also said that students who choose to do both Electives in UK would have to do the same Elective for 8 weeks, it wouldn't be possible to do two different 4 week Electives in UK. We originally had to submit the proposal for the Electives by 15 December, but NUMed extended the deadline to 15 January. On 17 December, I went back to Kulim. When I was in Kulim, a few of my secondary school friends were planning to have a dinner together and they invited me, but I chose not to join them. I returned to Subang Jaya on 24 December. On 24, 25 and 26 December, I met my cousins. On 27 December, I submitted my proposal for the Electives. Then on 28 December, I watched the movie Happy Death Day. I had wanted to meet up with my Taylor's College friends during that time, but unfortunately none of them were free.

Around that time, the battery performance of my HTC One E8 phone had become very poor. The phone would shut off randomly whenever the battery level was below 80%. As the battery was not replaceable, I knew it was time to get a new phone. My favourite phone is the Google Pixel 2, but it wasn't sold in Malaysia, so I planned to buy it online. Later, one of my Facebook friend suggested to me that I might be able to buy it at DirectD in SS15, Subang Jaya. On 29 December, I went to DirectD and as it turns out, the Pixel 2 really was available there. I decided to buy the Pixel 2. I also bought a cover for the phone. However, I was unable to get a screen protector designed specifically for the Pixel 2. As a workaround, I used a screen protector designed for a similarly sized Samsung phone. As the Pixel 2 was imported from the US, the charger uses a US style plug, so I had to use an adaptor in order to plug it into a Malaysian socket. As I had two SIM cards, I planned to continue using my HTC One E8 phone for as long as it continues to function. On 30 December, I bought a large suitcase which I would be using when I travel to UK for my SSC 3. On that night, I noticed that in the NUMed timetable, there was an event on 11 January. The event was untitled, but it was categorised under 'Stage 4 Assessments'. I started feeling worried again. Could it be a resit for the Stage 4 SBA examination due to another 'security breach'? Or could it be a newly introduced assessment?

January 2018:

On 1 January, I flew back to Johor Bahru. There was severe turbulence during the flight which made me feel very scared. My Student Selected Component (SSC) 1 which was 'Basic Statistics in Medical Research' started on 3 January. I and my SSC 1 teammate met our supervisor on that day. He gave us a few options for the SSC. We could either carry a questionnaire-based research project, or we could learn about the R statistical software. He gave us 2 days to think about that and make the decision. Later on that day, I asked the NUMed student office about the timetabled event on 11 January. They then told me that there would be no event on 11 January and that they mistakenly created the event in the timetable. I was so relieved to know that. On 5 January, I decided that for SSC 1, I would carry out a research project about the perception of medical students towards the SBA examinations in NUMed. Meanwhile, my teammate decided to have a course on the R software. On that night, I watched the movie Flatliners (2017). Around that time, I read the feedback report of the Stage 4 SBA examination. 15 students failed the examination this year. Much to my surprise, the pass threshold for this year was 55.81%, much higher compared to the pass thresholds for the past 5 years which were always between 51% and 53%. This made me feel a little worried of my results.

The results of the Stage 4 SBA examination was released on 9 January. I scored 68% in the examination. Although I didn't achieve my aim of 75%, I was still happy that I passed the examination, as this meant I could enjoy my SSC's and Electives without worrying about resitting the examination. On that afternoon, I went for lunch at KFC in Taman Perling, just to relive the memories of the examination day. On 10 January, I met my SSC 1 supervisor and showed him the questions I had created for the questionnaire in the research project. He then told me to arrange the questions in a professional looking format. Later on that day, NUMed informed me that for SSC 2, they had to reallocate me from 'Explorations into Primary Care' to 'Family Medicine' because the supervisor had pulled out. Since there would be two other students doing 'Family Medicine' as well, I would no longer be alone for SSC 2 and I was so happy about that. On 11 January, I brought my car to the Perodua Service Centre in Skudai for a service. On 12 January, I finished designing the questionnaire. My supervisor suggested that I pre-test the questionnaire to help identify any problems with it, but the pre-test cannot be done on NUMed students since this would lead to bias when they answer the questionnaire for real later.

To do the pre-test, I created a Google Forms version of the questionnaire and distributed the link to International Medical University (IMU) students through IMU Confessions Page. Later, a total of 14 IMU students completed the questionnaire without any problems. On 15 January, I created a data collection Excel spreadsheet to record the responses of the questionnaire. Later on that day, my supervisor contacted the NUMed Student Office and requested them to print the questionnaires for me. Then, the questionnaires were ready on 16 January. At that time, I found out that among the 15 students who failed the Stage 4 SBA examination, 13 were from NUMed. In comparison, only 1 NUMed student failed in the previous year. This was indirectly due to the 'security breach' of the Stage 3 SBA examination previously, and I felt quite sad. On that afternoon, I started distributing the questionnaires to a few of my friends and to a group of Stage 3 students. On 17 January, I distributed them to another group of Stage 3 students. As most Stage 4 students weren't doing their SSC 1 at the NUMed campus, I couldn't distribute the hard copies of the questionnaires to them. Instead, I sent them the links to the Google Forms version of the questionnaire. I continued distributing the questionnaires to a large group of Stage 5 students on 18 January and to the Stage 1 students during their lecture on 19 January.

