Is Being a Doctor Reasonable Anymore? Is there a Better Option Out There?
I’m 27, a junior doctor from India here in UK, will be appearing for PLAB
Part 2 exam soon, and will be appearing for the MRCS
Part 1 & 2 exams in January 2006. I had a dream to become a great general surgeon. My dad is a great, great laparoscopic surgeon, and so was my grand-dad a doctor. But now due to certain circumstances, which I shall be mentioning in detail in this article, I want to be different, do different and step aside from "standard protocol". I want to end this pattern of "insult" to our once-upon-a-time GREAT profession. I am therefore looking at alternative career prospects, simply because of the following:
The Madras High Court Advocates' Association (MHAA) has demanded that screening of Vijay-starrer 'Sivakasi' be stopped within a week, since it allegedly "portrays lawyers in a bad light".
In Sivakasi, Vijay's Diwali release that has been keeping the box offices ringing, the hero's friend, played by M S Bhaskar, is a lawyer with too many stupidities and too few cases. The lawyer is shown as using law books as pillows and serving tea to Vijay, who plays the role of a welding worker.
"Lawyers are portrayed as jokers and idiots in the film," said Praveen, a second-year law student in Madurai who filed the case against the makers of the movie last week.
looking at the situation we are forced to think that the medical profession has lost with glory n charm but trust me,when a patient looks at you n thanks you,all these feelings dissappear.
I agree with bruno that the respect has definitely gone down, take any profession. And also he thanks that nikhil mentions here, yup deinitely it feels great.
But its not so with payscales!! Doctors definitely dont get paid as much, if u consider the efforts they put in, esp if u look at their non -medico counterparts. IS it that we dont require money to pay for our roti, kapda and makaan??? then why this discrimination.
But then, inspite of all that, I think each & everyone is definitely proud to be a doctor & proud that he/ she has done his/her share to serve humanity.
as bruno said, the respect is gone down globally
and the reason we get frustrated is bcoz of our expectations
but if we tune down our expectations to a different level, then life can be easy
and payscales are down for dcotors all over the world, if compared to other professionals
dont know why
but most professionals take up the protest weapon to get their needs listened and done
some professionals, they cant take that route
but as everyone told we should be proud of what we are doing
I found these two interesting columns by Rashmi Bansal on the Internet. I would like to share them with u.
Of Indian brains and <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
here are two kinds of people: those who see reality and those who flee reality.
If professional waters are choppy, the realist takes note and adjusts the sails. Or chooses on an alternate way to reach his destination.
The escapist believes that knowing there is bad weather is of no use since it can't be changed. Members of this tribe often write in, accusing me of demoralising students by presenting a less-than-rosy picture of a particular career path.
So honestly, after the Doctors vs Engineers column, I was expecting some serious flak.
"The idea is not to give pros and cons and Budget analysis of various careers, but plain and simple education, and lo and behold you'll find people wanting to be a doctor even if they have to get by on Rs 2,000 a month", wrote Abheek Das.
The indefinite struggle
My question is why? Why should <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
school graduates be willing to watch others whiz past them while they struggle indefinitely?
Let's not compare apples with oranges by saying, "not all MBAs/ engineers get good jobs." Those who get into top ranking colleges certainly do, unlike their similarly brilliant MBBS counterparts.
Dr Shekhar's anguish boils over as he notes,"No one realises that the salary that a resident receives in <a href="http://www.rxpgonline.com/forum55.html">Maharashtra
</a>
is less than what a sweeper in BMC recieves. After slogging for 24 hours on call, if u happen to have a stressful day, it does not make a difference to anyone."
For reasons such as these, doctors are dissuading their kids from the profession. And that's a fact.
Says a reader, whose dad is a surgeon but advised him to take up engineering, "I have a younger brother on the verge of making the 'ultimate' career decision: <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
/ engineering? The choice is clear and unambiguous now. Eight out of 10 folks today cannot avoid the temptation of the get-settled-quick draw of engineering/ <a href="http://www.rxpgonline.com/forum118.html">MBA
</a>
."
