Right off the bat, I do apologize if this topic has been beaten up thoroughly, but I, like many others, think my circumstances are a bit...unique. Also, it will be a very lengthy read and I humbly request anyone having the time and a helpful suggestion to go through it as something may click and change my perspective.
If anyone is interested in getting to the point, you can directly reach the bottom "career" topic and skip the background. Thank you.
A Background about myself: I have done MBBS, thats bachelors in Medicine and Surgery from Pakistan, its a country in asia for those that don't know. I do hope there are people here familiar with our system, its more like the UK. I have completed what you could call Intern year/FY1 and I have to select a speciality exam to give now, we have separate exams for separate specialities e.g Surgery has its on entrance exam, medicine and its subs have a separate, anesthesia separate etc.
Ok, so, it might come off as a bit weird, but I was forced to become a doctor. In my country, generally we live with our parents for our entire lives, there is no concept of part times jobs or moving out of the house and I since the day I was born, my parents who are both doctors btw, decided I would become one. They would mock and shoot down any passion or suggestion I gave other than medicine. I did very poorly at school, poor enough to be able to enter a public Med school, but here we have this thing where you can just pay to get into a private med school without any real hassle, its expensive, but nothing near the U.S or the U.K. Regardless, I ended up being bruted and emotionally black mailed into medschool all the while being told what a shame and embarrassment I was for not being able to enter through good grades and merit. I resented myself and my parents and I still do after 6 years of being in medicine. Moving on, I passed through medschool successfully dodging everything and learning nothing. I studied 5 months in 5 years of medschool, passed all my exams with average or slightly above average marks due to our paper patterns being rather predicable. I kept telling myself it gets better after medschool, until last year I started my intern year and did the "real doctor" stuff and realized I actually hate being a doctor and feel worse than ever for not being able to fight for my life and tell my parents I don't want to do this, I pussied out when it mattered and now I'm a doctor with nowhere to go but deeper into it. I treat my patients with great care and respect, I try to the best of my abilities to go out of my way and get things done for them even if it means fighting a couple of lazy lab workers or higher ups, but I don't enjoy it. I would very honestly describe it as 'I don't feel happy if I treat a patient and I don't care if they die', I'm not numb to it, but there's only glimmers of happiness and sadness. I merely do my job. I'm not a passionate doctor, i'm just a calculated one.
A Background about our work environment: I live in a developing country where a very vast majority of patients do not speak a lick of english or even our official national language. They speak only their native local tongues which, obviously, our education was not in. The average patient we deal with has never heard of a microorganism, does not know what a liver is or what it does, has no idea about their past medical records, even taking a history of a bit of a chore as they simply do not consider may things as serious. There is absolutely no sense of self care. No one exercises or takes care of their diet in any sense here. It is also a conservative muslim country where interacting with females is a real task unto itself, you have to remain within great confines and be careful not to offend them or their families, even though their families only bring the female to the doctor when she is so disease ridden that she can no longer work like an arse, then they realize "oh well she's getting uselss, best take her to the doctor", though its a broad generalization it does hold true to some extend, there are also ofcourse educated folks and some highly so who come in. Speaking of offense, the patient's attendants/family will actually physically beat you bloody if they perceive you've done some kind of medical harm or if you could not save their patient even though the patient maybe quite serious when he/she comes in. They will drag you till your clothes rip and beat you bloody, maybe even threaten you to watch your back even after the beatings. There is no such thing as malpractice insurance here haha, no one sues you.
A background of the doctors and medical environment: Doctors here are totally asses. They treat patients like slaves whenever they can get away with it. Any patient asking for an explanation of their disease or the drug they are being given is mocked and told "Am I the doctor or are you?" and I find that extremely frustrating. The patients and their families are always afraid of approaching doctors lest they offend the doctor or irritate him, therefore hampering their treatments. My fellows mock me for explanation procedures beforehand, physical examinations and what not before hand or actually taking informed consent to surgeries. Here, none of that applies. If a patient dies, it is "god's will" and everyone simply moves on, whether it was due to negligence or what not, makes no real difference. You can hide from work, like literally sit at home and get paid in some places here. You can very easily take Cuts in every blood test/investigation you send for a patient e.g in every 5$ CBC, you can keep 4$s most of the times if you've got good terms with your local private lab and really most people coming into your office are poor folk who don't know their foot from their head and will do whatever you ask them to. The patiets themselves are no angels and some prefer being swindled of their money ( yes its very weird and hard to explain. my people like to brag and tell stories about being looted of money.....I have no explanation its just a local thing)
It is a dirty toxic place, and at the same time there are some very excellent and competent clinicians around here. They really are good at their clincal skills, diagnosis and management, however many are terrible at being ethical.
