THE SOAP of UERM Class 2016
By Jerald Pelayo
I am truly honored and humbled at the same time to receive this award today, knowing my limitations as a post-graduate medical intern. To everyone who believed in me, and in what God can do through me, from the deepest recesses of my heart, thank you so much.
I will not be referring patients to my residents or to any consultants present today. Instead, allow me to refer Class 2016, with whom I have, in so many ways, braved the rigors of 4 years in Medical School and 1 year of medical internship. Allow me to present our Class SOAP today.
SUBJECTIVE
Class 2016 is a 5-year-old, multicultural group, who has come together from all parts of the world, with different co-morbidities and personality traits. The Class came in for thoughts and feelings of anxiety of 6 months duration. Life was apparently well for the class until…
5 years prior to graduation, we accepted the challenge of a lifelong education, entering with a naïve but energetic spirit. We were lost in our own anxious thoughts, and were culturally shocked in the new environment we were immersed in. We were faced with the complexities of Anatomy, Biochemistry, and Physiology. From the ground emanated budding emotions of love and hatred, successes and failures. During the process, some left, some were left behind but still many survived.
4 years prior, more paper works were added to the already long list of subjects to study. Our time was consumed by preceptorships and interviews, thus studying had to be left in the crevices wherever they could fit.
3 years prior, the amount of paper works escalated exponentially to the point of neglecting the need to study or even listen to lectures. We kept on chasing deadlines that we forgot what really mattered – the very long examinations. For some, this was probably the most academically challenging year of all. If we recall, we were all instructed to attend clerkship orientation, clueless as to whether we actually made it or not. The rest was history, until…
2 years prior, we came to the end of classroom education and we were residing in the hospital as junior interns, living in a far different world where we slept in a cramped up or a make shift “lungga”. The class had its fair share of being addressed as “Ate/Kuya/Nurse/Miss/Mister/even worse simply a ‘Psssttttt!’”. We had endless duties day in and day out, sleepless nights because of bedside monitoring, referrals which were either torn or accepted, paper works, rounds, codes, OR/DR assists, labor watch, sleep-wake monitoring and the like. We weighed diapers, drained urine and colostomy bags, inserted and re-inserted IVs/NGTs/foley catheters and so much more. The time we spent together may even be longer than the time we spent with our own families, hence we got to know each other at a deeper level, allowing us to see each other’s good and bad sides during those good and bad times. These varied experiences shaped us and our perspectives, and with these, some inevitable twists and turns transpired along the way, where some old relationships and friendships were made stronger, some new ones formed and some old ones unfortunately came to an end. Nevertheless, we journeyed as one family until…
1 year prior, we had to be matched to our hospitals of choice, some of us were lucky with first matching, while the others were not, who were matched only until the first day of our official duty. Whether we were wrongly matched or not, we all went our own ways, separated by our choices. And here are the few that remained in our home base – whether chosen, forced, or left with no choice at all, who were ever ready to stand by the idea that we made the right decision when we chose to stay, ready to be enslaved once more! And finally, we got to wear the white coats, now as senior interns. We received referrals from our JIs and taught them what we learned from the previous years. Some of us enjoyed the blessing of authority through suggesting demerits and merits, crossing them out in their attendance logbooks, giving them quizzes, and sometimes doing midnight rounds with them. #ForYourLearningPurposesOnly #WalangPersonalan. This time, it was less physical work and less monitoring, but we had more censuses to edit and more responsibilities. We were actively involved in patient care under the supervision of our residents. It was a steep growth curve, but the class survived! And together, we conquered PGIship.
On the day of graduation, the class experienced ambivalence with a heightened feeling of anxiety hence this SOAP.
Review of systems revealed irritability, palpitations, muscle tension, sleep disturbances, and polyphagia.
PERTINENT OBJECTIVE DATA
…showed that the class is awake, alert, conversant, coherent but restless, not in cardiorespiratory distress. Vital signs are relatively stable, save for tachycardia. Other pertinent findings include cold clammy extremities and diaphoresis. Mental Status Exam revealed that the class is in a state of heightened anxiety as verbalized. PE findings of other systems are unremarkable.
ASSESSMENT
Generalized Anxiety Disorder secondary to pending PLE 68 days from now
s/p 4 years of Medical School, s/p 1 year of Medical Internship
PLAN
- Give BOLUS Signatures for clearances STAT. Please DO NOT DELAY!!!
- Diagnostics:
- ECG to check for residual heartaches and fears that need to be dealt with or resolved before the boards
- 2D echo to check for emotional abnormalities that need to be stabilized
- Electrolytes – to check for imbalances in doubts and self-confidence
- CBG – to check for acute spikes of panic attacks
- Treatment:
Allow me to share my treatment plan for Class 2016.
The first prescription is FAITH. “We have nothing to fear for the future, except as we shall forget the way the Lord has led us in the past.”* Remember, “man’s necessity is God’s opportunity.”**
The second prescription is DISCIPLINE. We are to discipline ourselves by gathering up every jot and tittle of knowledge and experience. Discipline also entails temperance and focus. Prioritize! Remember that the time we spent can never be brought back or re-lived.
Hence, remember this formula: FAITH + DISCIPLINE = EXCELLENCE
Do not settle for mediocrity. If best is possible, then better is never enough. God requires of us nothing but our best. Let us then strive for a rock-solid 100% passing rate. Class 2016, are you up for the challenge?
Excellence, after all, is not a skill but a habit; it’s not a destiny but an attitude; it’s not a seasonal aspiration but a way of life. Keep the faith, exercise discipline and achieve excellence.
Then lastly, follow-up with God. Make Him your FIRST, LAST and BEST in everything!
As difficult as it will be for any of us, I will miss and treasure the beautiful memories that we have spent together as a class. As we go on our separate ways, let us remember to look back to where we once were and move forward with greater hope that we can live the reality of our greatest potentials. Now, go and #LiveTheDreamUERM2016!
*Taken from EGW Writings, Life Sketches, p. 196, paraphrased
**Taken from EGW Writings, Testimonies for the Church, volume 4 p. 530
This was delivered by Jerald L. Pelayo at the UERM PGI’s Graduation (July 4, 2017) at the UERM Physio Auditorium. May this ever inspire our dear classmates, colleagues and friends!
With much love,
Jerald and Ardys
Your newly graduated Post-graduate Interns
TandeMD 