This is a beautifully written letter by Dr Wong Yin Onn, a Consultant Physician and Associate Professor at Monash Malaysia which you can also read over here http://myhealth-matters.blogspot.com/2012/03/do-you-want-to-be-doctor-by-prof-wong.html and here https://www.facebook.com/groups/179465178830655/#!/groups/179465178830655/doc/198885280221978/. Dr Wong is a senior Consultant Physician who is running a private clinic in JB town. When the Monash campus started in JB in 2006, he was one of the first to offer his service to teach the students. He is an excellent teacher who was thought by the giant, Prof TJ Dhanaraj, the founder dean and Professor of Medicine of University of Malaya, my alma mater as well. University of Malaya medical faculty was one of the best medical school in the world back then! I am sure you know why it deteriorated!
His reply is to the same person who emailed me and said that I am dampening the spirits of many budding doctors. Well, I am just saying the truth and the future prospect and Dr Wong do agree with me in this letter. However, if you have genuine interest in medicine and willing to put up with all the frustration that will come along the way, then by all means go ahead but it will never be a smooth sail.
Do you want to be a Doctor?
By Punna Wong in Aequanimitas
Dear Daryl,
Your aunt has asked that I share with you my thoughts on medicine and medical education today.
Let me start by saying that I am most blessed to have trained under your Aunt, Prof Florence Wang, and I recall my time in ward 12A at University hospital under her as a most formative part of my training. Thank you prof!
It has been 3 decades since then and the world has changed. The world of Medicine and medical education has changed beyond even the most imaginative of us all had dared to dream. Some things are good and much detrimental.
I will have to ask you very honestly why you wish to pursue a career in Medicine for this is very important.
Most students simply have very little knowledge of the world of medicine and some very quickly become disillusioned in their clinical years. ALL my students come to me with FULL distinctions or stand at >97 percentile of their cohort; that they are brilliant is without a doubt but sadly many are NOT that motivated to serve humanity. They come into medical school because their results qualify them too, they sing the right well rehearsed song at the interview and because they think it is prestigious, they want to be a medical student!
But the real world of sick humans with all the smell and excrement and drains rapidly reverse all those good feelings, and harsh reality sets in. Osler a great Physician whom your aunt and I both greatly admire said that THE VERY FIRST QUALIFICATION is a Love for Humanity. I believe that that quality is far more important than all the ‘A’s in your result slip.
AS a GOOD doctor, You will be very important. We have plenty of doctors but not many GOOD ones. The future of many lives and families depend on what doctors do and SAY; imagine all the Good or Damage that can be done. But to be a good doctor is NOT easy. I just had a tutorial with my students and told them that the VOLUME of information that they need to read up is so MUCH that any serious student will honestly spent ALL his time doing very little but STUDY. I hope this realisation will help you understand the quality of life you will have as a medical student, or rather the lack of it.
Modern medical education has moved far beyond lecture based learning; here in the Clinical school the word ‘LECTURE’ is OBSCENE and students learn through SDL – Self directed learning. Its philosophy being that the advance of knowledge is so rapid that Students MUST learn to teach themselves rather than being taught formally in a Lecture Hall. This demands very matured and disciplined students for to the lazy student, SDL means Sleeping DeepLy. Are you prepared for years of being a nerd?
Please remember that Doctors are first and foremost Diagnosticians… those training under me MUST not only be skilful in diagnosis and management but also in social skills and leadership. When I was under your aunt, she demanded History taking so detailed and meticulous that ‘War and Peace’ looked like a short story in comparison. Today students speak in SMS like language, and do “Focussed History Taking” instead of Detail History taking. Yes the Art of Clinical diagnosis is dying, and HIgh Touch Medicine being replaced by High Tech Medicine.
In many Once Prestigious Universities which I will not name, Final Year students now teach 3rd year students Clinical Methods!!! Your aunt will tell you that 3 decades ago, only the senior consultants in UM were allowed to teach Clinical Methods as it was considered so very2 important. Osler is certainly turning in his urn!!
In your mind, do you envision yourself as a doctor spending hours talking, feeling, touching, examining the patients…. or a doctor ordering scans and more scans with nary a glance at the nameless poor sick man lying on the bed? Ask yourself that question now.