On 20 January, I watched the movie Inception. In my opinion, it is the greatest movie of all time. On 22 January, I distributed the questionnaires to other groups of Stage 3 students. I met my supervisor on 23 January. He suggested that I learn about the R statistical software so that I could use it to perform statistical analysis on the data collected from the questionnaire. He then sent me some learning resource for R software. Finally, I distributed the questionnaires to the Stage 2 students during their lecture on 24 January and with that, the distribution was complete. A total of 180 students from all Stages answered the questionnaire. One thing I really enjoyed was the opportunity to meet students in other Stages when distributing the questionnaires. After that, I started reading up on the R software. The use of R software involves computer programming. The learning resource from my supervisor was rather difficult to understand, but I found another better resource on the internet. Soon, I understood the basics of R software, but there was still a lot I had to learn. On 25 January, I took my car to the Perodua Service Centre a 2nd time as the previous service was only partially complete.

I met my supervisor again on 26 January. He recommended a textbook on statistics for me to read up on various statistical tests. He also told me that he would be on leave from 29 to 31 January. On 29 January, I borrowed the statistics textbook from the NUMed library. The textbook had many chapters where each chapter was about a particular statistical test. However, the problem was that I didn't know which chapters I should focus on, as I had no idea which statistical tests were relevant for my research project, and I couldn't seek my supervisor's guidance during that few days as he was on leave. This meant I might have to read the entire book which comprised a few hundred pages. Apart from that, I also had to learn how to use the R software to perform those statistical tests. Worst of all, I didn't have much time left as the SSC 1 oral presentation was approaching. This made me feel very stressed. Luckily, the statistics textbook was written very well and I could understand it quite easily, which enabled me to finish reading most of the chapters within 3 days. By 31 January, I was quite sure which statistical tests I would be using. I also managed to learn the method to perform those statistical tests using the R software without much difficulties. On that night, there was a 'super blue blood moon', and I took photos of it.

February 2018:

On 1 February, my SSC 1 supervisor was back from his leave and I met him. After discussing with him, I decided that I would perform the statistical tests of Cronbach's Alpha and Analysis of Variance on the data collected from the questionnaire, using the R software. On that night, Newcastle University UK sent me the letter which I would use to apply for my UK visa. After doing the statistical tests, my research project was complete and I started designing my slides for the SSC 1 oral presentation. I would be presenting the findings of my research project during the oral presentation. Then, I started my application for the UK visa on 4 February. I filled up the information online, and I booked an appointment with VFS Global which would on 23 February. On 5 February, I met my supervisor again. He recommended that I make certain changes to my oral presentation slides, and I proceeded with making those changes. On 7 February, I had a practice session for the oral presentation with my SSC teammate, my supervisor and another lecturer. My supervisor was quite satisfied with my presentation, but he suggested that I make a few more changes to the slides. Immediately after that, I had another practice session with one of my friend who was doing a different SSC. I finalised my oral presentation slides and submitted it to NUMed on 8 February, one day before the deadline.

The last day of my SSC 1 was on 9 February. I and my teammate met our supervisor and we took photos together. My supervisor gave me a pass for all domains of my SSC 1 in-course assessment and his feedback for me was very positive. Later, I practised the oral presentation with my friend. On 10 February, I had dinner with another of my friend at Sushi Mentai in Bukit Indah. After dinner, we went to our friend's room at International Student Village to practise the oral presentation together. I then practised it once again on 11 February. On 12 February, it was the SSC 1 oral presentation. The briefing was supposed to start at 8AM. However, it was delayed by 30 minutes and venue was changed to another lecture theatre. While waiting, I became suspicious. Was NUMed going to tell us a bad news about the Stage 4 SBA examination? Thankfully, my suspicion wasn't true. During the oral presentation, everyone in the room was so interested with my topic which was about the perception of medical students towards the SBA examinations. As most other students did clinical SSC's, their presentations were about clinical topics. I performed the presentation quite well. Then during the questioning session, I was asked many questions by the students and examiners. I could answer most of the questions fairly well.

After the oral presentation, I registered for the NUMed Ball 2018. None of my friends were planning to attend it, partly because many of them would be doing the SSC 2 in their hometown so they wouldn't be in Johor Bahru at the time of the NUMed Ball. However, since I had missed the NUMed Ball 2017, I felt that I must attend the NUMed Ball 2018 no matter what, so I decided to attend it alone. On that afternoon, there was an ID session with the UK General Medical Council. They checked our passports and kept a record of that so that they would have our details if we apply for the UK Foundation Programme in the future. On 13 February, it was the start of my SSC 2 which was 'Family Medicine'. It was done at Klinik Kesihatan Mahmoodiah (KKM). NUMed required us to carry out an audit project during the SSC 2. I and my SSC 2 teammate met our supervisor on that morning and she told us to focus on the audit first. She said that diabetes, hypertension and asthma are commonly seen at KKM so we could do an audit on one of those diseases. I then met up with my teammates on 14 February to discuss about the audit project. Eventually, we decided to do an audit on the clinical monitoring of Type 2 Diabetes Mellitus patients at KKM.

