I read 2 interesting articles over the last 2 days. The first was in Malay mail which basically tells the truth of what is happening out there (see below). Many students nowadays do not know what they are getting into. Just because they score a good result in their exams, they feel that they are destined to do courses like medicine, dentistry, engineer, lawyer etc etc. Over the last few weeks I received many queries about which university to choose, which course to choose etc etc. Who am I to tell you which course you should do? It is entirely up to you to find a course that you feel you will have the passion to work for the rest of your life. Talk to people and friends who are working and get a feel of what the job is all about. In this blog I had written what medicine is all about and what kind of life a doctor undergoes. Similarly, you should find out what the other professions do. Unfortunately, many of the students are only interested on whether they will get a job, what is the income going to be and whether they can get a job overseas. Nothing is guaranteed in the future. Job opportunities changes over time. Who would have thought that doctors would become jobless ? But it is happening in many countries including developed countries.
The other article that I found interesting was ” 10 things to give up to become a doctor” which was written over here (see below). All those points had already been mentioned in this blog over the last 3 years. Nothing has changed no matter where you practise. One thing I always tell people is that, you will never become rich with a salaried job. Do you see any millionaires who are not businessman or politicians ? Even doctors are not going to earn a lot of money unless they start their medical business. The difference is, you would have spent tonnes of money studying and years of training even before considering opening a medical business. Furthermore, medical business is a 1 man show unlike other businesses where you can become a boss by the age of 35/40 and the business will run by itself. In medicine, that’s when you even think of starting your business. The era of opening medical business after 4 years of service is coming to an end due to stiff competition. Many GPs are now selling their clinic to companies that are running franchise clinics. That will be the future. You will not be able to run an individual clinic all by yourself. Without panels you will not survive. I just got to know that 1 more clinic just closed down near my place.
The articles below are worth reading…………………….
Tired of doctor, lawyer, engineer and accountant wannabes… — Cass Shan
JULY 26, 2013
JULY 26 — The truth is, most students don’t know much about the world after secondary education. They simply assume that the best career options are to be either a doctor, lawyer, engineer or accountant. And if they are good academically, they automatically get pigeonholed into these career paths.
While these professions are noble and worth aspiring to, too many students simply fail to grasp what it means to have a career and fall for the assumed social status and prestige associated with these careers.
And sure, some can argue that vying for social status and prestige isn’t all that bad, but surely there’s more to a career than that?
The recent spate of students complaining about not being offered courses of their choice is nothing new in Malaysia. Institutionalised racism aside, students should already know that if everyone got the course of their choice, there would be an over supply of doctors, lawyers, engineers and accountants — thereby driving down the market rate and value of these occupations. Thus, demand must exceed supply to ensure the value of these professions.
For those who fail to get a course of their choice; they can appeal or look elsewhere — either going abroad or seeking scholarships (which if they are worthy, they are more likely than not to get). For others who don’t have that option, it may not be such a bad thing to look at other career options.
For one, I sincerely question how many of these applicants are genuinely passionate about these courses they are applying for. True passion is when you are willing to do something for nothing, because just doing it gives you a sense of achievement or satisfaction. I am willing to bet that if the medical profession didn’t pay as much as it does in comparison to other professions, there would be a lot less takers despite it being a noble profession.
For instance, how many people actually grow up saying “My dream is to spend my working hours looking into people’s mouths and attacking cavities?” And yet, dentistry is a competitive course. I’m not saying that dentistry is not something to aspire to but essentially, a lot of students are taken in by the “halo” effect that the medicine line has.
I know a classmate in school who studied nursing because she truly cared for the sick. When offered a chance to pursue her career as a doctor with her already sound knowledge of healthcare, she turned it down as she saw how little doctors interacted with patients compared to nurses and stuck to being a nurse for the pure joy of caring for the sick. Now, Pamela Patricia Perera can truly hold her head high as someone who is truly passionate about helping the sick. How many of our doctor wannabes, if denied the option of studying medicine, would opt for nursing and still get to care for patients? And how many would take the longer path towards being a doctor by becoming a nurse first in their so-called ambition to be a doctor?
