Request: The Future.

There was a request from one of the readers here asking:

"What are you planning to do after medical school? It would be great to get some insight to what Canadian medics plan to do after their studies in the UK."

To be honest, the future can always change directions and I know I will have to be prepared for anything that life throws at me. My first choice is to stay in the UK and do my specialty training here as I know the system,   and I have gotten to know quite a lot of doctors who can give me advice for the future. I will try my hardest to stay in the UK, but laws do change. Hopefully the law won't change to prevent international students who study in a UK medical school from practising in the UK. In my eyes, I have spent 5 years in the UK. Moving isn't easy. The last thing I want to do is moving back and forth between countries. When I set my mind to something, I like to stay on that track and I am a very determined and ambitious person. In a way some people see it as stubborn, but I set goals for a reason - it is something for me to look forward to and to work towards to. I used to be quite a high level athlete and giving up is not an option. I do not like to stray away from the goal and when I do, I do get disappointed. I set high standards for myself and yes I know staying in the UK will not be easy, but I have set my mind to it. I have moved my life over to the UK and I personally don't see much of a future for me in Canada.

Now I may be determined and ambitious, but I'm not going to shoot myself in the foot. Always have a back-up plan. Things can go wrong. Life can throw a curve-ball at you. Rules can change. Who knows. The future is unknown and the most you can do is to be ready. Yes I have my mind set to stay in the UK, but I am still planning to take the Canadian MCCEE so if push comes to shove and I have to go back to Canada, I can. Nothing worse than ending up jobless and stuck in that awkward grey area.

I know quite a few international students wondering about taking the USMLE. (Note: I am not trying to start an argument/debate with this topic - just a personal opinion. Sorry in advance if anyone takes this persona/finds it offensive...) Who doesn't want to live the "American Dream". So why am I not taking it? Because I am not seeking for the "American Dream". To be very blunt - I do not care for working in the US. Some people see it as a great opportunity to make some good money. Some people just like the environment more. How I see it - if you are looking for the "American Dream", I'm sorry to break it to you, but in today's economy - there isn't much of an "American Dream" anymore unless you become a very famous doctor. The US is a very competitive place. Remember not only do you have to take a sickeningly hard exam, but you also have to score well in it. There's no point in just scraping a pass - you have to have a competitive score to get a desirable job in the US. I personally have my mind set on a specialty and it is a very competitive specialty. If I wanted to go the US, I would actually have to ace the USMLE. I don't want to end up working in some small southern town in the states in the middle of nowhere. The UK schools aren't geared to take the USMLE. UK medical students are geared to become practising doctors...not to take a US registry exam. That means students who want to take the USMLE, have to spend a lot of extra time to study for the USMLE alongside with their UK course work/exams. It is a very tough thing to juggle and you really have to be determined to go to the US and be committed to do well. So do your research.

Having said that, those who are determined to go to the US and have their eyes set on the prize - will probably do well in the USMLE. These people would probably take the exam seriously and study hard for it. Some might not really care what specialty they want to go into. These people will probably get a job in a desirable location. I'm sure I wrote a post about priorities before. Personal preferences and priorities - what is important to you, may not be as important to the person sat next to you. To make your priorities work, you will have to make sacrifices. At the moment, my #1 priority is to get into my desired specialty. This will probably require me to make quite a few sacrifices as it is a competitive field. The most likely thing I will have to sacrifice is: location. Someone else who wants to do the same specialty may see location as a huge priority. He or she may rather stay in London than do specialty X or he/she may not mind doing specialty Y in order to stay in London. It is all down to you.

All in all, the future is a personal thing. Everyone has his/her own path. No one path is the same. Know your priorities and stick with them. Don't let someone else alter your priorities or talk you out or into things. It is your life at the end of the day.

Tidbit for International Students.

Today I received my Student BMJ in the mail and while reading the front page articles on the newspaper - I managed to walk into a door. You may ask: "What's so interesting?"

Well there is an article called: "BMA rejects 'unjust' limits on training for non-EEA medics". A summary of this article is literally about the unfair treatment towards international students especially those studying medicine. I was shocked to see that us international students' tuition fee contribute £100m annually! WHAT! That's a HUGE number. Technically we should get equal rights on getting specialty training and with the new immigration rule of removing the Tier 1 Visa it will essentially be impossible to get specialty training in England. So in the last post I said that recruiters don't care if you are international and they are happy to accept them. THE annoying part is the VISA and that Tier 1 visas is our post-study work route for specialty training, which they want to junk.

