meine_schatze

tulI’ve always talked about the passionate side of my decision to take this vocation, that this is the only path I see myself in, the only way I know how to touch other people’s lives, the vital route towards self-actualization. But now, I’d like to express my practical concerns about med.

I’ve always been curious how the doctors I know got to where they are now - successfully living comfortable lives. I’ve always wanted to know how they struggled starting and building their own family with still, I assume, little reputation attached to their name as they probably were just fresh from residency or med school. How late in life will we reap the fruits of our very very hard labor in med school and training? I’ve always had low EQ, I don’t like waiting. If I had to, I’d like to know how long coz I don’t like waiting indefinitely. Not for anything.

I’d like to know these things because I have plans. As I mentioned in our mentoring session, my friends and I have concerns about the viability of our egg cells. hahaha. The best egg cells are released in women’s early to late 20’s. geniuses more likely born to mothers in their mid 20’s. hahaha. pero seriously, I’d like to plan my family. I’d like to get married and have our own house though they say living with parents for the first few years would help the couple financially. But i think that’s not for me.

I don’t want to start a family and have nothing, zero balance to my account. But I don’t want to go abroad either for faster bigger income. Aside from my RSO contract, the idea kinda disgusts me right now (I mean no offense to those who plan to do so, but in my context - of how I’ve always been surprised of my loyalty to this country, of how I promised my self to offer my services here, of how I argued that going abroad will be the last resort of finding a way to feed my children and support my family, I may disgust myself if I suddenly opt to turn my back on my own promise right after graduation!).

But the kwentuhan last wednesday with our mentors and this article I read today bothered me. I have high expectations for graduates of UP College of Medicine. My grandmother was never really enthusiastic about my decision to pursue med. She wanted me to take the pambansang kurso ng Pilipinas, go to the US, earn $, $, $, $. She even pointed out that a lot of doctors are becoming nurses for an easier route to greener psatures. She couldn’t understand my cheesy reason why I chose med. She had lost hope a long time ago.

And I haven’t. I’ve always believed that a graduate of UP will never run out of patients especially when most if not all UP doctors are the best and of world class standards. That a good, competent doctor will never become jobless. That money will come to you, that it will not become a concern and one can then truly treat med as a vocation and not just a profession.

However, as I mentioned, some things bothered me. Nakwento nung mentor namin na sa residency nila sa neuro, 3 silang naghahati sa isang item na 10k lang sweldo. Eh ilang taon ka na nun diba? tapos ganun lang sweldo mo? hindi nga kasya kung single ka lang, pano kaya kung may asawa ka na? tapos kayong dalawa pa pala yung nasa Neuro Residency. hahaha. kawawa.

then I read this. Panahon pa ata siya ni Marcos pero I doubt kung may significant improvement simula nun hanggang ngayon:

The last year of surgical residency training is a decisive year. The senior resident is usually a doctor in his late twenties or early thirties. The transitions from his four years in college for pre-med to five years in medical college and subsequently to another five years of surgical training have been relatively smooth. But this time, he is coming to a crossroad in his life.

Sometime during his training program, he might have found enough time to fall in love, usually with a fellow doctor or a nurse in the same hospital. He would have gotten married and settled to conjugal life with a kid or two in a rented apartment nearby. Their combined income would have been enough to support their simple lifestyles and that of their pre school children. But after five years of back breaking work, he finds his financial position untenable. His training ends, he is out of a job and without any visible means of support since he does not have any private practice. His wife’s salary alone is not enough for their growing family’s needs while he sets about building a private practice which takes a few years. But this usually was not a problem in PGH (Philippine General Hospital) because the majority of the graduates from the training programs were really not planning to stay anyway. The last year of training in Surgery was spent writing flurries of applications for internship/residency to good surgical training programs in USA. Acceptance in these training hospitals was assured after surgical training in PGH because these doctors were the best export materials we had to the USA. This transition was smooth because the importing hospital usually provided the family’s airplane fares to USA, provided them housing, and also looked for a job for his wife in the hospital. His salary as a first year surgical resident in USA far exceeded his combined five year income in PGH. So his five year sadomasochistic training in PGH actually turned out to be a golden parachute that took him to a soft landing into the good life in America. The problem only came with a few of the graduates who decided to stay in the country. And to me, as president of the PGH physician’s association (PGHPA) in my last year of training, this was a crucial point because the local atmosphere was actually hostile to the graduating resident who wanted to stay and practice in Manila.

So I formally requested the Department Chairman and the Hospital Director to officially allow the more senior residents in PGH limited and supervised private practice during their last year of training to acclimatize them to treat paying patients and to provide some financial support for their families after their salaries ceased. They refused to my request outright.

One senior member of the consultancy staff told me disdainfully in a conference that their duty was only to train the residents in surgery and they didn’t really care much what happened to them afterwards. It was useless to talk to him about the Little Prince and his Rose. He had not read St. Exupery. Ironically, some of the consultant staff now looked at their resident graduates as possible competitors in their profession. The Hospital Director was also indignantly against the idea. He was afraid it would open PGH to abuses by resident physicians. He told me it was an immoral idea. I told him that I could not think of anything more abusive and immoral in the PGH than the fact that the majority of the residents trained and honed their skills on poor Filipino patients but used them to advantage on rich American patients later. Besides, the private practice that I was suggesting was directly under the supervision of the department and the hospital, so it could not have been dangerous. But they did not want to discuss the idea any further. The PGH had existed for 60 years before I came in with my harebrained ideas and it would continue to exist without me in the next 60.

So I played my trump. A surgical resident went on 24 hour duty every three days and still held office hours officially in between duty days. That made a total of at least 104 days a week, not counting the hours the resident stands vigil over a dying patient. As government employees, we were supposed to work only 40 hours a week. If the hospital administration would not accede to supervised private practice for graduating residents, the PGHPA would demand for residents’ overtime pay for the balance of 63 hours per week. Or else. Hard ball. I saw the PGH Director pale in panic and stutter to me in anger that if I opted for that move, it would be immoral because PGH would not survive. I warned him the next time he called me immoral, he would have to be talking to my lawyer. I left him stunned in his office, as I usually did, and in a way, I pitied the man. He had been put in his office by a strike in my internship year, and he could be also booted out by another strike five years later. But the situation in 1975 was far different from the situation in 1970. Martial Law tolerated no strikes; and graduating resident physicians who had families to support were no longer the same militant students who had nothing to lose five years before. The present PGH director was also a personal physician of the Dictator and I knew what he was going to do. In no time, President Marcos issued an Executive order designating resident doctors in government training hospitals as Trainees and no longer government employees and therefore had to work more than 40 hours a week according to the programs they were in. I felt so sad and helpless. And so alone. It was such a desolate way to say goodbye an institution I had learned to love and cherish.

(MindaViews is the opinion section of MindaNews. Ting — Dr. Jose M. Tiongco — is a graduate of the UP College of Medicine Class 1971 and is chief executive officer of the Medical Mission Group Hospitals and Health Services Cooperative-Philippines Federation. He wrote about the early years of the cooperative hospitals and cooperative health fund in the book, : Child of the Sun Returning)

So pano na? Tama ba tong pinasok ko? Paglilipasan na lang ba talaga kami ng panahon? Natakot tuloy ako para sa kinabukasan ko…Kailangan ko ulit ng mentoring session…