I know a girl who loved airplanes since she was young, collecting model airplanes and watching “Airwolf” with anticipation in the ‘80s. This is someone who cuts out articles on aircraft engineering when she was in school despite not being requested to by the school syllabus. Not surprisingly, Ruth Anandaraj went on to study aircraft engineering and is now working for Airbus in the UK and will soon be working for Boeing in the US. This is what true passion is about — reading up information about your career choice with hunger in between studying for school exams.
On the other hand, I know a Mara scholarship recipient who studied engineering in the UK (and yes, he was academically bright with straight As) and came back to Malaysia only to ditch a career in engineering. It turned out a career as a sales manager was more rewarding to him and possibly the best turn of events that could have happened where he achieved money, respect and a fancy job title as a sales director at the age of 33 to boot.
Now, how many students say their dream is to be a salesperson? Not many I’m sure. In fact, among the so-called respected community of academic high achievers, a salesperson is akin to being a pariah in society.
I know of an accounting graduate who studied accounting on scholarship (yes, she was sent abroad to the UK) who called a floor of salespersons a “sweatshop” and equated salespeople to being “con artists”. She would never lower herself to that job title, yet she was happy to stay in her prestigious, high-paying, but unfulfilling job.
The point is, there is more to a career than academic results, money and presumed prestige.
A career isn’t necessarily about how good your exams results are. I’m sorry to break the news to you but scoring straight As in our education system only mean you’re good at memorising, it doesn’t guarantee that you are a critical thinker. A career is about whether your personality is the right fit for the job requirement. Many professions in Asia tend to require long hours and — before you make it — most graduates have to climb their way up the salary scale. So you better enjoy your work if you are going to be spending a lot of time in it.
The crucial test — would you do it if you weren’t paid for it — comes to mind.
In the instance of not getting a course you want, the world suddenly opens up with new possibilities. You may find out that nursing helps you care for the sick more than doctors do. Or that you really love doing PR because you love interacting with people more than you do staying in the office. You may find out that a career as a teacher is more rewarding than a fat paycheque when you see the improvements in your students. Or maybe, that “pariah” job as a salesperson is more fulfilling to your go-getter type of personality.
We face many setbacks in life and often, when a door closes, another opens.
Students shouldn’t be preoccupied with prestigious jobs and ask themselves hard questions of what personality type they have. They should ask themselves what they would still do even if there was no money on the table, and that they’d do it because it gives them fulfilment.
Too many students have a myopic view of life after secondary education and think that a prestigious job is the only way up. It may be a way up — but does it truly satisfy you or are you just looking for the next family reunion where you get to proudly mention your job title?
* This is the personal opinion of the writer or publication and does not necessarily represent the views of The Malay Mail Online.
10 things to give up to be a doctor
Following a recent article elsewhere which generated an interesting discussion, I started thinking about the things one must give up on the road to becoming a doctor. It’s a long road, beginning with an initial decision, some early voluntary experiences, an application to university and some hard work trying to achieve the barely possible at GCSE and AS / A2.
But it doesn’t even end there. The hard work really only begins at medical school where long hours and repeated exams are considered normal and where you need your patients more than they need you.
There are plenty of things you have to give up along the way, here are my top 10:
1. Your desire to be wealthy
Very few people in medicine ever become hugely wealthy, at least not in Europe. If riches are what you desire there are many many easier ways of getting that involve alot less heartache, money and stress. If you want to be a millionnaire before you’re 30, my advice would be to avoid university altogether. Most doctors are in the profession for genuinely altruistic reasons as well as the satisfaction that comes from knowing that you have the skills and knowledge to save lives and apply these every single day as a routine part of your work.
2. Your desire to change the world
Equally you must, eventually, give up on the idea of becoming some sort of medical superhero who can solve the worlds medical problems one by one. Yes doctors can do some impressive things when applying their skills to the right situation. But remember that however good your intentions, you will not be able to overcome the problems caused by poverty, war, government neglect or abuse, or coorporate profiteering at the expense of the sick. That doesn’t mean you can’t try to help people afflicted by any of these, you’ll just find that you are usually too small to make any real systemic difference.
3. Your free weekends
It starts at medical school when the work starts to pile up, and weekends are sacrificed to meet deadlines and for exam revision. Once you start working as a junior doctor, you’ll find yourself scanning each new doctors rota to work out where your on-call weekends have landed and who can swop with you so that you can still go on that holiday or get married or whatever. There will be sunny weekends when your non-medic friends will be having a barbecue whilst you sweat it out on a ward seeing yet another gastrointestinal bleed wondering why you chose this path.
