My journey towards General Practice (Family Medicine)

Since I started studying Medicine in 2014, I kept being asked this question "What do you want to specialise in?" I had always found it a difficult question to answer. As a matter of fact, I found every specialty interesting in its own way. Choosing a particular specialty would mean that I would be out of touch with the other specialties. It would be quite boring if I could only do one specialty.

I was also told "Don't be a GP (General Practitioner). There's already too many GPs in our country, it's useless to become one. You should become a specialist instead." I never agreed with that statement. I firmly believed that as long as you genuinely want to contribute to the society, all doctors including GPs and specialists play a very important and noble role.

In fact, I found the job of GPs really great from my observations. General Practice is very broad. Being the first point of contact for patients, GPs get to see cases of all specialties. This is certainly more interesting than doing a specific specialty. I also value work-life balance very much. GPs certainly have much better work-life balance with more manageable workload and working hours compared to doctors in hospital-based practice.

In 2017, I finally understood that General Practice is actually a specialty on its own, which is also known as Family Medicine. We can specialise in General Practice, and I started considering it. I was aware that it's extremely competitive to get into a Master's programme for Family Medicine at public universities in Malaysia. Therefore, I thought of taking the Membership of the Royal College of General Practitioners (MRCGP) exam instead.

Throughout Year 3 to Year 5 of MBBS, I performed particularly well in the General Practice rotation compared to other hospital-based rotations. I also found myself learning much more efficiently in General Practice settings compared to hospital settings. During my Electives in Year 4 of MBBS, I chose to do General Practice. Meanwhile, many of my friends had little interest in General Practice.

In 2019, I realised that GPs have to regularly follow up patients with chronic conditions. I didn't have much interest in that, due to my style of studying Medicine which places huge emphasis on managing acute conditions and acute presentations of chronic conditions. During the End of Stage MOSLER for Year 5 of MBBS that year, there were several follow up cases for chronic conditions. I performed poorly in those cases and ended up failing the MOSLER and having to repeat Year 5.

I also found out that the MRCGP exam can only be taken as part of a General Practice specialty training programme in UK; it cannot be taken in Malaysia. Consequently, my interest in General Practice waned and I had a change of plan. I decided to take the Membership of the Royal Colleges of Physicians (MRCP) exam and pursue Internal Medicine instead. Just like General Practice, Internal Medicine is very broad and encompasses many specialties. Unlike MRCGP, the MRCP can be taken in Malaysia as a standalone qualification.

After I started House Officer training at Kluang hospital in 2021, I found out a harsh reality that Medical Officers (MO) and specialists in hospital-based practice in Malaysia have to routinely work continuous 33-hour on-calls lasting from 8AM till 5PM on the next day. Just imagine how tiring and stressful it is! As a result, I decided I most definitely don't want to do hospital-based practice, including Internal Medicine. That leaves General Practice as the only viable clinical specialty for me.

In October 2022, I discovered that the RCSI-UCD Malaysia Campus (RUMC) offers a General Practice specialty training programme known as the Malaysia-Ireland Training for Family Medicine (MInTFM), which incorporates the Membership of the Irish College of General Practitioners (MICGP) exam. This provides an alternative route for joining General Practice specialty training in Malaysia apart from the very competitive Master's programmes at public universities.

I was once again interested to specialise in General Practice and I seriously considered joining RUMC's MInTFM programme. Later in 2023, I found out that we are only allowed to join the MInTFM under the Ministry of Health's Hadiah Latihan Persekutuan (HLP) scheme; self funding isn't allowed. Only MOs working with the Ministry of Health are eligible for the HLP.

After completing House Officer training in January 2024, I worked as a MO in Internal Medicine at Kluang hospital. Although I had a high degree of theoretical interest in Internal Medicine, the 33-hour on-calls and heavy workload were totally unbearable for me. I desperately wanted out of it, hoping to move to a General Practice setting or to become a Medical Lecturer instead.

In June 2024, I got transferred to Klinik Kesihatan Sundar in Sarawak. That was my first time working in a General Practice setting. Sundar is a very secluded village. Although the work there was quite fun and relaxing, I was deeply troubled by the extreme isolation and difficult life at that place. I couldn't enjoy the job and I was constantly stressed and frustrated. I applied for Medical Lecturer posts at multiple universities, but all were unsuccessful.

