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.

Planning Ahead.

I would like to think I am fairly good at planning ahead. I am quite a simple person and fairly straight forward, but few know that I actually think quite a bit about the future. Being an international student, you have to think about the future.  We try our best to not think about the future as anything can happen, but we also have to be ready for anything unexpected. My biggest advice to international students (no matter how confident you are about staying in the UK) is to have a backup plan. What happens if the UK government decide to throw us a curve ball and change the immigration/Visa rules? What happen if you suddenly have to return home due to family issues? And if you're not planning on staying in the UK, you really got to plan when to take the registry exams such as USMLE. It pains me when I see international students not having a single clue what they'll be doing in a few years time. Unfortunately it isn't a straight path for international students, let it be staying in the UK or going back home. Either way it won't be easy and you will have to make sacrifices. Anyways enough with the grim outlook for international students. It isn't all that bad to be honest. It's just that you have to constantly remind yourself you are an international student and it isn't a simple straight path. There will be many obstacles to cross and many walls to climb. It isn't easy, but hopefully it'll be all worth it in the end.

Anyways enough with the weird banter paragraph above. Maybe I should put the beer away. Haha. If you guys read my last post carefully, I did not talk about Friday. No I didn't have lectures...and no I did not go into placement. Then you must assume I was skiving. No I wasn't skiving either...well I wouldn't consider it skiving because I was actually doing something productive. I had a meeting with an Orthopaedic consultant at the central hospital to discuss about my Student Selected Component (SSC) project for this coming May.  The last time I met the consultant, I fell asleep in the chair and he had to wake me up...great first impression. Luckily it didn't really affect him as he was willing to see me again. He was actually quite keen to be my supervisor for my SSC and to mentor me. This time prior to meeting him, I made sure I was not going to fall asleep. I heard him come out from his office so I made sure I didn't look like I was dozing off...to be honest I was zoning out as all I did was stare at the wall. I had to wait for awhile as I was 30 minutes early for the meeting as I messed up on my travel timing so I was quite tired. Went into the office to discuss what I will be doing for my 6 week SSC project. We did a lot of brainstorming and came up with quite a few ideas.  Either this consultant is smart or was prepared to discuss about my SSC as he was rapid firing ideas at me. Unfortunately, I kept zoning out as to be fair...I did not understand half the things he mentioned. He was talking about the different type of implants used in Orthopaedics, and obviously I have never heard of the brands. He talked to me like I knew all the brands so you could imagine I was very lost. When I get lost...I zone out. It's a horrible trait I have. As he went on, he realized he should write down what I will be doing. He set out a bunch of aims and wanted me to expand on it and give it a think. He filled up half a page with notes on the aims of my project (looking at implants). I quickly put the paper away in my bag without looking at the paper.

And then I perked up as the consultant mentioned that during my project he wants to do some clinical things with me. I told him that I got to observe a few trauma surgeries and paeds orthopaedic surgeries over the last few weeks. He ended up throwing a curve-ball at me and told me that it is good that I'm making the effort and be keen to go see these things, BUT the difference is that when I follow him I will be scrubbing in and actually assisting. Oh man, I got so excited it was ridiculous. I immediately sat up straight and couldn't stop smiling. Scrubbing in and assisting = music to my ears. Finally I get the chance to get my hands in and do something that I am interested in. He also went on how I will be able to do some stitching (heart sank a bit as the last time I learned stitching was a year ago). Now, I was very excited about my SSC and the consultant surely knows how to make a student happy.

After the meeting I quickly went home and took out the paper that he wrote on. To my demise, I could not make out half the things he wrote. I regretted zoning out and I should've remembered doctors do not write legibly.  Took me ages to decipher what the consultant wrote. In the end, I figured out most of the things he wrote as I vaguely remembered the stuff he was talking about and managed to crack on with expanding on his notes. Note to self: Do NOT zone out while a consultant is talking to you. You'll regret it as you won't be able to read half the things he wrote down. Imagine if I couldn't decipher what he wrote...the embarrassment I would have to go through as I would have to email him and tell him I can't read what he wrote when I should have been paying attention during the meeting.

Anyways I'm super stoked about my SSC in May! One more meeting and a bit of paperwork before my SSC will be official. Cannot wait.

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!