the chronicles of a House Elf: my 10th month as a House Officer in Singapore + the eternal fight for work-life balance

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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’s been 10 months, or 305 days since Housemanship started (not that anyone is counting), and what an ordeal it has been. One part of our journey as junior doctors is slowly but surely coming to an end, although some days I’m not even sure if I’m looking forward to the next leg of this journey…will our quality of life get better as Medical Officers?

There’s been a lot of buzz in the local news lately about how the Omnicron surge is creating a huge strain on the healthcare system, and it’s all true. The public healthcare system has been overstretched, and its staff overworked long before the whole pandemic started (and long before I joined the workforce), with such issues only becoming more apparent now that more of us are speaking up openly about it.

And so it seemed fitting to write about work-life balance in this month’s post. Work-life balance is ‘the division of one’s time and focus between working and family or leisure activities’ – or to a House Officer, ‘Error: 404 Not Found’.

The usual disclaimer: This is a personal blog. Any views or opinions represented in this blog are personal and belong solely to the blog owner and do not represent those of people, institutions or organizations that the owner may or may not be associated with in professional or personal capacity, unless explicitly stated. Any views or opinions are not intended to malign any religion, ethnic group, club, organization, company, or individual.

basic human rights/work-life balance as a junior doctor in Singapore

The thing with having a social circle that mostly comprises fellow doctors or other overworked professionals is that our conversations often end up spiralling into commiseration sessions about how our twenties are not turning out how we had hoped that would, and how difficult it is to maintain semblance of a life outside of work.

I have friends working as junior doctors overseas (FY1/2s in the UK, House Officers in Aus/NZ), and across the board, everyone is definitely having a rough time, with long hours, chronic exhaustion and constant stress. But even my fellow doctor friends overseas concede that we have it far worse in Singapore.

Here’s a quick comparison between working conditions overseas (based on my friends’ experiences in various countries) and our lives as House Officers in Singapore:

  • Calls: To recap for those of you new to my blog, calls are 30ish hours straight of work (think 6am-noon the next day, sometimes longer), with no guaranteed rest periods. I wish I were joking but yes, this is completely real and legal. Meanwhile, calls don’t even exist in some countries. Instead, they have doctors assigned to cover the wards only at night, allowing the ‘daytime’ team to go home and sleep like regular humans. If it’s of any consolation, at least our employers significantly increased the call pay from ~$8/h to ~$14/h, and yes, minimum wage and overtime pay are foreign concepts.
  • Weekends: In Singapore, we’re usually expected to work at least 1 weekend every week, or 2 if the manpower is bad. The longest stretch I’ve worked without a single day off was 3 weeks (until I fell ill and had to take MC), but another friend made it to 4 weeks before getting a day off. If the same thing had happened overseas, I’m pretty sure the doctors would have gone on strike (like they’ve done in the past). My friends abroad get full weekends off by default, and some countries even provide designated off days on weekdays after 10-12 days of weekday work. It was absolutely mindblowing to hear how work-life balance is a basic right abroad, yet something we have to fight so hard for here.
  • Bonds: All medical graduates from Singaporean universities are bonded to MOH Holdings, a private company that manages our deployment to public hospitals and employment contracts. Undergrads are bonded for 5 years (excluding Housemanship), and the bond is valued at upwards of $520k, a hefty sum made to retain junior doctors in the public sector and its arduous hours. Meanwhile, my peers overseas (where bonds are not even a thing) were baffled at why I even signed a contract that would take the whole of my twenties away….#worstdecisionever?

This is just the tip of the iceberg if I’m being entirely honest, and it’s a sign of underlying issues and manpower shortages that we, as House Officers, are powerless to address.

Fortunately, with more of us speaking up publicly, greater representation in the press, and ministers catching wind of how bad the situation is on the ground (for all healthcare workers, not just doctors), the idealistic side of me hopes there will be a review of the existing employment guidelines and that we’ll see more concrete changes in the near future.

Some of my doctor and nurse friends were recalled from their Annual Leave due to manpower shortages (from other staff quitting), when they themselves are already so burnt out.

It’s hard to watch public healthcare workers suffering for the sake of our patients and altruism, but until the day that effective policies that protect our basic rights as employees come into place, we’ll just have to hunker down and slog on.

why I fight so hard to maintain work-life balance

It’s hard not to feel like our identity is reduced to our job title, especially since we spend easily 10-12h/day physically present at work (or 30h straight when on call). Throw in commute time and 7-8h of sleep, and we have maybe 2 hours of ‘life’ in this endless game of trying to save our lopsided work-life balance.

