the chronicles of a House Elf: my 6th month as a House Officer in Singapore (halfway there!) + I’m getting used to 30-hour work days & 70-hour work weeks but I probably shouldn’t

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This is part of an ongoing monthly series capturing the highs, low (and everything in between) in my working life as a doctor in Singapore. If you’re interested in finding more about medical/non-medical job options or getting answers to doctoring-related questions you’ve always wanted to ask, check out my brand new Chasing Careers series!

It feels surreal that we’ve been working for half a year now. As of today, we’ve somehow crossed the halfway mark of Housemanship (26th April 2021 – 25th April 2022) and obtaining full registration with the local medical council, and it’s yet another milestone that deserves to be celebrated.

I’m typing this in high spirits and in a state I’d dub as ‘slightly delirious-from-exhaustion’, coming off a 28-hour stint at work. Yes you’re reading it correctly, I didn’t mistakenly an extra digit in front of 8.

I just finished yet another call, mercifully spending under 30 hours at work (from 7am yesterday till 11am today), then went to the beach for my monthly pilgrimage, and I’m going to crash for the night after finishing this post. A precious 3 days of annual leave awaits me from tomorrow onwards (and my department gave me the weekend off too, so it’s a 5-day break)!

fun facts about our working hours

My younger self would’ve balked at the idea of working for nearly 30 hours straight and thought it was beyond the human body’s limit, but I’ve gotten used to doing calls to the extent that I celebrate when I manage to go post-call before the 30-hour mark. Oh how my standards and expectations have fallen after just half a year; maybe it’s all downhill from here??

*post-call = getting to go home after finishing the previous day’s call + half a day of work

In our little bubble of long-suffering junior doctors in Singapore (House Officers/Medical Officers/Registrars), our perception of work hours is skewed in a way that would make even the most hardened investment bankers proud:

  1. We consider anything less than an 80-hour work week excellent hours. My friends envy me when I tell them how ‘good’ my working hours currently are. Full disclosure: I work about 65h a week in my current posting (Internal Medicine), with my regular work days being 7am-5pm + an average of 1 call per week + a half-day of work each weekend. In my previous posting, I worked an average of ~70-75h a week. On the other end of the spectrum, my close friends in other postings work 80-90 hours on a good week.
  2. We’re happy to get ‘1 in 7’ – this means a monthly average of 1 day off a week, or about 4-5 days off a month. I’m not sure if it’s written in our contract that we’re supposed to be granted x number of off days, but throw a stone and you’ll hit a tired House Officer who hasn’t had a full day off in 2-3 weeks. It’s more common than we’d care to admit, because of manpower issues and high patient volume in many hospitals. My current department is very mindful of giving us ‘1 in 7’ and ensuring we’re sufficiently rested, so I’m in the blessed minority who has a semblance of work-life balance.
  3. One of my friends pointed out how comically tragic it is that we see 5 shifts of nurses changing over during 1 of our calls. We often arrive at work when the night shift of nurses are changing over (#1), then see the morning and afternoon shift nurses (#2/3) during a regular work day. We see the night shift of nurses arrive (#4) and work alongside them till the next morning until the morning shift takes over (#5). If you’re unlucky and don’t get to go post-call until the late afternoon, you might end up staying till the afternoon shift arrives (bonus shift #6)!
  4. Shift work? Nah, we work all the shifts! I’ve had so many aunties/uncles (my patients) ask if I’m working the night shift when I arrive at their bedside at 3am, only to express horror and sympathy when I tell them that I’ve been working since the previous morning. I remember chatting with a security guard on his night shift, and he warmly told me to take care of my health and eat/drink enough. :’)
  5. Legally, we’re supposed to spend no more than 30h at work; we’re meant to complete our 24h call and take a maximum of 6h to finish the next morning’s work & handover our patients to our colleagues before going home. I’ve personally never exceeded the 30h mark, but for many of my peers in surgical postings, they’ve gone post-call in the evening, clocking in an astounding (and very unhealthy) 36 consecutive hours of work.

