So long 2013 !

Praise the Lord for giving me -literally- the best year ever!

If we thought about every single moments which had already ensued during this year, Most of people in my class (Batch 2007/Class 2013) would profoundly agree : 2013 was remarkable. Reminiscing every great moments in 2013 :
- Year of graduation - Now,everyone officially calls you "Doc,...." -
- Year of vowing The Hippocratic Oath - The Oath that we hold until we demise, our ethical orders in every parts of our career -
- Year of passing Medical license's National Exam ( CBT and OSCE!)
- Year of starting the compulsory Internship(so-called-obligatory-community-services) year - a first milestone of our medical career, and this year is the first year that government raised our salary, isnt that great? -

For me, this year started with much hurdles. I lost my old rusty motorcycle. it is exquisitely old, so for some people who might get in the same shoes with me, perhaps they won't get bothered and simply just buy a new motorcycle or car. but for me, it has accompanied me during my hardest and finest time during my clerkship, so it brought so much memories. And also, since I took Elective in Germany last year, so I had tight schedule in order to catch up, hence I could graduate in similar time with most pupils in my class. well, dont ask me about my endeavour for that, I know I am not the brightest one,nor the luckiest, nor the most dilligent one, but I know the power of persistence and perseverance ;) . And modestly speaking, I learned that it is very necessary to plan every things accordingly and precisely. I consider : planning is part of making your dreams come true.

But this year also excruciatingly took me to another level of experience. Doing new and unexpected things would gladly gave so many perspectives. Bacpacking to Bali and Cirebon without any previous plan (decided 3 hours before flight) or any proper amount of clothes was crazy thing to do, but it was fun to travel spontaneously! Visiting so many places, not only common touristic places (London,Dubai,Oxford/Cambridge,or Scotland maybe?) but also the mundane places ( Bath, Stonehedge, Exeter,Devon or Truro,Cornwall), taught me about different culture and different people's way of life. Meeting new people from every parts of the world in The University of Oxford, Joining their eldest fraternity in medicine and academic, was a precious experience. And eventually, starting my internship year in Pariaman with great team and supervisor was such a blessing from Allah SWT

And I mulled every things above, and I decide,Ok...this year was splendid!

Well, there's still a dissapointment in my 2013 resolutions . I cancelled my Master (S-2) Application to Oxford this year. After pondering every possibilities and weighing on the pros and the cons very thoroughly, I decided it is better if I gave myself one year more to getting more working experiences and mulling everything again and again what I really want to do in my life. After all, the procrastination will not give me any further harm, beside,I am not in hurry,right?

But, I indoubtedly decide, 2013 is IMPECCABLE !

Thanks for everyone who already helped me to make it happen!

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Kriminalisasi Dokter

" Medicine is a science of uncertainty and an art of probability"

Begitulah pesan yang disampaikan oleh Sir William Osler - Dokter pendiri John Hopskin Medical School/Hospital,USA dan juga guru besar University of Oxford Medical School,UK - kepada para dokter seluruh dunia. Pesan itu bermakna bahwa ilmu kedokteran adalah sebuah ilmu dimana semua probabilitas dan kemungkinan bisa terjadi. Pesan ini mengingatkan kita bahwa Dokter bukan Tuhan, dan bahkan - walaupun sekarang - kita bisa membuat bayi tabung dan kloningan, memindahkan embrio ke rahim orang lain, dll, tapi masih banyak hal yang belum kita ketahui tentang tubuh manusia. Dan bahkan dengan pengobatan dan terapi secanggih apapun, atau menjalani guidelines yang paling precisely sekalipun, kematian pasien bisa sewaktu-waktu dokter hadapi. Seterampil dan seteliti apapun kita bekerja, adverse event sewaktu-waktu bisa datang.

Ada hal yang aneh ketika seorang dokter dituntut dengan tuduhan "malpraktek" ketika pasien meninggal walau sang dokter sudah mengobati pasien sesuai kapasitas dan kemampuannya yang paling maksimal. Baru-baru ini, dunia kedokteran dihebohkan oleh ditangkapnya dr.Ayu dkk di Manado atas tuduhan "malpraktik". dr Ayu ditangkap dengan tuduhan kelalaian sehingga menyebabkan seorang pasien ibu hamil yang baru dilakukan operasi, meninggal. Setelah dilihat, bahwa ternyata pasien itu mengalami emboli ketuban pasca operasi, yaitu suatu resiko setelah operasi yaitu terjadinya penggumpalan darah sehingga menyebabkan kematian pasien. Hal ini sangat jarang terjadi dan bahkan seorang ahli kedokteran yang paling mumpuni sekalipun tidak bisa memprediksi hal tersebut. Ini bisa terjadi kapan saja, dimana saja, di Manado, di Padang, di Jakarta, bahkan di luar negeri sekalipun.