Eventually in October 2024, I was transferred to Klinik Kesihatan Ibu dan Anak (KKIA) Limbang, another General Practice setting. KKIA Limbang is a total paradise, with supportive work environment, manageable workload and no on-calls, in the nice town of Limbang. I enjoy my work there so much and I make sure to show my fullest enthusiasm and dedication in my work. I always put in my time and efforts to communicate properly with every patient to address their concerns and expectations. I also realised that following up patients with chronic conditions is actually quite interesting.

I finally understood that General Practice is my true calling and I want to keep doing it in the future. With that, I set my minds on applying for RUMC's MInTFM programme. After my application was shortlisted, I took the Clinical Entrance Test on 21 January 2025 and attended the interview on 20 February 2025. On 26 February 2025, RUMC informed me that I was successful in the application. However, I may only join the MInTFM in July 2026, due to the fact that I am only eligible to apply for the HLP in the following year.

It marks a very significant milestone in my life, as this is my first time receiving an offer for a specialty training programme, even with the delayed start. I will still go ahead with completing the MRCP, as it too is very valuable for GPs. I look forward to my future career in General Practice (Family Medicine).

My 2025 Chinese New Year

I had a truly wonderful Chinese New Year in 2025. It surely is the best Chinese New Year I've had in the recent years. Just like in 2024, I went back to my hometown Kulim to celebrate Chinese New Year.

I'm working as a Medical Officer at Klinik Kesihatan Ibu dan Anak Limbang in Sarawak at that time. I had 16 days of holidays, from 25 January 2025 to 9 February 2025. It's the longest Chinese New Year break I've ever had.

24 January 2025:

It was my last day of work before the start of my Chinese New Year holidays. On that day, I and my colleagues had a photoshoot in front of the Chinese New Year decorations at Klinik Kesihatan Ibu dan Anak Limbang.

25 January 2025:

It was the start of my Chinese New Year holidays. On that morning, I went to Limbang airport and took a flight to Kota Kinabalu. The flight used a tiny Twin Otter plane. That was my first time taking a Twin Otter place. It was also my first time in Sabah.

After landing in Kota Kinabalu, I went to Queen Elizabeth Hospital to have a look. I then went to Imago Shopping Mall. There, I had lunch at Nando's. After lunch, I checked into Aeropod Suites at Tanjung Aru near the Kota Kinabalu International Airport. On that night, I had mala hotpot for dinner at 蜀天下老火锅.

26 January 2025:

I had nasi kandar for breakfast at Restoran Hameed Maju near Aeropod Suites. I then went to Kota Kinabalu International Airport to fly to Kuala Lumpur. I had my lunch at the airport. On the flight, I was served asam pedas fish with rice. I landed at Kuala Lumpur International Airport around 7PM.

My parents came to pick me up at the airport. We went for dinner at Old Western Cowboy Steak House in Taman Desa Petaling. After dinner, we went back to our house in Subang Jaya and I stayed a night there.

27 January 2025:

Around noon, my father took me to KL Sentral. There, we had lunch at Secret Recipe. After lunch, I boarded the ETS train to Bukit Mertajam. On the train, I ordered Nasi Lemak for my snack. I arrived Bukit Mertajam around 5:40PM.

My grandparents came to pick me up at the train station. We had bak kut teh for dinner at 老乡肉骨茶. After dinner, we went to see the Chinese New Year decorations in Bukit Mertajam town before going back to our house in Kulim.

28 January 2025:

It was the Chinese New Year's Eve. On that morning, I and my grandparents went to the Lunas Food Court to collect the roast pork which my grandmother ordered earlier. We then had dim sum for breakfast at 富二代 in Bukit Mertajam. That was my first time dining at that restaurant as it hadn't opened the last time I went back.

After breakfast, we went to AEON Mall Bukit Mertajam for some shopping. My grandparents bought some new clothes and shoes at UNIQLO and Skechers. We then returned home. For lunch, we had roast pork and steamed chicken at home. 

Later, I helped my grandmother with the preparations for dinner. On that night, I and my grandparents had steamboat at home for the Chinese New Year's Eve dinner. After dinner, we went to Kulim town to look at the Chinese New Year decorations. There's a new area near Kulim Central with many beautiful shops.

29 January 2025:

It was the 1st day of Chinese New Year. My grandparents gave me angpows on that morning. We went to Kulim Central and had breakfast at Texas Chicken. After breakfast, we walked around Kulim Central and my grandparents took a Chinese New Year photoshoot.

