It is the time of the year again, where the old ends and the new begins. Where we seek reassurance from the baffling resolutions we never meant to keep.
It is also a season for young students to decide the course of their career. Fresh faced and bright-eyed, full of hyped up myths and legends, they will inadvertently have one ambition in mind. A dream they have kept repeating from childhood or rather a mantra that was repeated to them : GROW UP AND BECOME A DOCTOR.
I am here to tell you what your parents conveniently forgot. There are things to consider before foolishly embarking on a journey not meant for you. In short, I am a myth buster. But in reality, I AM A DOCTOR.
Myth number one: The hard part is getting into medical school.
This is not the hard part at all. The real challenge is remaining in medical school till you graduate. The numerous exams and assessments will leave most of you gasping for reprieve.
My advice to you is to go to the nearest book store and browse through the medical books. Have you seen them? Do they look shiny and thick? Good. Now imagine spending your weekends with them. For the next five years!
Clinical exams on the other hand are unique to medical schools. Two examiners will observe your every move as you attempt to demonstrate the multiple clinical signs taught only once during your ward rounds. Mass production of doctors by a single medical school is a myth. A significant number would have dropped out by the time you graduate.
Myth number two: Internship training is not as difficult as it sounds.
You are absolutely right. It is infinitely much harder. Every decision you make will be scrutinized and criticized. Some senior doctors will humiliate you for simple errors.
There may be times your ignorance might be detrimental to a patient and you may lose a patient during the course of your internship. Recovering from the loss is hard, especially if there is a chance you could have prevented it. The guilt will eat you up, forcing you to drop out of clinical work. And this guilt will stain your conscience for life. It will never wash off.
Myth number three: Doctors are highly respected in the society
This may have been the case in the previous centuries but as our society becomes more affluent and educated, they invariably become more demanding.
Walk through the corridors of any hospital in major cities, wearing your white lab coat and stethoscope, you would be hard pressed to find any layman who greets you with a smile or a respectful nod to say the least. Forget about “good mornings” and “good days”.
Since the lawyers are fast becoming the bane of our existence, our daily work consists of evasion tactics to prevent lawsuits. A new form of medicine is being practiced now and it has superseded the “clinical medicine” that was taught to us. It’s called “defensive medicine” and it is being practiced throughout the world.
Unnecessary investigations and treatments are administered, which bleeds our health resources dry, just to protect ourselves from legal attacks. An example would have to be the fast emergence of resistance to most antibiotics due to injudicious use, which if seen from another perspective, stems from the practice of defensive medicine.
Myth number four: Patients will always be grateful to the doctors
Before you start filling up the forms to enter medical school, you need to get one thing embedded in your mind.
Most patients will never say “thank you” or “you did your best doctor” if they get better. They will assume it’s their birthright to get better once they see you and it is your duty to make them well as they pay taxes.
I have been in this service for seven years and out of the thousands of patients I have discharged home safely, I can say less than a hundred have expressed their gratitude. Most would be complaining about the time it took for the doctors to prepare their discharge notes and plan subsequent follow-up appointments.
Then when they come back to see us in clinics, they will complain about the waiting time, not knowing you would have been starving the whole morning, just to start the clinics early to reduce the waiting time of the patients. After the consultation, you would be the one thanking them, and they will be rushing for the door to get the next cab home, so that they can be back in time for lunch with their family. And before I forget, lunch is a luxury you don’t often get.
Myth number five: Patients always place their full trust in doctors
If I have not deterred your interest in medicine up to now, I guess this will do it.
You are no savior. Remember this, and remember it well.
You don’t walk into a ward with the authority of a royalty and tell your patients you are going to start some form of treatment for them regardless of how they feel about it because they should just trust you. You had better find another job because their lawyers will sue the pants off you.
There is something called “patient autonomy”. It is they who decide to pursue any course of treatment and this is based on the quality of communication between both parties.
You can’t force a Jehovah Witness to receive blood transfusion even if she is bleeding away after delivery and would rather die that see a drop of blood enter her veins. In a bustling labor room, you might get a few requests at the same time for a female doctor to attend to patients with specific religious beliefs when there are no female doctors around. I have had patients who insist on seeing only a particular doctor knowing well he is on leave, while the infection eats away their foot, vehemently refusing other doctors and medical interns to come near them.
