I didn't get registered- yet

Dear Doctor Mohamed Tarmizi,
Thank you for your email.
I’m writing to advise that your application has not been approved at this stage, due to the fact that your IELTS results do not meet the criteria of the current English language proficiency policy. The policy requires that a score of at least 7.0 be achieved in each of the four categories in order to qualify. I have attached a copy of the policy document for your reference.
Before your application for registration can proceed, you will need to re-sit and pass all four components of the IELTS exam.
If you have any further queries regarding this matter, please contact the Registrations Department.
Yours sincerely,
Registrations Officer

It is certainly another sad day for me. My results were considered not good enough for the Australians. FYI, I got 7.5,7.5,6.5 and 9 (full marks) for IELTS. It seems the 6.5 (short of 0.5 for writing was considered a failure). I am certainly “malas” to take the exams again. It is not cheap. I was hoping they would reconsider and make exemptions but unfortunately NOT. May be a 6.5 (for writing) could not assure patient's safety.?.?

Labuan- the 'Forgotten' FT

Once again, I am here to cover the hospital for a few days. We try to come here once a month from Sabah but we don’t have many specialists to juggle around with nowadays. I think Labuan, being part of the Federal Territory should be frequently visited by the so called many ‘I never come out from KL’ specialists from Semenanjung (i.e. KL).

The last O&G they had left the hospital about 2 years ago. At least he stayed for more than 3 years. Unfortunately, I think, his efforts and sacrifices were not appreciated by the people ‘above’. I must say it is not easy for anyone to leave one families in Semenanjung just to work in the ‘district’. If I ‘m not mistaken, early this year, one guy did come (or his UD52) to Labuan but I was told he reported and a day later went back to Semenanjung.

We produce between 10 to 30 O&G specialists yearly but how many are sent to serve the ‘district’? By the way, can we call Labuan (the often forgotten 2^nd Federal Territory as ‘district’ – yes my friend, it came before Putra Jaya). I think the government should make it compulsory for them to come here. Of course they will threaten to resign immediately, so what? Some of their seniors did sacrifice for the good of the country, why can’t they. Why can’t you guys come here and serve for 2 years (the most), then after you buy your low taxed Beemer or Merc, you can always go back. The MOs turnover is also quite fast here. By the way, they only have 9 MOs now. Someone should train and guide them properly.

Ketuanan Melayu

Came back from BTN.
Much was said about Kontrak Sosial and the above matter.
Bottom line, they told us not to question it so much. So, when a minister from the present government brings up the issue again... why tak bising?

my PTK course - a case of penny wise, pound foolish

I just got back from my PTK course recently. Nowadays, it is no longer for 7 days but they cut it to 1 and 1/2 days. One day for lectures and group work and 1/2 a day for group presentation.

Due to budget constraint we were placed in the Youth Hostel/Hotel somewhere near Jalan Robson. Not all of you may know where this Wisma is situated. Don't worry as most taxi drivers don't too. One of our friends ended up being sent to the cemetery.

The accommodation was bad. The room my colleague from Alor Star and I stayed in was run-down. The wall next to my bed was full of ‘fungus’. I was lucky not to have contracted ‘vaginal candidiasis’. It was dusty and dull (only a low powered neon light was illuminating our small room).

The toilet was OK but I have seen better floors in public toilet of the GSCs. The shower curtain was full with black spots and probably never once changed from 1979.

Poor kawan from Alor Star suffered rhinorrhea from the dusty carpet and was unwell the next day. Some rooms had rats ‘visiting’ them at night. I even saw one running across the stage during one of the lectures.

Oh…meals were not that great too. Yes, we did have 6 meals a day but some rather eat out or have tea tarik at the gerai next door. We had ‘uncooked’ nasi lemak on the last day and 'overcooked' nasi ayam for lunch. The tea were all tea bujang.

The organizers had no choice but to pick a cheaper venue after the cabinet announced this new ‘prudent culture’ spending since June. But I heard it was not that cheap to have it in the Wisma also. The amount spent was almost the same (if we had it done in the hotel which they have booked earlier). Besides, the organizers had paid 50% (of the booking fees to the hotel anyway) which went up in smoke (close to RM 19k – gone).

So, you be the judge if such courses can improve our ability to make good decisions as managers.

P.S. someone told me after the course that now we can have such government courses in hotels again…, mmmmmm…. Flippy- floppy.

