Moonlighting no more

Enduring the morning rush has become a new addition to my daily routine. Gone are the times when I could choose the days and hours to go to work according to my convenience. Yes, I am a regular employee now.

Well, I am actually a trainee. I am going through the arduous phase of my medical career called “residency training.” I guess the term was coined because we are supposed to “reside” in the hospital, figuratively and literally, so we can check on our patients 24/7. As excited as I may sound, there’s a bit of anxiety about what’s in store for me.

I was on my own, pondering what to do months after passing the medical board exams. Like the thousands of doctors who graduate and pass the exams yearly, the next step was the hardest to make. The newbie is left to make a big decision that will shape his career. Staying in the Philippines or going abroad are definitely options. What field of expertise to go into is another big problem. The practice of medicine is such an intricate profession. You can’t just graduate and act as if a sterling career already awaits you. It’s just not like that.

Making a decision took a while as my moonlighting stints kept me preoccupied. I have learned (but have not earned) a lot from my experiences, as I admitted in this space two years ago. Moonlighting has taught me firsthand the complexities of medical practice. It has shown me the value of work, ethics, professionalism and respect for peers, and more importantly, respect for patients. But it also demonstrated to me the realities of the state of the medical profession and healthcare in our country, and the culture of seniority, money and politics.

Nothing much has changed since I started my medical practice. My colleagues who continue moonlighting still receive salaries that are not commensurate to what they paid for their medical education. Some of them are at a crossroads of their career, while others seem resigned to being general practitioners.

My friends were actually hoping that I would not be stuck in general practice since they consider it a dead-end. I knew it but I also realized that some of us have no choice but to live with it. Still, a moonlighter makes more than a resident. So for those who have families and mouths to feed, it’s the lesser evil.

I had big dreams: to have an impressive curriculum vitae and to work overseas or stay in the country but still earn big bucks. But these would be hard to achieve in general practice owing to the dire situation of healthcare in our country.

I thought of practicing general medicine abroad, planning to settle in the country of my choice. But I had to abandon that plan when I learned that the country I wanted to go to has a closed healthcare system. Well, almost every country actually has limitations on accepting professionals. Foreign medical graduates need a stockpile of certifications to qualify.

I decided to stay. After a year of moonlighting, I applied for residency in a hospital located in Metro Manila. But I was not accepted. I thought my experience in general practice would be an advantage, but perhaps I thought wrong since what I applied for was not a job but a medical training slot.

I worked on improving my credentials. Upon the advice of friends, I decided to take the US Medical Licensure Exam. So what happened to love of country? They told me that passing the exam would look good on my resumé and increase my chances of having sub-specialty training abroad, and then I can come home with world-class qualifications and practice.

I was back to being a student. But with my medical license I was capable of earning some money, and so I could be called a working student. I did moonlighting again so as not to be too much of a burden to my parents, who had already spent so much on my education.

I passed the exam before the deadline for submission of the following year’s residency application. People wondered why I still wanted to train here when I was eligible for training abroad. And what a great opportunity that was. It would have been my chance to work in a country where the government puts a big chunk of its resources on healthcare.

But I also had to consider my parents’ health. I decided to stay and serve as their personal physician in gratitude for what they had done to me.

I re-applied for the same position denied to me a year earlier and got accepted this time. Now, I have actually increased my chances of getting the things I have been wishing for. And I am very thankful to the Almighty for this turn of events. I have this excellent training position, a chance to go abroad for further career enhancement, and I can come back to serve the motherland.

I am now halfway though my first year of residency but I am still trying to adapt to the culture. The medical profession has an imperfect system, but I suppose it is the only way to learn. I have made sacrifices and continue to make them, just like thousands of my colleagues—sacrifices made for the sake of having a better quality of life, for excellence, for compassion, and even for heroism. I hope to be an agent of change. With these fresh opportunities, I can start with the simplest of things and move on to bigger things.

But for now I reside in the infirmary to build myself up and learn from my greatest mentors: my patients. With the guidance of the hospital’s senior doctors, I will achieve my dream little by little and be the start of the change that I want to be.

The moon now shines with a different kind of light.

Dr. Alex U. Pisig, 28, is a graduate of the University of Santo Tomas and is currently a first year ophthalmology resident at Cardinal Santos Medical Center in San Juan.