Wednesday, October 16, 2019

New Places to Visit When in Cebu




Places evolve. That is my realization during the long time I have stayed in Cebu City. I have considered this place my second home for almost two decades now and it took on a lot of changes right before my very eyes in that span of time.



When I was a child, we regularly visited Cebu since it is my father's home city and we would visit my grandparents who were living in the southern part of Cebu Province. Our trip would not be complete if we would not drop by the malls then. Gaisano Metro felt like heaven for me and my sister, specially when we spend all our time on the rides, and do a little shopping too.



Fast forward to many decades later, though malls of our younger days like Gaisano Metro still maintain a strong following, its close competitors are not far behind, namely the SM and Ayala Malls. Going for a Cebu trip may still include shopping in these famous malls but a lot of attractions are drawing a lot of crowds too.



If you are planning to visit the Queen City of the South one of these days or in the coming summertime, you might want to include these places in your itinerary.



1. 10,000 Roses


    These are artificial LED roses that light up from dusk till night. This is the very first of its kind in Cebu City, built about less than five years ago. The roses shine brightly during evening so visitors usually flock during the night. Make sure to set your cameras or phone camera to night mode when you take pictures.  It is about an hour away from the airport, since the roses are situated in Cordova, Cebu, so you may visit this first before proceeding to Cebu City. There is also a cafe nearby where you can while away the time and enjoy the beautiful ocean view and the view of Cebu City just a few miles across the place. By the way, there is an entrance fee that one has to pay in order to view the roses, but do not worry, the fee is very affordable. 
     


                     Photo by Shing Camps

                   
                                        Photo by Shing Camps


2. Sirao Flower Farm


    Fondly named as the mini-Amsterdam of Cebu, the Sirao Flower Farm is situated in the mountainous barangay of this city. One would totally be in awe that these mountains nestle such a beauty or, shall I see beauties because of the countless flowers. The easiest way to get there (aside from hopping into your own car) would be by taking a habal-habal from JY Square Mall in Barangay Lahug. The habal-habal drivers would charge at least a hundred per head per way. Prepare yourself for a mountainous ride that may be bumpy along the way. Aside from that, upon reaching your destination, get ready to enjoy the breathtaking view of a lot of flower farms and the greenery of the mountains as well. Truly, a breath of fresh air away from the city. The farms again collect a meager entrance fee, which is actually nothing compared to the view that you will enjoy. 




3. Temple of Leah


     How would you feel when someone loves you so much that he or she built an extravagant structure to show the world his or her love for you?  Well, we may not be able to know how Leah would answer that question, but the Temple of Leah was built exactly for her  - Yes, Leah - by her husband. The temple was built last 2012 as a symbol of the endless love and devotion of Teodorico Adarna to his wife of 53 years, Leah Adarna.


         I had my picture taken at the lobby of the Temple, probably one of the most instagrammable spots in the area, right infront of the grand staircase that leads to a statue of a woman, sitting on her throne - an image inspired by Leah, of course.



              The Temple of Leah is a rising favorite as a pre-nuptial shoot venue.  But whatever purpose you will have for visiting the place, surely you would feel the love. It is suggested that the Temple of Leah be your side trip when going to the Sirao Flower Farm. People visit the flower farms first, which are more uphill in location, then stopover at the Temple on their way down and back to the city.
      








  

4. Simala Shrine
  
    Let's head down south, this time. When you feel wanting to have a moment with God and Mama Mary, this one is the place to be, The Simala Shrine.


          Nestled in the Hills of Lindogon in Sibonga, a town in the southern part of Cebu Province, this shrine is simply breathtaking for so many reasons namely, the scenery it offers, the intricate architecture and woodworks of the structures in the shrine, and most of all the evident serenity that surrounds the place especially that it provides a unique venue for one to be one with God.  To ask for blessings and guidance in your trips and endeavors, to ask for special favors, and most of all to give thanks for the many blessings you received and favors granted, you might want to pay a visit to the Simala Shrine.