The long course has no buzz
The lack of buzz around <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
is evident from the fact that even a sneeze at the Indian Institutes of Technology or Indian Insitutes of Management reverberates in the national media. In contrast, <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
hits the headlines only in the context of exorbitant fees being charged by private medical colleges.
In the recent budget, a one-line mention was made of the government's intent to set up more institutes along the lines of All India Institute of Medical Sciences. A week has passed and no further details are known. Actually, the government is simply reviving a proposal made by the National Democratic Alliance while it was in office.
Two years have gone by since that earlier, unfulfilled promise.
Incidentally, the NDA proposal clearly specified it would not 'create' new hospitals, merely upgrade the existing setups in six locations. Lack of funds, perhaps?
No such constraints seem to apply for the seventh IIM, which is being set up from scratch, in the North East.
I bet it will come up long before any of the proposed <a href="http://www.rxpgonline.com/forum2.html">AIIMS
</a>
campuses. Because IIMs 'sell'. And politicians, like channels, are always looking for ratings.
The strange bit is, medical education is the one stream where privatisation has flopped dismally. If an <a href="http://www.rxpgonline.com/forum118.html">MBA
</a>
aspirant does not get into an IIM, Faculty of Management Studies or Bajaj, s/he would be reasonably happy with non-sarkaari alternatives like XLRI, S P Jain, MDI, Symbiosis, NMIMS, etc.
Of the 1,000-odd B-schools in India, though, a large number offer a dud education, a decent number of reputed non-IIM brands do exist. The same goes for engineering.
In Mumbai, Thadumal Shahani, VESIT, Sardar Patel and D J Sanghvi are just some of the private engineering colleges which students are satisfied with and clamour to join.
The <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
aura
With <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
, however -- barring the odd exception -- government colleges rule. That's because a medical college must be attached to a good hospital in order to give students proper clinical exposure and experience.
Most private colleges don't fulfil that criteria. Their hospitals exist only on paper -- or function poorly. And students pay the price of the mismanaged hospital in many ways. Not only do they lose out in terms of learning, their fees are hiked to recover the losses the hospital is making.
After shelling out several lakh to study at a private college, what are the returns? Pretty dim.
Imagine students who have taken bank loans. How will these be repaid? The financial equation works out only if:
Your family already runs a clinic/ nursing home.
You manage to migrate to the United Kingdom or the United States of America and earn in pounds/ dollars.
As Jay Nitturkar wrote in to say, "I know some top IITians in America make lot of money being entrepreneurs, but that is probably 1% of them; among doctors of Indian origin in America, I can safely tell you the median annual income is over $350,000 (for over 50% of all Indian docs!) and for top 10%, it is even more."
The brighter lot gets the cheaper bit!
Great! But such opportunities are first going to be snapped up by the brighter lot. The ones who scored enough to make it to the government colleges where the annual fees are a dirt cheap Rs 18,000 to Rs 25,000 per annum (thanks to sarkari subsidy).
So the <a href="http://www.rxpgonline.com/forum55.html">Maharashtra
</a>
government now wants students who are benefiting from this largesse to furnish bonds.
From this year, the state government has raised the bond amount from Rs 100,000 to Rs 500,000 to 'ensure' that students work in state-run hospitals for a minimum of two years after their MBBS.
What's baffling is that the bond has to be signed by a third party who cannot be a close member of the family. This guarantor should also own property valued at at least three times the bond amount. Not surprisingly, most students are unable to find such a benevolent guarantor. It defies common sense!
The government's contention is that 'bonds given by family members have proved to be unsuccessful'. Which is precisely why people unrelated to the student would also refuse to sign.
Subsidised fees and payback!
In a free country, zor-zabardasti cannot be the solution. And any policy based on 'we are subsidising you, so now it's payback time', can't be restricted to <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
alone.