Don’t take it from me; you can read the Ministry of Health’s guidelines for junior doctors’ working hours below or at this link, although whether it’s adhered to is something I will not comment on:

Screengrab from MOH’s website (source)

Is this lifestyle healthy? Is it sustainable? No to both, but there’s nary an alternative for those of us bonded in the public sector. By no means should working that many hours or not having adequate time off work be normalised, but it’s just our bleak reality; and since everyone else around us seems to be pulling the same (or worse) hours, we just plod on in solidarity.

Plagiarising Wikipedia, ‘the boiling frog is a fable describing a frog being slowly boiled alive. The premise is that if a frog is put suddenly into boiling water, it will jump out, but if the frog is put in tepid water which is then brought to a boil slowly, it will not perceive the danger and will be cooked to death.’ Junior doctors are basically boiling frogs, oh joy.

I know that most of my blog posts invariably descend into my gripes about the poor work-life balance and long working hours, but I will continue to write about it to spread awareness about the realities of life as a junior doctor in Singapore, so prospective medical students and/or their parents can have a more realistic picture of the life they’re signing up for.

Gatsby Junior doctors believed in the green light 40-hour work week, the orgastic future that year by year recedes before us. It eluded us then, but that’s no matter—tomorrow we will run faster, stretch out our arms farther… So we beat on, boats against the current, borne back ceaselessly into the past.”

paraphrasing my favourite quote from The Great Gatsby

Being a doctor in Singapore isn’t just a job, it’s something that will consume your twenties if you’re not careful, so I sincerely want to help others make an informed decision when they sign 11 years of their life (for NUS/NTU med students) away on that fateful dotted line.

Anyway, less about the systemic issues related to local healthcare manpower (lest I get fired from my day job), and more about my past 6 months living as a House Elf/House Officer in Singapore.

6 months of working life/feeling like my glass is finally half-full again

For those of you new to this series, here’s a tl;dr/quick rundown of how the past half-year of my working life has been (or you can read the full series here):

  • Month #1/2: Had a pretty rough time adjusting to working full-time for the very first time in my life, pulling crazy hours (80-hour weeks, working overnight/being on call ~2-3 times a week on bad weeks, limited manpower), and the learning curve of the job itself
  • Month #3/4: Experienced the effects of accelerated burnout and anxiety (largely attributable to the culture in my then-workplace), nearly quit Housemanship entirely due to the toll it was having on my physical & mental health
  • Month #5/6: Started my second Housemanship posting in a new hospital/dept and started the process of healing & recovering from the first 4 painful months, and now I finally feel like I can breathe again

To be honest, I’ve been enjoying myself in the past 2 months and actually feeling somewhat closer to normal I will never feel completely normal because there isn’t anything normal about working these hours, but that’s beside the point.

I’m easing into a comfortable rhythm as a House Officer in this relatively chill posting, and slowly but surely recovering from burnout. I finally feel like my soul is at peace and not constantly anxious about the idea of being at work; I overwhelmingly attribute this sense of ease to the change in hospital/department and a much more wholesome work culture. This is a feeling I certainly won’t take for granted, and I’m just praying it’ll tide me over to the end of Housemanship.

It’s not exactly been the smoothest journey or the best situation for my physical & mental wellbeing, but I’m proud of myself and all my friends for persevering through the initial teething stages and the frankly tortuous first few months. My friends have been having far worse situations and postings than me, so I’m the last person who should be whining, and I can’t overstate how proud I am that we’re supporting/dragging each other closer and closer towards that hallowed finish line of ‘Full Registration’ (because all House Officers only have provisional licences).

Special mention to my mum, J, TL & Kat (my 3 best friends). I could not and would not have made it this far without them supporting me through my 101th mental breakdown and me insisting I was going to quit for the 101th time because being a doctor isn’t my calling (which it isn’t). They stood by me even when I was dead set on quitting Housemanship, and said they would support my decision fully as long as I was sure I wouldn’t regret it down the road. And when I made myself a promise to complete Housemanship year, they agreed to do whatever it takes to help me attain that goal. I’m endlessly grateful and blessed to have such fiercely loyal and loving friends/family.

counting down to ???

