Med Diaries

Wish Me Luck!

~ rachelleramilo ~ Leave a comment

Hello, guys! Just so you know, I am still alive. I was on hiatus for a while because internship got a little toxic. Yesterday was our graduation (my 7th graduation, grabe!) hence I have so much feels right now but then today’s my first day for board exam review so I’ll just have to set aside the kaartehan for now.

Okay, isang kaartehan lang please.

 

Friends since Day 1 of med school!
Andrew and the contra-titas
My constants during internship

Just wanted to say thank you for staying with me through clerkship until internship. Kasama ko parin sana kayo kapag licensed MD na ako this September. So, wish me luck! I smell a beauty kit giveaway soon!

 

Trying to keep the sanity,

Rach 💛

PS: Please, please include me and my friends in your prayers. Thank you, loves!

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On internship and wearing the white coat

~ rachelleramilo ~ 1 Comment

Hi, world! It’s been two months since my last post and this is a sign that this blog and its author are still alive!

What’s up with life lately? Well, post-graduate internship has started! I’m an intern now, meaning I am in my fifth (and last!) year on the road to becoming a licensed doctor.


All of us were really excited to wear our coats (lakas maka-aura!) but the tropical climate proves to be a challenge. For my group, first stop was two months in OB-GYN, which is already coming to an end in about a week.

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On scholarships, graduations, and finally getting a medical degree

~ rachelleramilo ~ 9 Comments

 

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When I decided to take that long and winding road to becoming a doctor, I had no idea about how much money and tears it would cost me (mostly tears for me) and my family.

First and foremost, I have always been my Lola’s (grandmother) scholar. She sent me, along with my brother and cousins to private schools in elementary and high school (except for me). I attended a public high school (with an outstanding science program) but she still supported all of us financially. Note that she was more than 70 years old at that time, but she still worked to help us achieve our goals. I was not pressured to study hard by anyone. Maybe I did my best to at least return the favor to my hard-working Lola and parents.

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Meet the best lola in the world, my wonder woman, Lola Dim
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Elementary graduation — yes, I am that chubby girl at the center (read about how I lost weight here). I was the Class Valedictorian.

During college in University of the Philippines Manila, I had a scholarship grant from the Department of Science and Technology (DOST) so I did not pay for tuition fees throughout those four years of education. I was lucky that my high school encouraged us students to apply for this particular scholarship because it really helped me. My Lola still supported us financially.

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During the UP Manila graduation (left) and College of Arts and Sciences recognition day (right) – I graduated with honors (cum laude). I can’t seem to find a high school graduation photo but I am proud to say that I was the Class Salutatorian.

Going into med school was a different story. After not being accepted by UP-PGH, I had to choose between University of the East Ramon Magsaysay Memorial Medical Center Inc. (UERMMMCI) and Pamantasan ng Lungsod ng Maynia (PLM). The former is a private school while the latter is government-subsidized. Going into PLM would mean less fees to pay for by my family but I just knew I would be happier in UERM. I was really selfish but I do not really regret this decision.

I was a University Entrance Scholar in UERM, meaning I did not have to pay for the tuition and miscellaneous fees for my freshman year. We literally saved about 250,000 pesos that year. The problem was that I overestimated my capabilities and underestimated the study of medicine. The effort I exerted during freshman year was so much more than how I studied from first grade to college combined. I did not understand why I just could not have an average of 88 (1.75 GPA) after all the late-night studying, missed day out with friends, and missed celebrations at home in the province. I would often call my parents in the middle of the night or past midnight just to cry and tell them how I was having a hard time meeting the required grade. If I won’t get a 1.75 GPA (1 being the highest), I would lose my full scholarship. To make things worse, we were having a financial crisis that year.

One night, I called my parents crying and my mom asked, “Gusto mo bang tumigil muna?” I know she only wanted what was best for me and the whole family but it really broke my heart. The thought of not being able to reach my dream despite all my hard work was killing me. I never thought poverty or not having too much money could actually hinder me from becoming a doctor. I felt hopeless; I thought that was the end for me. “Sana mayaman na lang kami,” I said to myself. There were so many questions in my head like, “Akala ko ba kapag masipag ka, walang imposible?”

Just when I thought everything was over, I had a call from my parents telling me that everything was going to be alright. During second year, I was a partial academic scholar (my average was 1.78 for first year, sayang talaga). It means I got a 50% discount on tuition fee. On top of that, the UERM Scholarship Committee gave me an additional grant which further decreased the amount we had to pay for. Lola Dim still supported me financially, and some of my aunts and uncles also helped. The same thing happened for my third year. That’s when I learned not to be hard on myself. I knew I did the best that I could and a partial academic scholarship was still a great help. I am very thankful for the financial and moral support I have received.