Saya ingat saya pernah menyaksikan secara langsung kasus tersebut ketika saya menjalani night shift di Women Centre di John Radcliffe Hospital, Oxford,UK. Waktu itu pasien baru saja menjalani operasi Sectio Caesarian , dan tiba-tiba kondisi pasien memburuk. Waktu itu memang pasien memang berhasil diselamatkan ketika pasien langsung diperiksa CT pulmonary angiography (yang saya tidak yakin selalui available di Rumah sakit Umum di Indonesia) dan ditemukan embolus di paru nya. Tapi saya ingin saya tekankan, bahkan dengan standar pencegahan paling tinggi sekalipun ( Oxford University Hospital selalu melakukan deep vein thrombosis prevention dan sesuai WHO surgery check list), tetapi kasus ini tetap terjadi.

Para penuntut mengatakan bahwa Dr.Ayu seharusnya melakukan semua prosedur pemeriksaan sperti rontgen toraks, EKG, dll untuk pencegahan. Yang harus diingatkan bahwa kasus obstetri (kehamilan) adalah kasus emergensi dimana setiap detik berharga bagi keselamatan bayi dan ibu. Seorang dokter harus bertindak sangat cepat. dan saya ingatkan kembali, bahkan dengan pertimbangan, persiapan, dan pencegahan yang paling cermat sekalipun, kematian pasien bisa terjadi.

Terkadang dalam hati saya selalu berkata " Andaikan saja para "oknum" pengacara dan para wartawan yang suka menyudutkan para dokter, bisa merasakan SATU HARI SAJA menjadi dokter, maka akan mereka terdiam dan tidak sanggup untuk menuntut dokter". Bagaimana para dokter harus mengambil keputusan secepat kilat dalam suatu keadaan yang sangat darurat dan kemungkinan terburuk dari keputusan ini adalah hilangnya nyawa seorang manusia. Harusnya mereka merasakan "adrenaline rush" itu sehari saja, dan bisa lebih berEMPATI dengan para dokter, dan tidak hanya berusaha mencari-cari kesalahan dokter.

" Tidak ada satupun dokter yang berniat mematikan pasiennya". Untuk apa kami -para dokter- melalaikan tugas kami, jika ancaman dari kelalaian kami adalah kematian manusia. Seharusnya para petinggi hukum melihat Dokter bukan sebagai montir . Tidak seperti montir yang kita nilai adalah hasilnya (apakah mobil kita kembali baik apa tidak) , Dokter seharusnya dinilai berdasarkan prosesnya ( bagaimana proses tatalaksana pasien), bukan berdasarkan hasilnya (Mati atau tidak). Ingat ! ada campur tangan Tuhan dalam setiap kehidupan dan kematian manusia !

Lalu Kenapa kasus Dr. Ayu ini menjadi sesuatu yang krusial untuk kita ?

untuk para dokter - tentu saja - merupakan hal yang sangat krusial. Karena untuk pertama kalinya dalam sejarah dunia kedokteran Indonesia (dan dunia) , seorang dokter bisa DIPIDANAKAN (berarti masuk dalam ranah kriminal) karena kematian pasien. Hal ini bisa sangat fatal bagi kinerja kita ke depannya, karena apabila Mahkamah Agung (MA) menjatuhkan sanksi terhadap dr Ayu, maka ini akan menjadi yurisprudensi , yang menjadi dasar hukum sah kedepannya bagi sesorang untuk memenjarakan dokter jika pasien kita meninggal. Keputusan MA ini akan menjadi senjata ampuh bagi oknum untuk memeras dokter. Jika ini terjadi, jangan heran jika kedepannya, para polisi akan datang ke tempat praktek kita dan meringkus kita ke penjara.

