DECISION TIME!

The time that most of us doctors at my level dislike has arrived.

Yeap, it is decision making time. The much dreaded job application has began. Now, I have to decide what I want to specialise in.

hmm.....is it respiratory? diabetes/endocrinology? gastro?

well, definitely not cardiology...neurology... renal...

or, is medicine what i really want to do for the rest of my career as a doctor??

or, should I switch to something that doesnt involved so much medicine, ie, psychiatry?

or, should I switch to something less frustrating, and more lifestyle-friendly job of GP?

or, should I go to a specialty where I do abit of everything...like acute medicine?

I really hate filling in forms...I hate deciding on things like this. The thought of choosing one specialty and the thought that I might not like it in the end is rather frightening. And, even if I want to do that particular specialty, I might not get the job at all....

Imagine, each deanery only has about a maximum of 3 available spaces for each specialty...

competition is tough.

arrghh....

R-U-B-B-I-S-H

The week has panned out to be pretty rubbish.

This is Day 9 of my 12 day working week. As the week progresses, things seem to be getting more out of control, crazy and frustrating.

On Sunday, I spent at least 6 hours in one of the wards sorting out a very ill patient. The thing that frustrated me the most was the fact that there was no proper plans created for the patient. The diagnosis made by the patient's usual team was of X, however, when the patient was seen by another team, the diagnosis was Y. The interesting about this was the team that diagnosed the illness X, is a specialist in the illness Y. So the diagnoses were sort of going against each other.

I was stuck in the middle, and I was asked by one of the teams to get ITU to review the patient....Unfortunately, they gave me a big mouthful because the diagnosis was unclear. So I resorted to telling them what I personally think it was. I am sure many junior doctors out there have been in the same position as me. It is just so difficult and uncomfortable being in the middle of an argument between 2 teams.

To add to the misery,

I really wanted to "aou huit" today.... that is a chinese phrase, which literally means "vomit blood." A patient was extremely agitated in the ward because of a severe infection. The patient has no capacity whatsoever to make decisions. A few doses of sedation was given earlier, but they had no effect on the patient at all. The interesting thing was again, there was no clear plan from the ward round about addressing the agitation.

So there I was, holding a syringe filled with diazepam, gently sedating the patient intravenously to allow us to provide treatment. I dislike doing that....but had no choice because I was doing it in his best interest.

The joys of being a doctor.....NOT!