          During my first visit to the shrine, what amazed me was the collection of crutches left behind by patients who used to move around with the aid of this ambulatory device. They donated their crutches after they have been healed and are able to walk again. There is also a collection of pens, pencils, graduation photos, and letters of thanks from students who successfully passed their licensure examinations after praying their petitions to the Blessed Virgin. 




               Photo by Shing Camps


5. Baywalk at the City of Naga


                             Photo by Shing Camps



        Lastly, take a walk at the baywalk at the City of Naga and enjoy the soothing breeze breathed out by the sea. You also get to enjoy views of cargo ships sporadically spread in the canvass created by the blue waters, or views of the planes that occasionally fly over the area. All day and all night long, there is no chosen time, whatever time you decide to visit the baywalk, I assure you it is always the best time.  The sea and the baywalk is beautiful both in daylight and at night. You can also treat yourself to the gastronomic delights offered by restaurants nearby. 


          That's about it. You may want to add these places to your Cebu visit itinerary soon.


          Enjoy and take care.











Wednesday, January 23, 2019

Silver Linings: Favorite Moments in Residency Training and Beyond



      
     

      An article I read in the New York Times somehow transported me to a warehouse of memories in my psyche.  


     As I looked around the "warehouse," I came upon a box which was in an almost forgotten corner. It was neatly covered with duck tape all over, and labeled "RESIDENCY TRAINING" with a red marker. I bend down to take the box, and for a few seconds, embrace it, like a long-lost lover.






      Doctors who underwent residency training for a chosen subspecialty know fully well that the period of residency is one hell of a rough roller coaster ride.


     I am one of the millions who can attest to that - being one and a half times a medical resident. Actually, I don't take full credit at all because every soul who underwent training can attest to that. Except maybe for an elite few who just got very lucky in this stage of their medical life.


     That New York Times article made me look back, and yes - scavenge inside that box - for good memories I had during residency training.


       One may ask, as quickly as a knee jerk, "Naa diay?!" (Are you sure, there are good memories?!). I will answer to that, "Naa ra man pud." (Somehow, there are good memories during residency training.) - with a smile to match. 


           I consider these moments as "silver linings," - an old idiom that gained popularity lately, thanks to Miss Universe 2018, our very own, Catriona M. Gray - that we hold on to amidst the sea of dark gray clouds or adversities and trials which are the currencies of residency training. 


    When one is subjected to such a stressful environment and lifestyle, I can truly say, the little things count - a lot.


     My family was a witness to my ordeals then. There was a time when I would air out my sentiments to my sister, and on the following day, when I, - drained from all the day's work - went home to our rented pad, she opened the door for me and shouted with extreme excitement,  "Tadaaaann...!!!" --- showing me that our mother had flew in unplanned just to comfort me and encourage me to go on, and to hold on. 


    There were times I would deliberately ask my mother - I remember sending her a text message in the middle of a sea of ECG tracings I had to finish reading - if I made the right decision of starting residency all over again, instead of trying out my luck in the Land of Milk and Honey. My mother would encourage me the way only a mother could.

 
     I remember, a fellow resident once asked me if I ever had the feeling of quitting every month. I answered her, "Yes I do have that feeling - everyday."


      However, not all days are bad, there were days when the sun shone so brightly into my soul that I felt I was in the right place and in the right time indeed.


      It is actually true when you hear doctors say, a simple thank you from a patient, creates magic in the life of a literally and emotionally-beaten physician, even though for just a few moments. 


      I had this one patient who was a little more extravagant in his thank-yous to the point that he promised to design my clinic once I graduate from residency training. He is an architect by profession. This same patient gave me a giant Toblerone chocolate from abroad - the biggest I have ever seen in my whole life - which he safely kept beside him while he was lying in his bed. 


      He was just transferred to the regular ward that time after a few days of being confined in the Intensive Care Unit (ICU) due to a life-threatening heart attack. I was in my first year of training then (I only saw him at the Out-Patient Department and at the Emergency Room when he came in for attacks of asthma) so he was not under my service, but a nurse told me he was looking for me so I decided to pay him a visit at the ward before I go home.


      I don't know if it was just me but I saw his face brighten when I entered the room, and like a quick reflex he reached out for something on his side, inside his blanket, which made me think he was hiding something there.