The actual career stuff: So, reading all the hoohaa above, I don't like being a doctor, I don't like interacting with patients much, but I also want money and some degree of fame. Not a huge amount of money, just enough to keep me comfortable getting gadgets and toys(I'm into electronic stuff, computers phones cameras etc). I've short listed it to Anesthsia, dermatology and orthopedics. My parents want me to go into an internal medicine subspeciality because they say Anesthetists are dependent on surgeons and with the kind of place I live in, my skill is not valued, but ass kissing is valued allot, I think I can manage ass kissing, but really who knows? what if I snap one day? Also, we have such a severe shortage of anesthetists in our country that doctors with 2 year diplomas are taken as attendings. Its an absolutely vacant market simply because everyone is discouraging people form entering anesthesia
Derma....I have HATED studying derma in medschool, I always skipped it. I simply DO NOT UNDERSTAND one rash from the other. I don't know what a macule,papule etc etc is/are. They all look the same its so confusing! xD but worklife balance and all? maybe I can make the sacrifice.
Orthopedics... I like it because the patients are general nice and clean, usually no dying gasping folks. The physical examination is very fascinating as is the imaging. There is a very wonderful attending that inspired me, the only person to honestly ever inspire me. I'd call him in the middle of the night when a Trauma patient would come on and he would show up like a freakin super hero and save the day. He used to love taking me to the OR and even let me drill a hole it a dude's leg. How cool is that? very cool. Trouble is, I can't hold my pee. I pee like every 2-3 hours even off of water. With water it can get absolutely crazy sometimes 3 times an hour. No I don't have DM :/ I also don't feel like getting it investigated either, I'm just lazy.
Finally: Why its difficult to pick? Job saturation. My country is not small, but its not particularly vast either. There are a huge number of patients, however there are also lots of doctors and lots of specialists. Derma and orthpaedics are saturated. There's like 10 orthopods and dermatologists under every rock I pick up here, i'm exaggerating obviously, but there's quite a bit of competition and I'm not sure how it is outside of Pakistan, but here a dying patient will wait 10 days just to see a Professor(what we call a senior attending. we have levels of consultants here) who is an dingus and doesn't care enough to go to work, rather than see a younger fresh attendant that very day.
Thanking you all in advance for any suggestions. Really I'll consider anything except ENT, Paeds, Pathology, Cardiology, Obgyn, any surgical except ortho.
If anyone is interested in getting to the point, you can directly reach the bottom "career" topic and skip the background. Thank you.
A Background about myself: I have done MBBS, thats bachelors in Medicine and Surgery from Pakistan, its a country in asia for those that don't know. I do hope there are people here familiar with our system, its more like the UK. I have completed what you could call Intern year/FY1 and I have to select a speciality exam to give now, we have separate exams for separate specialities e.g Surgery has its on entrance exam, medicine and its subs have a separate, anesthesia separate etc.
Ok, so, it might come off as a bit weird, but I was forced to become a doctor. In my country, generally we live with our parents for our entire lives, there is no concept of part times jobs or moving out of the house and I since the day I was born, my parents who are both doctors btw, decided I would become one. They would mock and shoot down any passion or suggestion I gave other than medicine. I did very poorly at school, poor enough to be able to enter a public Med school, but here we have this thing where you can just pay to get into a private med school without any real hassle, its expensive, but nothing near the U.S or the U.K. Regardless, I ended up being bruted and emotionally black mailed into medschool all the while being told what a shame and embarrassment I was for not being able to enter through good grades and merit. I resented myself and my parents and I still do after 6 years of being in medicine. Moving on, I passed through medschool successfully dodging everything and learning nothing. I studied 5 months in 5 years of medschool, passed all my exams with average or slightly above average marks due to our paper patterns being rather predicable. I kept telling myself it gets better after medschool, until last year I started my intern year and did the "real doctor" stuff and realized I actually hate being a doctor and feel worse than ever for not being able to fight for my life and tell my parents I don't want to do this, I pussied out when it mattered and now I'm a doctor with nowhere to go but deeper into it. I treat my patients with great care and respect, I try to the best of my abilities to go out of my way and get things done for them even if it means fighting a couple of lazy lab workers or higher ups, but I don't enjoy it. I would very honestly describe it as 'I don't feel happy if I treat a patient and I don't care if they die', I'm not numb to it, but there's only glimmers of happiness and sadness. I merely do my job. I'm not a passionate doctor, i'm just a calculated one.
