The Seats of the Ismaili Imamat: From Medina to Lisbon (632-2018) — Ismaili Gnosis

Through the centuries, the Seat of the Ismaili Imamat has been formally designated in one or more locations by the Imam-of-the-Time, depending on the requirements of the day. It has known many homes over the years – throughout the Arabian Peninsula, in the Middle East, in South Asia, and in North Africa. It moved to […]

via The Seats of the Ismaili Imamat: From Medina to Lisbon (632-2018) — Ismaili Gnosis



Failure to estimate our capability  will limited our desires to strengthen  our most obstuse and innococous intention. 

Life is limited  and with limited duration we should be doing everything that could move our prospect forwards. 

All technically and arrangement should be acurate so the journey with be smooth.

Bad demeanor of senior doctors

Residents are doctors too but not in Malaysia

Residency training is an additional couple of years of a physician’s life on top of undergraduate studies, medical school, internship and licensure examinations to add onto their unending expanding medical education. Specialities would include Surgery, Obstetrics and Gynecology, Pediatrics, Internal Medicine, Pathology, and Anesthesiology among others. Physicians who are undergoing this training are called “Residents” and as the term implies they are “residents of the hospital” as they practically live there due to the lengthy hours they spend working in the hospital.

The layman sees the resident as someone training to become a doctor. Though true to a certain extent as they are undergoing further education, what is not seen is that they are not just students, but also professionals who are licensed to practice. To change this skewed view, changes need to be made at the source.

Teach Me, Don’t Yell at MeAttending physicians have a tendency to forget that their residents are doctors too. They may be of lower training than them but they are future colleagues and deserve rightful respect. As much of a burden it is to mold another person into the finest, most well-educated, specialized physician he or she could be, failing to treat them with some dignity is too commonly practiced.

Shouting and name calling as well as chart throwing are seen in some countries as attending physicians take out their frustrations on their residents. The intent to teach them may be there, but the mode of delivery is not done in an appropriate manner. Residents tend to be ridiculed and even chastised by their superiors not only in front of their colleagues but also in front of other staff and even patients. Although residents have different reactions to these situations, in any case, repetitive tongue-lashings doubtlessly contribute to emotional exhaustion and depersonalization.

Lay Me Down to SleepSleep deprivation sits at the top-most seat in the list of major problems experienced by a resident physician. Several studies have compared sleep deprivation to the state of alcohol intoxication or drunkenness. When a person gets less than 8 hours of sleep they start to build up sleep debts that need to be paid off sooner rather than later. Declines in performance have been noted to begin at around 17 hours of sustained wakefulness. That amount of time spent awake has been compared to an individual with a blood alcohol level of 0.05% while 24 hours of sustained wakefulness is compared to one with 0.10%. A blood alcohol level of 0.10% is above legal intoxication in most countries and has a major impact on performance. It is illegal and against proper conduct to treat a patient when drunk, but residents are still made to treat them despite being sleep deprived.

The Warning SignsResidents are doctors who are people, not robots. Loss of self identity and becoming emotionally numb is a situation faced by many residents. Depression is a common mental disorder suffered by residents though not recognized by most. Presence of a depressed mood, loss of interest or pleasure in things one used to enjoy, feelings of guilt or low self-worth, trouble sleeping, poor appetite, low energy, and poor concentration are the main criteria for this disorder. A doctor tends to overlook their own symptoms as they are more focused on that of their patient. Mental health issues would, of course, lead to impaired medical practice where the resident is unable to use appropriate skills to safely practice medicine and care for a patient.

Residency training is just a short time in a doctor’s life. Though short, what could happen during this timeframe can have life changing consequences. Emphasis has been put on how to provide adequate academic training in the setting of a lower risk environment in order to improve the life of a resident physician. Training programs require reconstruction in order to provide a more balanced work and life balance, so that patient care would remain of good quality. Stressors cannot be eliminated, but the major adverse effects can be avoided as much