Yes, the practise of Medicine is in trouble.
Blatant commercialisation, rampant blood tests done without any doctors ordering or supervising, scans and probes of all kinds, are being conducted by laboratories and some doctors misguilded by wants rather than needs. When your aunt was holding the fort at Ward 12A, her ward rounds will start at 8am and the whole entourage of the Professor, Dr HC Ting the lecturer, the Medical Officer, the houseman and the medical students will follow her from bed to bed. The medical student or the houseman will present the LONG DETAIL history and she will then TALK TO EVERY PATIENT WITHOUT EXCEPTION about aspects of the history and personally examine every patient to confirm or correct the juniors’ findings. This of course was a long tedious process and the rounds will stretch till 1pm. But it was the Art of Clinical Diagnosis at its finest. Today, I am sad to report that rounds are spent looking at scans and reports and its a RARE occasion that the Consultant lays his hands on the sick. Sadly I am not exacerating. I wish I am.
Hope lies in every one of us doctors, present and you the future, for the sensible management of patients; YOU remain the hope for untold numbers of patients in the future. Sadly some doctors see patients not as patients but as a disease that needs treatment which provides our source of income. This is nothing new, physicians like Osler had repeatedly cautioned against not forgetting the man behind the disease, and medicine as a calling rather than a business.
“The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with potions and powders, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, of the wise upon the foolish”.~ Sir William Osler
Many doctors are unhappy with their work or simply too busy to talk, console or listen. Yes thats life in the 21st century where we sms instead of talk. Many just treat the disease and completely ignore the person who has it. We hear endless tales carried by patients of doctors who grunt instead of talk, who are capable only of monosylable conversation and who zip patients in and out of the consultation room with a speed that will make Superman jealous. I try my very best to teach my students the Art of Clinical Diagnosis but even I fear that its a losing uphill battle. My colleagues and I here are led by Prof Khalid who is a old school clinician, and we refuse to belittle the Clinical Art despite the advancing machinery all around us. Students are amazed and impressed by all the wizardry and sometimes to my frustration fail to practise the Clinical Skills as much as I want them to.
Ask yourself Daryl, what do you want? I do not want you to come to medical school and be disillusioned by what you see in the REAL MEDICAL WORLD as compared to the idealised world that we had projected.
Doctors must never forget why we became doctors in the first place, and the wonder of caring for fellow humans. Some may be a bit burnt out. We had in our careers, seen and taken care of more pain and misery than most people. We saw prostitudes, drug addicts, criminals and the worst of humanity. Yes, this is another point that I must raise to you. AIDS today is the TB of your aunt’s era, its everywhere! Most of my students come from very privileged families or they cannot afford the fees! Hence it is a shock to many when confronted with Vagabonds, homeless, addicts, pimps and Prostitutes. All the glamour flushes away when you realise that such folks are among the many that you will encounter daily unless you are in some Beverly Hills practise.
But of course we also treated decent human beings, doting grandmothers and innocent children. No doubt, the demands on our skills and the medical-legal complexities that accompany our practise would have made even the greatest of our medical ancestors shudder. And for this your training is NOT the 5 years of medical school BUT many2 years beyond. Are you prepared for such a LONG time spend in studies and training?
You had read Dr Pagal’s blog and written to him, while he may be harsh and discouraging, much of what he wrote to you with regards to THE SYSTEM has some truth to it. The system is basically dictated by our political masters, a system undeniably sick, and Dr Pagal has written frankly of much of our woes that only drastic administrative tsunamis can repair.
Yes the system only makes it more painful. Long waits for post graduate training positions is the norm now. Regulations as thick as a medical text. Pharmacies selling controlled medicines like sweets. To change that will require one of us to be the next Prof Virchow, plunging head on into politics to make a difference.
In school we rose above the hoard, we were the cream de la cream, and yes I can testify to that in my students. Some are so brilliant they frighten me. We obtained results the envy of most and we strove with pride to enter medical school. Could the same students have done well in other fields? Of course they will shine too!!
