Elective Posting At Hospital Angkatan Tentera (HAT) Tuanku Mizan By Muhammad Aiman Harith Bin Mohd Zubir (Doctor Of Medicine)

It is part of the medical school curriculum that a student attends their elective posting at a hospital of their choice, preferably at a setting that is different from their own designated clinical teaching hospital. I've been waiting for this opportunity ever since I learned about it during my pre-clinical years. When the time came, I opted to do it locally but at a place where it is not always open to the public as it mainly serves the dedicated armed forces of Malaysia: Hospital Angkatan Tentera (HAT) Tuanku Mizan, Kuala Lumpur. I always have had a huge respect for our armed forces, and I wanted to explore and observe their medical services. 

A tertiary hospital that first opened its doors in 2008, HAT has all the latest state-of-the-art medical facilities optimised for exceptional patient care as well as simulations of specialised training for the army. The medical department is also known as 'Kor Kesihatan Diraja'. 

I chose two departments for my attachment over there: the Emergency Department and Internal Medicine. Their emergency department is more or less the same like any other hospital with an exception: they would treat any patient that comes in but if you're not associated with the armed forces, you would have to be transferred out to a general hospital once stabilised. When I first encountered such a situation, I realized their admission scope only covered members of the military force, veterans, and their family members. 

Just beside the emergency department was a department that held a huge hyperbaric chamber. It is used to optimise wound healing specifically in diabetic patients and other diseases. One of its other uses is to simulate the pressure changes of being in deep waters or being high up in the sky where oxygen content is low. This is part of their army training, enabling them to survive in challenging conditions where the oxygen level is different than being on the ground. This chamber was interesting to me as it was my first encounter with such technology which provides better patient care and management as well as preparing the armed forces for their missions with adequate training. 

At the emergency department, it was always busy with patients coming in from time to time and I had a chance to witness and assist in various different cases. One case that was a highlight for me was when a veteran came in with loss of appetite and lethargy. He was initially triaged to the yellow zone but suddenly started vomiting continuously, with the vomitus being blood. His condition deteriorated fast and we had to resuscitate the patient. Experiencing these kinds of situations in real life was much more challenging than what I expected and was totally different from merely reading about it in medical texts. 

Moving on to Internal Medicine, I was attached with a Respiratory Physician. Most cases that I attended were related to malignancies. I got the chance to shadow the specialist, getting to experience and learn how to break bad news to the patient. It was done very gently and tactfully, and I learned a lot from it and would use the same approach that I observed during this posting when I have to handle similar situations in the future. 

The military also has a dedicated medical school at Universiti Pertahanan Nasional Malaysia, or better known as UPNM. Their clinical teaching hospital was also at HAT Tuanku Mizan. I got to know a few of their students, seen roaming around in the wards and donning their military attire under their white coats. From this I got to know that their daily attire is always the military uniform and that being part of the armed forces, it is compulsory for them to act according to military discipline. I noticed that every time they pass a medical officer or specialist from the army who are of higher rank, they would give an army salute and greet them. Seeing it as being a routine at the hospital, I picked it up as well and started practicing it too. 

All in all, it was a great experience to be in this hospital for a month's duration. I got to expand my medical knowledge and at the same time, discovered the medical world of the armed forces. My respect for them has only increased. I would like to take this opportunity to thank the elective posting team at my parent medical school, Associate Professor Dr Retneswari Masilamani and Puan Norsiah for enabling my placement as well as to the ever welcoming individuals at HAT Tuanku Mizan who took me in as a medical student and taught me very valuable lessons throughout my stay there.