The transition from third year to fourth year was the hardest. I was really nervous because third year was the most difficult. I was not able to get an academic scholarship for the following year. But the transition was so hard to bear because Lola Dim passed away during my last month in third year. She was 89 years old. I always dreamed of the day she would see me graduate. I was devastated to hear the news that she would not be able to witness the fruit of all her hard work and selflessness.

Not having an academic scholarship was a great obstacle. But you know, there were a lot of people who were willing to help and give overflowing encouragements — the doctors from the scholarship committee, my sisters from the Sigma Beta Sorority, my brothers from the Beta Sigma Fraternity, friends, and of course, my parents, my family.

Today, I am writing this as Rachelle Carmona Ramilo, MD. I will forever be grateful to the institutions that helped me, and the people who have always believed in me. From saying “Sana mayaman na lang kami,” I now say “Sana makatulong rin ako sa iba sa hinaharap.”

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I really wish Lola Dim was there with me, Tatay, and Mami on the stage when I got my diploma (our diploma). I hope I made you proud, Lola. Maraming maraming salamat po.

Rachelle

Things I Learned From My Patients

~ rachelleramilo ~ Leave a comment

Hello, world! I am no longer a slave! JUST KIDDING. Clerkship (4th year of medical school) has been a year full of learning and extraordinary experiences. I gained a lot of practical knowledge and I can’t wait for the next chapter of this career that I chose.

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But before I completely move forward, I want to share with you what some of my patients taught me. Akala ko drama lang yung sinasabi nila na you learn from your patients pero totoo pala. You can learn about tuberculosis more effectively by actually seeing a patient with this disease and then reading about it on your textbook or journal articles. The patients won’t tell you about the technicality of their disease, obviously, but what I learned from them are lessons that are deeper than the things you could read in a medical book.

So, these are the things I learned from my patients, in chronological order of my rotation as a clinical clerk.

Surgery

During our rotation in Amang Rodriguez Hospital (Marikina), a woman stabbed by her husband was brought to the ER. I definitely learned to stitch the scalp (yes, she was stabbed on the head!!!). But most importantly, I will always keep in mind to marry a keeper. Girls, stay away from criminals, and criminals in the making. Katakot!

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Trying to make sense of the CT scan plates…
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This was taken in UERM Hospital during a surgical procedure.
Medicine

I had a very lovable elderly patient who was obese, with heart failure and chronic obstructive pulmonary disease (COPD). Whenever I see him, I couldn’t help but associate him with Santa Claus! If only he stopped smoking a long time ago, started living a healthy lifestyle, and became proactive in taking good care of himself, he may have been living a comfortable life without fear of whether or not he would be hospitalized again in the near future.

Psychiatry

Patients in a mental ward are still human beings, with emotions and an innate kindness in them. One time, we taught them how to make pastilles during one of their occupational therapies. They were so sweet, they even gave us some of their finished products.

Ophthalmology

My mom had a cataract operation in UERM (thanks to Dr Felarca and the whole department!). I’ll never forget how happy she was to be able to see the smallest details again, for example, a tiny dirt on my dress. Let’s appreciate the small things in life. How lucky are we that we can send text messages, appreciate Instagram photos, and read wonderful novels?

Otorhinolaryngology & Head and Neck Surgery

There are bad people everywhere. Some may even break into your house at night and stab you in the face if you try to stop them. Keep your house and neighborhood safer. Again, katakot!

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Equipped to look inside your ears. There was one patient with a cockroach stuck inside his ear. I KNOW.

Pediatrics

Looking back, I actually learned the most in this rotation. The most unforgettable is the five-year old boy who had Cerebral Palsy, a neurologic disorder. While he was still in the womb, his mother was advised that it was likely for the child to have a disorder (based on the ultrasound). She still chose to continue with the pregnancy and to give birth to him even if she had the chance to terminate it (at that stage it was still an option). I would say this kind of love is definitely unconditional. The mother was doing everything she can to provide the child with a comfortable life.

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Cute babies make work so much easier! (Photo taken and posted with permission from the mother)
Obstetrics and Gynecology

For me, the most memorable part of this rotation is when I was coaching mothers during labor. I’ll never forget this line we kept on telling them — “Hingang malalim, pigil, and push!” It must be really hard and painful for mothers to give birth. Dugo, pawis, at marami pa ang pinuhunan nila. Thanks, Mami, for pushing me out of your uterus, to be a part of this amazing planet.

