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This is part of an ongoing monthly series capturing the highs, low (and everything in between) in my life as a freelance doctor working in Singapore. If you’re interested in finding out about medical/non-medical careers or getting answers to doctoring-related questions, check out my Chasing Careers series!
It’s been precisely 27 days since my last call, but who’s counting? I’ve spent the past few weeks in my first-ever Medical Officer posting of Occupational & Environmental Medicine, and it’s been nothing short of a dream, in terms of the working hours and lifestyle.
It’s almost as if those 30-hour calls are now a distant nightmare, and I feel well & truly detoxified from that lifestyle of constantly having to go ‘on call’. In this month’s post, I’ll be sharing about the MOPEX system, my current stint in Occupational Medicine, and also dropping some hints about my long-term plan, although I won’t be going into detail about it until later this year (but y’all, my loyal readers, will be the first to hear the big news).
For the first time in forever, I have a total of 0 calls, am working 40 hours a week (8am-5pm, with a 1h lunch break) with just 1 half-day weekend clinic a month, and have the chance to run clinics independently – which is basically everything I had dreamed of when I signed that fateful contract as a starry-eyed medical student all those years ago.
It’s a far cry from the 80-hour and 6-day weeks I had been pulling as a House Officer, and it’s so refreshing to not be constantly sleep-deprived, or get hit by the pre-call blues, or reschedule weekend plans when you’re suddenly required to work on a weekend. It’s nice to feel normal again.
Oh, and I’m finally done with 1 month of the 5-year government bond, because the bond only starts once we become Medical Officers (boo hoo).
an overview of the MOPEX system
Anyway, here’s a quick overview of the Medical Officer Posting EXercise (MOPEX) system. MOPEX is like the Hunger Games, but for junior doctors – it’s a nationwide exercise conducted by MOHH, where hundreds/thousands of Medical Officers across multiple batches (from PGY2s like myself, to PGY6s & beyond) apply for postings of their choice. We’re allowed to rank our top 10 choices, but this doesn’t mean you’re guaranteed any of those, especially if your top 10 choices are popular or chill, because everyone wants those too.
On results day, we’ll find out who are the lucky ones who got their top choices, and who were the poor unfortunate souls who were dumped in those few notably notorious postings that people would get on their knees to pray against. *coughCTVS*
Mutual swaps are allowed, and usually conducted frantically on a secret posting swapping spreadsheet over a few days, before postings are finalised. I’ve also heard of people swapping 3 (out of 6) months of their assigned posting for 3 months of another (i.e 3 months of posting A + 3 months of posting B), as long as you can find someone who’s okay to make the swap.
Each posting is 6 months long, and in the words of one of my seniors, is ‘a very long time to waste for people in their late twenties’. It’s not too terrible to while away 6 months of your life in a chill posting, with extra time to spend on hobbies & friendships, but it would be an absolute nightmare to be stuck in a posting that you didn’t select, coupled with terrible hours (some have 90-100 hour work weeks).
Of course, mutual swaps are allowed, but if you were one of those who ended up in a less-than-ideal posting, good luck with finding someone who would willingly swap into a world of pain & suffering.
Anyway, the timeline (for NUS & NTU PGY1 turned PGY2s) goes a little something like this:
- early May: the end of HOship/PGY1, and the start of Medical Officer life (plus our 5-year bond)
- May-early July: a 2-month interim posting for all girls & the guys who’ve completed NS
- July: the start of your first 6-mth MO posting
- every Jan & July: new MO postings ad infinitum, until your bond ends or you get into a Residency programme (which has its own fixed postings)
For guys who have yet to complete NS, the timeline is slightly different:
- May-early Sep & Sep-early Jan: 2x 4-month postings, one of which must be ED or Anaesthesia
- early Jan: return to NS, and the best part is those 2 years count towards the 5-year bond
- 2 years later: rejoin the MOPEX cycle with everyone else
International medical graduates are considered ‘out of phase’ for MOPEX, since they usually end their HO year a few months earlier than local grads, so they’re allowed to take anywhere from 4-10 weeks of No Pay Leave while waiting to start their MO posting. In stark contrast, local medical graduates are not even given any no pay leave (except under extenuating circumstance) after HOship or during MOship, so it’s potentially 6 years of non-stop work. Kinda dreadful innit?
why I chose this posting
For the interim posting, we were provided with a list of postings and allowed to rank 3 choices. Unsurprisingly, since I’m not a fan of ward-based work, my top 3 choices included none of the common specialties like Internal Medicine (or its subspecialties) or General Surgery.
I was pleasantly surprised to have gotten my first choice, because some of my other friends who had also selected ‘chill’ interim postings ended up being placed in General Surgery, as competition for chill postings is always fierce. (I’m honestly not sure how I got the only slot for Occupational Medicine, but I’m so grateful for that!!)
I know it may be hard to believe, but I chose this posting not just because of how chill it is. I’ve always been quite interested in exploring this specialty and will probably pursue a Masters in Public Health at some point in my career, just so I’m better equipped with tools to advocate for mental health in the community & among healthcare workers.
In Singapore, training for Public Health & Occupational Medicine both fall under the Preventive Medicine Residency programme, as 2 separate residency tracks. Public Health is related to policy work, and involves working with various stakeholders in MOH (Ministry of Health) or MOM (Ministry of Manpower) to conduct research or craft policies.