In medical school you will work like ants on a long march. You will stare at slides till you see mitochondria in your dreams and memorised volumes of facts and figures. Some of my students are NOT prepared for this; they thought that it will be a smooth passage and when they hear this old Professor here telling them to read XYZ, they simply turn off and zone away. Are you ready for a student life that has NO LIFE??
I take them for tough postings in Internal Medicine, I am among the strictest examiners, I expect the students to flourish in the drudgery of crowded wards, to work till hypoglycaemic on medicine rounds, to perform every procedure required in the book, and of course to pass their exams reasonably well. I expect them to look at X-rays until their eyes turned red. And do I have such students? Yes, I am blessed that many such students have walked the wards with me. And I am proud of them. And I know they will overcome every obstacle invented by our political masters to excel in their fields because they have the fundamental quality to be a good doctor; their love of Humanity and of the Art of Medicine.
You will finally graduate and become a house officer. Yes the field is as packed as sardines from Malaysia to UK to Australia, Dr Pagal is NOT exaggerating when he says that jobs will be difficult to come by soon. But if you are GOOD, you will be wanted! It’s TOUGH I do not deny that, and TOUGHER as the years pass by, BUT again I emphasize, if you are good, you will be wanted, for the good doctor is a rare specimen.
A few years later, you will pick a specialty, from paediatrics to surgery, family medicine to cardiology, internal medicine to radiology, and shuffled off to more clinics, rounds grand or otherwise, work and studies. And MORE EXAMs. Girlfriend? Oh what Girlfriend!!!
About 20% of my own class are still SINGLE!
In the 80s, new diseases appeared. I still recall with trepidation managing the very first patient admitted to our hospital with AIDS. We knew very little but feared a lot. As registrar, it was my duty to examine him. But again we survived. And learned. Now at almost every bedside teaching, I see patients with HIV. In your generation, you will see many many more new ones, from Avian flu number something to any new thing that crosses species as humanity ravishes the environment. Ready for that?
Your youthful enthusiasm and dedication will push you through the initial years. As young doctors, weren’t we incredible then, if only because we came back to the wards night after night, day after day for emergencies, calls, rounds or simply a ’tissued’ drip. “Bengkak” the nurse will phone and we leave our dinner to struggle with chemo wrecked veins for IV access.
Did you know that your aunt will reprimand the ladies for coming to the wards in pants? It is NOT acceptable then but now almost all my female students come in pants! OOPs sorry Prof for leaking such old tales!
We as doctors try to hold onto our commitment to heal, that wonderful calling. Then we see another world – the realm of the business of medicine, where every disease is a “case” to be investigated.
A very senior Professor tells me she had seen doctors ordering investigations before even taking a history! Here is also the world of the grunting and monosylable doctor, the superman of 2 minute consultations and management. True, the superb rare genius of a diagnostitian may well have obtained all the data that he needed sub- 2 minutes, but the poor human called ‘the patient’ needed at least 6 minutes of compassionate conversation. (By the way, that is why the OSCE exam is 6 minutes long, or SHORT from your examinee viewpoint… now you know how the patient will feel when the consultation is even shorter than this!). Recall that the only reason the woman in labour remembered the attending medical student is because they held her hand while she screamed.
We are the descendents of Aesclepius, the inheritors of all that is noble in the Hippocratic oath. We may fail to change the ideas of many doctors however we may preach from some elusive high moral ground. But as individuals can YOU NOT lose that ideal? If you can, welcome to the world of medicine and modern medical education. You will thrive no matter what! If not, seriously reconsider another vocation.
If we tell our students that the learning of medicine is through their apprenticeship to us their seniors, then we better be sure that we are good role models. Your aunt was a superb clinician and diagnostician and had inspired many of us.
As a future doctor, you can be the hope of the febrile, the breathless and the pregnant.
Do not let what you see in the misadventures of some doctors discourage you. Instead let them be teachers to you for you now know what you do NOT want to be like.
When a doctor have taken medicine to be a business or trade, he will ask what are his achievements — material success, cars, wealth, etc..
When a doctor has taken medicine to be a calling, he will ask what has he become — his character.