Buat Masyarakat, hal ini juga tentu sangat krusial. Jika memang keputusan MA ini dijatuhkan. Maka akan terjadi defense mechanism besar-besaran oleh para dokter. Semua dokter akan menolak untuk melakukan tindakan emergensi karena takut untuk dipenjara apabila pasiennya meninggal (Siapa yang mau dipenjara untuk hal yang tidak bisa kita kendalikan seperti kematian manusia? ). dan pada akhirnya walau pasien itu bisa meyakinkan dokter setelah memohon-mohon, pasien itu harus menjalani semua pemeriksaan yang penting maupun tidak penting dalam keadaan emergensi, hanya karena sang dokter terlalu "paranoid", yang tentu akan menaikkan cost dari pengobatan tersebut. belum lagi hilangnya waktu berharga hanya untuk pemeriksaan yang tidak penting tersebut. Sebuah kerugian besar bagi masyarakat dan pemerintah

Kasus dr. Ayu bukan hanya masalah medis, ataupun hukum. tetapi ad
alah masalah kemanusiaan yang semua orang patut untuk memperhatikannya

* Tulisan ini adalah sebuah dukungan dari salah satu teman sejawat dari Sumatera Barat untuk dr.Ayu.dkk

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Oliver Twist

Baru baca novel Oliver Twist karya Charles Dickens

Novel klasik ini ditulis Charles Dickens pada abad ke-19 ketika masa2 revolusi Industri Inggris sedang berlangsung. Saat itu negara Inggris masih kalah maju dibanding Portugis dan Spanyol.

Di novel ini diceritakan bagaimana miskinnya rakyat Inggris di zaman dulu, dan bagaimana besarnya disparitas ekonomi antara bangsawan Inggris/politikus dibanding masyarakat Inggris kebanyakan

Dan kita ingat sekarang, Inggris merupakan negara adidaya di muka bumi, mungkin kita tidak menyangka bahwa zaman dahulu negara ini pernah menjadi negara miskin

Membaca novel ini,mengingatkan kita akan kondisi Indonesia zaman sekarang,terutama ketimpangan ekonomi.tpi entah kenapa, saya menjadi optimis, bahkan bangsa Inggris prnah menjalani kondisi segetir itu, bisa menjadi bangsa yang makmur. Kenapa Indonesia tidak?

GDP Indonesia saat ini sudah melewati GDP Belanda, bangsa penjajah kita dulu..

I once watched Bloomberg channel in Television and the expert told the outlook that , by 2035, Indonesia's GDP will surpass United Kingdom's GDP....

Di Alquran, dikatakan Allah berfirman bahwa Allah menggilirkan kesejahteraan pada bangsa2 di muka bumi ini...

Mungkin tahun2 berikutnya,kita lah yang menjadi negara adidaya..amin

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A Deathtrap for Doctors

We, Doctors, somehow made our own system nowadays become a "deathtrap" for us.

From the beginning of our medical course, We were always reminded by our predecessors and community that we are : the chosen one. the "GOD" or "GODDESS" - whatever its term - that implies we could do everything. We're genius. We're tough and strong. We're rich. We're professional.

We already passed the hardest exam only to get an opportunity to learn medicine. Either you are genuinely-omniscient or you are extremely prosperous from very-wealthy family (doctor's families, perhaps?) so you can get this highly privilege to get admitted to medical school. 

Then, we busied our self to learn "human". But most of us forgot to learn to become a "human". 

We considered our self as genius. so we considered us we know everything. so we are indeed humiliated to concede that there's something that we simply dont know. and as a human, it is pretty normal to not know something as long as we want to learn further, but No, we doctors. so we try to pretend and hence make or give wrong advice and considerations. and to make it worse, we laughed at those colleagues who admit that they didnt know. 

We considered our self as tough and strong person We made a system from the beginning, that no time for enjoying our own life. Did you remember, when we are in training being a junior doctor (dokter muda) or resident doctor, we forced our own body to work more than 100 hours/weeks and 32 hours-straight night shift twice or 3 times a week in hospital and the rest of hours outside hospital to study. and we forced more more further when we become a consultant, working day and night without thinking even one second that we wasted our precious time. we forgot to workout, to maintain our own body. we forgot to enjoy our once-time life.we buried our-self to make people become healthy, but we forgot to take care our health. and Why did we do that? We pursued of what? 

Perhaps it was due to considering our self as a wealthy people from well-off profession.Nonetheless, Doctors in our community is regarding as one of promising-gleaming-prosperous profession. We are simply rich. But no, in reality, in perspective of finance management, we are terribly poor. What the heck is it when our own medical council and medical school made a system so we have to pass an extremely expensive national exam called UKDI? What the heck is it if we want to re-new our medical license we must collect points (SKP), and in order to do that, we have to join many horrendously overpriced seminars and workshops where inclined mostly to be located in five stars hotel that boost the costs till millions bucks?? What the heck is it we should have ACLS/ATLS which costs almost 3 times our full monthly income as an intern doctor, to apply competitively whatever practical job in both public and private hospital ? What the heck is it we made a residency training as an unpaid job (and forgetting their services in hospital) and disparagingly weigh on that every doctors is rich, therefore 3-4 years without salary, would hardly raise an issue?Why we made those hurdles over us ? Why we make those system? and because everyone thought that we are rich, we bought fancy things ; a car (or some cars), luxurious clothes, ect only to declare we earned money that much. 

