Most of us live in an ideal world. This world exists only in our minds. If there is a distortion and when reality sets in the truth is pretty hard to swallow for most.
We hear of many talented and brilliant youngsters with strings of achievements wanting to become doctors. Their proud parents no doubt played a major role. This article was written bearing them in mind.
Allow me to introduce myself. I am a physician working in one of our general hospitals. Hospital Sultanah Bahiyah, Alor Setar to be exact. I have been in service for more than 5 years now and in this short span of time I have been forced to swallow and digest many truths about my career. Along with that a great many myths have been dispelled as well. I will tell you all about it.
I was a high achiever in school but I never wanted to become a doctor. There, I have said it. My friends who knew me from high school would tell you just that. I wanted to be a lawyer specializing in criminal and constitutional law. I was that focused from young. Medicine never crossed my mind. If at all I had a second choice it would have been journalism but certainly not medicine. It was due to some unexpected turn of events which placed me in medical school. My father played a major role in this. He has always known me better than I have known myself.
Lets start with life in medical school. The first two years is all about hard work. Make no mistakes. You will not have as many assignments as others but that will be more than made up with the number of exams you will have to sit. Each exam will leave a wrinkle on your face and if you have a part time modelling career planned I dont think acne is the current fashion trend. Depending on the medical schools some will have an exam almost every 4 to 8 weeks. It may just be a simple exam to most but it carries cumulative marks for your finals. Your study materials may weigh more than you at times. And all this to be completed within eight weeks. Sadly, this is just the beginning.
The final three are known as the clinical years. If you are from a respectable instituition you will be expected to examine and learn from patients during bedside teachings. To the uninitiated I will tell you how it goes. You will be brought to a patient during rounds in the morning. Your clinical professor will then proceed to show you and maybe a dozen others how to elicit a clinical sign. Your colleagues will then hover over the patient with some craning their necks to get a better look. With luck it may make sense to you but if it doesn’t, all of you will still nod your heads in unison in fear of being labelled slow, lazy or stupid! Some of these signs you may never encounter during your daily ward rounds but will miraculously appear during exams without fail!
Your clinical exams are another issue altogether. Two hawk eyed examiners will watch your every move as you attempt to demonstrate the myriads of clinical signs that they presumably taught you during your bedside teachings. Guantanamo Bay may need these individuals. Without uttering a word they can make your heart race and your mind go blank in an instant. Some perspire so much during these exams that when they come out of the exam hall you would think that they visited a waterfall! Failures are common especially if you do not live up to their expectations. Mass production of doctors by our medical schools is a myth. You have no idea how many have been culled and are running around like headless chickens now!
If you are lucky (or unlucky!) enough to graduate there is more in store. After the fuss of graduation (where you will be forced to don dignified clothes the size of Brazil and take numerous flash photos that can sometimes be detrimental to your retina!), you will then proceed to housemanship training. If you thought medical school was bad enough you aint seen nothing yet!
You must have read about house officers. Their plight is often highlighted in the media and are garnering more attention than the presidential race in the United States. House officers training lasts for 2 years. You will rotate among the major departments in the hospital. During this four monthly rotation you will be expected to learn and manage patients with supervision from a senior doctor. Depending on the senior doctor or your own performance life may never be the same again. Your mistakes will be scrutinized and picked upon. You may think of it as a humiliation especially if its done in front of patients but this is the norm. Mistakes in an office might cost someone a fat contract but mistakes in the ward might cost a patient’s life. You will realize there arent that many broom closets in the hospital for you to hide and shed tears when this happens. It may remind you of the many ‘Scrubs’ episodes (where the senior doctors practically devour you for breakfast, lunch and dinner and leave some for supper that night) and its not as glamorous as ‘Grays Anatomy’. Sleep deprivation is no longer an issue at this point because due to the current change in the training system you will only be expected to work 60 hours a week.
The lesser hours may not be a boon for many. If you do not make full use of your training during this limited time further horrifying events might follow.