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Delivery room — where babies are born (East Avenue Medical Center)
Dermatology

We had the option to choose two elective programs for one week each and I chose Dermatology twice. You may think this specialty is shallow and easy but it’s the complete opposite. Skin lesions usually look the same and you have to read a lot (and see a lot of patients) to be able to distinguish one disease from another. I interviewed one patient who had Psoriasis, and his whole body was covered in thick crusts. He was a hard-working man but his condition was preventing him from going to work (kasi nakakahiya raw). Diseases affecting the skin not only affect productivity but the mental health as well. Everybody deserves to be confident in his or her own skin (I swear this is not a sponsored post, haha).

Neurology

During my first day in the ward, there was this one patient who was always grumpy. I’ve never seen her smile the entire day. But then, she was diagnosed with a brain tumor so I completely understood. The following day, she was visited by friends and family. She was smiling the whole time they were there, even long after they were gone. She had a brain tumor and nobody in the entire hospital (or the entire world) was sure of what would exactly happen to her after her operation; but she seemed happy and hopeful. So, what are the key ingredients for a happy life? I guess family, friends, and optimism.

Community Medicine

While teaching barangay health workers in a health center in Rizal, one of them asked if drinking pineapple juice can decrease blood pressure. You see, most people in the province believe that if one is having symptoms due to increased blood pressure, he only needs a can of Del Monte pineapple juice to alleviate the symptoms and normalize his BP. There are so many misconceptions about health and medicine that hinder us from preventing common diseases. I think kids should be taught in school about the important things they should know about healthcare. Let’s debunk the myths at their level.

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Our group with the receptive barangay health workers

This would be longer if I’ll continue to talk about the changes I would like to be implemented in our healthcare and education systems so I’ll stop right here. I’m not an expert and I know  the people in charge are doing their best (well, hopefully).

And no, drinking pineapple juice is not enough to decrease one’s blood pressure. A healthy, active lifestyle can, with the aid of medications (depending on the individual).

There you have it, a preview of 12 months worth of education. Thank you, dear patients! In a few months, I will be starting with my post-graduate internship which for sure, would be another year full of learning and meaningful stories.

Take good care of your health because I don’t want to see you in the hospital!

♥

Rachelle

On nearing the quarter life, and the joy of doing what you love

~ rachelleramilo ~ 2 Comments

You may not know this, but I just turned 24 a few days ago. I used to associate this age to being old but now, ironically, I feel young. Although I have to admit, I fear turning 25 next year. I think by then there would be more pressure to act like a real adult. But you know what, before I even turn 25, I think I already experienced that quarter life crisis. Or maybe there’s another inner struggle about to happen in the future? Oh, God.

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Life in the Time of Diarrhea: Why I Got a Health Insurance

~ rachelleramilo ~ Leave a comment

Hello, guys! Are you still there? Well, I’m still here, back from an unexpected hiatus from blogging. I became suddenly drawn to hospital work and group exercises at Gold’s gym, and realized how medical clerkship (4th year in med school) can be actually fun and enjoyable. Why am I suddenly going to talk about health insurance, you may ask? I have “diarrhea” to thank for this blog entry, actually!

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The Long and Winding Road to M.D.

~ rachelleramilo ~ 58 Comments

I’d lie if I tell you that not once during med school have I thought of why I am here, or questioned myself if I made the right decision. Because I did, more than once, to be honest. Despite these few moments of doubt, I always seem to get back on track and continue with what I have started. But, looking back to my old self eight years ago, I wish someone had told me what it really takes for one to get that “MD” on his name.

I am done with the second month (out of twelve) of clerkship aka 4th year med school aka “being at the bottom of the food chain.” But before I tell you how I feel as a clinical clerk, you may want to be enlightened how I got here. So here it goes…

THE PREPARATION BEFORE MED SCHOOL

1. Finish a pre-med course.

It was during the application period for universities when I thought I cannot be a Civil Engineer, said to myself that I did not want to be an accountant (although I was a “Mathlete” throughout high school… Okay, don’t start laughing! It was actually cool to be good with numbers! Haha), and decided that I wanted to become a doctor.

My parents are not doctors so I asked around and a lot of reliable people told me that BIOLOGY IS THE BEST pre-med course. So I took their advice like a good child. But what the heck, it is not the best pre-med course! You know what the actual best option is? NURSING! But maybe, there is no such thing as the best pre-med course because each one has its own pros and cons. However, if I am going to send my children to medical school in the future (don’t worry, I will not force them), I would definitely suggest BS Nursing. Nurses have a good grasp of the basics in the hospital setting. They know some things about the patients’ medications, and they are familiar with a lot of diseases.

Throwback to April 2012 during the University and College of Arts & Sciences graduation ceremonies. 

Then, you ask me, “What if you have a college degree not related to life sciences at all?” If that’s the case, then you can still become a doctor. I know of med students who are Engineering, Business Administration, Fine Arts, and Clothing Technology graduates. Some med schools may just require them to take some classes in Chemistry and Biology before they consider their application. The bottom line is, if you want to become a doctor, go get a college degree!