On that afternoon, we went to the Bukit Mertajam train station to pick up my parents who were coming back to Kulim on that day. My parents gave me angpows too. We then went the nearby Bandar Perda to have a look. After returning home, we had cappuccino using the new coffee maker machine at our house.

Once again, I helped my grandmother in preparing for dinner. On that night, I, my grandparents and my parents had another round of steamboat at home. After dinner, I prepared and served lychee drink for everyone.

30 January 2025:

It was the 2nd day of Chinese New Year. On that morning, I and my family went to the 广福宫斗母宫 temple in Kulim to pray. The last time I prayed there was during the Chinese New Year in 2020. After that, we had roast duck and pipa duck for breakfast at Lunas Food Court.

After breakfast, we went to Karangan. I hadn't been to Karangan for so many years. There's Klinik Kesihatan Merbau Pulas in Karangan. I had previously compared Karangan to Sundar in Sarawak. As it turned out, Karangan actually looks much better than Sundar.

In the afternoon, we had noodle soup with roast pork at home for lunch. On that night, we went to AutoCity Juru and had Nando's for dinner. After dinner, I wanted to have ice-cream at Häagen Dazs, only to find that it had closed down, even though it was still there just a year ago. We then went to Baskin Robbins instead.

31 January 2025:

It was the 3rd day of Chinese New Year. I and my family initially wanted to go to 榕树下饭店 for breakfast, but there were too many customers which meant having to wait for a very long time. Therefore, we changed the plan and went for hokkien mee at 亚丝福建面. That's one of the best hokkien mee ever.

After breakfast, we wanted to get roti benggali. However, the shop selling roti benggali in Bukit Mertajam had moved, and we couldn't find the shop in the new location no matter how we tried. We then went to Kedai Makan Pokok Buluh, where I bought curry fish and fried chicken for lunch. We also went to Minat Supermarket in Kulim. I had lots of childhood memories there.

On that evening, I and my parents went to Penang. The last time I went to Penang was in December 2020. We visited my maternal grandmother's house. We then went to the Penang Sports Club, where we had dinner with our relatives. My aunt bought me my favourite Phong Pneah from Ghee Hiang Bakery in Penang. The RCSI-UCD Malaysia Campus was just nearby and I could take a look at it. 

While I and my parents were in Penang, my grandparents had nasi lemak for dinner in Kulim. They left a small packet of nasi lemak for me, and I had it for my supper after returning to Kulim.

1 February 2025:

It was the 4th day of Chinese New Year. I and my family went to Restoran Yang Way in Butterworth for breakfast. There was a famous duck soup noodle stall there, but unfortunately it was closed. My grandparents and my parents had chee cheong fun there, while I just had kaya and butter toast as I don't eat chee cheong fun.

We then went to the neighbouring Kuan Nan Coffee Shop. There was another stall selling duck soup noodle there. It was open and I had it. After breakfast, I drove my family through the Butterworth Outer Ring Road, a new highway which we had never taken before. We passed through Penang Sentral, which I took a bus there when returning to Kulim for Chinese New Year in 2024.

After that, we went to Kepala Batas. Universiti Sains Malaysia had set up a new Advanced Medical and Dental Institute there. On our way home, we bought apam balik at a stall in Bukit Mertajam. My grandmother made steamed fish for lunch. We had planned to have dinner at Hilltop Thai Tomyam Restaurant in Bukit Mertajam on that night, so I called the restaurant to reserve a table.

However, it turned out that I had mistakenly called the neighbouring Tok Tok Restaurant, not realising they were two separate restaurants. As a result, we decided to have dinner at Tok Tok Restaurant instead. Tok Tok Restaurant serves Sichuan-style food and it's quite unique. During the dinner, we also celebrated my grandfather's birthday. My parents bought him a cake.

2 February 2025:

On that morning, I and my family had yam rice for breakfast at Sentosa Corner in Bukit Mertajam. It's the best yam rice ever.

After breakfast, I and my parents drove back to Subang Jaya. The traffic along the North-South Expressway was quite heavy and our journey took more than 7 hours. We stopped at the Ulu Bernam R&R, where I had the Yik Mun Pau. It's my childhood favourite and I last had it many years ago.

We had planned to have dinner at Fatty Crab, only to find it closed on that day. We then went to The Ship for dinner instead. After dinner, we went back to our house in Subang Jaya.