Occupational Medicine (my current posting) is more clinical, and includes reviewing workplace injuries, certifying people as fit/unfit for work, as well as routine screening & vaccinations in clinic. It’s 100% office hours and the work is done at a healthy – some might even say extremely leisurely – pace, a welcome respite from the neverending onslaught of tasks a la HOship.
I even had time to catch up with many of my long-lost* friends this month, staying out till late for dinner & drinks.
*long-lost to the depths of HOship, which we have since been liberated from
It’s nice to finally be able to enjoy Friday nights like a normal adult, instead of having to go home & sleep early in preparation for 7am ward rounds on a Saturday morning. (Disclaimer: most MOs still have to work on weekends, I honestly just lucked out with this posting)
how to pick the best MO postings
It depends on whether you define ‘best’ as ‘most chill’, or ‘highest learning value’, because those two tend to be mutually exclusive. But there’s a fair number of postings that fall somewhere in between, with a good work-life balance and yet sufficient exposure to new specialties (that we never had a chance to rotate through as House Officers).
We’re on call anywhere from 3-8 times a month: House Officers do roughly 5-6 calls a month, Medical Officers do 3-8 a month (depending on the manpower limitations of the posting), while Registrars typically do 3-5 a month. I’ve written about the hazards and misery of working such inhumane hours extensively in my recently-completed House Officer series.
One of my close friends did 8 calls this month in her very first Medical Officer posting, and it looked like the light had truly left her eyes when I saw her recently.
Anyway, to get any newbies here up to speed, ‘calls’ are dread-inducing and frankly hazardous 30-hour work days where doctors work non-stop (with no designated breaks or nap time) from the morning of one day until the afternoon the next. You go home, sleep it off, and show up at work bright & early the next day. 8 calls in a month means you’re on call every 3-4 days, which is nothing short of physical torture and pushing your body to an unhealthy level of sleep deprivation.
On the other hand, there’s a handful of us who picked postings without calls and minimal weekend work, so we’re able to enjoy 5-5.5 day work weeks like regular human beings, instead of the soulless robots that /they/ apparently think we are. I’ll leave it to your imagination to who ‘they’ refers to, since I don’t wish to get into trouble.
So, how does one go about picking MO postings? Here are a few tips that might increase the odds of getting your top few choices:
- In typical Singaporean fashion, you have to be ‘kiasu‘ and write in early. Some of my friends wrote in to their desired departments half a year in advance to indicate their keen interest. However, it’s still up to the department’s HOD if they want to rank you highly during the MOPEX selection process.
- Taking kiasuism to a new extreme, I know of some who’ve been gunning for certain residencies since their med school days, expressing their interest through publishing multiple papers, doing M3/4 electives with the department, and getting to know the bosses early. If you’re one of those, you’re probably a shoo-in for the department of your choice (for MOPEX, not residency).
- In the MOPEX online portal, you’ll be able to view the number of spaces available for each department. Ironically, people tend to rank those with more spaces higher, while not picking postings with 1-2 spaces or ranking them lower, because of the perceived difficulty in getting into a posting with fewer slots. So there’s honestly no harm in trying to strategise and rank those smaller departments more highly, cos you just might get it.
But sometimes, MOPEX sorcery happens and you may get your top pick with no effort at all, or you might try hard and still not get your top few choices.
Feb 2023 edit: My sources kindly provided me with match statistics for the Jan 2023 MOPEX cycle, but I’ve redacted a lot of data for confidentiality reasons
- Out of 168 departments/postings available for the Jan 2023 cycle, 9 departments had a ‘Top 3 choice’ oversubscription of over 10x; 40 were oversubscribed by 5-10x. The oversubscribed postings are generally those known for work-life balance. On the flip side, 24 departments had a ‘Top 3 choice’ subscription rate of <1x…no prizes for guessing which ones
- 79% of MOs were posted to one of their top 3 choices; 90% of MOs were posted to one of their top 10 choices
- So what happens to the 10% who get none of their top 10 choices? Factors taken into consideration include the MO’s preference of Medical vs Surgical postings, the MO’s previous posting (to prevent getting 2 ‘hardship’ postings in a row), and residential address
a hint at what’s next
As promised, here’s a small hint about my upcoming plans. It involves walking away from my current path, a few months of travelling, and then figuring out what to do for the rest of my life. Nothing is certain now, and I’ll explain things in greater detail in a 2/3-part series that I’m aiming to finish in August; I promise that y’all will hear it from me first (either here or on my Insta stories).
I’m very much toying with the idea of migration, but I’ve still got a few years to go before I can fulfil this dream (although I’m open to my dreams/goals changing over time), but I hope all of you will continue to walk with me on this long and unpaved road. :’)
Anyway, that’s it for this month’s post, because I’ve gotta go pack for my Bangkok vacation tomorrow, so be sure to follow my Insta or like my Facebook page to stay up to date with my latest stories & travel updates!
Here’s my song rec for the month, the very addictive As It Was (Harry Styles):
P.S. This blog is my passion project and self-funded, so if you enjoy my writing and want to contribute some spare change towards my annual WordPress Premium plan, why not make a little donation here? 🙂
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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, doctoring, psychology, random musings), or check out my most read series below:
- the Chasing Dreams series: a series chronicling my thoughts, dreams & changing ideals over the years (since 2018), including burnout, quitting the rat race, migration and trying to find my path in life
- the (not-so-definitive) guide to doctoring: Getting into Med School & FAQs | Surviving your Clinical Years | MBBS Tips | Life as a M1 // M2 // M3 // M4 // M5 during COVID // Life as a Doctor (monthly series) | Chasing Careers series
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