Almost one and a half months have passed since the announcement of the board exam passing. Where am I now? I have decided to take the USMLE Step 1 on the third or fourth week of January, then Step 2 CK on May and Step 2 CS on the second week of July. How am I feeling about this? I feel calm about it. However, I get some points of hesitations since I have to study everything all over again (well not really all over again). This review is like my refresher course to Medicine since I have just recently took the board exam in the Philippines.
What am I glad bout now is my opportunity to come up with a team building workshop for a group of high school boys. My constant calling for a "gig" like this suddenly came true. I was lucky enough that one of my batchmates thought about me in helping this group. Hopefully, this would turn out well since I am a little bit rusty given the 2-year delay of without practice.
I have also attended an volunteer orientation seminar in Kythe so I can be a part of their volunteer pool (officially). One of the steps that I proposed to take is to go back to Kythe. Why? Since it is where my affirmation to take up medicine started. Maybe I just need to take my white coat off for a while and let it rest for the meantime. Wearing a different set of spectacles might clear things a bit.
Being saturated with the same things can be nauseating.
My decision to continue Medicine as a 2nd year medical student forced me to swallow my own vomit over and over again until I got to finish it until the licensure examination. Yes, I know many would be annoyed since it is a privilege to be a doctor and to even pass the boards. Being in the world of Medicine for quite some time, I would say I have only met a few passionate doctors. Maybe some may argue on this terminology so let me define this. Passion means an overflowing emotion that one could not contain and could not help but spread it to other people. I have met a few such as Dr. Erric Cinco, Dr. Chris Soriano, Dr. Jun Cuenca, Dr. Joma Bravo, Dr. Cenon Alfonso. I believe passionate people are moved to look at things at a different light. They have managed to show that Medicine is not all about the books, agonizing rounds, egotistic consultants... they have showed that Medicine can be fun. It may be an old science but it is still new everyday. What?! How can it be both old and new? The old part is very much obvious. Medicine is new every day since more discoveries are announced, research done by the minute...keeping many doctors still confused in perfecting this art. That is why doctors constantly study even after the licensure examination, residency and fellowship. Yup, it does not end. However, I guess in any profession where you would wish to be successful, learning will never end.
I am just thankful that my parents supported the little old penniless me through my studies. Maybe one can question why I got burned out...well it happens. It happened to me now. I have kept my worries to myself for a long time that I feel like a candle burning the remaining parts of its wick. Some may call it a quarterlife crisis. It is good that this is happening to me before I make any form of commitment to any program. Yes, I will be delayed in my training by a year or two. But all is planned in His time. I will trust in Your slow work. This time I am now listening.
Saturday, October 26, 2013
Taking the Next Step
This is my last year as a student. What should be my next step? Lately, I have been having problems in terms of what to do after the boards. Hopefully, I would pass the medical board exam. Now, many are bombarding me with questions on what I plan to specialize in. Before, I can answer those questions with confidence, "I would be taking Pediatric Hematology-Oncology." Now, everything seems to be a blur. After my rotation at the neonatal ICU, I was discouraged by my residents' work ethics. What went on in my mind was I don't wish to have them as my seniors in the end. Then, my desire to take Pediatrics became less intense. After this, I am so lost right now on what I plan to do with my life. Taking up medicine has burned me out that I have no desire in diving into the same pool of sharks where fear and hierarchy reigns. Instead of allowing me to grow as a better person, medicine has managed to push me down again into that hole that I was once in. I thought, maybe it would be better if I go back to the reasons why I decided to take up medicine in the first place. First, going back to Kythe by doing volunteer work might add color again. My taste for life became so bland that my purpose for taking up medicine went with it. Second, regaining that thirst for surprises. My life as a medical intern has become routine that nothing new comes or comes unnoticed. I crave for that feeling of passion burning inside of me, literally. The jolt that I felt whenever I am into a new college project or organizing leadership programs. The zest for inspiring eager minds into making a difference. I miss my idealistic self. The Cla that I once knew. Third, I can apply as part of ASMPH's faculty or LS OSA. Maybe it can help bring things into perspective. I am sure of the following things: I love training people. I enjoy organization development for some reason I cannot explain. I crave for the thrill of meeting people full of ideas. I want to have those leadership opportunities wherein I can jump into without judgment. I know I will be a clinician forever. I hate doing clerical work. I dislike the idea of being someone's secretary. I love talking with people. I find sincerity in people important. Good work ethics matter to me. Appreciation is key to the success of any organization. I love foreign languages. I want to make a change. My training in medicine has discouraged me at some point to believe in myself, to trust in my capabilities. They may consider it weak to succumb to another person's "psychological vampirism" but I accept it as my weakness. No matter how hard you try, you are still not good enough. I believe this is one of the reasons why the health profession has never been a happy place. Patients are not easily encouraged to go for a check-up with their doctors unless they are sick. The price for healthcare is slowly making its way up the ladder that only a few are privileged enough to taste it. Your incompetence will be detriment of your career. I thought working as an employee is not fit for me since everything will be routine. I thought wrong about medicine. Still it is a routine, a boring not so happy one. Does this mean medicine was not really meant for me? Have I made a wrong decision and wasted 5 years of my life? What is my next step?