As you’d know, I’m obsessed with counting down. Who else would religiously visit the beach and write a blog post on each month-versary of Housemanship?

You might be wondering why I care so much about the numbers, and even be thinking to yourself that counting down from 365 is a pretty painful & long-drawn out form of suffering. Yes, it was excruciating at the start, but it feels better now that the number of days left has been slashed by half (182, for the record).

Honestly, I started this habit of counting down in M3/my 3rd year in medical school, and have maintained a countdown ever since (2018 till now). I honestly did enjoy my first two years of med school and the thought of counting down never crossed my mind, because I was out there enjoying my freedom like a regular university student, but the clinical years weren’t nearly as enjoyable.

The clinical years felt like they dragged on forever, and I floated through med school with an increasing sense of disillusionment and existential dread, knowing that I was wasting spending precious years of my youth pursuing a life path & career that wasn’t the best fit for me. That’s a whole other story (you can read about it here). But the counting down helped ground me and remind me to stay the course, because I had already invested too many days/months/years to quit without getting a degree.

Counting down (and writing these monthly posts) helps reframe my perspective and put the brakes on my tendency to catastrophise. It reminds me that everything is temporary and finite, and that each day that passes takes me one day closer to an indeterminate end point…perhaps the day I find enlightenment in the form of knowing what I actually want to do in life? Spoiler alert: I would write all day if it could pay the bills, but doctoring is not a bad gig either

I’ve promised myself to stop counting down after Housemanship ends, because I’ve lived the past 3+ years of my life just counting down to the end of ‘101 things that make me unhappy but it was really just Med school’. I’ll be just 2 months shy of 25 by the time I finish Housemanship, and it’s about time that I stop letting my future life/career fulfillment take a backseat to academic & work obligations. I just want permission to be me and to be set free from these shackles (but alas, my government bond will only end in 2027…).

the uncharted path ahead

Am I planning to stay in the public sector forever? Definitely not, and most of my peers feel the same way too. Once we’re done serving our 5 year bond, which begins after Housemanship year and lasts till 2027/when I turn 30, I doubt there’ll be sufficient incentive to stay. We’ll just follow on the heels of droves of our seniors who fled the public sector and opted to have a work-life balance instead of slaving the prime of their lives away.

It’s not that we don’t enjoy the work or don’t want to take care of patients in the public sector, it’s just that the amount of sacrifice (especially physical health), nights spent away from home & hours worked is grossly disproportionate to the benefits or remuneration, more so once we’re in our late twenties/early thirties and have other priorities in life. I shudder to think of a life where I’m still doing calls/overnight duty as a mid-thirtysomething, spending one night too many away from my family.

And it remains to be seen if I’ll even continue working as a doctor after completing my bond, or if I’ll explore alternative medical-related careers (which I have been speaking to various non-practising doctors about); either way, I’m just excited to finally have the permission live life like the main character in a ‘choose your own adventure’ book. Regardless of the life or career path I eventually choose, I’m grateful that I’ve had the privilege of serving as a doctor for however long it may be.

My song rec for this month is Abittipsy, an addictive and severely underrated synthpop bop by Youha, which I’ve been listening to on repeat:

But at night, my heart might ache
So I might call you

Usually in this situation,
You would be there for me to protect me
Sadly, no,
I’m just a bit tipsy today

YOUHA (유하) – Abittipsy (오늘 조금 취해서 그래)

Good night, and till next time! I’ll continue sharing my journey as a House Officer/junior doctor and wherever life takes me after Housemanship year, so be sure to follow my Insta or Facebook page to stay up to date with my latest posts and life updates (and see what I get up to on my Annual Leave)!

xoxo,
Faith

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If you’re interested in exploring my blog, click here for an index of all the posts I’ve ever written (travel, musings, doctoring), or check out my most read series below:

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