On 15 February, I took a flight back to Kulim to celebrate the Chinese New Year. My cousins were in Kulim as well. At night on 16 February, they were watching Star Wars V: The Empire Strikes Back. I had never liked Star Wars previously, so I didn't join them from the start. However, I happened to come across a really exciting scene, so I decided to continue watching the movie with my cousins. It turned out that Star Wars V was a really good movie, and I wanted to find out what would happen in the next episode. On the following night, I watched Star Wars VI: Return of the Jedi with them. This movie was very good as well, but as it was very late at night, I only watched the first half. Throughout the Chinese New Year, I played Monopoly Deal with my cousins many times, but unfortunately, I never won even a single time. I flew back to Johor Bahru on 19 February. At that time, the selection for SSC 3 was open. All my selections were SSC's at James Cook University Hospital (JCUH) in Middlesbrough. JCUH was the only hospital in UK where university-managed accommodation was available. On 20, 21 and 22 February, I and my SSC 2 teammates performed data collection for our audit project. We looked the records of diabetes patients at KKM and made notes on that. I then transferred the data to an Excel spreadsheet. We had data for a total of 150 patients.

At night on 22 February, I took a flight to Subang Jaya. I went to the Ministry of Foreign Affairs in Putrajaya to collect my Certificate of Good Conduct in the morning on 23 February. On that afternoon, I went to VFS Global at Wisma MCA for my UK visa application. There, I submitted my passport and the supporting documents. Many of my NUMed friends were there as well. Later on that night, I met up with one of my Taylor's College friend at NU Sentral. On 24 February, I once again met up with another two of my Taylor's College friends at Restoran Nirwana Maju in USJ 9. My parents then drove me back to Johor Bahru on that afternoon. At that time, the data collection for the SSC 2 audit project was complete. On that week, I and my teammates spent some time interviewing some of the nurses and doctors at KKM to get additional information for the audit. On 25 February, when I was having lunch at Restoran Yasin near KKM, I coincidentally met a few of my friends who were doing another SSC at Hospital Sultanah Aminah, so I talked to them for a while. On 26 February, I had dinner with one of my friend at Sushi King in AEON Bukit Indah. The allocation for SSC 3 was out on 27 February. I got allocated my 1st choice which was 'Cardiothoracic Anaesthesia and Intensive Care' and I was quite happy about that. Another student would be doing the same SSC with me. On 28 February, I and my SSC 2 teammates used Excel to perform some analysis of the data collected in our audit project. The skills I gained from my SSC 1 was quite helpful in this.

March 2018:

On 1 March, I continued watching the second half of Star Wars VI: Return of the Jedi. At that time, I started writing the SSC 2 abstract based on the audit project. On 4 March, I and my teammates showed our supervisor the first draft of our abstract. She was quite satisfied with it and this marked the completion of the audit project. The focus for the remainder of SSC 2 would be on clinical activities. For the SSC 3, I had wanted to travel to UK with my friends. However, vast majority of them would be flying on 30 March which in my opinion was too rushed. They also planned to tour around Europe before the start of SSC 3, but I really had no interest in travelling to anywhere in Europe outside UK. Consequently, I decided to travel to UK on 12 April with my parents instead. On 5 March, my mother booked our flight tickets. Then on 6 March, my UK visa was ready and the courier wanted to deliver my passport together with the visa to my house in Subang Jaya. However, none of my family members were at home so I told the courier to try again on the next day. On that afternoon, NUMed sent an e-mail to inform that for the next academic year, the NUMed managed accommodation would no longer be at Horizon Residences, instead it would be moved to EcoNest. I had been staying at Horizon Residences for more than 3 years and I had a lot of memories there, so I felt very sad about having to leave that place.

On 7 March, my passport together with the UK visa was successfully delivered to my house in Subang Jaya. However, my mother noticed that the visa would only be valid starting from 13 April, but we would be flying to UK one day earlier on 12 April. I then remembered that I had put 13 April as my planned date of arrival when applying for the visa. After searching on Google, I found out that if I arrive UK before the visa is valid, I could be denied entry. As such, I had no choice but to ask my mother to reschedule the flight to 13 April. She had to pay a total of RM900 for the rescheduling. At that time, one of my SSC 2 teammate wanted to give a present to her previous SSC 1 supervisor, and my friend happened to be doing his SSC 2 with that supervisor. Therefore, my teammate handed the present to me and I passed it to my friend for him to deliver it to the supervisor. On 9 March, it was the NUMed Ball 2018. As I attended it without any friends, I was a bit worried that I might end up being in an awkward situation. But as it turns out, I really enjoyed the NUMed Ball 2018 and the awkward situation didn't materialise. There were still a few of my friends who attended it. The menu was really great, and I was truly immersed in the performances. Besides taking photos with my friends, I also took photos with many students that I didn't know previously, including the girl who got selected as the Prom Queen. One of my friend who didn't attend the ball was jealous after seeing my photo with the Prom Queen.

