Sunday February 27, 2005

Hard work makes a doctor

BY DR KHOO TECK KIM

34. That's the number of hours of sleep I got in the last one week. From four and five hours of sleep to zero sleep when I’m on call.

There are times when the pride I feel in being a doctor makes my chest expand. But there are days too when I wish for a case of acute appendicitis so that I would not need to go to work. Would not need to get up at 5am. Would not need to hear the dreaded sound of my beeper.

Before I went into medical school, I had been told many times about the hardships faced by a medical doctor. However, nothing could have prepared my body for the shock of being so constantly tired. Never could I have thought it to be possible, to even speak, after being awake for 30 hours. But we find ourselves living, and even being responsible for people's lives, prescribing medications or even running cardiac arrest codes in that condition.

What propels me? Not monetary gains. Some colleagues have actually sat down and calculated that hour for hour, we as medical residents earn less than that pimple-faced kid at McDonald's. I suppose it's the thought that in the end, life will change for the better. That being a 'consultant' will be different. That the lives we touch makes the tears and sweat worthwhile. But can we ever quantify the sacrifices we make?”

Dr Khoo with other Malaysian and Singaporean doctors trying out some pumpkin-carving during Halloween.

My internship year (first year of residency), easily the most challenging ever in my life, is a few years behind me. The story I related above was just two years ago. I'm proud to say I survived, and survived well. And made some good friends along the way.

So when people ask me what it takes to be a doctor, I tell them, sacrifice,determination, hard work, faith, family and perhaps luck. Many are surprised to hear that I don't consider brains an important part. The way I see it, good grades are needed to get you into medical school, but grades alone will not keep you afloat for long. You need a lot of stubborn determination to progress in a field that requires a decade of training.

People I meet are in disbelief when I tell them I began my training in 1996, when I started medical school at the International Medical College or IMC (now IMU) before transferring to my second phase at the University of Calgary. In the process, I saw many medical students drop out because they felt that medicine was the wrong choice for them. Some enrolled only because of parental pressure, while others because the opportunity arose through a scholarship. After obtaining my medical degree, I began my residency (or 'specialisation') in internal medicine at the Mayo Clinic, in the United States in 2002.

(The Mayo Clinic is a large medical centre in midwestern US currently ranked second in US News and World Report. It employs over 3000 physicians, scientists and trainee doctors, with 1900 hospital beds, 100 operating rooms and medical airlift helicopters.)

Now, nine years after starting medical school, I am just partially done with my training. I will be completing my internal medicine training in four months, and will begin an additional three years of 'fellowship' in a subspecialty. After my residency I will begin fellowship training in endocrinology in July at the Mayo Clinic.

My dear friends from Malaysia and colleagues at Mayo, Dr Nick Choong, who went from IMC to McGill University medical school in Canada, has since left to continue his fellowship in Chicago, while Dr Tan Tow Shung who also graduated at McGill will be following suit next year.

(Dr Choong is currently training in hematology-oncology at the University of Chicago, and Dr Tan is scheduled to complete his training in internal medicine in 2006 before he proceeds to a fellowship programme.)

Although this is a small US city, we have been able to establish a Malaysian-Singaporean community, consisting of doctors in internal medicine, cardiology, gastroenterology, cardiac surgery and general surgery. This certainly makes being away from home and loved ones easier.

And we try to improvise when it comes to making Malaysian cuisine that we so dearly miss. My friends still laugh at my green nasi lemak which resulted from my using pandan essence for the rice. But there are some things you can never make up. For instance, being away from family and loved ones. I was abroad when my grandfather passed away. And when my best friend got married, or when my brother and sister-in-law had their first baby.

By the time I expect to complete my training and finally return to Malaysia, I would have invested twelve years of my life abroad training. So when I meet starry-eyed high school students who tell me they want to be doctors, and ask me what it takes, my answer is sacrifice and determination.

If one truly has the passion, the journey will be worth it.