     True enough, he was. He was actually reaching out for a big bar of that chocolate, which he handed to me with a big smile.  He told me that he safely kept the chocolate there since his family and visitors were eyeing on it. That act of thoughtfulness for me was indeed both adorable and touching. 


     In my second year as a medical resident, this fond memory somehow gives me a good feeling for honing and trusting my clinical eye. 


     There was this female diabetic patient who presented to the Emergency Room (ER) for body malaise. She has a background of erratic intake of medications and initial blood sugar tests taken at the ER revealed elevated blood sugar levels. I then insisted that she be admitted. Unfortunately, the patient was hesitant about admission. It is actually the rule (probably an unspoken rule and consensus among patients) to resist admission than to submit to it. I gave the patient enough time to decide, while waiting for the results of the other laboratory tests. Eventually, she gave in, and I, along with her family could not be more thankful that she agreed to be admitted. 


       Laboratory test results showed she was having a heart attack, and if she decided to go home, well it could be that she was ultimately going home to her final destination.


      What is special about this experience is that I became good friends with the patient's family after this important event in their life when they almost lost their mother. I haven't seen the patient for quite some time now, but her daughter updates me about her and I send my best regards to her as well. Last Christmas, I received another big package chocolate from the patient's daughter who is based outside the country - such remarkable thoughtfulness even when we are on the opposite sides of the globe.


      More than and beyond those chocolates, what is more important is the bond we have created, a bond that could last a lifetime. It feels good when we unexpectedly make good friends at work.


       In my last year as a medical resident, my favorite moment is when a brilliant neurologist simply told me, "Very good," when I told her what I did for the management of her patient. Those are just two words - two words that sound ordinary for many but those words were BIG and HEAVY for me, coming from an esteemed member of her specialty and coming from one of the rockstars in our field. She is not the strict type, this consultant, in fact she is very pleasant, but she is not also the type who frequently praises the residents if they or we have done good. I thought at least before I graduate, she appreciated my management, and it feels good to be appreciated and recognized for your efforts even in that simple manner.


      Now that I am a consultant, proudly serving the government, (which is an entirely different experience for me because I have been trained in and worked for a private hospital since I started) my favorite so far involves this stroke patient. 


        He is a teacher, particularly of the native tongue or dialect. It was just unfortunate that his stroke affected his speech that it became badly slurred, Rhat even us adults had a hard time comprehending it. How much more for his students? If that was not disheartening enough, half of his body was also paralyzed.


        I was worried and I felt for the patient - he had his family to feed.  The best I can do for him, aside from prescribing his medications and encouraging good compliance, was recommend an ample time of rest or leave from work, and also of course, hope for the best for him, that eventually he recovers from his stroke, so that he could get his life and career back on track.


      Forward to a few months after, I was again at the ICU, and there was this man who came in and asked about securing a medical certificate. I answered his query but I also threw back a question asking him about his diagnosis. He immediately reminded me that he was my patient, the language teacher who got a badly slurred speech after getting a stroke. His speech was perfect!


        I then asked him about his paralyzed limbs and he extended his arms briskly into the air to proudly show his limbs have regained their normal strength. It was symbolic for me when he did that - raise both his arms up high in the air - it was like a silent but meaningful act of reverence to The Guy up there. The ICU air was filled with sighs and gasps of happiness and exhilaration from the nurses and me when we finally recognized him. I will never forget that moment.


     I know that I am still a relatively young consultant. I am sure I will encounter more cases in the future, part of those will be memorable because they are pleasant ones, and others will be memorable because, uhhmm they may be filled with a lot of lessons both in life and in career practice. 


     It might be that my favorites now will be overtaken by new and better favorites in the near future.  


     I can only look forward to that, with God's grace and favor. All for the patients who find their way to me as they seek for care.






Wednesday, August 22, 2018

The Crossroads in a Physician's Journey

Replying to one of the emails/comments from one of our readers, Jesselyn, in The Tipster: The Idiot's Guide to Residency.


