Vampy's Weblog - Life of a Medical Officer

No, no. I have not killed any patients...yet. The reason for the title is because there is actually such a book in each ward in the hospital I'm working in. Why would anyone be so morbid and name it the "Book of Death"? Cos' it is a really a book about what to do when a patient dies. Surprisingly, there's a lot to be done when a patient dies. First you have to certify a patient has actually died. It's more than just saying "Time of death: blah, blah blah". You actually need to check whether patient is breathing, whether a heartbeat is present and of course, TV's favourite potrayal - shining a light into the eyes.

Then we need to fill in the death certificates if we think thet the death is not a coroner's case. This is where the book of death comes in. There's a set of criteria that would determine if the death should be reported to the coroner. If not a coroner's case, then we have to fill in the death certificate and cremation certificate. Filling in the death certs more complex than just putting in the person's demographics. You actually have to think about what really caused the death of the patient and it has to be specific. You can't write "Cause of Death: cardiac arrest".

Although formally, I do not start work on the wards till Monday, I have to go for a handover today. For this term, I will have to wake up at 5.45am for most days! 5.45am! The last time I had to do that was when I was back in the army! I really could see myself being chronically sleep-deprived this term. After the handover/ orientation of the wards me and 2 other interns would be in charge of this term which ended at 6.30pm, I'm exhausted and I wasn't even doing much. This is not a good indication. The scary bit of this term is that there is only the 3 of us - fresh interns looking after the wards most of the time. The registrars and consultants would be in operating rooms most of the time so in essence it's up to us fresh interns. It's scary to think about that. It did not help when I asked the outgoing team whether if patient in our wards crashes often and her replied is "Often enough." Yes, I'm suppose to call for a code when it happens so that the crash team comes but while waiting for the calvary to arrive I'm suppose to stablise the patient. How scary is that?!

After this one week of Orientation, next Monday would be the real McCoy. Now I know why some of my seniors who were doing their intern year said "I wish I could introduce myself as a medical student again."

Today was the first day of my career as a doctor. But it was all talks about what internship is about. In fact this whole week is about that and settling our ID badges, mugshots so that everyone in the hospital can laugh at our dorky faces, and so on. We also had a very important talk about our pay which at this point of time is something all of us desperately needs. You might think why do we need a talk about our salary. As it turns out, it is a extremely complex system that I truly believe requires a person to have multiple PhDs' and a rocket scientist to work out how we can get our pay.

Why in the world would someone invent such a complicated system of renumeration? There's exceptions to the exceptions. For example, if you work overtime, you will be paid 1.5 for the first 2 hours of OT and subsequently 2 times after. However, if you are working in these departments (which there is a powerpoint slide worth of list) you cannot claim for OT. However, this is only for this particular hospital and if you go to another hospital (which we will all have to), this does not apply. Seriously, I really think it is some bureaucratic means of ensuring that we don't claim OT just because of all the hassle of remembering the exceptions to the exceptions and the complex way of calculating it. I'm not the only person who were utterly confused at the end of the talk as I tried to ask some of my fellow interns whether if they knew what is going on. So The answer to the question of "How many doctors does it take to work out how to get paid?" "95" (cos' there's 95 of us, I believe).

Growing up sucks! I can now understand why people say that. I never could understand why being an adult is bad. But now that I'm about to start a REAL JOB, I'm beginning to realise that I'm really an adult. I can't say I like that feeling. Yes, the money that comes with a job is nice. Having said that, my hourly pay is $22 only - I earned more than that when I was a part-time university tutor almost twice the amount! The bad thing about a job is that you have to be there 8-5 regardless of whether you like it or not. Worse you have to grit and bear with pompous little super-egoists. Growing up means that you have to plan your finances and seriously my finances is in dire straits. I have to take up loan to set up my new life even before I start earning. How sad is that?!

Of course things would be better if I had stayed and work back in Singapore considering the fact that I would not have to buy a car (at least for the next 2-3 years) which means that I can actually save up some money first. Also, I will not have to pay any rent. Even if I were to pay all the utility bills that would have been at most $300 per month compared to $1600 excluding bills. But this was my decision - I'm not saying I made a wrong decision but I guess realizing that financially I'll be rather strapped for the next few years do put quite a damper on my spirits.

Anyways, I'm back in Sydney now and trying to "grow up" in the next 48 hours or so. Wish me luck!

2008 is gone and 2009 is here. 2009 is in many ways a new beginning for me. It's the first time in my life that I'm actually fully-employed, working on a full-time basis. It's a beginning of my career in medicine. While I have been living in Sydney for the past 4 years as a student, but when I go back this time I'll be going back to work and on a different type of visa. It will be the first time when the patients are actually mine (okay not really, they are techinically my consuyltants' patients but to a large extent I'll be their primary carer.) It is rather exciting and yet there is a certain level of apprehension.

2009 will also be the first time when I actually have to think about financial planning. During the past 30 odd years of my life, my parents have been supporting me financially and thus I have little need to think about budgeting and planning. I'm not sure if I will be able to plan as well as I think I can. 2009 will also be the first time I will actually buy a car. Up till now, my knowledge of car is limited to: 4 wheels, 2 or 4 doors (usually) and convertible or non-convertible. Having done some searching for the cheapest car I can afford to pay, I realise that there is a lot to choosing and buying a car than I thought.

As the days draw closer to me returning to Sydney, I'm faced with an overwhelming urge to bugger it all and just stay in Singapore for my medical career. During this past month of holidaying with nothing to occupy my mind, I have noticed how much my parents have aged. I'm not sure if I'm making the right decision to stay overseas to work. Yes, it is possible for my parents to migrate with me over there sometime in the future but this future seems rather far especially in view of the fact that my parents are in their 60s'. I know that if anything were to happen to them while I'm overseas I'll be devastated. Yet, I'm unable to see myself working here in Singapore.

It isn't that Singapore is a terrible place to work in but it's just not the kind of working life/ life in general that I want to have. Staying in Singapore definitely has it's advantages - friends and family are present, no need to pay rent ($1600 per month!), food is generally better, easily available and generally cheaper, can afford to provide for my parents a pretty decent level of living and perhaps even fulfil my mum's dream of renovating the house and no need to buy a car at least for the next 3 years or so. However, pay as a junior doctor in Singapore is low, working hours are much longer, working environment is much harsher and getting into the training program of my choice is much more difficult.

Working in Australia has always been a dream for me. I liked the lifestyle there - relaxed, slower in pace and generally more friendly, pay for junior doctors are higher but that is offset by the amount of rent I have to pay. Living expenses are generally higher and I have to buy a car straight out. It isn't that cars are expensive over in Sydney, it just that when you are first starting out on your career the last thing you need to is to get a loan especially if that amount of money could be better spent like saving for the downpayment for a house.

So I'm still left with the decision should I really be going back to Sydney or stay in Singapore. I wish that I have a crystal ball that could show me the results of both scenerios.

Anyway, Happy New Year and hopefully 2009 will be a better year for all humankind.