Practically, we made systems that suck our money and put us on a nearly poverty. 

Then because those system that I mentioned, we played dirty games with pharmacy (who mostly deliberately kiss our ass in the front, but stabbing our back) so we can afford that. and Man! we called it we are proffesional. 

We blamed Government over our situation nowadays, yes, it is utterly right that Government seems only put healthcare as political attraction rather than consider as an future investment. but deep down, we know, we partly also are responsible for making those system.

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Budaya Membaca

Dalam perjalanan pesawat dari Dubai ke Heathrow Airport,London, saya bersebelahan dengan seorang laki-laki berperawakan tinggi kekar, bertatto. Setelah pesawat take-off dia langsung memesan bir Heineken ke pramugari. Saya langsung berpikir "yah,..gua duduk sebelah preman nih..."

Tapi setelah itu dia mengambil alat elektronik sebesar tablet, dan membaca. Ternyata dia membaca sebuah buku dengan menggunakan pdf reader. Cukup aneh, karena kita tahu di Indonesia, jarang sekali orang bertampang preman membaca buku.

Perjalanan dari Dubai ke London yang memakan waktu 9 jam membuat saya bosan, sehingga saya memulai percakapan dengan penumpang sebelah. Ternyata dia sedang membaca buku "clash of civilization" Samuel Huntington. Sebuah buku yang menurut saya cukup berat untuk dibaca. Dan saya cukup terkesan dengan kemampuan membaca pria ini.

Tapi ternyata pria ini bukan lah satu-satunya orang yang gemar membaca.

Ketika saya naik kereta underground-tube (subway) di London, hampir semua orang di tube sedang membaca buku, apakah dengan pdf reader,atau buku,atau koran. Sangat sedikit saya lihat yang sedang mengobrol. Semuanya membaca. Bahkan sekali saya melihat pada saat bulan puasa,seorang bertampang arab memakai jas layaknya eksekutif muda, sedang membaca Al quran di dalam tube. Bisa kita bandingkan kalau kita naik KRL commuter line di Jakarta, rata-rata orang disana,kalau tidak tidur, pasti mengobrol.

Saya ingat waktu saya kuliah untuk program Elective di Oxford Medical School, hal yang sering didiskusikan oleh teman-teman saya adalah, "buku apa yang sedang kamu baca minggu ini?"

sangat jarang saya mendengar mereka bergosip, seringnya mereka malah saling mendiskusikan buku yang sedang mereka baca dan pendapat mereka tentang buku itu.

Budaya membaca ini mungkin yang membuat kita berbeda dengan negara maju

kadang, kita terlalu heboh bergosip atau eksis di social media mengupdate status sehingga kita lupa memperluas cakrawala dunia dengan membaca buku.

Budaya membaca mungkin akan menjadi kunci bagi kita untuk menjadi salah satu negara maju di dunia

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Next chapter of my life

Another chapter of my life will begin tomorrow....

Let me share this one-year-joyous-internship year with you...
My career as a doctor starts tomorrow..

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Re-born blog !!

I re-designed my blog!!

Since I have holiday until my internship year starts, so I tried to make something new, so this is my re-born personal website!!!

I started blogging when I was in Senior high, I started on friendster.com ( which the blog now is gone ; along with friendster death)

Then I wrote my silly personal writing in blogspot.com, I stop blogging when twitter astonishedly made me addictive. But, well, 140 characters sometimes is not sufficient enough to tell what is it in your mind.

But, now, I think I will start blogging again..

So this is it... My re-born blog!!

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Never failed : never tried anything new : never had success

Despair is a strong word.

Feeling that there is no hope. Feeling that whatever you did, will never be good enough to be a successful person. I have felt that feeling before. Actually many times.

Failure is also depressing. But one thing that that I am pretty sure about failure is everyone will got their own. So it's something that human will have to deal with. I like to read biography of famous person in order to see what problem they had before and how they cope the problem.
I personally like Thomas Alva Edison. He is a persistent guy. No matter how much he failed, he always wake up and try something new. I always amazed a persistent people.

anyway, I have a friend who works in London.
He is an Indonesian. he actually comes from Porsea, a very little village in North Sumatera.
I knew him because he initially worked in a Japanese company which my father worked there before he retired. one thing that you will firstly concluded about him is : he is a persistent person

He is a typical north sumatera-people : very straight forward-persistent-loudly speaking.