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Good afternoon po Doc. :) I recently passed the board exam (March 2018). And I still can't believe that I am already a licensed doctor. During med school I already had the idea of going to Internal Medicine with an interest in Nutrition and Allergies. But right now, I feel like a blank piece of paper. I don't know what to pursue for residency. It seems like I always doubt myself in pursuing such a busy, stressful and demanding training. I do admit being a sickly person (asthma, allergic rhinitis, menstrual problems, so on and so forth). My place is like a pharmacy bec. I have a lot of medications. Some of my seniors would even ask me why did I enter this field knowing my health condition is quite poor. Being a doctor wasn't really my first choice bec. I was thinking that my health might not be able to cope up with the stressful environment as a physician. But when my late grandfather told me that he wishes me to enter medicine, I took a chance. I made a promise to myself that for every year that I pass med school, I shall continue my craft to be a physician. And so I did. But in between those success in passing are the days and even weeks that I am not feeling well. I even had instances where my allergies flare up during exam days, and I had no choice but to take medications. Sometimes I find myself sleeping during exam. Our Dean would always tell me that I am incapable of being a good doctor and just quit. But for every time I get through these exams and hear the words "thank you" from my patients, it lights up my eagerness to be a doctor. I accidentally found your blog po Doc while I was scrolling down at Google search for what should I do in choosing residency training. I have read a few articles just now and I was really inspired. I hope to hear from you po Doc. God bless po :)
 I have posted it here so it can reach more readers.


**************

Hello Jesselyn!


I am so sorry that it took me quite a long time to finally reply to your comment.


First of all, I would like to thank you for taking time to read my entries. It does not matter that you found this blog serendipitously because that is how most readers found their way here. LOL! What matters is that you have found a companion, a confidante, as you begin your journey as a physician. There is nothing better than touching a person's life and I believe that somehow in my own little way, I have touched your life, and that is more than enough to inspire me to go on nurturing this blog.



Second, allow me to congratulate you for passing the physician licensure boards. Congratulations, Jesselyn! You made it! It is undeniable, it is on paper, and the PRC can give proof that you are a licensed physician! This victory, this triumph, definitely cancels out all the discouragements you have encountered before earning your license. Do not waste time dwelling and fretting about what has been said to you then, those comments might have propelled you to where you are now and that's it, those comments have served their purpose, which is to challenge you so that you can prove them all wrong. So again, congratulations! Our journey as physicians is actually not without trials and frustrations (sorry to break your bubble with that) but those tribulations will only mold us to become better individuals and able physicians who can deliver quality care for our patients. You've surpassed all those hurdles in health, in the people around you, etc., it would not be impossible that you will overcome other trials in the future. Hard but not impossible. Besides, that is life, Jess. We will only stop encountering challenges once we join the flatliners. So congratulations again, and rejoice! Life throws lemons at you because you are alive and it knows you can make lemonade out of it.


I could still remember that very first morning after the night when I knew I passed the medicine boards. The sun emanated an unusually pleasant glow. The meal I ordered at McDonald's tasted differently in a good kind of way, and lastly, I could not hold my smile. That's how victory felt and maybe, tasted.


Now, as we enter this milestone, we are beset with a lot of choices, like multiple decks of cards laid and neatly arranged in front of you, each card almost silently screaming at you to take it.


Well, how do I help you with this. 



This may sound cliche or cheesy but in this aspect, it would make sense - I say follow your heart. If you decide to go into a particular specialty for training, be sure it is the specialty that you see yourself practicing in the future. You have to set your eyes on the doughnut and not the hole. The journey to the finish line will be very challenging, I tell you, ( I found myself crying almost everyday when I was in training) but just think of your goal and your purpose. Just remember that short-term pains will lead to long term gains. However, let me emphasize that as much as possible, avoid setting money or being rich as your primary motivation. Of course, as doctors, we are assured of at least a comfortable life, but it is different when your mindset is, you wanted and indeed you became a doctor because you wanted to be very rich. In my honest opinion, money as a motivation, will easily make you dwindle and wither specially with the harsh reality of this profession - the almost unattainable expectations from your patients, your colleagues, and the workplace in general. This mindset which is mainly centered on money will easily lead you to the thought that anyway, there are other ways to earn big bucks, and even bigger than practicing to be a doctor. In other words, commitment is the key here. A consultant once told me that just do what is right, just give everything your best, and money will follow.