2. Take the National Medical Admission Test aka NMAT.

All medical schools require this for admission. I knew I was going to med school so I took the exam during college, around 3rd year – December 2010. This test can be taken during April or December each year. Know more about NMAT here.

NOTE: If one happens to be admitted to an Intarmed program (UP-PGH, for example), then he won’t need a college degree. It’s a program where only two years of pre-medical education (versus the usual four years) is required. But I do think intarmed students are still required to take the NMAT to be eligible to continue with med school proper.

3. Apply to medical schools, of course.

I sent application forms to three schools — UP-PGH, UERMMMCI, and PLM. I got interviewed in PGH but was not included in the final list. I got in to both UERM and PLM. Why I chose UERM, maybe this deserves a different blog entry or you may just ask me personally if you’re about to apply or in the process of choosing. This is a very crucial step because each med school has a different culture and approach on teaching students. As for me, since first year, I’ve always felt that going to UERM is one of the best decisions in my life!

THE REAL DEAL: INSIDE MEDICAL SCHOOL

While some of my high school friends were moving in to a new place for work, I was moving to Quezon City where UERM was located. Four years of Biology? Check! Now on to a new adventure; I was so excited! Then that summer before med school started, I went home to the province, people found out I would be taking Medicine, and the follow-up question was…

About the time: How many more years would it take until you become a doctor?

The simple answer to this question is FIVE YEARS. The slightly complicated version? The first two years was devoted to reading, lectures, and some group discussions. In third year, we got to see and interview patients, and examine them with consent. The fourth year is spent in the hospital as clinical clerks. For 365 days as clinical clerks, we have the opportunity to learn as much as we can about the patients, their diseases, diagnosis, and the appropriate management. After the 4th year, we’ll get our “Doctor of Medicine” aka MD diploma. However, in the Philippines, before you can legally practice as a physician, you need to have a one-year internship experience and then pass the board exam. So technically, you are a doctor after 5 years of hard work and a passing board exam score.

So you’ve got the time to spare for medical school. You’re fine if you don’t see your parents, friends, or lover regularly. But you ask, why won’t you get to spend time with them? Because you have to study! I didn’t know this was a legitimate reason to skip parties and meetings with friends until I became a medical student… But, aside from the time, what else do you need?

You have got to give a lot more than five years worth of your life.

About the right attitude: One has got to have the desire and determination to become a doctor. Or if you have parents who will drag you into medical school. Or both. Those who do it for themselves may find it easier to just swallow the things they’ve got to do or the materials they’ve got to read. Kasi nga, it was your choice. If anything goes wrong like failing an exam or the whole semester, you can’t blame it on your parents or other people. Just please, don’t do it for the pogi points.

After one of our small group discussions…

Med school becomes more fun when spent with crazy groupmates!

About the money: In contrast to Jesse J’s Price Tag, it IS about the money. To send someone to medical school is an investment, an expensive one. I did not come from a rich family, so imagine the horror when I found out that one semester costs 120K to 130K pesos. And that’s only for the tuition! It was a good thing that my school is generous enough to offer scholarship programs (academic and financial aid) to qualified students. Other medical schools in the Philippines also offer scholarship programs but maybe not as generous as UERM. Meanwhile, med students in UP-PGH only pay about 50K per sem while those in Pamantasan ng Lungsod ng Maynila (PLM) pay between 10K to 70K per sem, depending on the student classification (based on academic standing and place of residency).

However, even with scholarship grants, med school still doesn’t come close to being cheap. You’d spend a lot of money for the gallons of coffee you’d drink, a hundred pieces of highlighter, stacks of bond papers, and liters of ink for printing. Add lodging and utility fees if you are not from Manila, just like me. Medicine really is an expensive path, no wonder why one consultation lasting for at least 10 minutes would cost about 500 pesos, or more!

I’m the type who can study in my room all day, with the help of instant or brewed coffee. But there are times, especially during exam week, when I can’t concentrate in my room anymore. So, I go out and it means spending so much on coffee!

I think this is the longest blog entry I have written so far. A lot has happened since I chose this path about seven or eight years ago. Medical school may have taken a lot from me — money, time, effort, and tears, but it is worth all of these sacrifices. I gained a lot of knowledge, experience, friends, and memories that money can’t buy. Also, I may be in my 4th year, but I know that I have a looong way to go. After board exam comes residency (three years for dermatology, five years for general surgery). So, how do I feel after two months of clerkship have passed? Grateful, that I have parents and family who are with me on this journey; and hopeful, that I may not get tired of the routine and continue to do and give my best in everything that I do.

So, who wants to be a doctor?