Can a family man with Salary RM3,000 survive in Malaysia

Let's do some simple calculations here.

In Malaysia , the average family income is RM3,000 /month
(where father works, mother doesn't).

I understand there are many families whose
monthly income does not reach RM3,000,
but, to make things simple,
let's take RM3,000 as the figure. Ok lah, right?

Okay, let's start rolling with a family which has
Papa, Mama, 1 daughter and 1 son. Ngam-ngam ....

Calculation starts...

Electricity and water bill: RM100
(No air-con, No home theatre, No water heater ... ok?)

Phone bill ( Telekom): RM100

Meals for a happy family: RM775
(3 meals on RM25/day, RM25 for 4 persons...?)

Papa makan / teh-tarik during working hrs: RM155
(RM5/day, RM5 ... can eat what?) RM400
(A proton saga aeroback, 7 yrs repayment)

Petrol (living in city, traffic-jam): RM300
(go to work, bring son to school,
only can afford one car running)

Insurance: RM650
(kids, wife and myself)

House repayment: RM750
(low cost housing repayment for 30 yrs,
retired still have to work to pay!) <>RM80
(got that cheap meh? i don't think so)

Older children pocket money @ school: RM20
(RM1/day, eat bread?)

School fees: RM30
(enough ah?)

School books and etc: RM100
(always got extra to pay in school)

Younger children milk powder: RM50

Miscellaneous: RM100
(shampoo, rice, sauce, toilet paper)

Oh wait!!! I have to stop here, so...
No Astro,
no movie @ cinema,
no DVD,
no CD,
no online,
cannot KFC,
cannot McDonald,
cannot go Park walk during weekend (petrol expensive),
no chit chat on phone with grandparents, and etc...

Let's use a calculator to total up... WALAO EH! Shit! RM3,610 already...

EPF belum potong, income tax lagi........oledi RM3,610 ....

How to survive lah tuan-tuan dan puan-puan sekalian ???

Our Deputy Prime Minister asked us to change lifestyle?

How to change? Don't eat? Don't work? Don't send children to school and study?

Besides that, I believe in Malaysia population, there are millions of rakyat Malaysia which still don't earn RM3,000/month!!!

What is this? Inilah Malaysia Boleh... Sorry ... it should be Malaysians Boleh , because we're still alive and kicking!!

Our politicians must be mad!!!!

Minyak oh Minyak

Minyak naik lagi
Kenaikan paling tinggi
Semua letak tangan di dahi
Kecuali ahli keluarga Badawi
Dah tau naik minyak awai-awai lagi
Mereka beli berjuta-juta saham TNB
Kalau TNB naik seringgit pun jadi
Buat duit dalam masa tiga hari

Minyak naik tak terasa pak menteri
Sebab mereka naik kereta kerajaan bagi
Boleh lalu lebuhraya bertol berkali-kali
Begitu juga dengan mereka punya isteri
Ada driver mai ambik setiap hari
Siap dengan bodyguard ke mana pergi
Mereka tak pernah rasa cengkaman inflasi
Dan mereka akan shopping di luar negeri
Tak main la kalau ke Kamdar atau Pasar Seni
Bawa beg besar-besar jenama LV atau Gucci
Naik flight first class bukan kelas ekonomi

Menteri kata tak boleh elak lagi
Kerajaan terpaksa menanggung rugi
Sebab tak tahan nak bagi subsidi
Suruh rakyat berjimat bawa kereta 600cc
Gila punya cadangan wahai pak menteri
Hang lah patut berjimat awal-awal lagi
Cuba hang bawa kereta hang sendiri
Hang cuba ikut Umar atau cara nabi
Kurangkan program majlis rasmi
Majlis makan malam makan roti cicah kari
Sedap jugak sehingga menjilat jari
Tak payah udang besar atau mutton beriyani
Kurangkan impot artis luar negeri
Tak yah panggil Al Jarraeu atau Mariah Kari
Kurangkan jalan-jalan luar negeri
Ikut Guan Eng naik flight kelas ekonomi
Kediaman rasmi guna perabut buatan sendiri
Tak payah impot tiles dan perabut dari Itali

You all buat dulu baru bagi tau rakyat
Jangan suruh rakyat berjimat cermat
Tapi hangpa perangai macam taukua sumbat
Pandai cakap tapi tak pernah buat
Perut mereka di kampung telah lama diikat
Makan ala-kadar paling mewah air sarbat
Janganlah buat perangai munafiq dan jahat
Allah di atas sentiasa monitor dan melihat

Keris Silau
9 Jun 2008

How to save your $$$....