Sunday, September 8, 2013
Time to Dance with Reality
First of all, I would like to thank the Lord, St. Cupertino, St. Ignatius of Loyola, St. Clare of Assisi and Our Lady of Manaoag for guiding me as I prepared and successfully passed the medical board examination. Two weeks ago, I was so happy upon knowing that I have passed the board exams. Tears of happiness flowed from my eyes endlessly. I went to all the celebration events that were happening. After the Blue Toast, the reality strikes in just like lightning.
Everyone is going crazy about all the deadlines! With everyone going into residency, I got a taste of the pressure as well. Last week, I know I am not ready to go into residency just yet. Knowing what I have been through Medicine, and how it burned me out mentally, emotionally and spiritually, it is best that I would not go into the same battle again unarmed. Before I get into the same fiasco, I want to be recharged and excited to be finally achieving my dreams. Yes, there will be disappointments and questions of "Why am I not going into residency?" I firmly believe that 3 months may be enough for me to rest but it is not enough for me to consider all of my options. I doubted myself many times as I was studying for 5 years. I even thought of quitting med school during my 2nd year of training. But I said, just swallow it and finish it! Then again, I had the same doubt and frustration in Clerkship. But all went well during my Internship (thanks to my group too).
For residency, my top 3 choices are: (1) Pediatrics, (2) ENT-HNS and (3) Radiology.
Pediatrics: I love working with children. It has been a part of me since college. No other explanation needed.
ENT-HNS: I really enjoyed my rotations and loved it academically. What's stopping me is the surgical part. I cannot stand assisting in their very long ORs and tedious procedures, where the structures they would want to avoid are the structures that I cannot see!
Radiology: Considering that I enjoy anatomy, this is the closest that I can get (since I don't like Surgery). It is a stress-free specialization where there are no emergencies and I get to sit down and relax.
Being settled with foregoing residency for the meantime, the question is, "What should I do?" There were a number of options that were presented before me.
1. Take the USMLE Steps 1 and 2 CK/CS
2. Take a year off and teach
3. Pursue a non-clinical career
a. Health leadership training
b. Public health
c. Masters in Psychology
FIRST OPTION: USMLE
Since before, I was planning to do my training in the US for reasons I shall enumerate below:
1. Better training (highly recommended by doctors I've talked to)
2. US citizenship
3. Widening my horizon and going beyond borders (as Fr. Bu encouraged me to do so)
4. The promise of coming back and offering something better and different to the Philippines
5. Pre-requisite for my fellowship of choice
However, the cons of this choice are the following:
1. Different patients (foreign) compared to my final plan of practicing in the Philippines
2. Beyond my "comfort zone" (people, language)
3. Expensive (but my parents are willing to support me financially)
4. Delay in finishing my residency
5. No certainty of being matched right away to my choice of residency
This is a risky choice that I am considering. The uncertainty of this option makes me doubt myself on a regular basis if I am making the right decision. Deep down I know this is the best opportunity that I can get a hold of. Upon encountering this dilemma, people who are willing to help suddenly became available. I am glad that I have let myself dive into this dilemma since it has forced me to look for ways on knowing more about this choice that I am making. I got to talk with a consultant who also took the same path and is now practicing in Singapore.
However, the worry of not being able to adjust and being far from comfort are the ones holding me back (now that I've thought of it). I know it is no joke to study there, in an unknown land where I've only been to once in my life. English will be my primary language (I can but I express myself better in Filipino). Re-reading my previous blog entries, I found a common theme on how frustrated I am with the medical training I have been receiving: (1) unhealthy competitive culture, (2) inability to provide the best healthcare, and (3) irrelevant hierarchy. These points were enough reasons for me to choose which institutions I would choose to train here in the Philippines.
This frustration may be a craving of something more, of how healthcare should be. Studying in another country with good reputation on medical training may be an answer to this call for change. In knowing how things can be, hopefully, I can bring it back here and apply it. Rarely do people training abroad come back to the Philippines since they have a good life already there. That I cannot live with.
SECOND OPTION: TEACHING
I have come to realize my love for teaching during my year in med school. In every patient encounter, I enjoy explaining to them in layman's terms the physiology and pathology behind their diseases. It challenges me to translate everything that I know into simpler terms. After each encounter, they would thank me for taking time to explain things to them since no other doctor does allocate time for it.