3 February 2025:

My parents took me to University of Malaya Medical Centre on that morning. After that, we also went to the Faculty of Medicine of Universiti Kebangsaan Malaysia to have a look. Later, we had lunch at Restoran Sin Leong Huat in Subang Jaya. We also had yee sang during lunch.

On that evening, I met up with my friend at Sunway Pyramid. We had a hotpot dinner at Wagyu More. We did a lot of catching up.

4 February 2025:

I just stayed at home in Subang Jaya for the whole day on that day. I ordered food delivery for my lunch. I also did revision for my upcoming MRCP Part 2 exam. On that night, I and my family had steamboat for dinner at home.

5 February 2025:

My mother brought me for breakfast at Kayu Nasi Kandar in USJ Taipan. In the afternoon, we had lunch at Nikonhai Japanese Restaurant in Kota Kemuning. After that, I went swimming in the swimming pool of my apartment.

On that day, I was informed by RCSI-UCD Malaysia Campus that I had successfully passed the Clinical Entrance Test which I took on 21 January 2025 as part of my application for the MInTFM programme and that I had been shortlisted for an interview on 20 February 2025.

I met up with my friend again in the evening and we went to Pavilion Bukit Jalil. We had dinner at 农耕记. This restaurant serves Hunan-style food, which is a bit similar to what I had at Tok Tok Restaurant a few days ago. After dinner, I brought my friend to visit my house in Subang Jaya.

6 February 2025:

I and my mother had breakfast at Kaw Kaw Pakkopi in USJ Taipan. Later, we had lunch at Lim Fried Chicken in SS15, which is one of my favourite restaurants. On that evening, I and my family went to Fatty Crab for dinner. It's finally open this time.

7 February 2025:

My mother had planned to bring me for American breakfast at Peppercorn Cafe in SS15. However, it was closed on that day. We then went to the nearby Ooi Noodle House. It's one of the best pork noodles.

On that afternoon, I and my parents went to Kuala Lumpur International Airport and took a flight to Kota Kinabalu. On the flight, I had Korean chicken with steamed rice. After arriving in Kota Kinabalu, we had dinner at Welcome Seafood Restaurant. We then stayed a night at Pan Borneo Hotel in Putatan.

8 February 2025:

Early in the morning, I and my parents took a flight to Limbang. Once again, it was a Twin Otter plane. That was the first time my parents went to Limbang and I brought them around the place. We had breakfast at Thien Thien Chicken Rice, my favourite chicken rice in Limbang. We also visited Limbang Plaza.

Later, we had lunch at D'SOUP. My mother really liked the Sarawak Laksa there. We then went to the newly open MK Hypermart. On that evening, we had dinner at Crystal Palace Seafood Restaurant. We stayed together at the house I rented in Limbang for a night.

9 February 2025:

I and my parents had breakfast at Buffalo Corner Food Court in Limbang Plaza on that morning. In the afternoon, I drove my parents to Lawas, passing through the Temburong district of Brunei on our journey. We stopped at Ya-Nur Restaurant in Temburong for lunch. I had chicken briyani there.

I brought my parents to Sundar to let them see the place. I had previously worked at Klinik Kesihatan Sundar. We arrived Lawas around 5PM and checked into Hotel Perdana. We went to Lawas Supermarket before having dinner at the nearby Hao Wei Restaurant, my favourite restaurant in Lawas.

10 February 2025:

Early in the morning, I drove from Lawas back to Limbang, once again passing through the Temburong district of Brunei. I arrived Klinik Kesihatan Ibu dan Anak Limbang at 8AM and began my work. That marked the end of my Chinese New Year holidays. My parents flew from Lawas to Kota Kinabalu on that afternoon and they would fly back to Kuala Lumpur on the following day.

I celebrated my Chinese New Year across 13 cities, Limbang, Kota Kinabalu, Subang Jaya, Kuala Lumpur, Kulim, Bukit Mertajam, Butterworth, Penang, Damansara, Shah Alam, Petaling Jaya, Temburong and Lawas, which made it really remarkable!

If you liked this story, you may want to read this too:
https://www.daniellimjj.com/2024/03/my-2024-chinese-new-year.html

My bittersweet journey in 2024

At the start of 2024, I had high hopes for the year. I was looking forward so much to pursuing Medical Education after finally completing my House Officer training which took 2 years and 4 months.