What about government engineering colleges? Even with <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
, this rule currently applies only to state-run colleges, not those run by the Brihanmumbai Municipal Corporation.
A more viable alternative would be to charge higher fees from all MBBS students in state-run colleges (those who cannot pay upfront can avail of bank loans). After graduation, those who stick on to work at government hospitals can be rewarded with decent salaries, say Rs 25,000 per month. This will help take care of their bank loan repayments and, in a sense, reverse-subsidise their education cost.
I am sure many doctors who would otherwise have considered migrating or going to private hospitals would feel valued enough to stay on at government hospitals. Because the professional exposure -- and personal satisfaction -- at these hospitals is inherently greater than working in private clinics.
The long run equation
Yes, some will still be tempted to migrate. But in the long run, it doesn't necessarily hurt us. '<a href="http://www.rxpgonline.com/tutorial/?q=brain&s=0">brain</a>
drain' used to be an oft debated national issue. Now, we are reaping the benefits of having a large and cash-rich community of Indians worldwide. They have also created a global Indian brand: Every time you think of brains, think India.
Coming back to <a href="http://www.rxpgonline.com/forum90.html">Medicine</a>
-- yes, there is a need for young doctors to practice in rural India. And I think many fresh medical graduates would be willing to do so -- as a form of national service -- provided they were assured certain basic facilities.
Some years ago, when one year 'rural posting' was compulsory for those completing their MBBS from BMC-run hospitals, many a young doctor returned with horror stories.
We are willing to work, they said, but the primary health centres lack even the basic medicines. There are endemic problems -- like malnutrition -- which need to be tackled not just by a single, well-meaning young doctor, but the system as a whole.
The government wants doctors to be accountable because it subsidized their education. But who will the government be accountable to? Who will answer for the phantom medicines and foodgrains that are 'allocated' in the annual budgets but then 'relocated' by the forces of corruption?
Bottom line: Doctors still enjoy a great deal of 'respect' in society. But is that going to be enough to motivate future generations of bright young people to join the profession?
Not unless we put medical education under a scanner, diagnose what's ailing it and figure out a holistic form of treatment. In medicalspeak, "Case complicated hai..."
Just the right words to ignite a spark in doctors' eyes. And induce them, as a professional community, to rise up to the challenge?
Quote:
Doctor or engineer? Which has more money and demand?
here are two kinds of doctors in the world: those who see it as a career requiring selfless dedication and those who see it as a job that involves prescribing medication.
The first kind is becoming a rare, dwindling species, serving in the few large public hospitals which mostly treat the poor and needy.
The stipend that interns earn at these hospitals makes a part time job at McDonald's appear lucrative.
After years of academic slog, resident doctors make less money every month than fresh MBAs from Z-grade institutes selling insurance policies or credit cards.
So, yes, the 'noble profession' hangover remains a key motivator for those seeking careers in Medicine .
A few years down the line, cynicism sets in.
We, the 'brightest and the best' who made it to a medical college, we deserve better.
The most wanted!
Medicine and engineering have long been the two 'most wanted' careers for middle class India.
Slowly and steadily, though, engineering seems to be gaining ground. Four years of engineering study at a decent college fetches you a well-paying job.
Or one can choose to go abroad for further studies with a good possibility of financial aid and a quick job.
Five years of basic medical study -- even from the best institution -- gets you nowhere.
You have to do a post graduate specialisation (another three years). Preferably, you must also go in for 'super-specialisation' (another two years).
After these 10 to 11 years of study, the future is still uncertain.
The irony is that the demand for a doctor's service is, by definition, ever increasing. Especially in a populous country like ours.
Setting up practice, though, is not easy because in this profession, reputation brings in clients.
Moreover, reputations take years to build, especially when senior doctors are too insecure to promote junior talent and seldom, if ever, retire!
The lonely, more difficult profession
Medicine , thus, is not only a difficult profession, but a lonely one.
Many, many doctors rarely take vacations, afraid of losing patients to rivals.