When it comes to students, my love for formation and inspiring them to be a better version of themselves can be the caffeine that keeps me awake as I create activities or plans. I would read books, spend time learning and talk to more professionals so as to create the proper tools for these goals. I love the feeling of being able to share a part of me even in the simplest ways.
THIRD OPTION: NON-CLINICAL
This last option I have not really thought about it since it is my fall back. I have attended a Public Health Career talk last week headed by Dr. Jaime Galveztan's team. After the talk, I noticed that I did not have the same spark as the speakers or my close friend, Ginger did. I cannot connect to whatever they are saying. I applaud their efforts but I would say this is not the path for me. I cannot imagine myself living in distant communities and doing house-to-house visits. However, I can imagine myself creating systems for it and training people. Currently, I cannot see any opportunity for me here in terms of health leadership training among doctors. Most of the programs here are public health-directed (meaning targeted at the grass roots). The problem with public health is people have the passion but they don't have the tools of letting the community realize that they need to change their health behavior or beliefs. In becoming proactive about health will only the health system improve. If you see patients who ask questions on topics they have researched about, it would push the doctor to learn more and pursue further training. This will provide opportunities for advancement in the health sector. (I think too big, that's one of my illnesses.)
I have never found a decent answer to my question: "How can you encourage doctors, who are tired from studying, doing duties and taking care of patients, to do more in inspiring their other colleagues and other health professionals to go beyond their roles and do what it best for their patients?" That is what leadership is all about. Without you doing much, great things are happening. That's how we can move mountains. Concepts in business leadership is good and has been used in many professions. However, these principles came from structured environments where the goal is the be a great company which can be equated to income, employee performance and the like. Unlike in health, we deal with life. Now, how can you quantify such an abstract concept. Does it only matter if the patient lives or dies? Does his quality of life after discharge matter? How can you go beyond your specific roles as physicians in the clinics or hospitals?
There are programs offered mostly in United Kingdom on Healthcare Leadership but all require their students to be key players in the field of medicine. So this has to be parked until I reach that position in my life.
When all else fails, my love for Psychology will still be there. I can take a Masteral Degree in Psychology (which was my other option if I did not pursue Medicine). With this option, I would be training in the US for this.
WHAT IS MY CHOSEN PATH?
Currently, I am choosing to take the USMLE.
I wanted to be a Pediatrician but I also love Healthcare Leadership. It is just a question which goes first. Hence, Healthcare Leadership requires experience, I need to become a notable doctor or hospital employee for me to be considered. Knowing there are are only less than 30 Pedia Hema-Oncos in the Philippines, training here for fellowship is good but if opportunities of training abroad would be better given their advances in research and technology. Most of the protocols used are based in the studies done abroad. Hopefully, after being exposed, I can create my own cancer research facility where we can create protocols fit for Filipino children. With my training in Kythe, I would like to add this to the service it shall be providing to its future patients. It is great to dream but to make it a reality is the painful part.
My goal is to become a part of the hospital administration and be able to qualify for that Healthcare Leadership training.
I pray to God that he will always be with me in every step of the way. I know he would not give me challenges that I cannot handle. He gives me these opportunities since he believes I will grow and be a better person after.
Everyone is going crazy about all the deadlines! With everyone going into residency, I got a taste of the pressure as well. Last week, I know I am not ready to go into residency just yet. Knowing what I have been through Medicine, and how it burned me out mentally, emotionally and spiritually, it is best that I would not go into the same battle again unarmed. Before I get into the same fiasco, I want to be recharged and excited to be finally achieving my dreams. Yes, there will be disappointments and questions of "Why am I not going into residency?" I firmly believe that 3 months may be enough for me to rest but it is not enough for me to consider all of my options. I doubted myself many times as I was studying for 5 years. I even thought of quitting med school during my 2nd year of training. But I said, just swallow it and finish it! Then again, I had the same doubt and frustration in Clerkship. But all went well during my Internship (thanks to my group too).
For residency, my top 3 choices are: (1) Pediatrics, (2) ENT-HNS and (3) Radiology.
Pediatrics: I love working with children. It has been a part of me since college. No other explanation needed.
ENT-HNS: I really enjoyed my rotations and loved it academically. What's stopping me is the surgical part. I cannot stand assisting in their very long ORs and tedious procedures, where the structures they would want to avoid are the structures that I cannot see!
Radiology: Considering that I enjoy anatomy, this is the closest that I can get (since I don't like Surgery). It is a stress-free specialization where there are no emergencies and I get to sit down and relax.
Being settled with foregoing residency for the meantime, the question is, "What should I do?" There were a number of options that were presented before me.
