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Medical Officers' Column -

"I want to cure and heal my fellow human beings of sickness... so becoming a doctor is a natural extension of what I've always wanted to do"

The Way We Were

I vaguely remember sitting outside the tutorial room on the second level, next to the medical library, together with my fellow aspirants, to the noble profession of healing. Thoughts about how to answer the questions asked by interviewers raced through my mind. It feels like it was only yesterday.

"Why do you want to become a doctor?" Bellowed an eminent doctor sitting on the panel. "I want to cure and heal my fellow human beings of sickness… I get great satisfaction from helping people… so becoming a doctor is a natural extension of what I’ve always wanted to do." There were other similar questions that day. They were likewise answered with the innocent idealism and hopes that came with assuming this noblest of all professions.

Soon I found myself poring over books by Snell, Guyton, Harrisons, Bailey & Love (co-authors) and many others, in my thirst for medical knowledge. Rushing for tutorials and attending lectures on sleepy afternoons were inextricable parts of the package. It was a long and arduous process. Thoughts of giving up crept into my mind whenever the pressure got too unbearable. However, I kept reminding myself that I had to do well in my undergraduate studies if I wanted to become a good doctor and be of any use to my patients. I trudged on, still idealistic.

The finals came and went. Soon I was a house-officer, the lowest form of life! Yes! Even lower than an amoeba, as one eminent Professor once put it bluntly. It was a culture shock to say the least! Very different from what I imagined it would be. I had to grapple with innumerable demands made on me, both physical and emotional. The long hours, heavy workload (caused in no small measure by IVs, hypocounts and ECGs), patients dying on you, and occasionally unsympathetic seniors, all of which made it a living hell, to say the least. I reminded myself this was a rite of passage. And I trudged on some more, still idealistic.

Soon life was bearable as an MO. I was more confident of my medical knowledge and had become a valued member of my ward team. The workload was manageable through heavy. I began to enjoy my work and yearned for more. I was living my ideals; and so I thought.

The realities of modern society slowly crept in. I was getting older. Thoughts of marriage, owning a flat and maybe a car were some of the financial commitments I had to face. I was in my late twenties and without much savings. However, I considered myself better off than some of my classmates who had to borrow from the banks and had instalments to pay. Most of my JC classmates were already doing rather well career-wise as they had started to work a few years earlier than me _ many held good stable jobs, working only five-and-a-half-day weeks. Some lucky ones did not even work weekends. Some had already married and started families. The scholars among us were even better off _ they were able to build a small egg nest from their yearly allowances. The final comparison was stark.

At the same time, we began to talk in the staff lounge about opportunity costs, salaries that did not commensurate with the sacrifices we had to make, long working hours, heavy workload, less-than-optimal medical training … the list was endless. I started to question the reasons for trudging on in a system that demanded my sacrifices but offered little comfort and benefit. It did not help when senior doctors told us that we were having a better life now then they did _ albeit time. The medical world and society have changed drastically from their time, and so had expectations. I began to wonder whether there was a better way out to conquer this. Some found their own way by leaving the system. Many who could not afford to leave, learnt to accept and make the best of it. Others laboured on, disgruntled and frustrated, or even disillusioned. Really bites! Ouch!

We do live in a real world. Society has changed and so has its demands. Our attitudes have also changed. It may not be fair to expect life for doctors now to be the same as in the past for expectations, working environment and values of doctors have changed. Many of us feel that we have not been given fair remuneration for the sacrifices we make as compared to our peers in other professions and occupations. Comparisons are inevitable and doctors are also human beings with feelings and hopes. Managing the aspirations and expectations of young doctors today will be a difficult task for the Ministry of Health, but it is not impossible! We want to feel nurtured. We want to be consulted on issues that concern us. We want to receive good training. What we do not want is to be treated like just another employee, paid to do the job! Maybe more career guidance could be provided at the JC level about the expectations and demands of doctors today. At least potential medical students would know what they would be getting themselves into. And I am not talking about preaching the glamorous side of the profession but also the other side, the more down-to-earth realities and day-to-day issues. Maybe the Ministry of Health can also reach out to young doctors to explain the rationale behind certain ‘inpopular’ manpower policies. This may help remove negative perceptions of these ‘unpopular’ policies among young doctors.

I am thus glad that the Ministry has taken concrete steps to reach out to young doctors through surveys and focus group sessions with various specialty groups to obtain their feedback and explain policies. I hope that the feedback gathered could be translated to positive changes in the system. We, on our part, should participate actively in this process and be pro-active. We should exchange scepticism and cynicism with constructive suggestions and pro-active action. Only then, can we help to improve our system now and maybe, that of our children, if they are similarly inclined.

After all is said and done, I hope we can remember the way we were when we started on this journey and I hope will continue to trudge on towards our ideals, regardless of the difficulties that come our way. More importantly, we must never forget our raison d’Ítre for entering this noble profession, OUR PATIENTS!