residency options

During benign rotations such as family and community medicine, I preoccupy myself with thoughts of the future. I always say to myself, the future remains uncertain, but I'm pretty inclined to do research again; it seems that an endless sense of inquiry is in my very blood.

Anyway, as I was looking for job vacancies in PCHRD, Philhealth, and PIDS, and several hospitals offering residency training, I came across this website again, which I think I've encountered for the first time three years ago. 

I answered the 130-item questionnaire that asks about life values, and I was surprised with the results!

I only thought of pathology as an alternative; I never thought that I would fit in. Apparently, my life values are similar to most pathologists.

When I had psychiatric patients at the outpatient and ambulatory clinics last year, I was seriously considering a future in psychiatry. But recently, someone narrated to me her experience at the national center for mental health, which was quite revealing. There was one pavilion that housed criminal psychos, and I fear that my life will be put in danger if I was their psychiatrist. 'Nough said.

I envy their lifestyle: regular work hours than most on-call doctors. If I were to train in radiology, I would like to apply in big private hospitals because that's where the latest technology is. However I am quite unsure if I can make it big in Davao or elsewhere, likely because radiology works like a monopoly in any hospital in the provinces.

My batchmates see me as a future internist, but I am not sure about this. Ward work is stressful and the hours are long; I prefer rigid working hours and exploring life outside medicine.

I once wanted to become an obstetrician primarily because I want to see mothers give birth to healthy babies and witness God's gift of life in all its wonder and mystery. However, just like IM, you are always on-call, because many pregnant patients get fully dilated at the most unholy hours.

Among all residency choices, this is my first. It's critical care at its best. I look to Florence Nightingale as my inspiration, among other people of course. She was an intensivist at the height of war, taking care of wounded soldiers, a historic scene that resembles the modern post-anesthesia care unit. She was also a self-taught statistician, taking notes for patient census; not a lot of people know this. Anesthesia as a field is a conglomerate of medicine and other specialties in the perioperative setting. It is 50% brains (drug effects, physiologic changes) and 50% skills (intubation, lining) ; that's why I like it a lot.

One thing that bothers me is that I get easily frustated with geriatric patients. They are stubborn when I give medical advice, or sometimes, I just don't feel like they're listening.

No matter how much I deny it, I like giving advice to parents regarding their children. Also, I like to hear a kid cry during vaccination.

community health center

the community health center near Singalong, Malate, Manila,  a two-storey mixed wood-concrete edifice with ostensibly quaint features, may reek of malady and gradual decay, but at the same time, it embodies the rich history and strong sense of community inspite of circumstances. in fact, the health center houses a large mural that seems rather expensive and would rather belong in a national museum; however even the philippine general hospital has a lot of expensive paintings in its lobby so i guess this phenomenon is not new.

the health center is just one of the many community health offices in the country reflecting the dilapidated health system today, something that is in really bad shape and in need of constant resuscitation. i guess the dose of monetary adrenaline injected into the system was just not enough, or probably, the selfless hands that were in charge of the system got tired eventually. indeed it is difficult to expect much when you have multiple organ failure.

ambulatory care

my ambulatory care rotation was relatively benign: no psychiatric patients this week (although i have this weird feeling that i will enjoy probing the endlessness of a patient's troubled psyche) and no endorsed cases. the ambu clinic takes care of patients that have been informally rejected from admission to the emergency room (at times due to inadequate space) but nonetheless required urgent medical attention.

last saturday i was deluged with pediatric patients; i had two very young sisters who both had bronchial asthma, but the intern i was with said that she was also entertaining the possibility of pulmonary tuberculosis, following lymphocytosis in the complete blood count, and the fact that both parents were coughing the whole week. thus she advised the parents to consult the family medicine clinic as well.

i also had one gynecologic case of vaginal discharge and polyposis, and a lot of geriatric procedures in between. the breadth of family medicine is indeed wide, and most, if not all, patients are willing to share info about their private lives for the sake of completing the medical notes. once they open up, it feels like half of the job is done, and the rest of the consult becomes a breeze.

my first pf

an amazing aloha burger from jollibee, with fries and coke! that was last june 18 on my post-duty. well the parents of my pedia patient probably saw me harrassed and all, and took a pity at my shagged appearance. i turned pink when they handed me my would-be dinner, and started a litany of thank-yous.
in retrospect they got to abuse me the next few days, i.e., run labs needed stat, schedule ctscan by badgering the radio resident 3x on a sunday, write multiple clinical abstracts for pcso, et cetera.

but i guess i did something right that day. thank you Lord.