4. A good nights sleep
Gone are the days where doctors would be on call for 48 or 72 hours and then do a clinic for the boss before retiring to bed. However, modern working arrangements have brought into existence the ‘week of nights’ where you work 4 or 5 and sometimes 7 night shifts in a row.
As someone who has done these I can confirm that doing nights is pretty inhumane. The talk amongst doctors doing nights together often centres around changing specialty or leaving the profession. Don’t worry, it all gets forgotten once normal daytime duties are restored.
5. Your desire to avoid feeling like a fool
You will make mistakes from time to time in this job and your mistakes will all be potentially serious ones, simply because everything you do affects your patients’ lives directly.
Furthermore, there will be times when you have to withstand an onslaught from senior doctors who feel that teaching by humiliation is the only way forward. You will feel like an idiot at times and if the thought of that frightens you you should promptly pick a different profession.
6. Your desire to always put friends and family first
As a doctor your job usually takes priority and you simply cannot shirk your responsibilities simply because you have prior engagements of a personal nature. Over the years I’ve known many difficult situations including a colleague who had to turn down a role as best man for a close friend because nobody could swop his on-call weekend with him and the hospital refused to organise a locum to cover him.
Apart from sickness or bereavement, your first priority will be to your profession. Your friends and family may find that difficult to understand at first. They’ll come round to it with time, especially once they delete your number.
7. Your desire to please everyone.
Whether it’s your friends or family, as above, or your future patients you’d better get used to upsetting people from time to time. Telling your wife you need to postpone an evening engagement because you are still operating on a difficult case, or telling a patient you won’t be operating on them as they only have three months to live, are both likely to be met with upset. Each situation has it’s unique challenges and needs some communication skills, but the bottom line is that you will have times when you will have to make someone want to either hit you or cry in despair.
8. Your creativity
Not many people admit this but medicine takes people who are often very creative and turns them into workaholic, automatons who have little room left in their lives for creativity. If you want evidence for this, go to any dinner party that includes more than one doctor. Chief discussion topic will be work and medicine.That’s partly because anecdotes from doctoring are entertaining, but also because if the medics stray from this conversation topic, they will rapidly expose their banality and limited insights in other areas particularly all things creative.
Much of medicine does not allow much creativity in it’s day to day practice and the intensity of the work beats any desire for creative thinking right out of you before you even realise it’s happening.* Of course whilst accepting this fact you must fight this tendency and attempt to keep up your other interests, otherwise, I can guarantee medicine will invade everything you do.
*There are a few notable exceptions to this!
9. Your desire to stay in one place / live close to friends and family.
Want to do something competitive, like medicine? You have to realise that choosing your location is a luxury and you may have to follow your dream in a less than ideal location. Even after you graduate, having your heart set on one speciality is a sure way to geographical instability. Some people don’t mind this, but some with strong family ties or a mortgage, the need to move frequently is a pain.
I began to come to terms with this when I found that even the most obscure places have hospitals. Working in these places you’re just as likely to meet doctors who have also had to move from here from the other side of the country. It’s a great way to meet people but easy to lose touch once you move on.
10. Good health
You may not know it, but you’re joining a profession that has high rates of physical and mental illness as well as drug and alcohol misuse. Doctors are also less likely to seek help than other professions which all adds to a rather worrying picture.
Although ill health isn’t guaranteed in a medical profession you should realise the future risk now and take steps to formulate good lifestyle habits to minimise your risk factors. A good network of non-medical friends should also protect you from neglecting your own needs while you’re treating your patients.
That’s plenty to sacrifice just for a job isn’t it? However, I guess the reason you’re in medicine (or trying to get in) is that you’ve realised that medicine is not just a job, it’s a whole way of life, that’s difficult to let go of once you’ve decided to enter it, and these sacrifices are simply part of the deal.
Well, those are the 10 points I thought were worth including. If you have more I’d love to hear about them.
Leo
Top scorers of A+ – doctors, lawyers
Above Average – Teachers
Average – salary earners
Failed – CEOs
CHEAT – Politicians
Undergraduates – BILLIONAIRES (Microsoft, google, facebook)
“A” STUDENTS work for ” C” STUDENTS & ” B” STUDENTS work for the government.