On 10 March, I watched the movie The Prestige. At that time, I wrote another version of the SSC 2 abstract as I wasn't sure about something. Later, after discussing with my teammates, I decided to stick to one of the versions. I also started doing the SSC 2 poster based on the audit project. Every day, I and my SSC 2 teammates would go to a particular department at KKM to observe the consultations. We also had the opportunity to perform certain procedures such as venepuncture, glucometer and HIV test. We went to Klinik Kesihatan Ibu dan Anak on 12 March, where we saw many Paediatrics and Obstetrics & Gynaecology cases. On 13 March, I telephoned the private clinic in Subang Jaya to confirm my Elective placement there. I then submitted the Elective confirmation to NUMed. I would be doing 'Primary Care' at that private clinic for both Elective 1 and Elective 2. On that night, one of my friend's car broke down at Petronas in Bukit Indah and he called me for help. I picked him up and sent him home. He got his car towed to the Perodua Service Centre in Skudai. On the 14 March, his car had been repaired and I sent him to the Perodua Service Centre to fetch his car.

Around that time, my friend often came to Horizon Residences to seek my guidance in doing his SSC 2 abstract and poster, as he was not very good at using Microsoft Office. One day, he told me that he was not able to get a placement for Elective 2 because of late application. As such, he wanted to do the Elective 2 with me at the private clinic in Subang Jaya. I was very happy that I wouldn't be alone for Elective 2. On 19 March, I made the payment for the accommodation at James Cook University Hospital in UK. On 21 March, I and my SSC 2 teammates met our supervisor and took photos together. The supervisor signed off my logbook and gave me a pass for all domains of my SSC 2 in-course assessment. After that, we gave some presents to our supervisor and the other staffs at KKM. The last day of SSC 2 was on 22 March. On that afternoon, I went for lunch with my teammates at Sedap Corner. On 23 March, it was my 23rd birthday. Many of my friends and family members wished me. One of my friend bought me a nice birthday cake and I really appreciated it. I went to AEON Bukit Indah and had Nando's for lunch. Initially, I wanted to watch the movie A Wrinkle in Time. But on a second thought, I didn't want my birthday mood to be affected by this movie which was likely going to be emotional. As such, I bought the movie ticket for the next day instead. On 24 March, I telephoned the private clinic in Subang Jaya to ask if my friend could do his Elective 2 there, and they agreed. On that afternoon, I watched A Wrinkle in Time at TGV Cinemas in AEON Bukit Indah.

At that time, my SSC 2 abstract and poster were nearing completion. I was still making some modifications as I aimed to get a score as high as possible. On 26 March, I took the formative Prescribing Safety Assessment (PSA) online. I used the British National Formulary (BNF) which is permitted during the PSA, and I could answer most of the questions. On 27 March, I went swimming at the Horizon Residences swimming pool. One of my friend walked by and she was surprised to see me. On that night, I did a bit of revision for the Written Skills Examination (WriSkE). As the WriSkE was just formative, I didn't take it too seriously. The WriSkE was on 28 March. The questions were actually not too difficult and I felt that I answered reasonably well. However, the marking of the WriSkE is really strict, where making certain mistakes would result in 0 mark for the entire question. On 29 March, I and my SSC 1 teammate met our supervisor because we forgot to let him sign off our logbooks previously. On that day, I finalised my SSC 2 abstract and poster and submitted them to NUMed. The submission deadline was at 12 noon on 30 March. Hours before the deadline, one of my friend telephoned me and asked for my guidance. Surprisingly, he had just started doing his SSC 2 abstract and poster. In the end, he was able to complete them just in time for the deadline. On 31 March, I and my friend had lunch together at a Hong Kong restaurant in Bukit Indah.

April 2018:

On 1 April, I moved out of Horizon Residences, and my parents drove me back to Subang Jaya. I felt very sad as I would never be returning to Horizon Residences again. On 3 April, I watched Pacific Rim: Uprising with my mother at MBO Cinemas in Subang Parade. NUMed approved my Elective placement on 5 April. At that time, I realised that by doing just the SSC 3 in UK, I would only be in UK for 6 weeks which is actually quite short. I started thinking, perhaps I should have chosen to do the Elective 1 in UK as well? If I inform NUMed right away, it might still be possible to make the change. However, after some consideration, I decided to stick with my original plan. I was worried that it would be difficult to adapt to the life in UK so I didn't want to be there for too long. I was also concerned about the need to arrange private accommodation as I likely wouldn't be offered an Elective at James Cook University Hospital. On 7 April, I went back to Kulim. I then returned to Subang Jaya on 10 April. On 11 April, the results of the formative PSA was released. I successfully passed it with a score of 92% and I was so happy about that. On that night, I met up with my Taylor's College friend at Whup Whup Cafe in Bandar Sunway. She had previously studied in UK for a year, so she shared with me some tips for living in UK. After that, I packed my luggage in preparation for my trip to UK.