It was shown in studies that International graduates are not stealing away jobs from local students so they don't see why they should make an international student's life so difficult. I don't know if you guys have been around the hospitals a lot but I have noticed a lot of consultants aren't actually local British people. I've talked to a few consultants who are from India and we have had a few internationals who lectured us - and they appear to be quite skilled (well they are consultants). Unfortunately with the junking of Tier 1 and if these consultants have not declared citizenship...wouldn't they be in danger of being kicked out from the country?! That to me sounds quite shocking that the UK would want to kick out highly skilled people...especially extremely skilled consultants. It was also mentioned that it is unfair towards those medical students who are currently studying medicine and suddenly changing the immigration rule on us midway through our degree. If some of us knew about these immigration restrictions and not being able to do a specialty...some of us may have not chosen to come to study in England as essentially it appears to be a flipping dead end after foundation year 2.

Now with the NHS reform and the ridiculous suggestions...I do not know what is the UK government trying to accomplish. I feel that the UK heavily relies on immigrants for jobs and it is a shame that they believe that internationals are getting in the way of locals. While providing £100m annually from tuition fees in total and the NHS is spending a couple hundred thousand pounds to train each medical student (including internationals) I reckon the smart thing to do is to not shoo us away. If the UK is going to make working in the UK as a doctor and an international so difficult and almost impossible, just simply stop international students from applying to universities! With every article I read about the immigration rules and how it'll affect us, the less UK appears to be welcoming. Hopefully by the time I graduate the UK government gets their heads checked and really take a deep thought about the consequences of these immigration rules will do the economy and the work force. I feel that internationals play a vital role in the UK as a whole. Really is a shame if these immigration rules completely bar off internationals. Multiculturism is good to have and especially coming from one of the more successful multicultural countries (Canada) - I truly feel that immigrants are not as welcomed anymore in the UK.

Local students may argue with me on this, but really what a shame.

A Sigh of Relief.

Today was quite a cheerful day...well minus the gloomy/ridiculous weather. Went to meet my supervisor for my research attachment at the Bone Metabolism Centre. My supervisor has lectured us quite a few times during our MSK unit, but I always had the impression of him being a quiet/awkward guy. After meeting him - wow...he is a really chill person. He was relaxed and it was quite fun to talk to him. He told my group and I (3 of us in total) what the project entails and what is expected from us and everything just seems really straight forward. Best thing I heard was that he knows that we should be studying for exams and will not be expecting us to do 9-5 every day. In fact, he only expects us to come in once in awhile and go to some seminars/lectures and maybe visit the gait lab to see the equipment used and what the volunteers will be put through. Super excited about this. He also said that it isn't an intense research attachment and all of us breathed a sigh of relief. We were really worried that we'll be really busy and won't have time to study.

I'm definitely looking forward to this attachment and hopefully I'll get my schedule soon. We are supposed to start tomorrow but when we were leaving our supervisor said: "See you next week!". So I assume we get the rest of the week off...or until we get our schedule! Exciting stuff. To be honest I'm not being lazy and stuff as I'm genuinely really excited for this attachment and it is one that I wanted to do, but it really got the best of two worlds. Equal balance of the attachment and as well giving me study time to concentrate for exams. Great stuff.

As well, before the meeting the medical school decided to add a new clinical skill session for our year - venepuncture. We got to draw blood on plastic arm models and it was really fun. Gave us a reminder that we are studying to become doctors. Sometimes you tend to forget due to all the preclinical lectures of all the basics - you lose sight of what you're studying and sometimes it is nice to get reminded from time to time that in a few months we'll be on the wards and in three years we'll be qualified! Still seems a bit surreal.

Today was a great day...shame the weather couldn't cooperate though!

Unnecessary Stress?

Lately I have been getting a bit stressed. And I do not know if I am giving myself unnecessary stress. I've been having a lot on my mind. As some of you know, I am a Canadian and an international student studying in the UK. Just for good back-up should I take the Canadian registry exam so if things go bad or for some reason I have to return home to work I can. I have done some research and some people say take the exam after 2nd year because all the sciences stuff will be fresh in your mind. Some say do it after 3rd year so you have a bit more knowledge about the clinical side of medicine. Then there are some who say after 5th year (aka after graduating from medical school) because I would be more mature to take the exam. There are pros and cons for each year but you know if I am considering taking the exam after 2nd year or 3rd year I should really get thinking. I really do not know what to do. I'm stuck. In a way I am a bit hesitant about taking the exam after 5th year as I am worried I'll forget all the sciences stuff. But on the other hand, 2nd year could be too soon as I need time to study and it is now November...well in a few days it will be November and I also have to study for my final exam in the summer. Might be giving myself too much work! So in a way 3rd year seems like a good time but is it really too early to be taking the exam?