Unfortunately, I soon found out the harsh reality that I have to work as a Medical Officer (MO) to fulfill my compulsory service with the Ministry of Health (MOH) before I can leave to pursue Medical Education. Most medical schools in Malaysia also require their lecturers to have a postgraduate qualification such as MRCP, which I didn't have.

From January to May 2024, I had to work at the Medical (Internal Medicine) department of Kluang hospital. Although I have a strong theoretical interest in Internal Medicine, the very heavy workload at the Medical department made me really stressed. The worst part was the grueling 33-hour on-call shifts, which I hated so much. I didn't even have time to study for the MRCP(UK) Part 1.

I then got transferred to Sarawak on 27 May 2024. From June to October 2024, I worked at Klinik Kesihatan Sundar (KK Sundar). Although the work at KK Sundar is quite relaxing with a lot of free time every day, Sundar is a very secluded village, with the nearest Lawas town 30km away. The infrastructure in Sundar is so poor, with horrible living quarters and routine electricity and mobile network outages.

Since the very beginning, I didn't like Sundar. The extreme isolation made life quite challenging for me. Consequently, I was often stressed and unhappy. I kept complaining about everything. I looked forward so much to leaving after completing my compulsory service. The only silver lining was that the relaxing work at KK Sundar gave me plenty of time to study for the MRCP(UK) Part 1. I registered for the MRCP(UK) Part 1 exam on 8 June 2024.

On 19 July 2024, a vacancy for a Fixed-term Clinical Lecturer post was open. This post doesn't require any postgraduate qualifications, not even MRCP Part 1. I quickly submitted my application for the Clinical Lecturer post on 20 July 2024. I was confident that I would be the favourite candidate for the post, considering my experience and enthusiasm in teaching.

Even though MRCP Part 1 wasn't a requirement for the post, I still continued studying for it wholeheartedly. On 14 August 2024, I took the MRCP(UK) Part 1 exam. Coincidentally, that day was also the application deadline for the Fixed-term Clinical Lecturer post. I was confident that I would get a positive outcome within a few days. But 2 weeks later, I still didn't hear anything.

On 6 September 2024, I completed 1 year of compulsory service with the MOH, which supposedly would make me eligible to apply for exemption from further compulsory service. However, a few of my friends told me a bad news that effective 14 August 2024, the MOH no longer allows shortening of the compulsory service to 1 year; every one must complete 2 years of compulsory service, with the sole exception of those who got a lecturer post at a public university. That meant I couldn't join the Fixed-term Clinical Lecturer post even if I got it, since the post is at a private university.

I did a quick search and found a vacancy for a DU51P Trainee Medical Lecturer post at a public university, with its application deadline on 8 September 2024. I quickly submitted the application on 6 September 2024 itself. On 9 September 2024, I received confirmation that I wasn't selected for the Fixed-term Clinical Lecturer post; no reason was given for that.

On 13 September 2024, my MRCP(UK) Part 1 results was released and I passed it. I promptly updated it to the public university. On 17 September 2024, I was shortlisted for an interview for the DU51P Trainee Medical Lecturer post. The interview was held on 19 September 2024. It was particularly important, being my last chance to leave Sundar and pursue my Medical Education dream.

Unfortunately, despite all my efforts, I was informed on 24 September 2024 that I was unsuccessful in the interview. That didn't just mean I failed to secure the DU51P Trainee Medical Lecturer post, it also meant I would have to continue working at KK Sundar for another year till 6 September 2025, due to MOH's latest rules on the compulsory service.

I was deeply frustrated, affecting my emotional wellbeing and my enthusiasm for the job. It's clearly not productive for me to keep working in KK Sundar. My colleagues then suggested for me to be transferred to somewhere more urban.

At that time, Klinik Kesihatan Ibu dan Anak Limbang (KKIA Limbang) was looking for a new MO to take charge of the tuberculosis clinic. Since I had passed the MRCP(UK) Part 1 exam which demonstrated my good knowledge in Internal Medicine, I became a good candidate for it. On 7 October 2024, I was offered to transfer to KKIA Limbang, which I gladly accepted.

I started working at KKIA Limbang on 28 October 2024. Limbang is a nice town similar to Kluang. KKIA Limbang has a supportive work environment, with manageable workload and no on-calls. It's very much like what I envisioned about working as a doctor, back when I first decided to do Medicine. I am finally enjoying both my work and personal life now.

As 2024 ends, I am still unable to achieve my Medical Education dream. But what I have got now, feels like an acceptable start, and I am grateful about it.