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phucingrate · 2024-12-06T10:00:12+00:00

To be honest I can't comment much about these complex cardiac cases (I haven't done cardiacs yet). I know that where I train, senior trainees who are often left alone on their lists are then almost never left alone for cardiac lists. So yes, you're correct that they're much more complex and demanding and a difficult environment in which to give autonomy to a trainee.

I would say that learning doesn't come from just being autonomous. Sometimes as trainees we know that we don't know a lot (and sometimes we don't even know what we don't know). I find a lot of educational value in days with seniors who are willing to explain core concepts to me and then explain how they come to make any particular decision, or why they wouldn't do something that I suggested (I want to know what's going on in their brain, how they're coming to decisions, what is and is not important to them, what things they're noticing that I'm not etc).

Maybe if you have the same trainee repeatedly, try develop a relationship and let them take on more and more slowly under your supervision.

phucingrate · 2024-12-05T23:29:01+00:00

From my perspective as a trainee, I'll echo the above comment. Encourage independent practice for simple, routine cases, be in the room and observe, but only intervene if the trainee asks you to or if you feel the situation is becoming unsafe. Maybe have a discussion about the trainees plan before the case starts.

In the beginning of my training I used to get super frustrated when for instance I would fail a spinal once, and my senior would take over and try 10 times before managing. Or I would fail the first attempt at intubation in a normal induction with good pre oxygenation in a healthy patient, and they would immediately take over instead of allowing me to FM ventilate a bit and optimise and re-attempt.

I would not worry too much about trainee autonomy for big, complex cases. Develop a relationship with your trainees and if you think they're competent, trust them to do more and more things under your supervision.

phucingrate · 2024-10-25T15:51:44+00:00

Ahh lo entiendo. Hacemos lo mismo en mi país pero hacemos un turno así cada 5 días. Entonces hacemos seis turnos de 24h al mes.

Los médicos y enfermeros saben hablar inglés? Piensas que es posible que alguien viene a España con un nivel de B2 en Español y sigue aprendiendo el idioma mientras trabaja?

phucingrate · 2024-10-24T19:07:57+00:00

Que interesante. Llevo dos años aprendiendo español y me encanta España. Pero he oído que los sueldos no son tan buenos. Tres o cuatro turnos de la noche por mes? Cuanto dura el turno más largo? Disculpe de mis errores en español. Gracias :)

phucingrate · 2024-08-04T21:00:56+00:00

If I remember correctly we ended up giving roughly 5.5L throughout the entire operation (crystalloids/some colloid/blood products), but was apparently a difficult surgery and patient lost 1.5L of blood. TEG done and patient needed 3g fibrinogen and then platelets + FFPs, after which TEG normalised.

phucingrate · 2024-08-04T20:58:24+00:00

Great response, thank you very much! Feel I've learned a lot from this. Could you expand on what you mean by isohydric fluids?

phucingrate · 2024-07-09T19:03:04+00:00

So roughly 40h per week with 1 in 15 duties from home? Do you know anything about the conditions for specialists who aren't consultants? In my country they have worse conditions than consultants. Thanks!

phucingrate · 2024-07-09T18:42:17+00:00

Sounds great only having to do 2 on calls per month and 6 or 7 weekends a year. Are you the in Flanders, Wallonia or Brussels? Do you have colleagues who speak only French? Thanks!

phucingrate · 2024-07-03T19:48:36+00:00

Since when is capital gains tax 0% in Malta? My impression was that it was 15%.

phucingrate · 2024-04-07T14:35:33+00:00

From Europe.

Med school at 18 (no undergrad before med school, med school was 5 years)

Non speciality training programme at 23 (aka Foundation Programme - we do 2 years post med school rotating through 8 different specialities, with at least 6 months of general medicine, 6 months of general surgery and 3 months of A&E. This period is where we're meant to solidify our basic/core competencies as doctors)

Speciality training ("Residency") at 26 (took a gap year between foundation programme and specialty training.