Found this article recently.
Frankly, I think the government is on anti-psychotics... and its not working

15 WAYS TO NEGATE THE RECENT FUEL PRICE INCREASE*
by TV Smith
13/05/05

Improve your vehicle's fuel consumption - by as much as 40% - by changing the way you currently drive. There is a catch, though. You'll no longer qualify as a Malaysian driver...
Link to this artcle: http://www.tvsmith.net.my/duasen/130505_fuel.html
1. Pump More Here & Pump Less There
Don't wait until your car senget one side before inflating your tyres. Low tyre pressure forces your engine to work and drink harder. Driving on underinflated tyres also reduces the life of the tyres. A lose-lose situation.

2. Dig Your Nose
Digging your nose is more economical than gunning your engine while waiting at traffic lights. Jack rabbit starts cost you even more. Never floor the pedal unless there's an express bus looming in your rearview mirror. Learn how to accelerate (and brake) smoothly for better fuel efficiency.

3. Pay It Again Sam
You may be using an alternative toll-free road as a sign of protest or as a means of saving money. If the the old route is perpetually congested and longer, you may end up burning more fuel than the toll saved. Sad but often true.

4. Go Look Stop
Are you one of those who frequently get stuck behind a stalled vehicle, crash into road humps or potholes? If you look further than 3 meters while driving, you can better anticipate obstacles and avoid fuel guzzling start-stop situations. Good reason not to tailgate too.

5. Make Up Your Mind
I don't know if it's kiasuness or indecisiveness that makes people drive with the other foot riding the brake pedal. A slight touch might not be noticeable to you but it strains the engine, wears out your brakes prematurely and confuses the poor driver behind. Make sure your handbrake is down all the way too.
Link to this artcle: http://www.tvsmith.net.my/duasen/130505_fuel.html
6. Get Rid Of Freeloaders
The less passengers the less weight. The less load the better the fuel economy. If you want to car pool, pool the cost. Clear your boot by removing unutilised items like golf sets, prams, barbecue sets, scuba gear, etc.

7. Bear With Crow Shit
Park your car under the shade wherever possible. The hotter your car interior becomes, the harder the air-conditioning needs to work later, the more fuel the engine consumes as a result. The hot sun also increases fuel loss through evaporation.

8. Stay Safe & Save
Fuel consumption jumps dramatically after a certain speed. Keeping to the speed limit saves you more than traffic fines. Driving at 120 kph, rather than 100 kph, may increase fuel consumption by another 25 percent. The dangers of speeding far outweigh the travel time saved.

9. Get A Life
Stop pissing off your neighbours in the mornings and do yourself a favour. Most modern cars have no chokes or carburetors, so there's no need for long, noisy engine warm- ups. Hard revving a cold engine kills it faster than driving it.

10. Let The Bugger Go
There's no need to catch up with an offending driver just to show a finger or fist. You end up either paying more for fuel or a hefty hospital bill.

11. Learn From Your Mistakes
If your wife or girlfriend says she needs to pop into a warehouse sale for a quick look-see, find a parking spot and turn off the engine. Long idling wastes fuel and pollutes the environment.
Link to this artcle: http://www.tvsmith.net.my/duasen/130505_fuel.html
12. Don't Be A Drag Queen
Remove that empty showoff roof rack or that ugly ill-designed Ah Beng spoiler as it causes unnecessary drag. Smoking with your windows down at cruising speed also increases drag. Newer cars (except the Juara) are aerodynamically designed for fuel efficiency. Stop adding unnecessary external accessories such as jutting elbows.

13. Meter The Meter
Keep track of your car's fuel consumption by monitoring the odometer or tripmeter. A sudden drop may mean mechanical problems. Timely oil change and other maintenance can save you significant amount of fuel.

14. Try A Different Nasi Lemak
All petrol are the same except for the additives and advertising. Contrary to what most Malaysians believe, you can mix your fuel. There's really no need to waste fuel by driving out of the way just to fill up your favourite brand and redemption card.
Link to this artcle: http://www.tvsmith.net.my/duasen/130505_fuel.html
15. Get A New Boss
Use online banking or find a better employer. Stop driving to an ATM every hour just to check whether your salary is in.