And his story is remarkable. He was actually only uptown boy from rural area in North Sumatera and magically became a downtown boy in London, the most vibrant metropolitan city in the world.

he was not as lucky as we are right now. Initially he was a very village boy. His father is only a farmer. But because his family is really nice to employee, he is hired by company. (My father company has electricity generator in Porsea). But his position was in the bottom of hierarchy. But no, he doesnt want to be that position forever. So, he worked really hard in company. Until his boss know his work and try to give him another position. He worked that hard Until no one will not notice his hard work. So he moved to headquarter office in Jakarta. During that time, he tried to take undergraduate degree and also still working in company.

He said how sad his story is during those periods. he had to wake up in the early morning so he could catch up at work punctually, then in the afternoon, he had to catch up bus so he can go to college. After studying in class and back home, he still had to finish the paper work or study, then wake up earlier tomorrow.It went again and again everyday.

Then he graduated. He want to continue his study into the next level, but he didnt have money. So he must get scholarship. He said he tried so many times persistently applied to many institution. Almost every institution.

He become despair, but no he said. He dont want to be an ordinary person.

Then there is Wesminster University in London. It offered him a scholarship, without thinking furthermore,he took that opportunity. Until he graduated as Master from Westminster University.

Now,he tried to apply to work in finance company in London.
United Kingdom economy now is not as bright as before. There is alot of unemployed people in England. So as non UK citizen- asian - short person, you have slight ( nearly impossible) chance to work in UK,particularly in London. But, he is a persistent guy

He applied to many companies in London, houndreds interviews, but no one want to hire him. But he doesnt lose hope. He still applied to every company in London, until one little company tried to hire him as a employee. Slowly he showed his work until now he is a finance manager in his company. He always joked about "from Porsea to London" .

He is now an executive in London. He afford salary that he could never imagine before. He even treated me to have lunch in a luxury Thai Restaurant in Trafalgar Square, centre of London, near Buckingham Palace, when I met him.

From nothing to something. It is a story worth to tell....

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Being an Oxford Elective Student part III

So, Why I decide Oxford ?

Well, first of All. it is Oxford. Without telling any word,everyone already know about Oxford.

but, to put it very bluntly, at the first time, my reason why I chose Oxford over its rivals ( Harvard or Cambridge) is simply because it is completely free. Like I posted before, Harvard charged you approximately USD 3500/month (totally ridiculuos), Cambridge charged 250+900 pounds for administration+accomodation fee. You could compare among them.

But free of charge is not enough for Oxford. They offer ; not only you will get opportunities to be trained in one of the best and greatest NHS teaching hospital in United Kingdom, but you will also get similar privilege as local Oxford students.

As an elective student, you will get your own College ( Green Templeton College), which is a good way to feel "Oxford vibrant". You will also can attend so many journal readings, lectures from many internationally-recognized proffesors from the best institution around the world, and get involved with a new-sophisticated treatment for patient. after finishing your Elective in Oxford, you could also be enrolled as a member in Oxford Medical Alumni (OMA) ( but you have to pay small amount of pounds for member's fee).

You will get a University Card which is very useful to visit many Colleges, Chapel, botanical garden, library, and museum which belongs to Oxford University , FREE of charge ( people usually have to pay each, if they want to visit them).

And those reason ensured me to apply for elective in University of Oxford. I knew this program is highly competitive. Oxford only accepts few students per year, but this program is irresistable.

But I must admit : University of Oxford Elective Program is very outstanding and excellent program. I did Proffesional Exchange in Germany last year, so I have comparison to work in developed country hospital, but Oxford is beyond. Beyond my expectation ,beyond all the things. The program is very well-organized, and they managed this program very seriously.

On my first day, Mrs.Carolyn Cook, The Oxford Medical School Elective Coordinator brought me to JR hospital, the place where I have to work and study during my Elective. she explained every single details. Furthermore, she gave me all stuffs that I probably need, hospital map, university card, security card ( so I can open the doors in my department in JR Hospital) ect. And she was almost available every time I need during my Elective.

I also met my supervisor, Dr. Paul Greig, an anaesthetist consultant. He was the one who open his door for me and made a cup of coffe on my first meeting. He discussed with me about my learning objectives ( I should give my objectives to Oxford Medical School before , what I want to learn,what I want to see) during my Electives. It is very rare because in Indonesia, No consultant would like to discuss " what student want to learn" to students. It is about compulsory lesson.