I and my parents checked in our luggage at Kuala Lumpur International Airport (KLIA) on 12 April. I felt quite excited about my trip to UK. Early in the morning on 13 April, we took a taxi to KLIA. There, we had breakfast at Plaza Premium Lounge. At 9AM, we boarded Malaysia Airlines flight MH 4. The plane was a new A350 and I really liked it. For the 1st meal on the flight, I chose to have nasi lemak with chicken rendang. After the meal, I slept for a while. Then, I watched the movie All the Money in the World. We were served chocolates and chicken sandwich for snacks. I chose to have chicken satay with rice for the 2nd meal. At 4:40PM UK time, we landed at London Heathrow Airport Terminal 4. We had to wait for quite some time while clearing the immigration. Out of my expectation, the airport looked really underwhelming. At the airport, I bought a Three SIM card for use in UK. After that, we took a taxi to Ibis Hotel in London and stayed a night there. On the next morning, we had English breakfast at Ibis Hotel which was really tasty. We then took a train to Middlesbrough. After having fish and chips for lunch at Orchard Cafe, we took a taxi to James Cook University Hospital. I moved into Corby House which is the university-managed accommodation, and I met many of my NUMed friends who were also staying there. On that evening, I explored the area near Corby House. There were 2 grocery stores and 4 restaurants within walking distance. I bought my dinner at Peking Chef, a Chinese restaurant.

On 15 April, I and one of my friend travelled to Middlesbrough town centre. We initially planned to take a bus there, but we happened to meet one of our friend with his landlady, who offered us a ride in her car. In Middlesbrough town centre, I and my friend went shopping at Cleveland and had lunch at Banana Leaf Restaurant. On that day, I switched to my UK number for WhatsApp. Every NUMed student registered at James Cook University Hospital (JCUH) on 16 April. My 1st occupational health appointment was on that day, where I underwent blood test for tuberculosis. The doctor had difficulties taking my blood and he had to try a total of 3 times. On 17 April, my SSC 3 which was 'Cardiothoracic Anaesthesia and Intensive Care' started. As our supervisor was away on that day, I and my SSC 3 teammate met his colleague instead. He brought us to the cardiothoracic operation theatres. I then observed a case of coronary artery bypass surgery. There was a really nice anaesthetist who gave me a lot of guidance. On 18 April, the results of the SSC 1 oral presentation, SSC 2 poster & abstract and WriSkE were released. I passed all of them and I was very happy about that. For the SSC 1 oral presentation, I scored 6/10 for knowledge and 36/50 for skills. For the SSC 2 poster & abstract, I scored 34/40 for both knowledge and skills which was really high. For the WriSkE, I scored 73.7% which was a huge improvement compared to my score for the previous WriSkE in Stage 3.

On that day, there was a lecture on Cardiothoracic Anaesthesia and Intensive Care at JCUH and my supervisor told me and my teammate to attend it. The lecture was meant for specialist registrars and its content was really difficult, so I couldn't understand most of it. I went to the cardiothoracic intensive care unit on 19 April. On 20 April, I and my friend cooked chicken soup together for dinner. There was a lot of smoke from our cooking. When someone opened the door to the kitchen, the smoke escaped to the corridor and triggered the fire alarm there. The fire alarm was really loud and everyone in Corby House evacuated. Later, someone came and stopped the alarm. On 22 April, I and my friend cooked butter chicken together again. I created a WhatsApp group for all NUMed students who were doing the SSC 3 at JCUH on that day. On 23 April, I observed several cases of thoracic surgeries. However, the last case was really long and that made me feel very exhausted. Consequently, I no longer enjoyed my SSC 3 very much. The reason I had chosen to do 'Cardiothoracic Anaesthesia and Intensive Care' was because I was interested to learn about anaesthesia. I had known that anaesthesia is closely related to surgery, but I never expected that I had to spend so much time on surgery which I don't like. Worse still, after I returned to Corby House on that night, I received a warning letter from JCUH for the fire alarm incident previously.

Everyone in my unit had to meet the undergraduate medical education manager on 24 April due to the fire alarm incident. Each of us ended up paying a fine of £12.50. After that, I attended my 2nd occupational health appointment, where I was given the MMR vaccine. Later on that day, when I was observing a surgery, a surgeon asked me 'Are you more interested in anaesthesia or surgery?' and I answered 'Anaesthesia'. Then, another surgeon said 'You can tell, he doesn't like surgery at all.' I was quite embarrassed by his remark, although he was right. On 25 April, I met my SSC 3 supervisor. I observed a case of valve replacement surgery on that afternoon. On 26 April, my friend who was doing another SSC happened to be in the same operation theatre with me, so we took photos together. I went on a day trip to Whitby with my friend and two girls on 28 April. The girls were my group mates during the Stage 3 System-based Weeks previously, but I was never close to them due to my refusal to get out of my comfort zone to get to know them. I regretted the mistake, and I finally had the opportunity to correct it during the Whitby trip. I initiated conversations with them and pretty soon, we were having quite a lot of conversations. We visited Whitby Abbey, Whitby beach, Whitby Harbour, casinos, Cinder Track, Pannett Park and Whitby Museum. We had fish and chips for lunch at Silver Street Fisheries and had another light meal at Humble Pie and Mash. We met many other friends who also went to Whitby. Finally, we went shopping at Co-op. On 29 April, I and my friend bought pizza for dinner. After dinner, I watched the movie I, Tonya.