1. Take the USMLE Steps 1 and 2 CK/CS
2. Take a year off and teach
3. Pursue a non-clinical career
a. Health leadership training
b. Public health
c. Masters in Psychology
FIRST OPTION: USMLE
Since before, I was planning to do my training in the US for reasons I shall enumerate below:
1. Better training (highly recommended by doctors I've talked to)
2. US citizenship
3. Widening my horizon and going beyond borders (as Fr. Bu encouraged me to do so)
4. The promise of coming back and offering something better and different to the Philippines
5. Pre-requisite for my fellowship of choice
However, the cons of this choice are the following:
1. Different patients (foreign) compared to my final plan of practicing in the Philippines
2. Beyond my "comfort zone" (people, language)
3. Expensive (but my parents are willing to support me financially)
4. Delay in finishing my residency
5. No certainty of being matched right away to my choice of residency
This is a risky choice that I am considering. The uncertainty of this option makes me doubt myself on a regular basis if I am making the right decision. Deep down I know this is the best opportunity that I can get a hold of. Upon encountering this dilemma, people who are willing to help suddenly became available. I am glad that I have let myself dive into this dilemma since it has forced me to look for ways on knowing more about this choice that I am making. I got to talk with a consultant who also took the same path and is now practicing in Singapore.
However, the worry of not being able to adjust and being far from comfort are the ones holding me back (now that I've thought of it). I know it is no joke to study there, in an unknown land where I've only been to once in my life. English will be my primary language (I can but I express myself better in Filipino). Re-reading my previous blog entries, I found a common theme on how frustrated I am with the medical training I have been receiving: (1) unhealthy competitive culture, (2) inability to provide the best healthcare, and (3) irrelevant hierarchy. These points were enough reasons for me to choose which institutions I would choose to train here in the Philippines.
This frustration may be a craving of something more, of how healthcare should be. Studying in another country with good reputation on medical training may be an answer to this call for change. In knowing how things can be, hopefully, I can bring it back here and apply it. Rarely do people training abroad come back to the Philippines since they have a good life already there. That I cannot live with.
SECOND OPTION: TEACHING
I have come to realize my love for teaching during my year in med school. In every patient encounter, I enjoy explaining to them in layman's terms the physiology and pathology behind their diseases. It challenges me to translate everything that I know into simpler terms. After each encounter, they would thank me for taking time to explain things to them since no other doctor does allocate time for it.
When it comes to students, my love for formation and inspiring them to be a better version of themselves can be the caffeine that keeps me awake as I create activities or plans. I would read books, spend time learning and talk to more professionals so as to create the proper tools for these goals. I love the feeling of being able to share a part of me even in the simplest ways.
THIRD OPTION: NON-CLINICAL
This last option I have not really thought about it since it is my fall back. I have attended a Public Health Career talk last week headed by Dr. Jaime Galveztan's team. After the talk, I noticed that I did not have the same spark as the speakers or my close friend, Ginger did. I cannot connect to whatever they are saying. I applaud their efforts but I would say this is not the path for me. I cannot imagine myself living in distant communities and doing house-to-house visits. However, I can imagine myself creating systems for it and training people. Currently, I cannot see any opportunity for me here in terms of health leadership training among doctors. Most of the programs here are public health-directed (meaning targeted at the grass roots). The problem with public health is people have the passion but they don't have the tools of letting the community realize that they need to change their health behavior or beliefs. In becoming proactive about health will only the health system improve. If you see patients who ask questions on topics they have researched about, it would push the doctor to learn more and pursue further training. This will provide opportunities for advancement in the health sector. (I think too big, that's one of my illnesses.)
I have never found a decent answer to my question: "How can you encourage doctors, who are tired from studying, doing duties and taking care of patients, to do more in inspiring their other colleagues and other health professionals to go beyond their roles and do what it best for their patients?" That is what leadership is all about. Without you doing much, great things are happening. That's how we can move mountains. Concepts in business leadership is good and has been used in many professions. However, these principles came from structured environments where the goal is the be a great company which can be equated to income, employee performance and the like. Unlike in health, we deal with life. Now, how can you quantify such an abstract concept. Does it only matter if the patient lives or dies? Does his quality of life after discharge matter? How can you go beyond your specific roles as physicians in the clinics or hospitals?
There are programs offered mostly in United Kingdom on Healthcare Leadership but all require their students to be key players in the field of medicine. So this has to be parked until I reach that position in my life.
When all else fails, my love for Psychology will still be there. I can take a Masteral Degree in Psychology (which was my other option if I did not pursue Medicine). With this option, I would be training in the US for this.
WHAT IS MY CHOSEN PATH?
Currently, I am choosing to take the USMLE.
I wanted to be a Pediatrician but I also love Healthcare Leadership. It is just a question which goes first. Hence, Healthcare Leadership requires experience, I need to become a notable doctor or hospital employee for me to be considered. Knowing there are are only less than 30 Pedia Hema-Oncos in the Philippines, training here for fellowship is good but if opportunities of training abroad would be better given their advances in research and technology. Most of the protocols used are based in the studies done abroad. Hopefully, after being exposed, I can create my own cancer research facility where we can create protocols fit for Filipino children. With my training in Kythe, I would like to add this to the service it shall be providing to its future patients. It is great to dream but to make it a reality is the painful part.