*Your mileage may vary

Mahathir says we have LOADSSSS of $$$$

'Kerajaan ini melimpah wang' - Mahathir

(Harakah) - Penasihat Petronas Tun Dr Mahathir Mohamad berkata bahawa mengekalkan dan mengurangkan subsidi minyak secara berperingkat adalah merupakan pilihan lebih baik memandangkan beban kenaikan harga yang terpaksa ditanggung oleh rakyat. Beliau percaya umum terpaksa menerima kenaikan harga petrol namun yang menimbulkan kemarahan ialah jumlah kenaikan serta dalam keadaan tergesa-gesa. "Perdana Menteri sebelum ini seolah-olah mencadangkan kenaikan hanya pada bulan Ogos, tetapi ianya datang dua bulan lebih awal, sejurus selepas pengharaman penjualan kepada orang asing. "Jika kenaikan berperingkat, rakyat tidak akan terlalu terasa. Tetapi ini bermakna Kerajaan perlu terus beri subsidi walaupun tahapnya akan menurun," katanya mengulas kenaiakan bahan bakar yang diumum Dato' Seri Abdullah Ahmad Badawi. Katanya Malaysia mengeluarkan lebih kurang 650,000 tong minyak sehari dan mengguna 400,000 tong manakala selebihnya iaitu 250,000 tong adalah tujuan export. Tambahnya lagi bahawa tiga tahun lalu minyak mentah dijual pada kadar USD30 satu tong dan harganya pada hari ianya USD130 iaitu satu kenaikan sebanyak USD100. "250,000 tong yang dieksport sepatutnya memberi Petronas sejumlah lebih RM27 billion, "Tetapi Petronas untung lebih RM70 billion, yang kesemuanya milik Kerajaan. Kerajaan ini melimpah dengan wang," katanya yang mengulas lanjut di blognya. Kata bekas Perdana Menteri susulan keputusan itu kos sara hidup sudah tentu meningkatmalah akan tercetus inflasi dan taraf kehidupan akan menurun. "Memanglah kenaikan harga petrol di sini jauh lebih rendah daripada di United Kingdom, mahupun Amerika Syarikat. Tetapi pendapatan per kapita kita adalah lebih kurang satu pertiga mereka. Berasas kepada kuasa membeli kita kenaikan harga adalah lebih tinggi dari UK atau Amerika Syarikat. "Kenaikan ini menyakitkan, tetapi sakitnya lebih dirasai bukan kerana kenaikan dari segi peratusan adalah lebih tinggi daripada negara-negara maju, tetapi kerana cara kenaikan tersebut dibuat," katanya.

Schering Plough Talk SELECT 2008

For the first time, I spoke in front of 100 (or more) pharmacist from all over the country. Biasalah... bidan terjun

Should IVF be finance entirely by the government?

Statistics has shown that 2 in 10 of newly married couples will have difficulty to conceive after a year of marriage. In-vitro fertilization or IVF, introduced exactly 30 years ago (this year) has helped thousands if not millions of couples to overcome this problem. IVF involves the use of many different types of drugs to stimulate the ovary to produce enough eggs (from the women) for harvesting. This stimulation requires a series of injections. Furthermore, a good and efficient lab with competent embryologists is essential to ensure the success of an IVF cycle. No doubt, setting up of an IVF lab needs money. In addition, the drugs used are not cheap. Some infertile couple may not be able to afford it, therefore, it has been suggested that government should fund IVF fully. But is it possible?

It is only fair to help couples who are infertile to get pregnant. They should receive proper medical advice and treatment for their problem. We have seen so many who have suffered from anxiety and depression from the pressure families and friends put on them. Unfortunately, not all can afford this treatment.

Conversely, the government's expenditure on health care will increase tremendously if free IVF treatment is given to all patients. This money can be channel for the treatment of patients with more severe diseases like cancer or chronic organ diseases. This group of patients can die if treatments are not started immediately. Those who are in favour of this option will certainly argue that no patient have died just because he/she can not conceive.