May 2018:

On 1 May, I and my friend cooked naan for dinner. I had an off day on 2 May and I played frisbee with several of my friends near Corby House on that evening. On 5 May, there was a formative clinical assessment at JCUH for the Stage 5 students of Newcastle University UK. Simulated patients were needed for the assessment and I volunteered to be one. On that afternoon, I watched the movie Black Panther online. I and my friend were planning to visit York on the next day, but he later cancelled the plan. On 6 May, another of my friend wanted to watch Avengers: Infinity War and he invited me to join him. I had wanted to watch this movie as soon as possible because many people were trying to spoil it. We watched it at Cineworld in Middlesbrough. On that night, I had dinner with my friend at Toby Carvery. 7 May was a bank holiday in UK. The Microsoft Build 2018 was on that day and I watched it online. Then, the Google I/O 2018 was on 8 May and I watched it as well. On 9 May, I and most NUMed students took group photos together with the staffs at JCUH. On that evening, I played frisbee with a few of my friends. After having pizza for dinner, I followed the 14th Malaysian General Election online. In the end, Pakatan Harapan won the election.

I received a certificate on 11 May for my participation in the formative clinical assessment earlier. On 12 May, I went on a day trip to Durham with my friend and the two girls. At that time, I had become quite close to the girls. We visited Durham Cathedral, St Chad’s College, Market Hall, Durham Castle, Durham University, Wharton Park and Clayport Library. We had fish and chips for lunch at Bells. We had wanted to walk to the beach, and Google Maps stated we could get there in 30 minutes. But after walking for a long time, the time to get there was still 25 minutes. Then, we realised it was the time needed to get there if we were taking a car. It would actually take 4 hours to walk there! We decided to go shopping in Durham instead. On 13 May, I and some NUMed students had a desserts potluck with a Foundation doctor at Durham House which was right next to Corby House. On 14 May, I and many NUMed students had a pizza and fried chicken party at Corby House. The fried chicken was ordered from Peri Peri Original Middlesbrough and it was really delicious. I started doing the SSC 3 e-portfolio on 15 May. On 16 and 17 May, I performed intravenous cannulation on a few patients at the operation theatre, which was part of my learning outcomes for the SSC 3.

On 18 May, I and my friend watched Deadpool 2 at Cineworld in Middlesbrough. Right after the movie, we met a man dressed in Deadpool's costume. Initially, I dared not approach the man to take photos with him, but my friend managed to convince me to do so. I then had dinner with my friend at Akbar's. The Indian food served there was very tasty. I travelled to York with my friend and another two girls on 19 May. We visited Yorkshire Museum, Museum Gardens, York Minster and Dean’s Park. We joined a tour where the tour guide took us to King’s Manor, York Art Gallery, Bootham Bar, York city wall, Shambles, Merchant Adventurers’ Hall and Clifford’s Tower. After that, we had lunch at Wok & Go and visited York's Chocolate Story, Shambles Market and National Railway Museum. On that night, I had dinner at Corby House with my friends after returning to Middlesbrough. On 20 May, I suddenly started feeling very weak. Later, I had diarrhea. I most probably was suffering from acute gastroenteritis. Due to my illness, I took a day off on 21 May. However, I still had to spend some time doing the SSC 3 e-portfolio. I felt better on 22 May so I could attend the operation theatre for half day. Then, I completed the SSC 3 e-portfolio on 23 May. On 24 May, I had recovered from my illness and that was my last day attending operation theatre.

On 25 May, it was the last day of SSC 3. I went to the cardiothoracic intensive care unit on that morning. Later, I met my supervisor. He signed off my logbook and gave me a pass for all domains of my SSC 3 e-portfolio and in-course assessment. I then took photos with my supervisor and teammate. On that afternoon, I and my friend went to Cineworld in Middlesbrough to watch Solo: A Star Wars Story. After that, we had dinner at Manjaros. On that night, I and another of my friend took a bus to London. We arrived Victoria Coach Station in the morning on 26 May. We visited Buckingham Palace, Westminster Abbey, Big Ben, London Eye and King’s College London. We went to Borough Market for lunch, where we had doughnut, Ethiopian marinated chicken, duck confit and ice-cream. Then, we visited London Bridge, Tower Bridge, Tower of London, Trafalgar Square, Leicester Square and Chinatown. In Chinatown, we had dinner at Ruyi Chinese Restaurant. On that night, we stayed at London Backpackers Hostel. On 27 May, we took a train to Cambridge in the morning. We met 2 other friends on the train. We visited Cambridge International Examinations (CIE), Emmanuel College and King’s College. We also joined the punting tour in Cambridge. After having lunch at The Copper Kettle, we visited Garret Hostel, King’s College, Clare College, Trinity College and Market Hill. In the evening, we returned to London and visited Earl's Court. There, we had dinner at Masala Indian Restaurant. We took a bus back to Middlesbrough on that night.