My goal is to become a part of the hospital administration and be able to qualify for that Healthcare Leadership training.
I pray to God that he will always be with me in every step of the way. I know he would not give me challenges that I cannot handle. He gives me these opportunities since he believes I will grow and be a better person after.
Friday, March 23, 2012
The Game of Failure
Today, I have just attended batch 2012's graduation. For some reason, it felt right for me to come and listen to the speech of their valedictorian, Kenneth Abante. In that podium representing success and greatness, he spoke of failure.
I remember one of my classmates quoting one physician, "Once you enter medicine, be ready to fail." Now, how would you react to such statement? Some may take it as an excuse for mediocrity. Some would consider it as a death sentence. As for me, I considered it as a challenge. However, one thing that I am allergic to is FAILURE. I hate it. I despite it. Recently, I have had my share of failure - having a re-orals for my strategic management paper. After hearing those painful words from my professor, shameful as it was, I cried buckets of tears - not knowing who or what can comfort me. Never in my life have I failed such a big task (as proud as it may sound). After this, I was really disappointed with myself. It made my look back on who I was before.
It made me realize how much I miss my old self. I remember myself being zealous about life, exuding energy and overflowing with passion. After 4 years of taking up medicine, it got the best of me. Let me rephrase it, I let myself succumb to its wrath of a tiresome hierarchy and a tasteless life. After hearing Kenneth's speech, it once again lit up an old flame inside of me. I am nothing but a bucket who receives. For years, I admit myself to becoming proud that I may have failed to listen intently to some advice worth taking. With a lifestyle of a machine, I neglected my soul to be fed with grace through prayer and silence. I lost sight of myself, that I lost sight of what my passion is in life.
I was invited last year to answer some questions for an audiovisual presentation for my organization. As the camera was recording, I was faced with an empty me. At that point, it confirmed my emptiness and how I have lost touch. That was the start of my frustration leading to self-blame to poor performance. I got so mad at myself that I never believed again. It's as if my former self is an unreachable goal. I forgot the power of BELIEVING. I have read in a book (The Alchemist by P. Coelho) that in believing in something, the whole world would conspire to make it happen. Basically, it is really us doing the magic. Putting some theory into things, everything begins with a thought, a belief. Approving of this thought or belief, we act on it. In constantly performing it, it becomes a habit. In becoming a habit, it strengthens such a belief until it becomes a VALUE.
In the end, failure is really not believing in our own value as a person. Failure is putting up a wall, rejecting whatever may come. Failure is forgetting to accept that we need help once in a while. In challenging failure, we must learn to be open, to accept. Eventually, we may learn to love again - to love our own self.
I remember one of my classmates quoting one physician, "Once you enter medicine, be ready to fail." Now, how would you react to such statement? Some may take it as an excuse for mediocrity. Some would consider it as a death sentence. As for me, I considered it as a challenge. However, one thing that I am allergic to is FAILURE. I hate it. I despite it. Recently, I have had my share of failure - having a re-orals for my strategic management paper. After hearing those painful words from my professor, shameful as it was, I cried buckets of tears - not knowing who or what can comfort me. Never in my life have I failed such a big task (as proud as it may sound). After this, I was really disappointed with myself. It made my look back on who I was before.
It made me realize how much I miss my old self. I remember myself being zealous about life, exuding energy and overflowing with passion. After 4 years of taking up medicine, it got the best of me. Let me rephrase it, I let myself succumb to its wrath of a tiresome hierarchy and a tasteless life. After hearing Kenneth's speech, it once again lit up an old flame inside of me. I am nothing but a bucket who receives. For years, I admit myself to becoming proud that I may have failed to listen intently to some advice worth taking. With a lifestyle of a machine, I neglected my soul to be fed with grace through prayer and silence. I lost sight of myself, that I lost sight of what my passion is in life.
I was invited last year to answer some questions for an audiovisual presentation for my organization. As the camera was recording, I was faced with an empty me. At that point, it confirmed my emptiness and how I have lost touch. That was the start of my frustration leading to self-blame to poor performance. I got so mad at myself that I never believed again. It's as if my former self is an unreachable goal. I forgot the power of BELIEVING. I have read in a book (The Alchemist by P. Coelho) that in believing in something, the whole world would conspire to make it happen. Basically, it is really us doing the magic. Putting some theory into things, everything begins with a thought, a belief. Approving of this thought or belief, we act on it. In constantly performing it, it becomes a habit. In becoming a habit, it strengthens such a belief until it becomes a VALUE.