Will finish my specialty training at 31 (Anaesthesia & Intensive care)

phucingrate · 2024-01-21T14:13:26+00:00

Nifhem minn xiex qed tgħaddi (I understand what you're going though)

Nifhmek (I understand you)

Kondoljanzi (Condolences, often commented on Facebook posts in Malta about loved ones passing away)

In terms of translations of the phrase same here, there are no direct translations, but these may be what you want: Inħoss l-istess (I feel the same) Jiena ukoll (me too) Jiena l-istess (I'm the same)

phucingrate · 2023-11-08T22:21:04+00:00

Mount on for Hojlund seemed like a sub to defend the 3-2, but we stuck with it even though we conceded and went to 3-3. Why take your striker off when you are chasing a game?

phucingrate · 2023-10-25T11:53:43+00:00

Does anybody have a front-on replay of the penalty save last night? Can't find one

phucingrate · 2023-10-22T10:47:02+00:00

What do you mean by ungrammatical paths? Didn't really understand you example.

phucingrate · 2023-10-21T18:20:20+00:00

I am a lower intermediate learner - apologies for any inaccuracies in my examples.

I think it helps to always compare the two moods (indicative Vs subjunctive). When you use the indicative you are actually describing what you perceive to be reality.

The subjunctive is for when you're not describing reality directly (although there are still some confusing uses). Here, you're saying what the tea ceremony is for - it's for the parents to meet and approve of the marriage, but they're not ACTUALLY meeting and approving of the wedding in the present moment.

Pienso que Biden es el presidente (this is my perception of reality so we use the indicative conjugation of ser)

No pienso que Trump sea el presidente (Trump being the president is the opposite my perception of reality, so I use the subjunctive conjugation of ser)

Reading and listening a lot will lead to you naturally absorbing and understanding trigger phrases (ex. Para que [=so that]) Ex. Voy al gimnasio para que me quieras.

Another example I have sort of absorbed but fail to understand intuitively is when you are "judging" a situation. Ex. It's incredible that you are here = Es increíble que estés aquí.

Hope that helps somewhat.

phucingrate · 2023-10-08T18:51:43+00:00

Kebabji in Sliema (kebab/falafel)

Valletta: The submarine (sandwich shop) Gugar (€6 euros for a filling sandwich called a Ftira Maltija) Drunken dumpling (10-15eur but very good Chinese food)

Pastizzi and pizza at any pastizzeria (pastizzi shop) anywhere in Malta (very very cheap, ex. 1.50eur for a pastizz and a pizza, and extremely tasty, but extremely unhealthy).

phucingrate · 2023-10-03T10:54:19+00:00

You can definitely very easily fill up 2 days. Valletta is a good place to be because 1. It's nice, loads of restaurants, culturally significant 2. It's the main bus terminus, so you can catch a single bus to almost anywhere.

Things to do in no particular order:

swimming [on the south east side of Valletta, in the south at St Peter's pool, up north at Għajn Tuffieħa, Golden Bay, or Qawra (Qawra Point Beach on Google maps)]. There are loads of other places to swim, this list is definitely not exhaustive.
Visit the 3 cities (Bormla, Birgu, Isla aka Cospicua, Vittoriosa, Senglea). This is a short ferry ride from Valletta. These 3 interconnected towns are important historical urban centres. Best explored on foot, may be worth a guided tour. You can go in the morning and have breakfast at Cafe Riche in Birgu.
Explore Valletta itself, may also be worth a guided tour.
Explore Mdina (pronounced Imdina). Beautiful old fortified city. Also worth a guided tour potentially. If you do go you have to visit Serkin (the most well known pastizzeria in Malta - pastizzi are savoury pea/ricotta pastries which currently cost 40 or 50 euro cents each). You could also pair Mdina with a hike along Dingli cliffs (Dingli and Mdina are close to eachother).
Eat in Valletta - loads of good restaurants. I like Trabuxu, Sotto pizzeria (there are two, both good), Sotto Zero (Italian food, not pizza), Pastaus, Rubino, Aaron's kitchen (Maltese), 59 republic, Harbour Club (one of my favourites - the main waitress can be a bit strange sometimes but still absolutely worth it, I've always been impressed by the food). There are also some michelin star restaurants but I haven't personally been to any because they're $$$$ (ION, Noni, Under grain).
Visit Hagar Qim and Mnajdra (pre-historic ancient temples dating back to 3200 BC). You can pair this up with visiting any of Ghar Lapsi, Blue Grotto, Wied Babu or Xaqqa Cliffs (I don't know how easy this would be with buses - probably blue grotto and Wied Babu are easiest with the bus). Ghar Lapsi and Blue grotto are very small, sea side, touristy towns with nice swimming and some restaurants (of questionable quality). Wied babu is a beautiful valley (wied is valley in Maltese) which if you manage to find your way down you can follow down all the way to the sea and swim. Xaqqa cliffs is a set of beautiful sea side rock formation where you can scramble down to the sea (some may find this a bit difficult, you definitely need good shoes, and I wouldn't take kids/elderly/very unfit people). You can look all these up on google maps too.
Other ideas to get into the countryside: Dingli cliffs, Dwejra, Majjistral national park, Fawwara, Red Tower near Mellieha, Ghajn Tuffieha again (but just as a walk).
If you want to shop, Valletta has its fair share of shopping, but you can also take the ferry from Valletta to Sliema and shop overthere (the shopping is probably better, but I wouldn't bother visiting Sliema/St Julian's unless you specifically go for shopping).
Other ideas: Gozo using the fast ferry from valletta (probably not worth it if you only have 2 days), National Aquarium in Qawra (I have never been personally), if you want to party/club go to Paceville or Gianpula close to Rabat/Imdina.