I hope this helped, Jess. God bless you in your journey and who knows, by chance, we would meet somewhere sometime soon in one of our conferences. 



Mabuhay ka!

Thursday, August 2, 2018

What’s your excuse?






The woman in the picture, carrying her newborn child was referred to me for medical clearance for surgical procedure. In the middle of my interview with her, my attention was diverted to the man in the picture, who was sitting at the foot of the bed. He was in fact, her husband. 




I even looked closely (yes,like, literally) to check if I was seeing what I was seeing then. Both of his eyes were blind. His right eye had a dominant opaque lens and it exhibited a right-sided nystagmus. I asked as politely as I can and he told me he has been legally blind on both eyes since the age of six as a complication of measles.


In layman’s term, legally blind would mean he cannot even perceive light on both eyes. Pitch black.


I went on to ask him what he does for a living, and he said he makes cabinets and furniture. I was even amused how he is able to pull that off considering that he has to mark his measurements on wood and cut the wood too. He just smiled and said it may sound unbelievable but that is  what he does and his smile was beaming with pride when he told me that the products he builds and puts on display does not stay idle very long and are sold out after a few days. He also accepts other errands that would give him pay after a day’s work.


What struck me even more was the absence of even the slightest hint of bitterness in this man. He was smiling most of the time when we were talking, not because of embarassment, but simply because he had long accepted his reality and is at peace with it.




He even mentioned something to the effect that his mother probably forgot to have him vaccinated against measles when he was young. He ended that statement with a soft chuckle, giving me the impression that that does not matter a bit at at all. That is small stuff now.


He is at peace, even if he does not run out of trials, to add to his condition. His wife of 22 years just gave birth to their newborn baby boy, their 7th baby (7th heaven?) - adding to the six small mouths he already needs to feed - not including his wife’s and his. 

Amidst all that, he maintained a positive mindset, confident that they will surpass all these trials and that the Almighty will not forget them and forsake them. He was kind of worried though if ever they would need to stay longer in the hospital. A longer hospital stay would mean a loss of opportunity for him to earn for his family. Now that gives us more than a hint of the diligence, perseverance, and sense of responsibility that this man has. 


I may not exactly be super duper pious but I concluded our conversation by blessing him and wishing him well. Here is a man deprived of his sight since childhood but does not consider it as a hindrance to work hard for his family. His disability did not even succeed in crushing his hope for a better life for him and his family.


He may be blind, but his eyes which have long become strangers to light, are radiating with a lot of positivity of the almost blinding kind. 


He is an inspiration.


Now, what’s your excuse? What’s our excuse?




Note: Photo taken with permission. It shows in their smiles, doesn’t it? :D

Thursday, March 8, 2018

To go public, or not?




I was more than delighted to receive an email recently from one of my readers.  I am posting it here hoping to enlighten more doctors, specially the young ones who are finding themselves at a crossroad in their career path.

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Good day po, doc.  I have read your blogs regarding residency and I just want to ask you questions lang sana if it's okay.  I just passed the board exam last march 2017. I've been moonlighting na ever since. I plan to go on residency by Jan2019. I'm planning sana to take IM. I wanted to try applying in private hospitals in Manila but medyo takot ako na baka di ko masustain ang mga needs ko with only limited salary. I cannot depend on my family naman. Kaya option ko n rin magpublic hospital para at least bigger ang pay. May I know what residency did you go into? And if private or public hospital ba pinili mo? I just want sana to at least have an idea. Thank you, doc! - Nicole


********




Hello Nicole!

Thank you for taking time to visit my blog and read my entries. At least, in my own little way, I can be of help specially to budding physicians like you.

I had my residency training in Internal Medicine in Cebu Velez General Hospital in Cebu City. It is actually the base or mother hospital of my alma later, Cebu Institute of Medicine. It is a private hospital, and I admit, the pay is a bit meager compared to that of public medical institutions, therefore I had to make a few adjustments particularly with regards to my expenses.