I hope we doctors can discern and reflect on what we have become in the practice of medicine, and teach all our young charges, delivering them safely through the long 5 years of protracted labour into a reasonably sane medical world. Daryl, I hope I have helped you somehow. Your aunt, Prof Florence has taught me much, this is my little tribute in return, my Bunga Emas to her.
Thank you
Associate Professor Wong YO.
Pagalavan's Avatar 
Thanks Prof. A very well written letter and should be read by all. It will remind you of why you took up medicine in the first place. Cheers!
“About 20% of my own class are still SINGLE!”
I think this is not a great statistic. To be truly empathetic, one needs a family. To understand the true meaning of losing a loved one, one should be in a position to lose a loved one. All things aside, I know everyone can’t get married etc. But show me a family physician who never had a family, and I can tell you he cannot truly empathize. then again, empathy is probably a weakness for the perfect clinician, no?
I seriously have no idea where I stand in the brink of medical line. I go to the university everyday sleepy as ever, nodding off lectures and tutorials. The only lecture I was not bored was pharmacology because I loved how chemicals worked back in STPM.
I thought I had the drive, at least 1 year ago before I waited for months to get into a medical school. But now its like I’m a dead body walking around the corners of the university not knowing why am I enrolled in a medical program.
Dont worry too much Robinn… EVERYONE finds those lectures boring. Tutorials, depending on the tutor, can be very boring and uninspiring as well.
Medicine in real life is nothing like what you experience in medical school because real lives are at stake. It’s a feeling of responsibility and the ethereal rewards that come with doing a decent job that makes it really appealing.
Treating real patients and being responsible for them is so so so so so different from even the best case base learning / problem based learning scenarios.
it is interesting
it stimulates the mind
it rewards the soul.
Envision yourself in a position whereby you will have to make the decisions that affect peoples lives.
If that’s your thing, you’ll enjoy real life medicine.
Very inspiring letter.
Hang in there Robin.
I’m a dental student, 4th year already, guess what, I don’t even know what a dentist does before I was enrolled.
Silly me, I never had met a dentist in the first 20 years of my life. It was not somehow my calling, but I’m half way through.
My simple advice to young people who wish and dream to be one, please reconsider. It wasn’t bad to be a clinician, but the burden and stricken pain of mental oppression against all odds – political as above said, death, foul smells, heavy workloads, definitely no time for sweety pea love.
I really hate to listen from senior clinician who define this job as a source of income, as if their daily prayers encompassing around others’ drowning in pain and sick states just to make sure he/she (able to) speeding highway in porsche, and throwing huge party in their mansion. You want to get rich, sell firearms and build your own machintosch.
No joke. I seen medical student with precarious mindset. excel in paperwork but definitely no empathy at all. I heard of top aces diagnosing like ATM machine, spending no more than 5 minutes, maybe 5 minutes top with patients. These are medical students, imagine how would they treat a patient if they are real doctors?
Smart will not bring one further, wisdom does. If you get what I mean. Smart people ruin the world, wise people stays behind to salvage it. Choose your card, and that’s the kind of clinician you will be.
Thanks for such a truthful insight of our current profession. I can’t agree more with what that’s been said. Yes, sadly the great old-school medicine in the past is dying (or long dead), and we see the replacement with modern days medicine which somewhat resembles a factory’s conveyor belt.
I belong to the group who dreamed of being a top physician to save the world but as time goes by decided to have a life. Not that I’ve been disillusioned or disheartened, but as one grow older you can’t help but choose to treat yourself and your family a little bit better. If you can’t look after yourself, how can you treat your patients well?
Let’s do a simple comparison:
Dr 1: A great physician who is top of the class, with ultimate passion for humanity, knows it all, work 18 hours a day and can diagnose every disease in every patient, at the same time so compassionate he spend at least 30minutes with each of his patient. He is single and live onsite next to his ward so that he can attend every emergency at first instance. Medicine is his calling he has no regret.
Dr 2: A normal physician who graduated fine, with moderate amount of passion for humanity, work 9-5, married happily with 2 kids, spend 6 minutes with his patient each and can just about to diagnose and treat every disease. Medicine is what he doesn’t mind doing, and is the source of income to support his family and to afford a reasonable house, car and 2 vacations a year.