It is my opinion that the government should help those who have difficulty to conceive access to affordable assisted reproductive treatment. These patients do not choose to be infertile, so why should they suffer (both mentally and emotionally). However, I feel patients should share part of the treatment cost as this will instil a sense of responsibility on them to see the entire programme through. Probably treatment should be partly subsidized by the local health department and patients pay a nominal fee for the IVF programme. The government should also set up more IVF/ART centres across the country. HKL has actually started their first IVF cycle in 2006 (under the patronage and hard work of Dr. Anisah), but I have no figures on how many cycles they have done so far. I know Trengganu (with the effort put in by Dr. Zul and Dr. Nasir Tak Abd) shall start their lab soon, Ensha Allah. I am glad KKM has selected our centre Likas as the third centre of referral for IVF. The question is of course “Where to get the embryologist!!”

IVF treatment is expensive but it should be made affordable to all infertile couples. Free treatment may not be practical but the government should make an effort to subsidise it. May be the first cycle can be made free to the patient but subsequent cycle should be paid. Infertility should be seen as a ‘disease’ like any other diseases suffered by our people. Thus, cheap and appropriate fertility treatment should be made available to all citizens of Malaysia.

IVF... how can I reduce ectopics???

We were fortunate to complete 8 cycles of IVF last month. Unfortunately only 4 got pregnant. One may say that the results are extremely good (50%) but 2 got ectopics. Both were young patients (below 35y).
After searching through the net, I fail to find the answer on how to prevent ectopic pregnancy in IVF. It is a known fact that IVF carries a high risk of ectopic pregnancy BuT how do one prevent it.???
There was an interesting article in the European Society for Human Reproduction and Embryology Journal back in July 2003 on "Risk of ectopic pregnancies after IVF declines with age in women with tubal disease"
I like to quote, if I may from the article"The question that remains unanswered is why the risk of ectopic pregnancies should decline with age in women with tubal disease.
ALSO "endometriosis appeared to be a risk factor for ectopic pregnancies after IVF-ET. Incidence rose to 2.3% in these women AND there was a small but significantly higher incidence of ectopic pregnancy when three embryos were transferred rather than two."

I post this question to anyone out there who may have the slightest idea- how do you prevent!!

P.S. By the way, we put back 3 embryos..

Welcome back... to me

It has been more than 6 months since I last wrote anything on this blog of mine. Well, let's see... what has happened so far...
For one, I am still eagerly waiting for AMC's reply on my EICS. You see, it is part of the requirement before registering with the Australian Medical Board.
Oh ya, another problem is that English exam again. Still can get the minimum requirement. I just hope the AMC is not too strict... Common man... after all only one component-lah!

Zuhair & I

Tan Hong Ming

Coool Ad...... Click on the name above

Happy Birthday

Yeah, Today is my 37th.
Unfortunately, feeling unwell today. Got low grade fever with body ache all over. Started last night. You know what they say, 3 days to stay, 3 days to go away.
The clinic bought me 2 cakes today and had a surprise birthday party. well, can't really call it a real party, just makan cake.
Did not want to blow the cake at first, i only fanned the candles out.
But they said I should blow the candles, so they re-lit it. Well, all my germs is on the cake by now, i suppose, but they still ate them....!!@??. Don't tell me i didn't warned you guyz.
Praise be to Allah. May I see 38 (hopefully in the UK or Australia or somewhere overseas).

MRCOG P2 Exams

GOod luck to those setting (or has set) for the Part 2 (and One) exams.
Heard the Part 1 was terrible ( esp. Paper 2)... I mean who wants to know about endometrial receptors????. But I heard the good news is if you think it was difficult then the rest would have done equally as bad as you did anyways.

Was called by the courts again today. Somehow I'm quite famous in the court now. Even the Pak Guard there knew me (according to our Hospital Driver lah).

Got screwed by the defense lawyer as usual. But this guy was a 'senior'. He asked me better questions then those junior ones I've gotten in the past.
I will not put the diagnosis alleged raped again. He cornered me by saying if I put such then I dunno if the rape had occurred. It was a trick question actually. It is not for me to decide but the court, isn't it?

Why is it only me who gets call every time? That is the question. On the average now, I get 2 cases per on-call. (They just called me 2 minutes ago, yet another!!!). The paper work I have to do is pilling up on the desk. BoRiNg!!.
Will have 2 more cases this month then one in October. Hope I don't have to go. Cancel and PG je la bang... senang!!!

After completing 6 months of Fertility work in HUKM, I am back to restart work here.
Missing Semenanjung and the people there already.
Back to our new house in Likas Court. Wow! Such a mess. Took us more than 2 weeks to complete unpacking.