After he discussed my objectives, he arranged my timetable so I can get as many opprtunity as I can so I could fulfill my objectives. He then gave me the timetable, and once again, he brought me to see JR hospital, the OR,the ER, the scrub room,the changing room. Then we discussed again about anaesthetics. He also give me timetable for lecture and tutorial during my Elective.

What I really like about Elective in Oxford, their program is really well-organized. they never really let Elective student alone without nothing to do. There is always learning opportunity for elective student to enhance their knowledge and skills. And it is not just observeship program. they do let Elective students to have clinical exposure with many patients as much as They can. I did many intubations, IV cannula, putting LMA, all clinical skills. They emphasized also on basic sciences. every little thing we do in medicine has science reason on basis.

Oxford is also has an International environment. It seems like many people from every parts of the world study in Oxford. I remember, when I had formal dinner in my college, in my table, there are many various nations ; Indonesia,Malta, Australia, United States,Greece,China, Taiwan,Korea,Japan, India, Germany ect and we came from different background and different field of study. I know this is because my college is for Graduate Student and,most graduate student are non- UK citizen, but I like the international vibrant in Oxford.

Oxford city itself is simply beautiful. Many ancient buildings with long history along with UK beautiful scenery make Oxford as the city of dreaming spires. Some people considered Oxford people are typically-British-elite. They speak British English Received Pronunciation (RP), they talk in advanced vocabulary. Sometimes it is true, but beyond of that, Oxford is one of the best cities in United Kingdom, and it is a good place to learn English Culture and History.

Being an Oxford Elective Student, indoubtedly is an honour.

It is recommended program and every people should always consider to apply into this program...

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Being an Oxford Elective Student part II

"What is an Elective Program?"

Many, Many friends and colleguaes of me asked about that. They heard about me studying in Oxford, and many people would like to follow my step. I can say I am the first pioneer of person from my university ( or Indonesia?) to study medicine in Oxford and join this program. Some people ( who did not understand ) considered me going to UK only for traveling ( since I really like to explore foreign country). But I took this program for some reasons.

I understand "Elective" is not part of Indonesian medical education system. But it is a compulsary program for developed country (like United States,United Kingdom,ect) doctors before taking residency/housemanship. It is part of curriculum. So if I someday, want to be enrolled as a resident doctor in those countries, I should -at least- have had an Elective Program in my medical education history.

Taking residency abroad always be one of my choices. Residency in Indonesia is a bloody hell crazy system. You work in hospital more than 100 hours/week, 2-4 night shifts in a row, 32hours straight working hours, but you dont get paid by hospital. in fact you have to PAY to hospital. It is a forced-labor-system made by government. Moreover, we should talk about a daft junior-senior relationships. You literally dont have life outside hospital.Ridiculously, it is 180degree different in another country. Resident doctor is paid job, and the working hours is more friendly.

Well, eventhough I dont really like those Indonesian system, but actually I havent decided yet whether taking residency in Indonesia or not,because living outside Indonesia forever is not also my intention. I always want to go back to my home country. But well let it be one of my choices. And knowing that I have another option is really soothing.

Having an Elective programme is very necessary for someone who intend to take residency outside Indonesia. I have friend who now struggling to get residency in US, but he havent taken Electives. Now he desperately need them because he already graduated as a doctor long time ago. He now tried to get an "observeship" program instead of elective program in rural hospital in US. He has to pay alot of money for getting into the program eventhough actually observeship is way less appreciate than elective in terms of residency. It is because only few indonesian medical student know how important elective program is, but it was extremely late for them when they finally realize about that. The programme is also important to get LoR (Letter of Recommendation) from professor or supervisor. A good LoR from supervisor in good institution will definitely boost you Curriculum Vitae (CV).

It is also important for Indonesian medical students to take Elective at the end of his/her final year or before he/she join internship program. It is because ,there are alot of bursaries and travel grants offered by ministry of education for us, and it can only be accessed when you apply as a medical student. I applied DIKTI scholarship when I was a student, though I went to Oxford after finishing all rotations in Indonesia and passing national exam (UKDI). Most medical schools also only offer you an Elective placement when you applied as a medical student, hence, it is likely very important for Indonesian medical student to aware more about elective and searching which med school is best for their elective and apply as soon as possible, if they have a plan to take residency abroad.