To give you an idea of what a day in my life is like, here’s my rough schedule:

  • 5.30am-6.15am: Wake up and commute to work
  • 6.15am-5pm: W O R K (and no, we don’t have protected break times)
  • 5pm-6pm: Commute
  • 6pm-7.30pm: Shower and eat dinner
  • 7.30pm-9.30pm: Have a bit of a ‘life’
  • 9.30pm-5.30am: Get 8h of sleep (because sleep debt is the leading cause of death in House Officers)

Alternatively, when I’m on call, my day goes a little more like this:

  • 5.30am-6.15am: Wake up and commute to work
  • 6.15am-5pm: Take care of our ‘daytime’ patients
  • 5pm-8am the next day: Non-stop work, straight through the wee hours of the night
  • 8am-usually noon: Continue caring for our ‘daytime’ patients
  • Afternoon: Crawl home to sleep and try to enjoy the rest of our day, and then it’s back to a regular work day the very next day…

I don’t dispute that work can add fulfilment to our lives (if you’re in the right job), but everything should be done in moderation. On the spectrum of ‘a job is just a job’ to ‘workaholic and proud of it’, I’m definitely closer to the former, as I don’t believe that any job should be taken to the point where it feels soul-sucking or that one’s physical/mental health is compromised.

on revenge bedtime procrastination

As funny as the name sounds, ‘revenge bedtime procrastination’ is an actual psychological phenomenon in which people choose to delay their bedtimes in response to stress, frustration or a lack of free time earlier in the day. And it’s a bit of a vicious cycle, since it causes more sleep debt and exhaustion, making you harbour even more negative feelings towards work.

While I personally stick to my 10pm bedtime with a near-religious fervour (since I have to wake up before 6am daily), I too, am guilty of manifesting my frustration at the lack of free time in other ways.

Ever since Housemanship started, I’ve been pushing myself to maximise every single hour of free time outside of work, because there’s honestly not that much leisure time and it feels like a huge waste to spend my precious free time doing nothing.

I spent way too much of my life in medical school doing nothing other than going back home to study after a full-day of clinical/hospital postings, and it felt like I wasn’t able to enjoy life particularly much back then. That’s probably the reason why I’ve swung to the other extreme of playing too hard, to make up for those lost years and all that lost time.

I set myself a tangible weekly to-do list, so I wouldn’t get the feeling like my entire week had flown past with nothing to show for it:

  • Meeting up with friends at least once a week
  • Doing something outdoorsy once a week, usually cycling or hiking
  • Watching one sunset a week
  • Visiting my grandparents
  • Exercising at home* on any day that I wasn’t going out
  • Watching a Marvel movie (perhaps as a form of escapism)

*btw if you’re looking to start a 5-7 min daily workout routine, I highly recommend Workout for Women, a free phone app that’s been life-changing for my energy levels and health ever since I started regularly using it 2 years ago!

If balancing work vs leisure time were a game, I was already playing it in ‘Hard’ mode with my endless slew of activities interspersed with being on call 1-2 times a week. I upped the difficulty setting to ‘Extreme’ ever since 2022 began, when I signed up for an MMA gym membership and had to magically fit gym sessions into my already-hectic schedule.

It’s been physically tiring at times but still extremely fulfilling, because being tired but happy is better than the alternative of sitting at home staring at my computer screen (which was how I lived the past few years of my medical student life).

learning to take it slow

I’ve been making an effort to attend Muay Thai classes 2-3 times a week ever since I signed up for the membership, going on days when I was post-call (running on 3h of sleep, tea & prayers) and trying to squeeze in classes after regular 5pm work days. My friends and co-workers were baffled at how I had energy to do all that, but I guess it was the endorphins and the sheer fun I had during the classes.

It was going well for 5 weeks, until I fell sick.

Earlier this month, my body finally gave me a sign, telling me I needed to slow down and stop pushing myself so hard. I reckon I had compromised my own immune system by attending one too many Muay Thai classes while insufficiently rested.

I caught the nastiest and most severe bout of gastroenteritis (stomach flu) in my near-25 years of existence, and it left me absolutely incapacitated. I was so sick and running a fever that I was made to go home halfway through a call (partially because everyone was worried I was down with COVID), and subsequently camped near the toilet for 2 days straight, unable to eat or drink. Even when I had to return to work after 2 days of MC due to manpower issues, I was still feeling weak and minimally functional.

2 weeks on, and I’ve only just started to feel like I’m back to my usual energetic self. While I felt frustrated at myself for being out of action and having skipped 2 weeks worth of gym class & hanging out with friends, I suppose it’s a much needed wake up call that both too much work and too much play can be a bad thing, and that I should probably pace myself better, even if it means doing less in my precious free time outside of work.

Guess I’ll just have to seek out a new, calmer balance in this eternal fight for a decent work-life balance.

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!

Introducing this month’s song rec, Scarlett by Holly Humberstone. The lyrics have been stuck in my head for quite literally the whole month; give it a listen and maybe you’ll get addicted as well!

I said, “Darlin’, will we go the distance?”
As I stood there, pouring my heart out with you just completely unfazed
And you said, “Scarlett, I don’t need to be responsible for everything you’re feeling
You’re an emotional grim reaper, I feel bad for you
I can’t entertain these games, hate to rain on your parade
It’s just the way I’m feeling

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:

2 responses to “the chronicles of a House Elf: my 10th month as a House Officer in Singapore + the eternal fight for work-life balance”

  1. Keep going! Two more months of Housemanship!

    Thank you for everything that you and the rest of the front-line workers are doing for us Singaporeans! 🙂

    Like

    1. Thanks for the support @theflutebruh/Sam, and stay safe/take care! 🙂

      Liked by 1 person

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