Instantaneously for those of you who’ve been in the profession long enough, we already have a mental picture of Dr. 1 and 2. We know Dr. 1 is to be respected and worshipped like god but not certainly the one we want to work with for all the reasons we can think of. 9 out of 10 times he is a man of little words; prefer one-man-tasks than teamwork, probably because everyone else is deemed not as dedicated or as knowledgeable as him. Dr. 2 on the other hand, as competent but may not be as great, 9 out of 10 times is a happy man with infectious smile and energy who might appeared a little too chilled but always get his stuffs done and buy the colleagues treat occasionally. What I am trying to point out here is the Ideal vs. real world, Professional vs. Personal character building, Work vs. Life, Hardcore vs. mediocre. Physicians in the past are priests/clergymen who devote their lives and souls to god; they need no life outside their callings. How many of us can follow their steps?
Medical practioners are human beings too, and there’s only so much we can do within limits. Let’s face it, politics dictate every element of medical practice today, society evolves with time, so as doctors we need to change with time too. Let’s talking about consultation time vs. quality vs. efficacy. Yes, a 15 minutes consultation is perfect to build rapport with a patient and a proper history taking, examination, diagnosis, treatment. You see 4 in an hour. 32 in an 8 hours working day. 5 minutes consultant may seem too short, but with the right focused history and appropriate ‘high tech’ investigation, you see 12 in an hour, 96 in an 8 hours working day. So, if you’re the latter, in a way you helped a whopping 64 more patients a day. Some might argue that misdiagnosis may be of higher occurrence with shorter consultation time, but what about the extra ‘potentially-acute’ cases that you are be able to attend to which would otherwise be staggered down in the waiting list days after. On the other hand, are the 30-minuters perfectionists willing to work 24hrs to see all 96 patients? Simply physically impossible. In the good olden days, only the very sick and those who can afford come to a medical establishment; today, medical attention is freely available so undoubtedly the workload has increased exponentially and we simply cannot afford similar luxury of time. High-tech investigation, why not if it helps with diagnosis? A pair of ears with years of experience will not allow you to pick up a lung lesion by auscultation with your stethoscope; a pair of hands with years of training still will not allow you to palpate an ovarian tumour. Let’s stop our ego and move on to the modern investigations – blood tests, imaging, but use appropriately with clinical judgement.
For aspiring medical students, I would say do what you think is right for yourselves. Even if you decide that being a doctor is not the calling when you completed your training, there are many opportunities outside medicine with a medical degree. You have all the opportunities available under the sun if you want to take some time off medicine. Doctors are highly regarded in the financial/corporate management world. Over years I also noticed that many doctors are so focused in theirs sciences and maths in younger age that they’ve ignored their artistic capability. Some of those that I know went on to pursue very successful musical/arts careers, and if you happen to visit the annual exhibition by The Medical Art Society in London, you’ll be amazed how many hidden talents are there in the medical world!
The fundamental fact is that medical school not only train you to be a doctor (good or bad, genuine or pretending to be genuine), it prepares you well as a human being. You are almost guaranteed to come out the other end a more wholesome adult compare to your counterparts in other courses. You learn to treasure life more than ever when you witness all the misfortune. You open your heart and widen your horizon by interacting with people of all walks of life. You leave all the luxury at home to learn to live in the real world with the real people. You graduate in your mid-20’s but your minds and characters mature way above your look. Have you not been told that doctors are extremely attractive in any social setting if they hide their identity and do not talk about medicine? By law of natural selection, no doctors are meant to be single, the singletons probably chose to be single or has chosen career over family.
Some might argue – why then clog up a precious spot in medical school when you don’t want to be a doctor? Well, let’s face it; education is not just about graduating as a professional in the designated field, it’s a process to be enjoyed, to be treasured, to be outlived. We doctors, especially from the Eastern world are often so narrow-minded we struggle to see the bigger picture in life. It takes variety to form a balanced group of people – the nerdy and the cool, the studious and the playful, the naturally gifted and the hardworkers, the down-to-earth and the flamboyant, the genuinely passionate and the not-too-sure-but-I-got-in souls. It is the interactions of all these to shape an interesting professional communities, or it would simply be a Nazi camp where everyone is mashed up and mould into the same final product, how boring! Don’t mind the drop-outs, don’t mind those who decided not to be a doctor because they have contributed to our professional training and will be valuable contacts in life.