Official complaints to the administrators will follow suit if we don’t comply to their every wants and needs. Media bashing and Facebook groups with ridiculous demands are only a tip of the iceberg. The internet age has created many pseudo-doctors who assume they can challenge your treatment plan and knowledge based on a few articles they have read online. They will quote everyone and if possible even their neighbor’s cat which according to them recovered from appendicitis without any surgical intervention (True story!) .Go figure.
Myth number six: Sleep deprivation is a thing of the past
Sleep deprivation will remain in your present, brought forward from your past and linger on in your future. Medical interns will suffer the most. Depending on the sub specialty you choose, sleep deprivation will follow you like a shadow. No amount of adjustments to working hours will prevent this because the diseases don’t come with an appointment. As you climb higher up the ladder, responsibility increases exponentially and sleep quality reduces dramatically. Sounds poetic but it’s true.
Myth number seven: Doctors are guaranteed a job for life
Get this idea out of your head. Due to the blossoming of medical schools in most countries the supply is fast overcoming the demand. Some countries can’t cope with the number of doctors being churned out every year, that stringent entrance exams are enforced prior to permanent placement for internship. Requirements for specialty and sub specialty trainings are stricter now than they used to be.
Legal ramifications and higher costs in setting up private hospitals and clinics are fast reducing the number of experienced doctors who tend to live on their pensions and lead a relatively stress free life. The only thing you are guaranteed is the title in front of your name, which after a while numbs you and loses its sense of appeal.
Myth number eight: Doctors make lots of money
Doctors make a decent living. We don’t mint money if that’s what you’re after. If you are motivated by money I suggest you find another way to earn it. You will never be happy in this field. It’s just not for you. And it’s not your fault if you are motivated by financial riches. Just don’t use the pain and suffering of others for your own gains. There are other ways. Please find it.
Myth number nine: Life is easy for doctors in some countries compared to others
I don’t have to travel around the world and speak to every doctor, living or dead alike to tell you this. Life of a doctor is never easy, regardless of which corner of the world you work in. If it’s easy, then you’re not doing your job right.
Each country has its own challenges and any reasonable clinician with a sound insight will tell you the same thing. Perhaps they will venture to add-on some that I have missed out. You can try running but you will eventually end up where you started.
Living conditions and pay structures may change but human nature remains a constant throughout the world. Since our profession deals with human ailments and diseases, handling their behaviors and concerns conjointly falls on our shoulders. This is where the interminable difficulties lie, not in the diseases, but in the unpredictability of human responses.
If you do find or hear of a country where the doctors there have it easy, do let me know. I will swim there or drown trying.
Myth number ten: Doctors are busy but they still have time for their family
Finally, if you have been reading patiently up to now, courageous and steadfast in refuting most of the myths, telling yourself “I know what I am getting into”, then this is the last weapon in my arsenal.
If you love spending most of your time at home with your family, if you see yourself being around your children when they grow up, if you want to be there for your wife when she is pregnant with your children, hold her hands while she delivers your baby, if you yearn to witness the first few steps your child takes, then this unfortunately is not your path.
Medicine will take up most of your time and very little will be left for your family. Many marriages have broken down for this reason alone. Children have grown up blaming their parents for not being there for them during their formative years. You will miss the important anniversaries, dance recitals and football games. Do you think a mere job is worth all this?
For now, this is all I have. I have painted a bleak picture. You have just seen it. And all of it is true.
So do you still want to become a doctor?
If your answer is still a resounding “yes” then I will let you in a secret. The important piece of information withheld up to now, meant only for those who truly deserve it. I have no regrets as well. Do you know why? Because we are the select few chosen to ease pain and end suffering. It’s a selfish act of being selfless. For one good day in this profession, I am willing to weather a hundred bad days. For a single smile of gratitude, I will brave a wave of indifference. For a person to be returned to their family, I am content if I only get to kiss my child goodnight.
I wake up every morning with a reason to live. It is profoundly better than those who wander aimlessly in a life of wealth and comfort. There will always be dark clouds. Even if I can’t see the sun, I know it’s there. And this sun is invincible. I hope you see it too someday.
Dharmaraj Karthikesan's Blog 
Good write up Dharma. I hope I was not the bad senior you mentioned above.
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You were the best senior MO I have ever worked with. Period.