Actually, my pathway to residency, and to finally completing it, was quite unique in the sense that I went into residency twice.


The first time I went into residency, I was a total newbie, fresh from passing the boards, with barely any savings at all. 


The year was 2006. Still high after nailing the licensure exam and oozing with desire to be independent and to take a load off my parents’ back, I moved out of the apartment I rented when I was a medical student. I knew that my monthly salary of... (drumroll please).....
Php. 12,000.00,  would not be able to support my simple lifestyle (yes, simple, no kidding!) so I chose to avail of the free board and lodging offered by the hospital.


Free lodging meant we had our own rooms at the upper floor of the hospital, free water and electricity - not a bad offer at all, except that the upper floor above ours, was where the owners of the hospital live, and when we went down one level, it was already our workplace, our battle grounds - the wards. Still not bad. No transportation expenses at all in going to the workplace. Those were minor, almost negligible hurdles compared to the challenge called residency. 


Free board meant free food from the hospital dietary - still not bad because we would occasionally have lechon kawali, pork barbecue, freshly-squeezed kalamansi juice (yes, healthy!), and I am a fan of a number of the dishes they serve even if I have been their customer for half a decade. At least I could brag and say, there is such a thing as free lunch.


I finished the first year in residency but decided not to continue to the next level since I decided to try my luck with the USMLE. I spent four years working for my American Dream and during that span of time, I moonlighted in another private hospital in Tagbilaran City in the beautiful island of Bohol. 


It was during my moonlighting stint that I was able to get hold of a relatively large amount of money that I did not encounter in my life - not really in the million levels but pay was never better than I have known since I started my career then. I was able to afford stuff that I wanted, on top of my needs. It was also during that time when I brought for myself my very first investment, a life insurance from Sun Life. I am proud of that achievement and I consider that as one of my remembrance purchases during moonlighting - something that will outlast that gig of mine. When the time came that I had to go back to residency, I had to face the fact that adjustments had to be made once again.


Presently, I am an employee of the Philippine government, since I am affiliated with a DOH-retained hospital in Mindanao. I can say compensation is quite satisfactory.


For you, Nicole and for budding doctors like you, I have enumerated the following points, which I believe are major issues that need to be considered in choosing which hospital to train
-- private or government-owned. "To go public, or not?" -- that is the question that we all hope to answer.


1. Work load -- To establish a baseline idea,residency is like a vampire that only desires to suck out all the life and blood out of you. Do not get me wrong here. I favor residency training as long as your circumstances would allow.  I am not trying to scare you or discourage you from going into training but at least I want to give you an idea of what you will soon be getting into. In my own humble opinion, work load is a little bit - just a teeeeeeeeeeeny weeeeeeny bit - forgiving in the private hospitals. In the government hospitals, aside from your designated job description as resident, you might find yourself also doing a lot of scut work, like pushing wheelchairs, extracting blood specimens yourself, sending specimens to the laboratory, and other stuff like that. I even hear testimonies from fellow physicians that they go as far as buying stuff like IV catheters for their patients using money from their own pockets. Government hospitals, specially the referral centers, are always flooded with patients, it's like there is a party at the Emergency Room every single day. You have to prepare yourself for that reality in case you go for the government hospitals.


2. Compensation -- Dito naman bumabawi ang mga pampublikong ospital. A lot of doctors nowadays are finding themselves in government hospitals because of the very attractive compensation. The government gives 13th and 14th month pay, that's one month of your salary that is tax-free. There is what we also call Philhealth sharing among the hospital
employees, wherein we receive our share of the Philhealth earnings of the hospital. Sharing could be at least Php 5,000.00 every month, that is on top of your monthly salary, monthly laundry allowances, uniform allowances, hazard pay, and many others. I knew all about this when I started working for a government hospital. In this case, all your efforts and sleepless nights actually pay off as you find yourself laughing as you pay a visit to the ATM machine to check on your salary. In the private hospital where I trained we only had the 13th month pay
to look forward to, and a modest love gift from consultants, which both come in December, that's all.