At that time, I was feeling quite regret for not doing the Elective 1 in UK. I was having a lot of fun with my friends in UK throughout SSC 3. Most of them would be doing their Electives in UK, but I would be returning to Malaysia instead, ending all the fun. Unfortunately, it was way too late for me to able to do the Elective 1 in UK. On 29 May, I went to Peri Peri Original Middlesbrough for lunch as I wanted to try the fried chicken again, but I mistakenly ordered roasted chicken instead. I and my friend had dinner at Toby Carvery once again on that night. On 30 May, I travelled to Newcastle with my friend and two girls. I followed them to Safestore where they stored their luggage. We then visited Life science centre, Chinatown and Eldon Square. We had lunch at KFC. After that, I separated with them at Eldon Square bus station and I felt quite sad about that. They were travelling to Amsterdam, Netherlands and they would return to Newcastle to do their Electives. Then, I visited Newcastle University, Newcastle Medical School and Royal Victoria Infirmary myself. After studying MBBS at NUMed Malaysia for so many years, I finally could see the Newcastle Medical School in UK. I took many selfies there. Later in the afternoon, I took a train back to Middlesbrough. I had the opportunity to take photos of the Tyne Bridge when the train passed by it. After arriving Middlesbrough, I walked around James Cook University Hospital (JCUH) and took several selfies. On 31 May, I went to McDonald's in Middlesbrough for lunch myself.

June 2018:

On 1 June, out of my expectation, a few persons who weren't NUMed students moved into my unit in Corby House. At that time, I was the only NUMed student staying in Corby House as all the others were travelling somewhere. I had lunch at Peri Peri Original Middlesbrough again and I correctly ordered fried chicken this time. On that afternoon, I packed my luggage as I would be returning to Malaysia on the next day. I went to Akbar's for dinner on that night. Suddenly, I realised that I had not bought any souvenirs in Middlesbrough. I tried walking around to get one, but unfortunately all the souvenir shops were closed. On 2 June, I moved out of Corby House. I felt very sad because I would never return to Corby House again. I had English breakfast at the JCUH cafeteria and took a train to London King's Cross Station. I then took the tube to London Heathrow Airport Terminal 4. I had lunch at Oriel Restaurant in the airport. At 9PM, I boarded Malaysia Airlines flight MH 1. Once again, it was a new A350 plane. For the 1st meal on the flight, I chose to have beef kerutup with rice. After the meal, I slept for several hours. Then, I chose to have nasi lemak with onion sambal for the 2nd meal. At 6PM Malaysia time on 3 June, I landed at Kuala Lumpur International Airport. My parents picked me at the airport and brought me for dinner. For several days after that, I was experiencing jet-lag.

Looking back, I didn't truly enjoy my SSC 3. My time throughout the SSC was largely spent on surgery instead of anaesthesia. During a surgery which often took a few hours, nothing would be going on in the anaesthetic room, so the only thing I could do was observe the surgery, which I find rather boring. Worst of all, I usually had to be at the operation theatre from 8AM to 5PM every day, which made me feel very tired. However, despite the shortcomings of my SSC 3, my experience in UK had been really great in overall, thanks to every one of my friends who were in UK with me. I was sure that I definitely made the right decision to go to UK for the SSC 3. I still regretted not doing the Elective 1 in UK. Therefore, I decided to continue using my UK number for WhatsApp until the end of Elective 1, just to give myself the feeling that I was still in UK. On 7 June, the pass list for Stage 4 was released. Before that, the results of every assessment in Stage 4 were already out and I had passed all of them. As such, this pass list was just meant to be a formality and I could check it while feeling completely relaxed, unlike the previous years. Surprisingly, only 2 NUMed students got the Merit award this year, and no one received the SSC Poster Prize. With that, I had actually completed Stage 4. However, NUMed considered the Electives to be still part of Stage 4, although it would be assessed only in Stage 5.

I had dinner with my family at Sofitel Hotel in Damansara on that night. On 9 June, I went back to Kulim. I gave my grandparents some of the souvenirs I bought in UK. I then returned to Subang Jaya on 10 June. On 11 June, it was the start of my Elective which was 'Primary Care' at the private clinic in Subang Jaya. For Elective 1, I was doing it alone. However, this wasn't a great problem for me since I was living at home with my family. Previously, I had done Family Medicine for my SSC 2 which is essentially the same as Primary Care. As NUMed encouraged us to do a range of different specialties for the SSC's and Elective, some of my friends questioned my decision to do Primary Care again for my Electives. But in my opinion, Primary Care is a very wide topic that encompasses Internal Medicine, Psychiatry, Obstetrics & Gynaecology, Paediatrics and Orthopaedics. As such, I was actually learning about multiple specialties in Primary Care, so doing Primary Care for both SSC 2 and the Electives wasn't really an issue. Every day, I would observe the consultations at the clinic, and my supervisor would sometimes let me perform certain procedures. Whenever there was an interesting case, she would explain to me about it. Unlike the SSC's, the in-course assessment for the Electives was just formative, with the exception of Professionalism. Therefore, my Elective was quite relaxing.

In the past, there often were IMU students doing their Electives at that clinic. My supervisor got so used to it that in a few occasions, she mistakenly introduced me as a 'medical student from IMU' to the patients. On 14 June, the FIFA World Cup 2018 started. My favourite teams in the FIFA World Cup were England, Australia and South Korea. One night, I had a weird dream about me going on an adventure in Penang. On 16 June, I watched Star Wars III: Revenge of the Sith. I went to 1 Utama shopping mall with my family on 18 June. I hadn't gone into this shopping mall for many years. On 23 June, I met up with my Taylor's College friends at Restoran Gold Chili in SS15. Then, I watched Star Wars IV: A New Hope on 24 June. By 27 June, Australia and South Korea had been eliminated from FIFA World Cup. Among my favourite teams, only England advanced to the knockout stage. My support towards England was particular strong, due to the fact that I just went to UK for my SSC 3 recently and there were many things I liked about UK.