Second, I have a strong passion for surgery. Ever since I had the opportunity to learn/discover about surgery I have been non-stop thinking "I want to be a surgeon". Also for my 2 week hospital placements to shadow surgeons/doctors, I was fortunate enough to be paired with a general surgeon and a paediatric surgeon. Compared to others I found surgery really interesting. Can't believe some people say it is boring and actually would do anything to avoid going to watch surgery. I have been criticized by people that I am thinking too early, but to be honest, it is never too early. I want to prepare myself and really try to find as early as possible what I want to specialize in and whether or not surgery is genuinely right for me. About three years ago I was first exposed to Orthopaedic surgery. I was hooked. I thought it was interesting and I really enjoy sports medicine. When I reached medical school, I have seen a lot of surgeons/doctors teasing orthopaedic surgeons which essentially put me right off. "The carpenter of the hospital." "Oh you hear the hammering and drilling sounds? Ah must be the orthopaedic surgeons working." It seems to be that orthopaedic surgeons don't get enough respect. I personally feel that they should get a lot more respect than they really do as they do help a lot of people's lives feel better. Yeah they might not always be saving a life like a neurosurgeon or a trauma surgeon, but they have their part in changing someone's life for the better. Anyways so after being put off from orthopaedics, I found that I had a huge interest in learning about the heart. So I thought about cardiothoracic surgery. Sounds great. Love the anatomy of the heart, get to save lots of lives, prevent people from dying, and great pathology. Oh wait....it is at risk of getting phased out by them interventional radiologists. Plus the other day I went to attend a talk by an Orthopaedic - Spinal surgeon who discussed about thinking about the future. Need to think if the specialty you want to go in will still be here in 10 years time. He listed cardiothoracic and vascular surgery will be at risk. Great. Hmm. I obviously want to do something that has a lot of potential and has plenty of time to develop and not be at risk of disappearing. I did pay a lot of money and study really hard to get into a UK university and I definitely don't want to spend a lot of hard work at training into a specialty which could diminish in a few years time. I like to be on my feet, and excited about the future. The new technologies for surgeons and a field that is developing.

So the other day after attending the spinal surgeon's careers talk, I gave orthopaedics another look. Like it is a field that is developing and we have an aging population. There will be higher demands for hip replacements, knee surgeries, etc. So yeah I'm now jumping back and forth. Deep inside me I feel like I will end up in orthopaedic surgery as I always tend to go back to my first choices. Orthopaedics clicked with me early on and yes pathology isn't huge...but I could do a sub specialty into something that may involve interesting pathology.

Some others I have thought about are surgical oncology and ...well that's as far I have gotten to for now. My mentor is a surgical oncologist and specializes in breast cancer and after having a brutal four hour lecture from him, it actually seems quite interesting. Cancer will be out there for a long time and I don't see it disappearing anytime soon. It is constantly developing. Huge research goes into it. LOTS of people are affected by it. Very interesting pathology. Quite enjoyed it last year when we had lectures on it.

So you're probably thinking:

1. Are you done ranting?
2. Ok so what's the big deal? It isn't like you're graduating next year.
3. ZzzZzzZzz

On top of what I mentioned earlier, to become a surgeon you need a CV that stands out from the rest. What did I do last summer? Relax aka did absolutely nothing. My classmates? Oh well they volunteered and worked at their GP surgeries, went to the hospital to shadow surgeons and doctors. Great....my CV is already looking real unique now...more like in a bad way. So now I'm on full blown motivated mode. To be honest I need to speak to someone about my future. At the moment we are in the midst of changing our mentoring program and we still do not have our new mentors. I don't know how much longer will I have to wait to get my new mentor and I don't know how much longer I can wait with so much in my head. I don't know who else to ask other than my mentor from last year as he seems quite knowledgeable. Maybe I should have a chat with him, but he is soooo busy I feel bad wasting his time when I am no longer his "mentee". Hopefully he'll have the answers. If not, time to search for someone to ask.

Sorry for the long post. Hope everyone is having a great time at uni still and enjoying medicine!