Many others work long, stressful hours not just because it is their duty to attend to the sick but because consulting at three different hospitals and running one's own clinic/s is the only way to build a name.
There is also the system of General Practitioners referring patients to particular specialists and labs for a 'kickback'. Newly minted doctors may recoil at the thought, but seniors see it as a standard (only borderline unethical) practice.
More troubling are the doctors who order unnecessary tests, prolong hospital stays and generally prove themselves unworthy of the patient's trust.
These are the rotten eggs that exist in every profession. Except, here, the guilt is compounded by the nature of the work.
So, like I said, these are the dudes who see doctori as just another job which involves prescribing medication.
The balancing act
Between the 'excessive dedication' and 'excessive medication' lot lie the majority of doctors, trying to balance the conflicts of the profession.
To serve without losing one's humanity, yet keep a distance in order to preserve one's sanity. To make a good living, yet resist the temptation to make an indecent one.
Part of the problem is that every doctor is competing for the low-hanging fruit, ie the well heeled patient.
The irony is, there is a huge demand for even ordinary MBBS graduates, but in areas where doctors fear to tread.
And I am not talking about rural Orissa.
Drivers, maids, peons in Mumbai's slums -- they all pay good money -- but to quacks who inject them with saline solution for common colds.
The Brihanmumbai Municipal Corporation recently identified 250 such frauds operating in Mumbai alone. And I am pretty sure that with the sheer volume of patients they treat, the money they make is not inconsiderable.
But how many medical graduates will ever consider such a location to set up a practice?
Who will make more money?
Coming back to the career question: Medicine versus engineering, I think there is no question that in the long run, good doctors will always be in demand (and make money).
The question a student needs to answer is: do I have the required patience?
Both PMT and JEE are difficult exams, but making it to IITs or other prestigious engineering colleges means no more worries.
Medical students, on the other hand, must again compete for scarce PG seats. And consider alternative options, if they fail to get one.
These options include 'going abroad' through one of two routes:
a. Appear for United States Medical Licensing Exam, a necessary prerequisite for Indian medical graduates seeking a residency post in that country. After clearing USMLE
steps 1 and 2, you need to actually go to the US and give the Clinical Skills Assessment examination, where you have to examine mock patients in a stipulated period of time.
The entire process is long, difficult and expensive (running into a few lakhs).
Also, getting a residency post is not easy or certain.
A similar exam, PLAB
, exists for those wishing to practice in the United Kingdom.
b. Give the GRE
and then take up MS/ Ph D in subjects like Public Health, Genetics, etc.
This means research/ academics as a career, giving up clinical practice altogether.
Some are okay with that. Or maybe they are just resigned to their fate.
The GRE
route of 'going abroad' seems to be gaining popularity. It is easier both to get there and get a job.
And, what do you know, doctors are even aspiring for MBA
courses! Although the number is tiny, it is happening.
1% of IIM Ahmedabad's class of 2006 lists its background as 'Medicine '. That is just about three students, but it was unheard of until recently.
But why not? If 17-year olds who joined engineering can later realise this isn't what they want to do for the rest of their lives, the 17-year olds who similarly opted for Medicine should be free to make the same choice.
Somehow, that isn't so. Clinical research, it is being said, may be the next big thing. Especially if India can convince the West to outsource its clinical trials here.
Hospital management courses are becoming popular. Yet, neither is attracting medical graduates in a big way.
In that sense, unlike any other graduates, doctors still have a great deal of pride in their skills. They also give it up less easily than engineer/ MBAs who will happily sell shampoos or manage hedge funds, with no love lost for their original subjects.
Just for that, I salute the unsung, underpaid, unwilling-to-give-up young doctor. Aapka number aayega, zaroor aayega.
Go ahead and fleece us MBAs. God knows, we somewhat deserve it
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Doctors definitely dont get paid as much, if u consider the efforts they put in, esp if u look at their non -medico counterparts. IS it that we dont require money to pay for our roti, kapda and makaan??? then why this discrimination.