A Background about our work environment: I live in a developing country where a very vast majority of patients do not speak a lick of english or even our official national language. They speak only their native local tongues which, obviously, our education was not in. The average patient we deal with has never heard of a microorganism, does not know what a liver is or what it does, has no idea about their past medical records, even taking a history of a bit of a chore as they simply do not consider may things as serious. There is absolutely no sense of self care. No one exercises or takes care of their diet in any sense here. It is also a conservative muslim country where interacting with females is a real task unto itself, you have to remain within great confines and be careful not to offend them or their families, even though their families only bring the female to the doctor when she is so disease ridden that she can no longer work like an arse, then they realize "oh well she's getting uselss, best take her to the doctor", though its a broad generalization it does hold true to some extend, there are also ofcourse educated folks and some highly so who come in. Speaking of offense, the patient's attendants/family will actually physically beat you bloody if they perceive you've done some kind of medical harm or if you could not save their patient even though the patient maybe quite serious when he/she comes in. They will drag you till your clothes rip and beat you bloody, maybe even threaten you to watch your back even after the beatings. There is no such thing as malpractice insurance here haha, no one sues you.
A background of the doctors and medical environment: Doctors here are totally asses. They treat patients like slaves whenever they can get away with it. Any patient asking for an explanation of their disease or the drug they are being given is mocked and told "Am I the doctor or are you?" and I find that extremely frustrating. The patients and their families are always afraid of approaching doctors lest they offend the doctor or irritate him, therefore hampering their treatments. My fellows mock me for explanation procedures beforehand, physical examinations and what not before hand or actually taking informed consent to surgeries. Here, none of that applies. If a patient dies, it is "god's will" and everyone simply moves on, whether it was due to negligence or what not, makes no real difference. You can hide from work, like literally sit at home and get paid in some places here. You can very easily take Cuts in every blood test/investigation you send for a patient e.g in every 5$ CBC, you can keep 4$s most of the times if you've got good terms with your local private lab and really most people coming into your office are poor folk who don't know their foot from their head and will do whatever you ask them to. The patiets themselves are no angels and some prefer being swindled of their money ( yes its very weird and hard to explain. my people like to brag and tell stories about being looted of money.....I have no explanation its just a local thing)
It is a dirty toxic place, and at the same time there are some very excellent and competent clinicians around here. They really are good at their clincal skills, diagnosis and management, however many are terrible at being ethical.
The actual career stuff: So, reading all the hoohaa above, I don't like being a doctor, I don't like interacting with patients much, but I also want money and some degree of fame. Not a huge amount of money, just enough to keep me comfortable getting gadgets and toys(I'm into electronic stuff, computers phones cameras etc). I've short listed it to Anesthsia, dermatology and orthopedics. My parents want me to go into an internal medicine subspeciality because they say Anesthetists are dependent on surgeons and with the kind of place I live in, my skill is not valued, but ass kissing is valued allot, I think I can manage ass kissing, but really who knows? what if I snap one day? Also, we have such a severe shortage of anesthetists in our country that doctors with 2 year diplomas are taken as attendings. Its an absolutely vacant market simply because everyone is discouraging people form entering anesthesia
Derma....I have HATED studying derma in medschool, I always skipped it. I simply DO NOT UNDERSTAND one rash from the other. I don't know what a macule,papule etc etc is/are. They all look the same its so confusing! xD but worklife balance and all? maybe I can make the sacrifice.
Orthopedics... I like it because the patients are general nice and clean, usually no dying gasping folks. The physical examination is very fascinating as is the imaging. There is a very wonderful attending that inspired me, the only person to honestly ever inspire me. I'd call him in the middle of the night when a Trauma patient would come on and he would show up like a freakin super hero and save the day. He used to love taking me to the OR and even let me drill a hole it a dude's leg. How cool is that? very cool. Trouble is, I can't hold my pee. I pee like every 2-3 hours even off of water. With water it can get absolutely crazy sometimes 3 times an hour. No I don't have DM :/ I also don't feel like getting it investigated either, I'm just lazy.
Finally: Why its difficult to pick? Job saturation. My country is not small, but its not particularly vast either. There are a huge number of patients, however there are also lots of doctors and lots of specialists. Derma and orthpaedics are saturated. There's like 10 orthopods and dermatologists under every rock I pick up here, i'm exaggerating obviously, but there's quite a bit of competition and I'm not sure how it is outside of Pakistan, but here a dying patient will wait 10 days just to see a Professor(what we call a senior attending. we have levels of consultants here) who is an dingus and doesn't care enough to go to work, rather than see a younger fresh attendant that very day.
Thanking you all in advance for any suggestions. Really I'll consider anything except ENT, Paeds, Pathology, Cardiology, Obgyn, any surgical except ortho.