Dr Mahatir.
I repeat. DR Mahatir.
also vitamin salesmen. See, med is still lucrative.
Haha, it’s politics ,
Hi Dr.. I’m actually monitoring the medical industry as in-term of Malaysian population, no of medical graduates/year, and the due time of a patient in a hosp. Can you guesstimate/estimate what are the current/future (short-term) data/no of medical graduates in Malaysia ?
I’m also with you to get an estimation of where will this lead, as pilots just have been hit hard of no job, till recently Malindo started to operate.
I’m not a medical student or wat-so-ever, i’m a business analyst for an oil and gas company. =) Just little curious about medical industry.
Thnks!
I had written some over here
You can also read this
if you are interested – i can give you an overview and in-depth analysis of where is this country healthcare going. drop me an email at pungkur@yahoo.com
Would “no where, ceteris paribus”, be the short answer? 🙂
doctor, we must also note that not that all people trying to be a millionaire or rich is going to become one..note that most people who try will fail..business is a gamble, however that is the only way to go to become rich..profession is what people will go back to if their business fail..it requires great luck to be successful in business and if they dont have a backup profession they will be back to poverty..at least a stable profession can support a person’s life adequately without the need to be poor..life is altogether a gamble,however if we dont do something than nothing will ever change =p..we should be content at trying our best in our life and not aspire for something too far to be reached
Yes, as I said , unless you take a gamble in business, you will never become rich. A salaried job will never make you rich but it is a stepping stone for venturing into other possibilities. A business will only become successful if you have new ideas and new business model. Of course you need to work hard as well with right partners etc etc. Unfortunately, many of the younger generations think that they are going to become rich with professional jobs which is getting saturated out there.
exactly doctor.i’m also a student but never once in my mind i think i’m gonna get rich by just being a doctor/engineer etc.i have my brother and relative who is doing business as well with not even spm but did well and he supports all of us now.but i understand it is also because of great luck and determination shown by him that got him far,it is fortunate for us too.most we can get from salaried job is 10k which is still not enough to be entitled ‘rich’.but i have heard a doctor in malaysia though who claimed to get 90k of salary per month being a paedatrician his name is Dr. Musa..do you know him doc? =p
As I said, it is a medical business. IT is possible but you will be in the hospital almost 24 hours a day, including weekend! Not worth it at all. You ail also end up paying high tax. And if anything happens to you, your income is zero!
Dear Leo…
Its not just doctors who have to give up all those 10 Things that u mentioned. Professionals in most careers have to give up the same 10 things. So it no big sacrifice that is limited to the medical profession alone.
Of course this blog is mainly written for & by doctors…so take heart you guys are not alone. All managerial positions calls for dedication, long hours, sleepless nights, need to work on weekends etc etc etc.
Engineers have to be on call 24 hrs a day, Accountants cant know what time they can go back home each day…work is never ending, Lawyers have tons of cases, u just go back home cos u need to rest. Need I say more…it applies to all professions.
Agree completely, Ashraf. As the old saying goes, the grass is always greener on the other side. While Confucius was right in ““Choose a job you love, and you will never have to work a day in your life”, every profession requires dedication, working hard and smart.
The most successful businessmen are all very big risk takers (gamblers)and if one is to look at their background, most if not all had a “go for broke” attitude. So it’s easy to say that one might as well use RM1million to go into business, rather than applying that towards a medical degree. One can see nothing of the RM1m investment when the business fail completely, and we all know businesses need more than just acumen and capital, to succeed. Not everyone can be a businessman.
Business need a lot of planning and risk to take. Never invest huge amount of money from the beginning. The most successfull businessman that I have seen are those who started small with new ideas. They are millionaires by the age of 35. Just because you invest 1Mil, does not mean you are going to get back the investment immediately. Everything takes time. Same goes to medicine. Just because you spent RM 1mil to do medicine, does not mean you are going to make tonnes of money back. Don’t forget the number of years studying and working for undergraduate and postgraduate.
You can see my reply to Ashraf as well.
I didn’t imply that spending RM1million for medicine will lead to making “tonnes of money”. As you have continually opined and analysed in your blog, no future doctors are expecting that, and some are still going for it, despite the knowledge that there may not be a job for them upon graduation. Hopefully these are the ones who will rise above the thousands and thousands who will also graduate, somehow or another.