In the end, failure is really not believing in our own value as a person. Failure is putting up a wall, rejecting whatever may come. Failure is forgetting to accept that we need help once in a while. In challenging failure, we must learn to be open, to accept. Eventually, we may learn to love again - to love our own self.
Sunday, November 20, 2011
Sincerity and Service
Currently in my Obstetrics and Gynecology rotation at QMMC, I am a witness to the continuous decline in the luster of hope for our country. In each duty, no doubt almost 50 patients give birth to either healthy or unhealthy babies. Many say that the youth is the new hope for our country. Looking into the process of bringing hope to our tired motherland, it is a process anyone would not want to witness. A maximum of 20 mothers undergo labor all at the same time in one room, with 2 pregnant women sharing a bed. The stench of a woman's vaginal secretions and feces emanates from the room. Being only dressed in their gowns, their private areas are exposed for the whole world to see. Inside, it seems like a zoo where a number of mammals are trying to give birth. Many complain of the pain - then ask them, why did you then get pregnant? Such question speaks of how uneducated many Filipinos are. The lack of knowledge on the process of bringing life and how delicate it is seems to be missing in the lustful process of making it.
Such an ugly picture that I have illustrated right? But that is the reality. As one doctor told me, we are exposed to both worlds: ideal vs reality. However, shouldn't we aim for idealism in any institution? Are we just content with inefficiency, ineffectiveness and pain? The sincerity of service in the health sector appears fake in text and in teaching. How healthcare providers treat their patients speaks for itself. On the other hand, no one can blame such attitude given the stubborn patients that we get. Then, who should be blamed for such disparity? Everyone. It just takes one to make a change. We tried and were appreciated by our patients. But does it work? That I cannot still answer. The growing population stems from 16-year old girls giving birth and multiparous mothers who never quite understood the consequences of a large family. Frustrating.
From the patient, we go into the realm of the healthcare practitioners. In order to provide proper healthcare, we need materials - needles, gauze, tubes and the like. It is like a scavenger hunt every time blood should be extracted or change of dressing should be done. Endless donations breed learned helplessness on the side of the patients. I have noticed how Filipinos lack the will to improve themselves continuously. The attitude of contentment with simplicity seems to be wrongly construed. Again, another frustrating fact. No efficient system was ever developed to hasten processing of laboratories, OR scheduling and other requests. Going in and out of the room and dressing up again wastes time and energy. Yes, you will learn skills but are these the correct ones?
Guided-teaching seems not to be the thrust in Philippine medical practice. You are left on your own, figure things out on the spot given the current problem that is facing you and swallow up that fear you are about to feel. Misaligned expectations bring about frustration among the team members, creating misconceptions of each other. A student is expected to be knowledgeable of being a first assist in a CS case on her first try. There are no excuses for being slow or ignorant - or else you will be judged by the audience. Other healthcare workers smirk or laugh at your mistakes, bring you down and raise an eyebrow whenever you ask for help. Yes, that is the service they have sworn in their own oaths. This is the kind of service and camaraderie the Philippines is capable of.
All of what I have written is irritating and ugly. Yes, many would say that I should not write this especially on the net, but this is the truth - the accepted reality so it seems by many. A number of students have passed by this hospital, yet improvement appears to be stagnant. Many have lost to look farther into the horizon and venture into new paths.
As a future doctor, one should ask the following questions: 1) Are you sincere in providing service to these kinds of patients?; 2) Are you satisfied with the kind of service that you provide?; 3) Would you say that you take part in the process of grooming future physicians who are better?; 4) Would you say that you care enough to the point of doing more? and 5) Do you think your kind of service is what the patient expects of you?
Wanting to be a doctor is easy. But being a sincere one is the most difficult task one would ever do. Skills can be taught but the matters of the heart are learned through time.
Such an ugly picture that I have illustrated right? But that is the reality. As one doctor told me, we are exposed to both worlds: ideal vs reality. However, shouldn't we aim for idealism in any institution? Are we just content with inefficiency, ineffectiveness and pain? The sincerity of service in the health sector appears fake in text and in teaching. How healthcare providers treat their patients speaks for itself. On the other hand, no one can blame such attitude given the stubborn patients that we get. Then, who should be blamed for such disparity? Everyone. It just takes one to make a change. We tried and were appreciated by our patients. But does it work? That I cannot still answer. The growing population stems from 16-year old girls giving birth and multiparous mothers who never quite understood the consequences of a large family. Frustrating.
From the patient, we go into the realm of the healthcare practitioners. In order to provide proper healthcare, we need materials - needles, gauze, tubes and the like. It is like a scavenger hunt every time blood should be extracted or change of dressing should be done. Endless donations breed learned helplessness on the side of the patients. I have noticed how Filipinos lack the will to improve themselves continuously. The attitude of contentment with simplicity seems to be wrongly construed. Again, another frustrating fact. No efficient system was ever developed to hasten processing of laboratories, OR scheduling and other requests. Going in and out of the room and dressing up again wastes time and energy. Yes, you will learn skills but are these the correct ones?