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See the comment below 🙂
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Terrible English … No wonder doctors r losing respect … Injudicious ???? Just looks like a sour apple story crying for attention … 😜
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Dear Tony,
I think you did not read the whole article. I will try to improve on my ‘terrible English’. By the way, injudicious means showing lack of judgement, being unwise or imprudent. This is all the English I know. Take care. Have a nice day.
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respect u 🙂
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Thank you 🙂
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Are you basing these experiences from your time in Malaysia? If that’s the case, what about doctors making a living abroad? Does all this apply to them as well?
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Dear Vinod,
Thank you for your comments.
Firstly, yes, you’re right. This article was written based on my experiences in Malaysia. I worked briefly in London for my clinical attachment prior to completion of my MRCP. The challenges faced there are similar but to a varying degree.
I strongly believe regardless of where you work or study, life as a doctor is never easy. If it’s easy, you are not doing your job right. The stresses and challenges I have underlined are not mine alone, but it is what I have constantly heard from my fellow doctors and seniors. You can say I have added and accumulated their experiences as well in my writing.
You don’t have to take my word for it. Speak to senior doctors in your country, with a good insight regarding the direction of your healthcare and they will tell you pretty much the same thing. I daresay, they may also add a few things I missed out.
But hold on to my last paragraph, being a doctor is rewarding and it’s certainly worth the while if you understand what you are getting into.
Thank you once again. Have a nice day. Cheers 🙂
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Love the article, good job Dr. You said it like it is. From another dr from prehistoric era.
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Dear sinari,
I am the guy in yellow. I am standing next to my late father who got me through most of the challenges I faced as a doctor. I am glad you liked the article. Cheers 😉
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Excellent piece of writing dharma!!! Way to go man! I’m impressed with the myth 3 4 5, only us as doctors will understand it better! BRAVO man!!!
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Thank you lally 🙂
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Thanks for sharing…i totally agree with what you have mentioned although i doubt those not in the profession will agree or commisserate!!!! In my opinion, the only non-medical person who will understand are spouses and children of doctors, that too somewhat begrudgingly….
And yes – no regrets here as well…days where a smile is the thanks i cherish for the whole week……some patients really make you soar above the dark clouds!!!
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Thank you for your kind words. I wrote this bearing in mind the young people who are interested in medicine. They should at least have an idea what they are getting into. Cheers 🙂
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Good article doctor! It’s very inspirational for me.Hope this article will help all other medical students as well.
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Thank you 🙂
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Well said Raj…
Che An
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Abang Anuar! Thank you 🙂
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I applaud u for having the guts and decency of telling it like it is, the hard truth of being a doctor..agreed with everything that was said.. Hoped everyone reads and passes this around, so that many does not end up disappointed that bein a doctor is not all its cracked up to be.. Nonetheless, i still love doin wat im doin..
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Thank you 🙂
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wow i didnt noe u have blog..cool
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Well Naim… I do. It’s just that I don’t update it that often. Only when I have something important to say.
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Great post, Dr. Raj, as I am sure you know.
I will be lying if I said that I have never regretted my decision to become a doctor, especially during housemanship training.
But mine is the case of learning to love medicine, rather than falling in love with it. It was hard at first, but it feels natural now, especially now that I get to do psychiatry, a field I have always had a passion in.
In my personal experience, learning to love is better than falling in love. It makes the love stronger because it is not blind.
Your post will help others out there to not blindly fall in love, too. A great help to aspiring doctors out there.
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Thank you 🙂
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That’s a very nice post Dr Dharma! I’m a medical student. Amid the problems of surplus of doctors that we’re facing now, I still believe there are good doctors to guide us later on during our housemanship. It’s extremely worrisome reading on the deteriorating quality of doctors that are being produced by the universities nowadays. Btw Dr, can have your email please? Thanks a lot Dr 🙂
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Dear Sathiya,
Thank you for your comments. We are now in the verge of one of the greatest crisis in our healthcare system. What was once a shortage is now a crisis of overindulgence and surplus. The challenges I have mentioned are real. Any sane doctor will tell you that unless they are living in a cocoon of denial. And they will also tell you how rewarding it can be if you get the balance right.
I wrote this for you, especially for the students who are holding the entry forms to a medical school at this very moment. You need to understand completely what you are getting into.
I read a comment recently that there is a grey area for those who choose financial rewards over passion to serve especially if they have spent a huge amount to earn the title. As such it justifies their need to place importance to monetary gratification.