By the way, accountants and lawyers can be engaged in meetings over lunch and cannot pick up their kids too. I’ve seen it, and sometimes clients demand total attention, and someone else will need to go pick up the kids.
BUT, being a doctor is more a vocation than anything else, and therein lies the difference, I suppose.
Medicine is life and death matter and it can come at any time. As for other desk jobs, meetings can always be on appointment basis and can be shelved. Urgent meetings are rarely a norm.
Totally agree in terms of workload but there are differences between other profession and medicine. I have family members is each of the profession that you have mentioned. For all the profession you mentioned, they do work overtime etc etc BUT it is mainly desk job! You can decide how and when you want to do it and still take time offs to rest etc depending on how you plan your time. You can even bring back the job to home and continue doing it. Even for engineers, the busiest time is when they have a new project but do they do that everyday throughout the year ?
Unfortunately in medicine, we don’t do desk jobs. WE are at field throughout the day and throughout our career. We can be called at any time of the day and we can never fixed an appointment for anything. If I get a call at 2am for an asthmatic case, I have to go no matter what. If I don’t go and anything happens to the patient. I have MOH, MMC and lawyers to answer to. WE can’t bring back our job to home! Mistakes made by any other profession can be corrected or rectified. Mistakes made by doctors will cost a life and legal suits will await you the next day. My sister is a lawyer, she can still send her kids to school in the morning and pick them up in the afternoon. Can I do that? Definately NOT. I can get a chest pain patient at 1pm and there goes my lunch and picking up kids!
So, there are differences between medicine and any other profession. How many doctors do you see playing golf or socialising in clubs unlike many other professions? This is because, throughout our career , there is NO fixed time in our job. Of course all job need dedication and hard work if you want to be successful.
I did my bSc..and my starting salary only 2.5k..in other hand my bro did bA..and his starting salary more than 4k..i used to think art student one level below then science..but when i enter working life..i realize science student can only mkn gaji and our job scope is limited..same goes to advancement..but if u did art stream(business,management..etc) theres lots of possibilities..
But theres few of my coursemate who act really lucky get 5 figure salary before 30 y/old..but they work in heavy industry..working shift..and crazy working hour but not as crazy as doctor..and bad environment (factories..mill)..but at least they bring 5 figures salary..
I got offer once,basic 6k + allowance but i want a better environment (office work..lab)..so i just go for the 2.5k job..mybe if i took the job i already get 5 figure before 30..but the job scope is better for a guy..when i took the course i definitely know about the shitty job scope but i want to get highly paid..
I want to do something i enjoy for the rest of my life..and salary is just a bonus..i dont want to do something that i hate but i will gain lots of money..when i took the course..i was so naive thinking im up for the challenge..i thought i will put everything aside..family..time just to gain lots of money..and at age 29 my salary is 6k..its not a lot..i can get more than this if i took the factory job..but money is not everything..
Yes, you are absolutely correct. The demand now are in arts and technical field. That’s where the money is. Your salary at 29 is higher than a doctor in civil service at the same age by atleast RM2k!
You know how much an interior designer earns? I got a friend who just bought a house and going to be ready soon. He hired an interior designer, who is his wife’s class mate. Total cost for designing a semi-D house was RM 10K! All done with computer software. If you take her contractors to do everything than the fee is waived (aka included in construction fee)
Dr Pag..
.i can see that your knowledge of the responsibilities in other professions is quite shallow so i will “forgive you for you know not what you say”. None of these other professions are “desk jobs”…although you are seated in an office unless you are clerical staff. (Btw, you do have an office right Dr Pag !)
And again just as you have answer to MOH & MMC & Lawyers….so too those in other professions.Every job has its related accountabilty and legal implications if & when somethings are not done correctly. Am sure you read & hear daily of legal suits been filed against CEOs, accountants etc etc….so please Dr Pag…dont over-glorify the medical profession at the expense of other professions.
Now as for your “no fixed time” arguement …its the same in all professions. Dr Pag. In your job…as a specialist if you are called out to attend to emergency cases, you charge for your services. In all the other professions (unless u are consultants) you dont get paid a cent…cos it your job to attend to the problems even outside your office hours.
Rest my case.
