Another post..

Sorry.. for lack of a more creative title..

And so sorry for the lack of updates.. Not my fault acutally.. Was intending to blog a bit more during this electives period but my computer decided to go on strike.

Doing medicine electives now at Tan Tock Seng Hospital.. Electives has been good here. The tutors here are very nice and eager to teach.. Right from the senior consultants to the house officers.. The HOs here are very knowledgeable too and there's lots to learn from them. Actually during this medicine elective, I start to realise that I am going to be a real doctor soon.. Okay maybe not a full doctor cos a HO is basically just a clerk and odd job labourer.. But still there are more responsibilites.. Especially during night calls when it's just you and the medical officer. And patients might collapse on you any moment. And all these are going to happen in slightly less than a year's time.. if everything goes smoothly.. I feel so unprepared.

Also started thinking about what I want to do after I graduate.. I know I said before that I wanted to be a polyclinic doctor.. but nothing is cast in stone yet. Anyway for those of you who are still confused as to what the path is like for a medical student after graduation. Here's a little explanation. Cos I realised non medicine people have great difficulties understanding what I tell them.. so I always get questions like "are u working now?" and "what are u specialising in?"

As of now as medical students, we are not working and we have no pay.. From year 3 to year 5, we are attached to hospitals, rotating through all the departments including things like anesthesia, forensic pathology, obstetrics and gynecology and psychiatry. What do we do? We don't have patients under our care. We have tutors who will teach us about diseases, teach us how to take a proper history and examine the patients. They can bring us to see the patients in the clinics or wards and demonstrate some signs to us. Sometimes we approach patients at our own time and talk to them and examine them, with their permission of course. Then sometimes we are required to present the cases to our tutors.. "This is Mr so and so.. He is admitted yesterday for a right-sided blah blah.. During examination, I found a blah blah.. My provisional diagnosis is a yahdah yahdah.."

At the end of year 5, we will take the dreaded final MBBS. After which we become qualified doctors and ready to undergo the baptism of fire through one year of housemanship. I think in some countries, they call it internship. After that, we are promoted to the rank of medical officers/residents. Thereafter the rise through the ranks differs from person to person depending on what one wants to do and how good he/she is.. For guys who disrupted NS like myself, after one year of housemanship, we will be medical officers for either half a year or one year.. Then we will go back to the army to serve our remaining 2 years as army medical officers.. After which we will go back to serve out the remainder of our bond in the government hospitals..

Where does specialisation come in? During the time when we are medical officers, we can apply for specialty openings and specialist exams. So this is a supply and demand thing. Some specialties are hotter than others.. Some like internal medicine are not as popular and probably easier to get in, provided u pass your specialist exams.. So all these preparation for exams and taking of exams happen when we are medical officers in the hospitals.. If u pass the specialist exams and a hospital has an opening for that specialty and wants u, then u will become a junior specialist or what we call a registrar.. Normally by the time this happens, it would have been about 3 years already after housemanship.. This varies a great bit cos some people will take longer to pass exams.. Imagine driving test, it's something like that.. A registrar will then need to take higher exams after about 2, 3 years before becoming an associate consultant, then consultant then senior consultant..

So if u don't want to specialise? Actually there might be no such option.. Even if u decide to become a GP, in the past u can just leave the hospitals after finishing your bond and become a GP, but now u have to have a specialist degree in family medicine before u are qualified to be a GP..

Yup, that's what our career paths are like.. what I will be trapped in for the next 10 years or so.. Actually it's the same everywhere.. Just that in the medical profession, it's much more structured and there are really not many options, it's either National Health Group or Singhealth or the private sector..

What am I going to become? I only know I will most probably not be a surgeon, so that excludes surgery, orthopaedics, obs and gynae, ear nose throat (ENT).. =)