July 2018:

I watched Star Wars VII: The Force Awakens on 1 July. I really liked this movie and I had become a huge Star Wars fan at that point. On 3 July, England played against Colombia in the round of 16 of the FIFA World Cup. England managed to win 4-3 after a penalty shoot-out. On 6 July, it was the last day of Elective 1. However, I was doing 'Primary Care' at the same private clinic for Elective 1 and Elective 2. If I had done my Elective 1 in UK, I would be travelling back to Malaysia at that time. Since the Elective 1 had ended, I switched back to my Malaysian number for WhatsApp. The match between England and Sweden in the quarter-finals of the FIFA World Cup was on 7 July and England won 2-0. On 8 July, I watched Star Wars VIII: The Last Jedi. On 9 July, my friend travelled to Subang Jaya and started his Elective 2 at the private clinic with me. England and Croatia played the semi-finals of the FIFA World Cup on 10 July. I had expected England to win without much difficulties, but much to my disappointment, Croatia defeated England 2-1. Worst of all, many Croatia fans kept teasing England. Consequently, I disliked Croatia.

Throughout the Elective 2, I and my friend had lunch together every day. I took him to Mr Rice Corner on 12 July and to Ooi Noodle House on 13 July. Both are my favourite restaurants in SS15 which I hadn't gone to for several years. On 14 July, I and my friend had bak kut teh at Samy & Tien Restaurant in Klang. My friend really liked the bak kut teh there and he said that it was the best he had ever tasted. On that night, England played with Belgium in the third place play-off of the FIFA World Cup and lost 0-2. The final match between France and Croatia was on 15 July. Eventually, Croatia lost 2-4 to France and I was quite happy about that. England ended up getting the 4th place in the FIFA World Cup 2018, which I felt was still a great achievement. I watched Rogue One: A Star Wars Story on 16 July. With that, I had watched every single Star Wars movie, except for Star Wars I and II which in my opinion aren't worth watching. On 16, 17 and 20 July, I met my cousins.

My friend's favourite place in Subang Jaya was SS15 and we often went there for lunch. This made my Elective 2 feel so much like when I was studying A Level at Taylor's College back then, where I had lunch with my friends in SS15 almost every day. Since the Elective Assignment would be assessed only in Stage 5, I planned to start doing it only when I begin Stage 5. On 25 July, NUMed informed us that it is now possible for international students to complete house officer training at University of Malaya Medical Centre and gain full registration with the UK General Medical Council. On 30 July, the only student who didn't pass the Stage 3 SBA resit examination in September 2017 passed her repeat year of Stage 3 successfully and I felt happy for her too. The Elective 2 officially ended on 3 August. My supervisor gave me a pass for all domains of my Elective in-course assessment. I and my friend then took photos with the supervisor. That marked the official end of Stage 4. I had 3 weeks of break before starting Stage 5.

Conclusions:

Stage 4 had definitely been a very interesting year for me. In the 1st semester, most of the topics involve understanding and application of knowledge instead of memorising. Personally, I like to learn by understanding, so I enjoyed the semester. In the 2nd semester, I was able to choose the topics for the SSC's and Electives based on my interests, so they were definitely enjoyable for me. I had a lot of interesting activities with my friends throughout Stage 4, especially in the 2nd semester. Unlike the other years of the MBBS course, Stage 4 was really smooth for me. Back in Stage 1, I nearly failed the in-course assignments; in Stage 2, I nearly failed the OSCE; in Stage 3, I almost failed the clinical assessments. But in Stage 4, I didn't face significant problems with any of the assessments. I didn't have to worry about failing throughout Stage 4, and I could finally consider myself as a good student.

I think Stage 4 is definitely the easiest year in the MBBS course. Most people agree that the SSC's and Electives in the 2nd semester are easy. However, many feel that the 1st semester is the most difficult semester in the course, due to the Stage 4 SBA examination. In my opinion, while this examination is difficult, it is nowhere close to being the most difficult examination, in fact it is relatively easy compared to other Stages' examinations. This may be thanks to my effective and consistent revision during the 1st semester. Stage 4 began with the 'security breach' incident, which no one would wish or seek to condone. But I have to say, the incident actually benefited me in the long term, as it boosted my enthusiasm for Stage 4. If the incident didn't happen, I might not have chosen to do my SSC 3 in UK, causing me to miss out on a lot of fun. In addition, I might fail the Stage 4 SBA examination, and the need to resit it would completely ruin my SSC's and Electives.

If you liked this story, you may want to read these too:

https://daniellimjj.blogspot.com/2020/10/my-5th-year-of-mbbs-course-at-numed.html

https://daniellimjj.blogspot.com/2017/08/my-3rd-year-of-mbbs-course-at-numed.html

For information about the MBBS course at NUMed, go to this link:

http://daniellimjj.blogspot.com/2017/07/information-about-mbbs-course-at-numed.html