Nope, we don’t have a office. Neither do any of the government doctors. WE run clinics and it does not belong to us. In private you rent your clinic and in government, except for the head of department, the rest just sit in any clinic that is available. Only GPs who own their clinic, do.
Yes, of course, anyone can get sued in this world. But as I said, a mistake done by accountants, engineers etc can be rectified or corrected. A mistake by a doctor causes mortality and morbidity. How frequent a lawyer that looses a case get sued?
If we are called for an emergency, the patient has the right not to pay. It has happened many times. Based on private healthcare and serviced act 1998, a doctor/private hospital have to attend to any emergency whether you are paid or not. I have attended to many emergencies in my hospital ER where the patient do not pay anything.An I am a consultant!
Ummmm….salaries always commensurate with responsibilities attached to the job. If the job of a doctor’s job is so fantastic and so much “responsibilities” and so much “risks”…..I wonder why doctors are paid what they are paid.
So if the doctor’s mistake can cause ‘mortality and morbidity’…how much should they they paid? Life is priceless….so maybe each doctor should be paid a million a month….is that a reasonable assumption ! is that how the argument should go !
And the interior design cant ‘kill’ anybody…so why pay him RM10k… For that matter even a nurse could negligently kill a patient….so does that mean she has to be paid very highly…say higher than the accountant…afterall accountants mistakes “dont kill anyone”?
Ummm….There must be some logical explanation why doctors contribution is not recognised.
Salaries does not all the time related to risk taken. It depends on demand and supply. The job that is high in demand will be paid the highest. This is the capitalist world.
FYI, doctors in civil service are the highest paid for grade equivalent compared to any other civil servants. IN private sector, it is supply and demand. IN Klang valley when the ratio is 1doctor to 450 people, logically the income will drop due to competition. You just have to take what you are offered to survive.
That’s the reason arts stream students are better paid nowadays, including interior designers because they are difficult to find. I told my sister in law to do designing and she did graphic design. She could easily find a job with comfortable salary!
Actually there is a misconception. Any other profession would have easily land a job back in those days. Most of us are comparing what we are facing currently in our own field to what we knew of the other fields. Most professions are no longer as easy as it seems. In Boleh-land where the education industry are not well regulated, now everyone can study and even be a professional student. It all bogs down to the individual himself/herself whether he/she would succeed in the field.
Even arts field are saturated, and the better paid job would even be those blue collar job where electricians/plumbers can earn even more (provided that they have the brains to do it). My house electrician plumber earns >RM20-30k a month and are always too busy 2-3 months ahead at the very least. Not that I wouldn’t call others, but they are the very few left who had the brains to solve our plumbing/electrician issues
But no one has an ambition to become a plumber or electrician! I totally agree that it is this type of technical jobs that brings you money.
I agree with you, Dr Paga. It’s all about supply and demand. Sadly, most people don’t realize this until it’s too late (myself included lol).
Why do eg (top) footballers make millions? Because there is demand for them – they provide entertainment, advertising avenues, etc.
Why do eg physics graduates have a hard time finding jobs, even though the degree is hard as hell? Because there’s little demand for physics outside academia.
Steve Jobs said it well:
“Your customers don’t care about you or your product. They care about themselves, their hopes, their ambitions.”
Dr. Paga,
Sometimes i feel that it is not worth to explain the misery and misadventures of being a doctor to other people. Because they just cant understand. It is a different world to them.
Some more in Malaysia where people will look at your cars and houses and material wealth.
Being a doctor is like your super-ego. What you have mentioned in this posting is all about super-ego. It is not the same when you wake up in the morning, and the first things you see when you enter the ward, patient is going to collapse and at the same time your parents at home are unwell and your 2 year old sons are unwell also. Different right?
You will know the price of your job when you lose lives.
Dr. Khairul
Yup, agreed. People just don’t get it.
Hello Dr Pagalavan. After reading your passages, I am really starting to lose my spirit to be a doctor. I am currently an A-Level student and I will be entering uni next September. Will the condition be this bad by the time i graduate(6 years later) even for academically capable students? And I feel like choosing other careers in the healthcare field. Do you happen to know anything about the condition and the future of bioengineering or biomedicine? Will these two courses provide a better future than medicine?
Do medicine if you have the passion and life long learning. There is no such thing as good future no matter what field you choose. It all depends on luck and your personal interest. read my latest blog posting, which will be posted by today.