Guided-teaching seems not to be the thrust in Philippine medical practice. You are left on your own, figure things out on the spot given the current problem that is facing you and swallow up that fear you are about to feel. Misaligned expectations bring about frustration among the team members, creating misconceptions of each other. A student is expected to be knowledgeable of being a first assist in a CS case on her first try. There are no excuses for being slow or ignorant - or else you will be judged by the audience. Other healthcare workers smirk or laugh at your mistakes, bring you down and raise an eyebrow whenever you ask for help. Yes, that is the service they have sworn in their own oaths. This is the kind of service and camaraderie the Philippines is capable of.
All of what I have written is irritating and ugly. Yes, many would say that I should not write this especially on the net, but this is the truth - the accepted reality so it seems by many. A number of students have passed by this hospital, yet improvement appears to be stagnant. Many have lost to look farther into the horizon and venture into new paths.
As a future doctor, one should ask the following questions: 1) Are you sincere in providing service to these kinds of patients?; 2) Are you satisfied with the kind of service that you provide?; 3) Would you say that you take part in the process of grooming future physicians who are better?; 4) Would you say that you care enough to the point of doing more? and 5) Do you think your kind of service is what the patient expects of you?
Wanting to be a doctor is easy. But being a sincere one is the most difficult task one would ever do. Skills can be taught but the matters of the heart are learned through time.
Sunday, October 16, 2011
A Surprising Turn
I just finished my rotations in Surgery and Orthopedics. I would say these were the best days of my clerkship year. It started out bumpy but it was fun in the end. I have learned a lot and felt more like a doctor compared to my other rotations. Yes, I've gained weight given the crazy and overwhelming supply of food. Surgeons, really, are the well fed species in the medical arena.
For the past 2 months, I have done my first 2 minor operations - excision of a sebaceous cyst and a tendon sheath cyst. It was hard doing the suturing and cutting but I felt proud of myself after - and more confident. In order to survive surgery, all it takes is confidence and courage. Confidence in yourself, that you can do the procedure powered up with courage knowing that you have done your part in studying it before doing it.
Surgeons are not mere butchers who would carelessly cut through tissue just to get the job done. Surgery is an art where in each slice, you open yourself to awe and wonder of the human body. Surprisingly, after my rotation, I placed surgery as part of my choices for residency.
Thank you to the great surgery residents that I've been with. You may have pushed me to my limits, but I have realized an undiscovered part of myself. But I am afraid there is a need to tame that stronger side of me given the environment and types of people that I will be working with.
For the past 2 months, I have done my first 2 minor operations - excision of a sebaceous cyst and a tendon sheath cyst. It was hard doing the suturing and cutting but I felt proud of myself after - and more confident. In order to survive surgery, all it takes is confidence and courage. Confidence in yourself, that you can do the procedure powered up with courage knowing that you have done your part in studying it before doing it.
Surgeons are not mere butchers who would carelessly cut through tissue just to get the job done. Surgery is an art where in each slice, you open yourself to awe and wonder of the human body. Surprisingly, after my rotation, I placed surgery as part of my choices for residency.
Thank you to the great surgery residents that I've been with. You may have pushed me to my limits, but I have realized an undiscovered part of myself. But I am afraid there is a need to tame that stronger side of me given the environment and types of people that I will be working with.
Tuesday, August 2, 2011
Embracing Medicine
Last July 24, 2011 (Sunday) was my last day as a medical clerk in the Internal Medicine department. To orient you, my rotation started with 3 weeks of being with an IM resident assigned to the floors (or wards as some would call it). Then, I had 2 weeks of ICU/ACSU rotation with the 2 best consultants I have ever met. Then, 1 week in the Pasig City General Hospital in their out-patient department. Lastly, 2 weeks in the Emergency Room.
My first week as a medical clerk was bumpy since I am totally clueless of what I should do and how the definition of "initiative" comes in so many forms. The endless continuum of such noun is hard to grasp. Initiative may be defined as doing almost everything. It can be termed as continuously asking questions and participating in the discussion with your consultants. Or volunteering to be on duty despite completion of requirements. Yes, I know it is complicated. People who show initiative get merits. Merits where the criteria are taken from space.
First lesson I've learned as a medical clerk, INDEPENDENCE is the key to survival. No one will guide you or watch out for you. If you would show an inch of such need for guidance, they would mistaken you as being pampered or spoon-fed. You can never lean on someone to help you out (except for your co-clerks) especially in times of influx of patients. With independence comes self-directed learning. You seek for your own answers to feed your hunger pangs for knowledge. Read, read and ask.