I will paint you a scenario. After housemanship training you might be sent to a district hospital with the nearest general hospital a ferry ride away. You will then be expected to work 36 hours straight without sleep, single handedly manning a casualty department of a district hospital. A patient might come in the wee hours of the morning and worse still if its an ill child with a reversible illness. You will then be expected to perform a procedure you have only seen once during your entire housemanship training. Your seniors are conveniently not contactable. How are you going to perform? Its a life saving procedure and you have only seen it once. If you are lucky or talented enough you may get it in your first attempt. But what if you are not that lucky? What if the child dies because you could not do it? Can you look the mother in the eye? Sleep deprivation might become the natural order after that. And thats the bitter truth.
Upon completion of housemanship you might want to further your studies in a preferred speciality. Studying medicine was already bad enough but working at the same time is plain torture. Taking care of young toddlers during this period is not an added advantage. If your training requires being away from your family and rotating among the different hospitals in our country it requires divine-like patience and perseverance. Some exams requires you to fork up exorbitant amount of money for each sitting. Since failure rates are high and the exam fee might cost more than your monthly pay, you might end up being slightly better off than a waiter in the end.
After becoming a senior doctor or a specialist you will then be given many responsibilities. One of which may include training of young doctors. If you are as lucky as I am (most of the time) you will be given the chance to work with bright and enthusiastic house officers. Some unfortunately are not that lucky and may end up in private practice or take up another career path altogether.
Why take up medicine if all that I have painted sounds like entering ‘hell’ and consorting with the demons?
Medicine is a vocation. Its a divine calling. Its a selfish act of being selfless. Its a priviledge bestowed upon a select few to serve mankind and to alleviate their pain and suffering. Gratitude in the eyes of patients and relatives once healed of their disease and ailment is priceless. Your teachers will become your pillars in life. They will pass on to you the time honored traditions of being a doctor which in turn you will pass to the next generation. Thats how it has always been. If you have done your work sincerely and passionately they will proudly accept you as one of their own. Unless you are a soldier fighting side by side in war, the friends you make during this period will become your lifeline. Some of them have done so much for me while expecting so little that I would gladly take a bullet in their place.
You may not have enough time with your family as others might have but you would have returned someone back to their family. You would not have enough sleep at times but when you do, you will sleep with a sound conscience. You may not make as much as your friends in other ventures but your patient’s will consider your very presence invaluable.
Finally, you may ask me this. Do I have any regrets in being a doctor? I do and there is only one. Its that I never realized this earlier. When I wake up every morning I cant think of myself doing anything else but this. I would not change a single thing about my life because it has brought me exactly where I want to be. Its a pleasure to learn, treat, teach and in turn be treated. I count myself blessed to feel this way. The journey so far has been worth the while. And I can still keep on going.
Dharmaraj Karthikesan's Blog 
Very well written, Raj!!
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Thanks boss. All of you inspired me to write this.
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*smile*
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Shared your post on Facebook. Hope you don’t mind. 🙂
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Thank you. I am glad you liked it. I tried to be as truthful as possible.
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As somebody who went into medicine and spent many of my call nights wishing I had dome something else, I feel strongly when people go into it for the wrong reasons. (I once had someone tell me they went into medicine because JPA gave them a scholarship for it and they didn’t know what else to do.)
We need more Drs. who will still clerk, take the blood, do the dressing / other relevant procedures for the patient who comes in 15 mins before “shift” ends. Drs. who will know all their patients and not tell the MO “Sorry, Dr. I’m night shift, that man came in the moring.” (You get the picture.)
In my time, I already thought we were a spoilt lot compared to people who’d gone for HO-ship when there was only 1 person on call for the whole Department. I shudder to think what this batch learns.
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Rest assured there are many decent ones around. I hope this article brings some sense to them.
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The first 3 paragraphs, especially the 2nd and 3rd, made me feel like i was reading my own autobiography…
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I hope you found the article worth the read. I tried to be as impartial and as truthful as possible 🙂
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