If you are going to spend exorbitant amount of money just to become a doctor, motivated by nothing else but financial riches, casting aside even an ounce of passion to serve, let me warn you now and warn you well ; you are never going to be happy.
Keep service to your fellow mankind at the forefront of your mind and all else will fall in place. Trust me. You will have more than you will ever need.
Take care. God bless 🙂
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Hi Dharma, it’s a very well-written piece! Hope my parents and my society can understand why I chose not to be a doctor in the first place.
I wrote a similar piece about why I don’t want to be a doctor here http://akirastory.com/2012/12/15/why-i-hate-becoming-a-doctor/ The English is not as great as yours, and your points made mine look so selfish. Nonetheless I really like your points.
and to those who had seen through the bleak picture of being a doctor and are still willing to be one for a greater cause, I salute you guys.
Cheers, God Bless!
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Dear Akira,
Thank you for your comments and your kind assessment of my proficiency in English.
I read your blog before replying and let me assure you, that you have more insight and decency than someone years ahead of you in age and experience.
We are not so different, you and I, what we feel about the direction our lives should take is similar. I did my undergraduate studies in UNIMAS and did my clinical attachment in Sibu which after reading your blog I understand to be your hometown.
Thank you once again and I am glad to have had your acquaintance. God bless 🙂
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Reblogged this on AKiraStory and commented:
I found this blog on my News feed, and I couldn’t agree more. I never went through the hardship to be a doctor at the first place, so I do not know much about being a doctor to comment much. Every job has its own hardship and its own reason to begin with. Embarking a journey for the wrong reason will only lead you, or even worse, those around you, to despair and unhappiness.
And to those who are willing to sacrifice their time and everything they care about to be ” the select few chosen to ease pain and end suffering”, you guys have earn my respect.
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I have received many comments, mostly encouraging and I have tried my very best to justify their comments with appropriate replies. Some I have not approved because not only do they lack context and comprehension, they are beyond the realm of my judgement and intellect to construct a suitable reply. I am steadfast in my belief that I can never win an argument with a person at the opposite end of a moral spectrum and with those on an entirely different intellectual plane. To the doctors, laboring tirelessly in impossible conditions to care for your patients, I am always there for you. And I write so you can be heard.
Kind regards,
Raj
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Ive always wanted to be a doctor since I was small bcse I thought it wouldnt have to go through a lot of hardship and I could spend most of my time with my family. But after reading this I think its quite true. Ive seen a doc had to rush to the hospital at 4am and they had a small amount of time to spend with family. But I think you earn my respect. Being a doctor is not an easy task but its a noble job(:
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Thank you ☺️
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Hello there!
I’ve recently completed my form 5 and am aspiring to pursue my career in the field of Medicine 🙂 Your blogpost gave me something to think about, and after reading it I still stand firm in my future career choice, plus it gives me more motivation and eagerness to start!
Thank you so much for the well-written blogpost 🙂 Do share more experiences or thoughts as I think there are many others who too will look forward to reading them.
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Dear Annlee, thank you for reading and for your kind comments. God bless.
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I think this should be a must read and a compulsory read for anyone applying to join med school. Am in the middle of my clinical years, still young in the heirarchy of the medical sphere yet all you said stands true, the studies, at times the despair and worse the sleepless nights however the feeling of gratitude you do get from patients from time to time is enough of a reason to be going through all those hurdles… Your writings are definitely worth reading… All the best ahead…
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Dear Adam, thank you for your kind words. All the best.
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I read this article with great delight. Myth 8 struck me the most. I remember my uncle’s words the day I graduated from Medical school, ” Medicine should always be a practice. The day medicine becomes a business is when you should stop being a doctor.”
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Well said! Obviously written from the heart to be shared for the benefit of this noble profession. Have just discovered your writings and you have my admiration.
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Dear Doctor, I come from a family where several are in the medical profession. So several of your myth busters are known to me. I am not in the field of medicine (as I did not have the patience nor the stomach to pursue medicine), but I have had students who were pursuing a bachelor’s in science as a pre-med degree. I told them: if the reason you want to be doctors is because you want to become rich, then you are in the wrong field of study. You should want to be doctors because you want to be health care professionals (accent on care). I have just forwarded one of your articles to one of my former students who happens to be re-thinking whether the path he has chosen is the right one. Let us hope that he chooses the right path that God has chosen for his good and the common good.
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