Work work work revisited

In the previous episode: KC described all the factors leading to his choice of studying medicine.

Now, what will KC do with his medical degree? I'm taking a different approach this post. Let's start with Exhibit A, the results of an online test designed to tell me what my most suitable medical fields are based on my personality and preferences.

1 psychiatry 42
2 med oncology 42
3 dermatology 42
4 general internal med 41
5 neurology 41
6 preventive med 40
7 emergency med 40
8 hematology 39
9 rheumatology 39
10 pediatrics 39
11 allergy & immunology 39
12 aerospace med 38
13 occupational med 37
14 radiology 37
15 pathology 37
16 physical med & rehabilitation 35
17 nephrology 35
18 family practice 34
19 endocrinology 34
20 radiation oncology 34
21 pulmonology 33
22 infectious disease 33
23 neurosurgery 33
24 obstetrics/gynecology 33
25 cardiology 32
26 anesthesiology 32
27 gastroenterology 30
28 nuclear med 30
29 otolaryngology 29
30 orthopaedic surgery 29
31 thoracic surgery 29
32 colon & rectal surgery 29
33 ophthalmology 27
34 urology 25
35 plastic surgery 25
36 general surgery 24

Psychiatry? Hmm it's not such a bad choice. From a worker's point of view. The hours aren't too bad, it's regular hours. And I'm sorta suited for it, since I gotta say I'm quite good at reading into the motivations and ideas of people. And it's a new, sorta-unknown field where new discoveries happen all the time. It's not some crazy-stressful career like general surgery, not many night calls, and the competition isn't fiercely aggressive such as...

...Dermatology. Which pays really well when you start your private practice and treat all sorts of cosmetic skin conditions. But hey, I'm not exactly cut out for cutthroat competition. Dermatology interested me quite alot in my posting to National Skin Centre in my job shadowing in junior college.

Or Internal Medicine? The hospital's version of the jack-of-all-trades physician. The one who deals with cases that can't be pigeonholed into cardiology or respiratory medicine or any of the clearly-defined fields. It's where the best diagnosticians do best in. I've personally seen this young patient who had a common faint eventually get worked up and found to have either multiple sclerosis or acute disseminated encephalomyelitis. And another young guy got worked up for the same reason - and well, he had anaemia. And hey, there's hardly any competition for traineeships.

Preventive medicine. Hell of boring. But hey it's honourable, because prevention is always the best, and you know that right? Why suffer the pain of illness when you can prevent it in the first place? Alluring, sitting in an office drawing up policies does have its benefits, but then, it's an office job.

Haematology. I'd love to haematology. It's a brainy, problem-solvey kinda field where you base much of your treatment on blood tests, blood films, advanced DNA tests and stuff. Cutting edge medicine, in essence. And it's not much of procedural skills, as you all know, I'm a klutz. Oh, and so many haematology cancers and stuff are so treatable, it'd definitely make my day when patients do get completely cured from stuff like acute lymphoblastic leukemia. Survival rate without treatment? 0%. Cure rate with treatment? About 80%.

Allergy and immunology for the same reason, all the gadgety and high-tech and cutting edge science. And hey, it affects so many people, it's gotta be worthwhile! Used to be really keen on it. But now, it seems sort of daunting though, with all that high level research and the fact that all the immunologists are quite big shots.

Digressing. I had an inspiring PBL teacher who was an internationally-known immunologist, and a haematologist who specialises in cancers of the immune system as my first clinical teacher. Did that influence me somehow? Oh, and in my medicine posting, I had a haematologist as one of the 2 teachers.

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Let's take a look again at the list. Of the top 10, there are 5 fields that I did not highlight. I'll explain.

Medical oncology. To be honest. Med onco is where all the metastatic, terminal cancer patients go to have a last chance at palliative chemotherapy in an attempt to prolong their lifespan by that last few months. Depressing.

Neurology. While there's the really treatable stuff like myasthenias and all, most of the patient load is for strokes, and sadly, once a guy is stroked out, there's really not much a neurologist can do to improve the immediate condition, short of a referral to rehab. Sigh.

Emergency medicine. Stress. Shift work. Bleagh.

Rheumatology. Old ladies with swollen joints. I can't really communicate with the elderly well, with their dialects and their ideas and beliefs and all. Oh well.

Paediatrics. I haven't done my posting in that, but I'm seriously wary of kids. Too hard to handle! And the competition's tough!

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Or screw it. Maybe I'd pick an alternative career path? I could go back to novelist, in the same vein as Dr. Michael Crichton and Dr. Robin Cook.

Or if luck permits, an esteemed chef or something! Hey they do earn more than the top surgeons. Or even char kway teow (the most successful ones earn as much as a senior surgeon).