University of Oxford Elective program itself, I admit, is undoubtedly very excellent. I will tell why I choose Oxford as my elective placement in the next chapter...

To be continued...

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Being an Oxford Elective Student part I

I've just arrived in Indonesia after I finished my Elective program in Oxford, England.

Well, first of all, without a doubt, University of Oxford Medical School is a good-internationally- recognised medical school. Medicine has been taught in Oxford since 13th century so we can imagine, How good they are to provide teaching in this area. and We rarely heard Indonesian studies in Oxford Medical School, albeit when I "declared" that I took my Elective in Oxford, Many people got impressed, amazed, even jealous about this special "infrequent" privilige to study medicine in Oxford like I got.

It actually started when my good friend, Dr. Oliver Quick invited me to come to his teaching hospital in Keele, Stoke on trent, UK. And because his invitation,I became wondered, whether there is an opportunity to be trained in highly-ranked international medical school like Harvard or Oxford. Then I started searching.

Harvard automatically were not my choices anymore when I read that you have to pay tuition fee USD 3500/month. But I become interested with Oxford because Oxford promised : not only their training is completely free, but they also stated that we have similar privilege with Oxford student. the program itself is highly competitive since Oxford only takes 50 persons worlwide per year to got accepted in this program ( compare with Harvard which accept 1000persons/year). So instead of applying to Keele ( or Harvard), I decided to apply to Oxford for Elective program.

I began to prepare all the requirements. TOEFL, Letters of recommendation ( I got from 2 proffesors in my medical school and also I attached letter from my boss in World Health Organization(WHO) when I worked with them),CV, transcript of academic, and writing an essay. My friend, Oliver were "insanely" really nice. not only he corrected my essay ( so it sounds more "British") but he also kindly offered to bring along all the documents to England so he could posted them from Keele to Oxford. it easier and cheaper. Huge gratitude for him.

Then, I got an email from Mrs. Carolyn Cook, Elective Coordinator in University of Oxford Medical school.She happily informed me that Oxford University already secured one place for me to able to be trained and study as an Oxford Elective student. but there is one issue.

Though Oxford didn't charged me for tuition fee, but Oxford can not provide financial assistance for airfare,living cost and UK Tier-4 visa ( which ridiculously very expensive). The invitation letter from Oxford University came, right before I would like to leave for Germany for IFMSA Professional exchange, my school program. These package from Oxford University remained untouched until I came back from Germany.

Then I started to think for searching scholarship. My medical school, Faculty of Medicine, Andalas University, indeed provides international travel grants for students. But since I just took international clinical rotation in Germany ( which I fully financially supported by my med school and Germany). I must be very greedy, if I took this grant for second time. So I started looking for scholarship from outside. I applied a proposal to Higher Education directorate (DIKTI) for scholarship. Then I got phone call from them for interview particularly about this program and how I got accepted in Oxford. Lucky me, and I am so grateful that Oxford has a good reputation, I got full scholarship from DIKTI based on HPEQ scheme!

Actually, HPEQ doesnt have a particular scheme for this program, but because this is Oxford university, they have willing to change the scheme, so it will fit to HPEQ program, only because it is Oxford. Despite they entailed more time to procceed, but eventually they commited to cover all the expenses .Very many thanks HPEQ and DIKTI!

Before departure, I was very busy with my final obligations in my medical school. Finishing my clinical rotations, preparing for national exam (UKDI). After I finished all obligations, I flew to United Kingdom for the first time to come to Oxford as a student, financially supported by DIKTI.

Anyway, I forgot to mention about how difficult I was before to get UK Tier 4 visa. I have to fly to Bali only to give my visa application because I hardly got an appointment in visa application centre in Jakarta. Moreover, my documents must be sent to UK embassy in Bangkok,ect. The proccess itself in my opinion is really tiring,time and money-consuming,and completely "bureaucrazy". Well, if you are non EEU or UK citizen, and have plan to apply for elective in Oxford, you MUST always thoroughly ponder visa application as your priority because in my academic year in Oxford, there is an elective student who must cancelled his coming to UK due to his visa is declined by United Kingdom Border Agency (UKBA)

But, because this visa hurdles, I felt how professional Oxford is for managing and maintaining its students. I got extremely a quick-rapid-fast response from Oxford medical school and also University. They contacted all authorities (UK embassy in Jakarta,UKBA manager in London,ect) they have to speed up my application proccess. They always assist their student and dont let their student to cope their problem alone. No wonder they got a prestigious reputation as a world class university.

then, finally I got UK visa.I distinctly remember ; I flew on Thursday from Jakarta in the early morning by Emirates. Stopped by in Dubai. I took my times there to have lunch in Restaurant and enjoying Dubai International airport : One of the luxurious airport in the world, they claimed. Funny, I met many Indonesian workers there, and Indonesian languange are easily heard there. Then I took second flight directly to Heathrow Airport, London.