One final advice, I suggest all prospective medical students to find out more about life as doctors in different countries as the experience varies a lot. Please talk to practising doctors in Malaysia, Singapore, Hong Kong, Australia, New Zealand, UK, Ireland, Continental Europe, US, Canada, because each will tell you different stories of their own. Medical qualifications (from the right universities, with decent CVs) are diamond-grade international passports, so don’t fix and frame yourself down with the local picture. Put aside your pride and patriotism (after all our passion with humanity should not be limited with geographical borders and skin colours) and make sure you find out all the possibilities for yourselves before you commit to a lifelong career. It also helps to form a rough career development guide which will serve to motivate your through hard times in medical schools.
We as doctors, don’t live in Medicine, we live with Medicine!
Thanks all for those words of wisdom, I realized future path of medicine apparently not easy, and strictly speaking from my experiences in my own medical faculty, students just stand individually and do not work together as a team, teamwork for me can be very useful to deal with certain difficult cases. They r not willing 2 share their knowledge instead choose 2 compete among each other over marks and grades. After all passing examination is one thing, result is another side matter. for me enthusiasm in sharing among colleagues will be another way to improve approach patients in better manner. I am still a medical student that enjoy teaching my colleagues and juniors as well seeking advises from seniors so that I can keep on par with progress of medical facts as medicine is an ever changing subject. I learnt 2 recall my memories thro interacting with juniors, colleagues and seniors. So sad that most of my colleagues do not concern much abt it. Individualism is way so rampant in my faculty. That all I would like 2 say.
I would blame our education system !!
Sharing is caring. Medicine is all about teamwork, your coursemates today will be your comrades in the future. It’s never a one-man-show. Eg: A gastroenterologist will need a radiologist help for interpretating a difficult CT, a pathologist to look at a biopsy specimen, and a hepotabiliary surgeon to operate on his patient. If you’re decent and friendly, your request will often be taken seriously, which in turn ensure best patients care.
A good doctor is often one that’s good with his patients, good with his colleagues and attract a smile when his name is mentioned, not only for his medical knowledge, but his personality and interpersonal skill.
Competition fuels progress, collaboration guarantees excellence, kiasuism is one practice to be discarded – you keep one thing from 10 colleagues, they deprive you of 10 things, who at the losing end now?
Say for example, when building a CV for a training position – why fight for a research project, do a solo presentation in a professional conference? Why not teaming up with 2 other buddies, do 3 inter-related studies, get all 3 published and presented with each other’s help, attend an international conference as a group. Not only you get your name cited on 3 abstracts, people respect a team of enthusiastic clinicians more than a solo fighter! This is what a few friends and I have been doing since med school and we all flourish in our own specialties. Even though we’re spilted up in Malaysia/Singapore/UK, we still keep in touch professionally and in private. I’ll never have to look far for international collaboration, just flip through your phone book or facebook list!
Education system is indeed slightly flawed but I’d say the leaders (consultants, professors, senior specialists) need to show a good example. I have witnessed some very bad intra-departmental warfare few years back during my electives, and was told that these are very common in Malaysia. Time for a change, start from yourself to influence people around you!
I can totally empathize with you.
Used to think medschool was the end of the hypercompetitive types… But it was not.
You could easily tell those who have a genuine passion for medicine as they are always willing to share… they will come to you and tell you about interesting patients (hey have a look at XXX) and then say “oh and i learnt from consultant XX that bla bla bla”. Interesting people to be around at work.
The competitive type on the other hand are interested in throughput and would rarely talk to you about anything. They rub off as being cocky and write crappy notes because they are trying to see as many patients as possible.
A few weeks ago some of them were reprimanded for the crappy notes and told off about how having a high thoroughput was not desirable if it involved sacrificing standards. I am not a vengeful person but i cant help but smile :p
Nice letter Paga. However, I find medicine very interesting, invigorating and meaningful. It has it’s ups and downs. It has it black sheep as well. Besides, which job nowadays is not stressful. The good and hardworking chaps will do well in whatever career they embark in. If someone wants to do medicine, I will say go for it provided you have very good grades and have the interest to be a doctor. Cheers!
yup, good grades and genuine interest! not for good life and good money!