3.  Conducive learning environment -- Now this would not depend on the hospital but this one last issue depends on you, the main player of the game. Just ask yourself, in which environment will you find yourself at the peak of your learning. In which environment would you feel more motivated to work and learn at the same time. Remember that residency is all about learning the ropes before we go into the real world. It is all about learning skills, developing good habits and clinical practices, and sharpening our clinical eye. Which environment will bring out the best in you?


To come up with a decision, consider each issue carefully and just be honest with what you feel about it. Remember, you are at the receiving end of the outcome of this major decision you are going to make. Be kind to yourself first, so that this kindness will radiate on to your patients, whether they find you in a private or a public hospital.


 I wish you all the best and I hope that somehow this has shed some light to your queries.


********

Keep the e-mails coming, dear readers.

Thank you.






Friday, November 3, 2017

Why doctors are a special bunch when it comes to building financial wealth






It is a well known fact that we physicians only start to earn in the later stage of our lives, compared to the general population. This is primarily because we spend around ten years of our lives in school trying to earn our medical degrees, that does not yet include the years spent in specialty and subspecialty training.


          When we come to think of it, most physicians actually get to start or embark in most milestones in life rather late  - we earn our medical licenses at about 25 or 26 years old (I for one, earned my license when I was 26 years old), some start to build their families and have kids at around 28 years old to 30 years old, and most importantly, we start building our financial future around this age also, or maybe even later than that, like me.


            So why are doctors a special bunch when it comes to building financial wealth?





1. We bury ourselves in our medical books while our counterparts start earning. After graduating from college at around 20 years old, we are in for the journey of our lives, as we jump from the pot to the fire by the time we enroll ourselves in medical school. 

          
          I remember the first week of class in medical school when our biochemistry professor then told us that in order to survive medicine, we have to live, breathe, eat, and sleep medicine. It was short of saying that in order to earn our medical degrees, focus and determination are on the topmost list of the requirements. Grit would be an appropriate word. One has to have grit in medical school, to withstand all the challenges that the course encompasses. Of course there were sunny days, there were eureka moments that instantly reminded us of our reasons of why we were where we were back then. (I think I just created a tongue twister right there.)


          Back to our topic of building financial wealth, while our high school batch mates were already starting to earn, we were still beginning to achieve our dreams of becoming doctors. 


          By the way, since our educational system has recently implemented the K-12 system, this only means that the incoming batches of medical students will come in two years later - or older - than we did during our time. 


2. Even when we have earned our medical licenses, we continue to bleed ourselves dry as we slave ourselves away while on training for our chosen specialty.  We almost jumped over the roof when we knew we passed the board exams. It was such a nice feeling, knowing that from that time on, we will be addressed as "Doc" and all our efforts in medical school have finally paid off. 


         However, passing the boards is just the start of another rollercoaster ride since our journey does not stop there. Residency is next in line, as we choose and decide whether we want to be pediatricians, internists, obstetricians, or surgeons. Read more about entering residency training here


          By the time we step into slavery -  I mean residency - our counterparts have already established  their niches in their careers. We earn our first salaries when we go into residency but compensation is only about 20,000.00 (at least during my time of training and maybe that has increased a bit now) in Philippine currency, still exclusive of taxes. 


        In this day and age, imagine what life a monthly compensation of Php. 20,000.00 would give. That does not include taxes, and contributions to PhilHealth and SSS. 


          A single physician-in-training who is self-supporting and living alone and far away from home, has to do some tight budgeting with that amount, and try to make it sufficient to pay for rent, gas, decent clothes, laundry, food, and yes - coffee. During our time, books would have to be included in the list but with the advent of e-books that would not be much of a problem. 

             In my case, I availed of the free board and lodging offered by the hospital during my (first) stint in residency.  


           There are some resident doctors who are blessed enough to have their lifeline still active, with continuous financial support from their parents. However a vast majority of the resident doctors' population are striving - or may be starving - to make ends meet. This is actually a challenge because the prevailing notion is that once an individual has passed the phyisician licensure exam, it is almost always equated to having a lot of money, almost instantly, like magic! But hell, no, I am sorry to disappoint you guys, it is not always the case.


