1.

Introduction

"Medicine is not only a science; it is also an art. It does not consist of compounding pills and plasters; it
deals with the very processes of life, which must be understood before they may be guided." This quote
by Paracelsus, a 16th-century physician and alchemist, captures the essence of my passion for medicine.
I have always been fascinated by the human body and its functions, and how medicine can help to heal
and improve it. I consider medicine as both a science and an art, requiring knowledge, skills, and
compassion.

I started my medical journey at the Faculty of Medicine, University of Kelaniya, in 2019. It was a dream
come true for me, as I had worked hard to get into this prestigious institution. I was eager to learn from
the best teachers and mentors, and to interact with diverse patients and colleagues. I completed my
third year clinical experiences at the Colombo North Teaching Hospital of Sri Lanka, where I rotated
through various departments such as medicine, surgery, pediatrics, obstetrics and gynecology,
psychiatry, and other minor departments. I learned a lot from these rotations, not only about the
diagnosis and management of common and rare diseases, but also about the ethical, social, and cultural
aspects of medicine. I also developed my communication, teamwork, and leadership skills, as well as my
empathy and professionalism.

I am currently in my fourth year, and I am doing my clinical experiences at the Colombo North Teaching
Hospital. I am enjoying this new environment, as it offers different challenges and opportunities. I am
exposed to a wider range of patients and cases, and I have more responsibilities and autonomy. I am
also learning from the feedback and guidance of the senior doctors and nurses, who are very supportive
and helpful. I expect to learn more from these experiences, and to enhance my clinical reasoning,
problem-solving, and decision-making skills. I also hope to improve my research and academic skills.

My short-term goal is to pass my part 2 examination with distinction, and to complete my final MBBS
examination with a high merit rank. I want to excel in both the theoretical and practical aspects of
medicine, and to demonstrate my competence and confidence. My long-term goal is to become a
Obstetrician and gynaecologist, and to serve the people of Sri Lanka, especially the underprivileged and
marginalized communities. I want to use my knowledge and skills to provide quality and affordable
healthcare to those who need it the most. I also want to contribute to the advancement of medical
science and education, by conducting research and teaching the next generation of doctors.

I am grateful to my parents, teachers, friends, and everyone who has supported me throughout my
medical journey. They have inspired me, motivated me, and encouraged me to pursue my passion and
achieve my goals. I am proud to be a medical student, and I look forward to becoming a doctor who can
make a positive difference in the world”.
 2. Leadership/teamwork skills during clinical placements with PATS

I am grateful for the feedback I received from my colleagues on my leadership and teamwork skills
during our clinical placements. I appreciate their honesty and constructive criticism, as they help me to
identify my strengths and areas for improvement. I also value their recognition and encouragement, as
they motivate me to continue learning and growing as a future healthcare professional.

One of the aspects that I received positive feedback on was my commitment to the clinical placement.
My colleagues acknowledged that I was always punctual, prepared, and proactive in our group activities.
They also appreciated that I shared my knowledge and resources with them, and that I was willing to
learn from their perspectives and experiences. I agree with their assessment, as I believe that
commitment is a key factor for success in any endeavor. I enjoy being involved in the clinical placement,
as it provides me with opportunities to apply my theoretical knowledge to real-life situations, and to
develop my clinical skills and competencies.

Another aspect that I received positive feedback on was my contribution to the clinical placement. My
colleagues recognized that I completed my tasks on time and with quality, and that I always sought out
information and feedback to improve my performance. They also valued that I contributed to the group
discussions and presentations, and that I supported the group objectives and outcomes. I agree with
their assessment, as I believe that contribution is a key factor for excellence in any profession. I strive to
do my best in the clinical placement, as it challenges me to enhance my knowledge and skills, and to
demonstrate my professionalism and accountability.

