When Reality Sets In

I'm the type of person who prefers to have things planned. I'm not the obsessive compulsive type, I just don't feel comfortable with the uncertainty that comes with spur of the moment ideas. Nor do i feel comfortable with drastic changes.

I already have this rough blueprint of how I'd spend my life in the coming years. When I (hopefully) pass the board exams, I'd apply for residency at a certain local hospital (I have yet to decide which one). Pre-residency usually lasts a month. After that, I'd probably do part time work at a local clinic, or some municipal hospital wherein they pay you on a daily basis. Come January, I'd start the grueling journey of residency, which would last for 5 years. After that, fellowship which would last for another 3 years.

Then a few days ago, my father kept on bugging me to take the USMLE examination so I could take up residency in the USA instead. Whoa. That caught me off guard. For one thing, I'd never expect such a suggestion from him, because he kept on saying that he doesn't want any of his children to go abroad. And if I take the USMLE exams, that would drastically alter my plans for the next 5 years. If he brought that up 5 years ago, I would have wholeheartedly agreed. After all, one of the reasons why I thought going through med school was not such a bad idea was that I could go as far away from home as possible when I graduate. I was a selfish 21 year old back then, and a reluctant would be med student. Funny how 5 years can change a person's perspective.

You could say I'm eating my words right now. I imagined my life would be miserable because I'd be stuck in a profession that I don't really want. But I've learned to like what I'm doing. Even when it gets too hectic at times, to the point beyond saturation, all of those things begin to fade away when you see patients that you take care of actually become well. And nothing beats the joy you'd feel when patients say "thank you", or when they even give you stuff to show their appreciation, even when you know they barely have money to pay for hospital expenses. Nothing can give a person more happiness, than knowing that he has touched the lives of others. Another reason why I'd rather stay in this country is that I would prefer serving my countrymen. I don't think I'll feel content serving foreigners, knowing that a lot of people back home can use my help. Call me idealistic now, but I'd prefer service than monetary benefits.

One minor reason why i'd rather stay in this country is that my family and my close friends are here. I've come to a realization that I would probably feel homesick when I go to a foreign land. And to think I once thought I could live alone, that I don't need anyone. The high probability of discrimination also won't be helping. Who would want to work in a place where they'd treat you as a second class citizen, when you are appreciated back home? Again, I don't see money as a reason. No amount of money can pay for such ill treatment.

Yesterday though, I had a conversation with a friend who has been planning to work in the USA from day 1. I guess it was an eye opener. Sure, he said, I can be idealistic now because I can afford to be. Monetary benefits are only secondary because I can still rely on my parents for that. But what will happen a few years from now, when I have my own family? i guess that's when reality will set in. What's real will overcome the ideal. I used to think all these people who dream of going abroad are only blinded by colonial mentality and the promise of greener pastures. I used to think doctors going abroad were selfish. They'd rather make money than serve their countrymen. I even thought those doctors who study nursing just to be able to go abroad were pathetic. Now, reality sets in. In reality, money is a factor. Indeed, how can you serve others, when you have nothing to eat, no place to live, because you don't have money? One has to take care of one's self before he can take care of others.

Medicine is not a lucrative profession--- at least not initially. Whoever said it was needs to be hit hard in the head to bring him back to his senses. Return of investment takes such a long time. After spending a fortune to get through med school, you'd spent 3-5 years in residency, wherein they pay you such a small salary. The amount you get is definitely not proportional to the work load. In this country, nurses get paid more, even if in some hospitals they mostly just sit around and chat. Residents are one of the most underpaid professionals in the country. It's enough if you live alone, and if you live a very simple life. It's definitely not enough if you're planning to start a family. No wonder those who can afford to go abroad go abroad. After that, you'd spend another 3 or so years to subspecialize during fellowship. You'd need to if you want to be competitive. By the time you finish fellowship, you'd be in your late 30's. That's when the return of investment would come in--- provided you've subspecialized in a field that has a huge demand. It would be hard to have a lot of patients if you're in a very competitive field. And knowing myself, such return of investment won't come quickly--- I won't have the heart to charge excessive fees for my services after all.

So now I'm back to square one. I have no definite plans as of now. I haven't decided which path to take. Maybe I'd take a year off instead, to have some time to think. I guess there's no rush anyway, I have so many years ahead of me.


If only there was a way to combine the ideal with what is real...