               At this stage the new physician is at last and at least earning but he or she is either under-compensated or the cash-on-hand is just enough for the rookie doctor's basic needs. The common priority therefore at this time is to make ends meet, rather than setting aside a certain amount for savings.



3. Others who chose not to go into training start earning a lot of bucks but... Moonlighting is the term coined for physicians who are working as doctors in certain hospitals but are not under a specialty training program. Moonlighting is a very attractive option for new doctors specially that it offers a good take-home pay, sans the psychological, emotional, and physical battery that goes with residency training. 


           However, for someone who has just started earning and has a lot of wants, saving might still be on the last part of the list. 


          The newly adapted ideologies of the young generation today, particularly YOLO and FOMO, can also, in a way hamper  these young individuals from starting their journey to financial freedom.
           
          You cannot blame someone who has just held in his or hands a 5-digit salary that is at least amounting to 30,000 pesosesoses, to finally buy the latest mobile phone he or she has been eyeing, or that G-shock watch of his favorite color, or to finally go to that dream destination whether that is inside or outside the country.


         It is a fact that there is a lot of money in moonlighting. Those moonlighters are the rich bunch in the line of rookie physicians. Yes, they are already starting to earn big time but building financial wealth or maybe even thinking of retirement are among the least of their priority.

         To moonlight, or not to moonlight? Read more here.







4. Even when we are done training in our specialty and subspecialty, we realize even more that it is a dog-eat-dog world that has been waiting for us at the finish line. A doctor who has just graduated specialty and subspecialty training will finally take a breath of exhilaration. He or she is about to start the rest of his or her life as a medical practitioner. 


           Another biting reality will reveal itself during this stage. The physician who has just started practicing realizes that money does not come easy. This is at least for the majority of new physicians who have not inherited a practice from their relatives. There will always be exceptions to the rule you know and these lucky ones are that. Good for them.


          One has to spend and count hours, and even days, sitting patiently and painstakingly at the clinic to wait for patients. While I do this at the clinic, I keep reminding myself,  "This is a waiting game." Repeat three to four times a minute.


          I am going to tell you a secret. You know what I do inside my clinic while I wait for patients? I organize my tasks. I am really into To-Do Lists and so while waiting I check my progress, and tick off the items in my list that I have already accomplished or completed, or in the case of my monthly bills, those that I have already paid. There is still one thing that I love to do though while waiting for patients -- of course this one will just place a close second to sleeping while waiting.


         I cut a lot of paper. I cut old magazines and recycle them into envelopes. Actually I have made a lot of recycled envelopes already, that I am thinking of donating them to the church so they can be used as offertory envelopes. Their recycled lives would at least be spent for the greater glory of God. So can you imagine now how many hours I have spent inside the clinic waiting for patients? 

          However, whether you like it or not, the waiting will soon be over. To put it in another light, there are days that are not spent waiting.


          There are always firsts, like the day when your first patient walks into the clinic. Then you get to earn your first professional fee.  Oh, what a joyful moment that was! I felt like dancing round and round, and at the same time jumping, while holding my secretary's hands. 



5. Financial management is never taught in medical school. This is very true. Maybe medical school administrators can invite resource speakers who will speak to us about financial management. It would also help if resource speakers on taxation would also be allowed to speak to medical students, or if not to those newly-minted physicians, so it would not come as a shock to them, how much they have to pay for taxes, how to get a TIN, and if they really need to employ the services of a book keeper or accountant.



         
         If you are like most physicians (or any other individual regardless of profession) who have not yet started building your financial wealth, do not be disheartened. It is not too late to start. I tell you, I have been there – got into a credit card mess, brought all the gadgets that I want during my moonlighting stint, and there was a time when I barely had savings – but I was able to rise above all that, and I believe that you can, too.


        Hoping to share more to you soon so that you will be inspired to start building your financial wealth and secure your future. Together let us all aim for financial independence and eventually, aim to achieve financial freedom wherein we would not have to work for the money at all, but our money will be working for us.


          I tell you, that is very possible.

          Love and light!



 





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