Arriving in London for the first time was such a holly-gracely-cultural experience for me. I guess it is because I raised with many British Cultures ; famous five and all Enid Blyton Novels, Sherlock Holmes, The Beatles, Adele, One Direction. I remember I always said that one of cities that I want to visit before I die is London. And now dream comes true.

When I arrived in Heathrow,London,I think Heathrow airport is pretty similar like Schiphol airport in Amsterdam (I visited Amsterdam last spring). Huge, busy, but well-organized. When I wanted to pass UK border in Heathrow, due to having bad experience with UKBA and their bureaucracy, I prepared all the stuff I need. CAS, passport,insurance, even I brought all my hard documents in my bacpack, in case UKBA ask for that. I dont want to be a "double-checked-person". But no, my fear is not coming. Even the officer lady commended me for arranging all stuff very organized so it made the checking easier.

I took my luggage, took cash money from ATM (I only brought few pounds from Indonesia), and directly went to bus station in Heathrow. Many Indonesians and foreigners always think that Oxford University is only a university which located London. no, it is wrong. University of Oxford located in Oxford city, the old ancient city, one hour from London by bus. I drove to Oxford which X90 bus and I arrived safely in Oxford, stopped by in Headington Shop, a shopping centre in Headington hill, a place where John Radcliffe Hospital ( JR Hospital) and Oxford Clinical Medical School located. All shops were closed since it was already 9 pm, but because it is summer in England, The Sun still there. I called a taxi to JR Hospital ( only 6 pounds), took my flat key in main receptions, and pulled my massively huge luggage to my flat. I am extremely exhausted with long flight, so even outside still was eventide, and without changing clothes, I quickly hit the hay. Tomorrow I have to meet Carolyn for my orientation.

To be continued...

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God Bless the Broken Road : simple tips for broken hearted

I dont write about love.... usually....

Love and relationship is not my thing. I am completely suck with all these stuffs.I always consider that I must be the last person to whom someone would like to talk about relationship/love with.

People like family or even only so-called-friends always wandered about my love life. I always think that part of my life is secret. very personal. hidden.concealed. It must remain in the closet. I avoid to discuss this topic with strange people, it is exclusively only shared with someone that I consider very close to me.Beside, it is simply very hard for guy to share about his crush or love problem with people. Like I said before, it is just not my thing.

My thought deliberately changed when years and years I got more ages, and start my adult life. This topic is inevitable. and I start questioning this issues. It is pondered as important part of human being. It is a world citizen problem. Most songs persistently convey to us about love and relationship.

And there's one moment that I always avert, - Broken Heart -

Well, Relationship is hard, love is cruel, love is blind...
sometimes it is extremely funny, in the name of love, a hunky muscled guy could become a drama queen when his girlfriend broke the vow, or vice versa, a debilitated old lady could stand still very bravely and remained strong when her husband passed away due to brain cancer.

But the good news is : everyone would always get this feeling. Not once, but alot

Every people's hearts eventually would be broken when he/she start to commit a relationship with someone. it seems like when we love someone, we must sign a contract to be a broken hearted. It is a consequency to love someone. To got hurted by someone you loved.intentionally or unintentionally. Some people would rather to be alone so no one would hurt him/her that way.

When your heart is broken. Nothing seems interesting, no food looks appetizing. All you want to do is sleep, and drown yourself in your own sorrow. Your body is filled with a mixture of anger and sadness. " How could this have happened?” is all that crosses your mind.

You replay every moment of the relationship in your head, thinking of why it was so good, and what you wish you could go back in time and fix. "Is this my fault?"

and believe me, I know the feeling be betrayed by someone you loved. Lie.Betrayal. Affair.
There is no greater pain than the pain of betrayal. The pain hurts you so much, haunts your life and the only thing that you can do is letting go. And forgetting and forgiving your lover.

But here is the secret : There is time as a medicine. Time eventually will heal your pain.

Time will erase this feeling. Gradually all this bad feeling would go and you start forgiving. You will start another chapter of your stories. Some will take longer that someone else. But at the end. Time is the answer.

And one thing that I believe so much about Thee-on-Heaven promise :

God Bless the broken road.

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