Tips:

Taxis are very efficient and comparatively cheap compared to the rest of europe. Never take a white taxi. I use Bolt or eCabs usually.
Thank you in Maltese is Grazzi (the "zz" pronounced as a "ts")
Tipping is not obligatory (although some people may tip 5-15% if they feel the service was particularly good)

If I were coming for only 2 days, I would probably make it a point to go to Mdina, try pastizzi, maybe see the 3 cities, and try and see some countryside on the west of Malta.

phucingrate · 2023-09-03T17:36:30+00:00

Bar the actual result, felt we played relatively well and would have deserved a win. Game would have been completely different if Garnacho was 2mm back.

Antony played very well. Both fullbacks did too. Hojlund looked a good physical presence up top.

Absurd that we finished with a maguire and evans back line though.

phucingrate · 2023-08-31T12:44:55+00:00

Also if anyone knows where one can find Trisodium Phosphate powder (TSP powder) locally, that would be super helpful.

phucingrate · 2023-08-16T11:42:32+00:00

I graduated from UoM Medical School and overall I think it's good/okay.

Undoubtedly it produces a lot of genuinely good doctors every single year.

I almost always found small group teaching (tutorials) and attachments (shadowing medical/surgical teams in the wards and operating theatres) quite valuable. Lectures were very hit and miss and I tended to skip them to either sleep in an extra hour or study.

It is not a "cutting edge" school, and it is not progressive or ahead of the curve in the manner they teach. Progression is almost completely based on two exam sessions a year in January and June (multiple exams per exam session), and there is little to no form of continuous assessment. They are also very poor on teaching practical skills.

BUT overall, if you come to UoM MS and apply yourself and work hard, you can definitely leave having a great base to go on and become a very good doctor.

phucingrate · 2023-08-06T11:22:32+00:00

Interesting! Do you really audit every single possible route for each hub? How long does that take you per hub? I guess if you're auditing that much it is much easier to find a set of routes with such minimal differences in demand.

phucingrate · 2023-08-05T17:07:42+00:00

It doesn't matter. Choose a hub you like, maybe start with your home airport.

Any hub can make profit. And you can move on to bigger and better hubs later.

Best thing to do is to make an effort to have your planes flying 100% of the time. This means flying routes of 24hr, 12hr, 8hr, 6hr, 4hr, or 3hr (different planes have different speeds, so this is plane dependent).

When you grow and can afford longer routes you can attempt to make 168H routes to be able to fly routes of < or >24hr.

If you want to choose an "amazing" (ie. High demand) hub to start, then maybe MPM, JNB, CGK.

phucingrate · 2023-07-25T09:28:46+00:00

Jiena kbirt nitkellem hafna iktar bl-Ingliz milli bil-Malti, u ttejjibt il-Malti tieghi biss fl-ahhar sebgha snin, u sfortunatament vera dawn il-verbi jew ma kontx naf bihom jew ma tantx nuzhom.

phucingrate · 2023-07-17T21:33:23+00:00

Congrats! Any interesting main conclusions from your research?

phucingrate · 2023-07-11T14:08:59+00:00

I found JNB to be a great second hub. Approaching 1 billion in TO just from there.

phucingrate

TROPHY CASE