Second lesson is the need to be FEARLESS and SHAMELESS. Note that the adjective I have used is not courage, bravery nor boldness. Fearless in terms of conquering whatever fear of inadequacy you might feel in your bones -- try to get rid of it. I have had my own dose and it did not help. The fear of not knowing on how to handle a case of difficulty of breathing and seeing the patient gasping for air made me crumble before my residents. Now, I have learned my lesson. I need to be shameless to learn. Emotions are not entertained in this kind of field and training. Physical endurance is the key in the floors and the ER. I almost cried due to the physical struggle I had to deal with during my first few days in the emergent and urgent section. Despite giving your all, your ALL isn't still good enough. But, learn to shrug it off and keep on going.
Third lesson is, of course, EXCELLENCE. Excellence comes hand in hand with initiative (which I believe still needs clarification). The competitive nature of medicine stems from this value. In any patient that you encounter, one is expected to provided optimal care and to know everything about the patient from their history down to their physical examination and laboratory results, the pathophysiology of their disease, your different differential diagnoses -- would I still ramble on? I think you get the point. There is no excuse of being ignorant once you enter the realms of the hospital or any clinical setting for that matter.
Despite these, I was able to get a good realization from my 2 months of rotating in IM. I have learned to appreciate happiness in its ultimate simplicity. Ever since my duty started, my mother would always try to make time in making me sleep comfortably and prepare my things. She would pack my things since I have decided to stay in the hospital for 4 days straight. The simple lending hand a co-clerk would offer would be much better. The little jokes that we make during the dead hours of the night just to keep us awake make me feel better. A simple sign of gratitude from your patient keeps the heart warm despite the freezing temperature inside the hospital. A good night's sleep makes me excited every now and then. A simple chat with a friend in a coffee shop assures me that everything will be okay. The wonders of simple Facebook messages reminds me that people still care for me.
It is not all that bad. I am slowly entering reality and its diversity. Bumps in the road come along the way but I must keep a steady hand on the wheel and my sight along the horizon. I am still trying to find my place here and unleash that firework kept hidden for a long time.
My first week as a medical clerk was bumpy since I am totally clueless of what I should do and how the definition of "initiative" comes in so many forms. The endless continuum of such noun is hard to grasp. Initiative may be defined as doing almost everything. It can be termed as continuously asking questions and participating in the discussion with your consultants. Or volunteering to be on duty despite completion of requirements. Yes, I know it is complicated. People who show initiative get merits. Merits where the criteria are taken from space.
First lesson I've learned as a medical clerk, INDEPENDENCE is the key to survival. No one will guide you or watch out for you. If you would show an inch of such need for guidance, they would mistaken you as being pampered or spoon-fed. You can never lean on someone to help you out (except for your co-clerks) especially in times of influx of patients. With independence comes self-directed learning. You seek for your own answers to feed your hunger pangs for knowledge. Read, read and ask.
Second lesson is the need to be FEARLESS and SHAMELESS. Note that the adjective I have used is not courage, bravery nor boldness. Fearless in terms of conquering whatever fear of inadequacy you might feel in your bones -- try to get rid of it. I have had my own dose and it did not help. The fear of not knowing on how to handle a case of difficulty of breathing and seeing the patient gasping for air made me crumble before my residents. Now, I have learned my lesson. I need to be shameless to learn. Emotions are not entertained in this kind of field and training. Physical endurance is the key in the floors and the ER. I almost cried due to the physical struggle I had to deal with during my first few days in the emergent and urgent section. Despite giving your all, your ALL isn't still good enough. But, learn to shrug it off and keep on going.
Third lesson is, of course, EXCELLENCE. Excellence comes hand in hand with initiative (which I believe still needs clarification). The competitive nature of medicine stems from this value. In any patient that you encounter, one is expected to provided optimal care and to know everything about the patient from their history down to their physical examination and laboratory results, the pathophysiology of their disease, your different differential diagnoses -- would I still ramble on? I think you get the point. There is no excuse of being ignorant once you enter the realms of the hospital or any clinical setting for that matter.
Despite these, I was able to get a good realization from my 2 months of rotating in IM. I have learned to appreciate happiness in its ultimate simplicity. Ever since my duty started, my mother would always try to make time in making me sleep comfortably and prepare my things. She would pack my things since I have decided to stay in the hospital for 4 days straight. The simple lending hand a co-clerk would offer would be much better. The little jokes that we make during the dead hours of the night just to keep us awake make me feel better. A simple sign of gratitude from your patient keeps the heart warm despite the freezing temperature inside the hospital. A good night's sleep makes me excited every now and then. A simple chat with a friend in a coffee shop assures me that everything will be okay. The wonders of simple Facebook messages reminds me that people still care for me.
It is not all that bad. I am slowly entering reality and its diversity. Bumps in the road come along the way but I must keep a steady hand on the wheel and my sight along the horizon. I am still trying to find my place here and unleash that firework kept hidden for a long time.
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