However, I also received some negative feedback on two aspects of my leadership and teamwork skills:
my support and my leadership. Two of my colleagues felt that I did not support them enough in
completing their tasks in the wards, and that I focused more on my own duties. They suggested that I
should be more collaborative and cooperative, and that I should help them more when they are
struggling or need assistance. I partially agree with their feedback, as I admit that sometimes I prioritize
my own tasks over the group tasks, especially when I have limited time or resources. However, I also
disagree with their feedback, as I think that I do support them whenever I can, and that I respect their
autonomy and responsibility. I understand that support is a key factor for teamwork in any setting, and I
will try to improve this quality by being more attentive and helpful to my colleagues.

Two of my colleagues also felt that I did not provide leadership in various relevant activities during the
clinical placement, and that I became confused in critical situations. They suggested that I should be
more confident and decisive, and that I should take more initiative and responsibility in leading the
group. I partially agree with their feedback, as I acknowledge that sometimes I lack confidence and
clarity in my decisions, especially when I face complex or uncertain situations. However, I also disagree
with their feedback, as I think that I do provide leadership when it is needed, and that I manage the
group effectively and efficiently. I understand that leadership is a key factor for impact in any role, and I
will try to improve this quality by being more assertive and proactive in leading the group.

Overall, I am satisfied with the feedback I received from my colleagues, as it reflects my leadership and
teamwork skills during the clinical placement. I am proud of my positive qualities, and I am aware of my
negative qualities. I am committed to improving my skills, and I am confident in my potential. I thank my
colleagues for their feedback, and I look forward to working with them again in the future.

3. Reflective account on ethical/moral dilemma

I. Description
One of the incidents that I experienced during my clinical placement was when a female nurse
who was working in the ward was touching and squeezing medical students in an inappropriate
way. This happened on several occasions, when we were doing ward rounds with the consultant
or when we were attending to patients. The nurse would come close to us and touch our arms,
shoulders, backs, or even our chests or buttocks. She would also make suggestive comments or
noises, and wink or smile at us. She seemed to target both male and female students, and did
not care if anyone else was watching or listening.

II. Feelings
I felt very uncomfortable and violated by the nurse's behaviour. I did not like being touched or
harassed by her, and I felt that she was disrespecting me and my colleagues. I also felt angry and
frustrated, as I could not focus on my learning or my duties, and I had to escape from her
whenever I could. I felt powerless and helpless, as I did not know how to stop her or report her. I
was afraid that if I confronted her or complained about her, she would retaliate or deny it, and
that I would get into trouble or lose my placement. I also felt guilty and ashamed, as I wondered
if I had done something to provoke her or encourage her, and if I was overreacting or being too
sensitive.

III. Evaluation
The event was bad and hard for me and my colleagues. It affected our learning, our
performance, our confidence, and our well-being. It also created a hostile and unsafe
environment in the ward, and compromised the quality of care for the patients. The nurse's
behaviour was unethical, unprofessional, and unacceptable, and it violated our dignity and
rights. We did not do anything to deserve or invite her harassment, and we were not
overreacting or being too sensitive. We did well by trying to avoid her and support each other,
but we could have done better by speaking up and seeking help.

IV. Analysis (General)

The event was an ethical dilemma, as it involved a conflict between our values and our actions.
On one hand, we valued our learning, our professionalism, our safety, and our respect. On the
other hand, we did not act on these values, and we tolerated the nurse's harassment. We faced
several barriers that prevented us from acting, such as fear, uncertainty, power imbalance, lack
 of support, and lack of awareness. We also lacked the skills and the confidence to deal with the
situation effectively. We could have applied some theories that we have learnt to understand
and resolve the situation, such as the four principles of biomedical ethics (autonomy,
beneficence, non-maleficence, and justice) ¹, the six-step model of ethical decision making ², and
the assertiveness techniques ³.