Well, who doesn’t want a good life and money.
ya, but there is no such thing as good life and money!
nur
i wish i can have a happy family as my priority is always my family.. can i be a good doctor then?
i love to cook n serve my family.. ;(
You will know when you start a family whether you can be a good doctor. You can but you will have a hectic life.
im married Dr.. but a long distance marriage.. im a final year student n my hubby is a H.O in malaysia…
Frankly speaking, getting married before or during housemanship is not a good idea. I have seen many who could not cope and resigned!
but i also have seen many can cope and succeed.. by the way,, do you have some tips for married couple doing housemanship..?
Sorry, I don’t have any tips but pls do not get pregnant during housemanship. Your workload will still be the same and you will end up prologing your housemanship when you go for maternity leave. Yes, some can cope but these are people who are married to a another doctor who can understand your problems.
so im the fortunate one as my husband always told me.. u dont have to to cook once u work.. we will be eating outside.. it is so miserable. huhu.. and he wish i can get pregnant only after my housemanship.. but i think i will left everything in God’s hand.. tq Dr Paga! 🙂 nice to read ur article.. it somewhat motivating me.. i wish i can learn from u..
a future doctor:
so im the fortunate one as my husband always told me.. u dont have to to cook once u work.. we will be eating outside..
Are you saying that he expects you to take on the bulk of the cooking chores if you’re not working?? Sounds terribly old-fashioned to me!
The letter by Prof Wong reminds me of my days as a med student. Our clinical practice is shaped by prior experience, and our teachers’ experiences depend on the experiences of the teachers before them. As a medical student, I had the privilege to be taught by Prof John Camm, Prof Sutherland and Prof Oliveira, all of them old school consultants and respected leaders in their specialty. However, as specialists these days have many more commitments other than teaching medical students, we did not have business rounds like those of Prof Florence every day. Instead, we had twice weekly consultant rounds and on top of that, twice weekly group based teaching. Like what Prof Wong demanded, we were also expected to obtain very detailed history from our patients, even the shortest histories will easily take 20 minutes for any student. Back then, even the brightest student spend long period of time obtaining history simply because you want to cover all corners and not miss out on any details, be it how significant or insignificant it can be. The motivation for doing so is because you really don’t want to look stupid in front of 3 Prof, 4 consultants, 7 registrars, 5 SHOs, 2 HOs and 4 medical students. For every patient that we presented, a consultant / prof will reassess the patient and compare his findings with that of our presentation and we will have discussions on what was good and what could be improved. As a result, despite the availability of top notch investigation modalities, most of us were confident to rely on our clinical assessment and start management; diagnostic modalities were only used to confirm or exclude our clinical suspicion.
When I did my elective as a final year student in UMMC, for any keen student, the exact same approach was used by Prof Idzwan, but a bit more relaxing because of the much smaller group of people around and more informal. The teaching of the art of medicine as opposed to the science of medicine can only be done in the presence of real, unsimulated patients, these include the art of extracting history for some difficult patients. However, in order to gain the most out of the experiences of good teachers, students need to have the passion and be ready to get dirty sticking their hands on every orifice they can find. I used to be told ‘if you cannot stick a finger in, then you need to stick a foot in’, which shows the importance of doing things ourselves as experience cannot be taught.
Perhaps some of the teaching methods of the old should be restored, and examinations be made harder and stricter, only then will we be able to weed out the many bad apples that we have. I came through the system with PBLs, SDLs and god knows what other Ls, but I also had the good old methods blended into my training and I think these good old methods were very important in shaping the clinician that I am today.
agreed. The old methods are still very important.
This scenario is very evident in our schools today! Sadly, they don’t understand that medicine relies heavily on communication be it with patients or colleagues.
after reading i guess i would like my children to involved in other courses instead of studying doctors.
Hi Dr,
May I know why does the University of Malaya medical faculty deteriorated?
Many good professors either retired or left to private sector since end of 1990s. But they are still OK compared to many others.