Finally I feel like blogging again since April 2009. Since then, I traveled thousands of kilometers; first in suburban and remote rural south India and then flew across to another country chasing my dreams. It was a long and challenging war that followed my exit from the so-called Corporate Clinical Medicine into Public Health and finally back to Clinical Medicine. The war is far from being over.
The decision to transition to Clinical Medicine:
Public health generally speaking is Medicine "wholesale" and Clinical Medicine is its "retail" counterpart. But often in the practice of Public Health by organizations I came across bosses dealing with mundane statistics and numbers, taking decisions based on assumptions the credibility of which can be questioned many a times; and very generally speaking in my opinion you do not need to be a medically trained person in the first place to analyse incidence and prevalence of illnesses and the social determinants affecting the same, at least you need not necessarily be a Physician to do this. But when a medical doctor with a sound clinical background is "running the show" (which I got to witness during my Rural Stint after med school), things are different, since he has the perspective of a clinician. And to develop this perspective it is necessary to have undergone rigorous training. Hence the need for further training in clinical medicine; or else there is no much difference in the perspective of a Doctor or a Lawyer interested in Public Health. And of course, the joy of dealing with individuals, talking to them, going through the complex process of diagnosing and coming up with a treatment plan is something I could not trade off with Public Health.
Training in Clinical Medicine in the First World Versus the Third World:
I tried as much as I could or probably lesser than what I was capable of to get into a specialty training program in India itself, but as the prevailing circumstances at the time would have it, I had to choose between a high paying job overseas with a possibility of entering specialty training Vs the prospect of spending another year and most of my waking hours poring over books, spending my father's money for not only my expense but also that of my young and growing family..... all of this to get into a training program which will pay me pittance and make me work so hard, that at the end of it I will probably not recognize myself in the mirror. I was stilling willing to face the prospect of taking up a job in India itself while I still try my luck at the Indian exams, but some of my friends convinced me to give the other option a try at the very least. And very soon I was on a flight to Singapore, and before I knew I was already doing ward rounds in Geriatric Medicine with a COW (Computer-on-wheels). It was probably the biggest change that I had ever experienced so far, moving out into another country. Never before had I ordered as many CT and MRI scans like I did, giving Pipericillin/Tazobactam and Carbapenems. This was the first time I am working in a proper tertiary care setup since my internship days. I spent most of my waking hours in the hospital and finally, I applied for the Internal Medicine Residency and was blessed to have been accepted into it. Thank God I did not stay back in India to pursue specialty training or Public Health.
Inspired by the sheer number of online accounts and portals for me to log in and document my improvement during the course of my residency, I decided that I will start blogging again, as a sort of parallel log. So I hope to keep this blog more active until the foreseeable future at least....
Some of God's greatest gifts are his unanswered prayers.
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