V. Analysis (Specific)
The situation could have been made better by us and by others. We could have made the
situation better by expressing our feelings and thoughts to the nurse, and telling her to stop her
behaviour. We could have also reported the situation to our supervisor, our tutor, or the ward
manager, and asked for their advice and intervention. We could have also documented the
incidents and gathered evidence, such as witnesses or recordings, to support our claims. Others
could have made the situation better by noticing and acknowledging the problem, and by
providing us with support and protection. They could have also confronted the nurse, and taken
disciplinary actions against her, such as warning, suspension, or dismissal.

VI. Action Plan

I have learnt a lot from this event, and I will use the lessons learned in the future. I have learnt
that harassment is a serious and common issue in the healthcare setting, and that it can have
negative impacts on the victims, the perpetrators, the colleagues, and the patients. I have also
learnt that harassment can be prevented and stopped, and that there are policies and
procedures to deal with it. I have also learnt that I have the right and the responsibility to speak
up and seek help when I face harassment, and that I have the skills and the confidence to do so.
If similar situations happen again, I will do the following:

- I will tell the harasser to stop their behaviour, and explain how it makes me feel and why it is
wrong.
- I will report the situation to my supervisor, my tutor, or the ward manager, and ask for their
advice and intervention.
- I will document the incidents and gather evidence, such as witnesses or recordings, to support
my claims.
- I will seek support from my colleagues, my friends, or my counsellor, and share my feelings and
thoughts with them.
- I will continue to learn and improve my knowledge, skills, and attitudes on harassment and
ethics, and apply them to my practice.

4. Portfolio entry on medical humanities: exploring the creative and human side of medicine
through art and literature.

I chose to write a poem as my individual project. The poem is titled "Yearning for home", and it
expresses the feelings and thoughts of a medical student who lives in a hostel room, away from
their family. The poem is written in simple English, using rhyme and rhythm to create a musical
effect. The poem has eight stanzas, each with four lines, and follows an ABAB rhyme scheme.
The poem uses imagery, metaphor, and repetition to convey the theme of longing for home.
I learned a lot about the role of art and literature in medical education through participating in
group activities and individual project. I learned that art and literature can help me to:

A. Develop empathy and communication skills. By reading and writing art and literature, I can
explore different perspectives, emotions, and experiences of other people, such as patients,
colleagues, and myself. I can also express my own feelings and thoughts in a creative and
effective way, using various techniques and styles. This can help me to understand and relate to
others better, and to communicate with them more clearly and respectfully. For example, by
writing the poem, I was able to empathize with the feelings of loneliness, nostalgia, and hope
that many medical students may experience when they are away from their homes. I was also
able to communicate these feelings to the readers, using vivid images, metaphors, and rhymes.

B. Discover and reflect on my own identity. By engaging in art and literature, I can explore my
own values, beliefs, goals, and challenges, as well as my strengths and weaknesses. I can also
examine how my identity is influenced by my culture, background, and environment, and how it
affects my decisions and actions. This can help me to know myself better, and to grow and
improve as a person and as a future healthcare professional. For example, by writing the poem, I
was able to reflect on my own identity as a medical student, and how it is shaped by my family,
my dreams, and my struggles. I was also able to appreciate the importance of my home, and
how it gives me strength and motivation.

I also reflected on how engaging in art and literature may help me maintain empathy,
understanding, and compassion throughout my future career in medicine. I think that art and
literature can help me to:

- Keep a balance between the scientific and humanistic aspects of medicine. By engaging in art
and literature, I can appreciate the beauty and complexity of life, and the diversity and dignity of
human beings. I can also acknowledge the limitations and uncertainties of medicine, and the
ethical and moral dilemmas that I may face. This can help me to avoid becoming too detached,
cynical, or arrogant, and to remain humble, curious, and open-minded. For example, by reading
and writing art and literature, I can learn from the stories and experiences of different patients,
colleagues, and cultures, and how they cope with illness, pain, and loss. I can also challenge my
assumptions and biases, and expand my horizons and perspectives.
- Cope with the stress and challenges of medicine. By engaging in art and literature, I can find a
source of joy and inspiration, and a way of expressing and releasing my emotions. I can also find
support and comfort from others who share similar experiences and feelings. This can help me
to avoid becoming too overwhelmed, burned out, or depressed, and to maintain my well-being
and resilience. For example, by reading and writing art and literature, I can find a creative outlet
for my stress and frustration, and a positive way of coping with my difficulties and challenges. I
can also connect with others who can empathize and encourage me, and who can offer me
advice and feedback.
- Connect with my patients and colleagues. By engaging in art and literature, I can learn more
about the lives, cultures, and preferences of my patients and colleagues, and how they cope
 with illness, pain, and loss. I can also share my own stories and insights with them, and create a
rapport and trust. This can help me to avoid becoming too distant, indifferent, or judgmental,
and to foster a relationship of care and respect. For example, by reading and writing art and
literature, I can understand the needs, expectations, and emotions of my patients and
colleagues, and how I can best help them. I can also communicate with them in a clear,
respectful, and empathetic way, and show them that I care about them as individuals.

5. We created MedMate, an online platform that connects pharmacies across the island. We
wanted to help people who need regular medicines, old people, busy people, and people who
live far from cities. This was hard but also rewarding. We learned a lot about how to make a
good business plan and how to be ethical in healthcare.

We had to learn many things about medicines, rules, and partnerships. We did a lot of research
and talked to experts. This helped us to make a better plan and to work well with others. We
also learned how to be ethical in both business and healthcare.

We improved our skills in entrepreneurship, especially in healthcare. We learned how to

communicate well with customers and partners. We made sure our data was safe and followed
the rules. We also learned how to work with different people and their needs.

We used different ways to market our service, such as online ads and text messages. We also
added educational content to our platform. This helped us to reach more customers and to keep
them informed. We also learned how to manage our costs and revenues. We balanced our
spending and income and worked with other businesses and healthcare providers.

We gained a lot from making MedMate. We saw how business and healthcare are related. We
developed skills that we can use in our medical career, such as communication, problem-solving,
and financial management. These skills will help us to face challenges and to care for patients.

This is a summary of our journey. It shows how we made a business plan and what we learned
from it.

6.
During my clinical observation, I learned a lot about the professionalism skills and qualities of a
doctor. I saw how doctors should treat patients and other health care workers with respect,
kindness, and empathy. I also learned how to communicate clearly and effectively with different
people, such as explaining medical terms, listening to concerns, and giving feedback. I also
observed how doctors cope with stress and emotions, such as taking breaks, asking for help, and
expressing feelings. I was inspired by some positive role models, such as doctors who were
compassionate, confident, and knowledgeable.
However, I still need to develop or improve some professionalism skills and qualities. For
example, I need to work on my time management and organization skills, as I sometimes felt
overwhelmed by the workload and deadlines. I also need to improve my critical thinking and
decision-making skills, as I sometimes struggled to analyze complex situations and choose the
best course of action. I also need to enhance my cultural competence and awareness, as I
sometimes felt unsure how to interact with patients from different backgrounds and beliefs.

To develop these skills and qualities, I have a plan for future activities. First, I will set SMART
goals for myself, such as completing tasks on time, solving problems creatively, and learning
about different cultures. Second, I will create a list of actions that will help me achieve these
goals, such as using a planner, reading more books and articles, and attending workshops and
seminars. Third, I will set a timeline for each action, such as weekly, monthly, or quarterly.
Fourth, I will designate resources that will support me, such as mentors, peers, and online tools.
Fifth, I will monitor my progress and evaluate my outcomes, such as by keeping a journal,
getting feedback, and celebrating achievements.

I hope this plan will help me to apply what I have learned about being professional in my future
practice. I want to be a doctor who is respectful, kind, empathetic, clear, effective, confident,
knowledgeable, organized, creative, critical, decisive, and culturally competent. I think these are
the skills and qualities that will make me a good doctor and a valuable member of the health
care team.