Chasing Careers \\ “I want to quit Housemanship” + breaking the bond + other FAQs

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In the Chasing Careers series, I’ll be shedding light on medical & non-medical career options for doctors and answering all the questions you might’ve been too afraid to ask. If you feel like reading about the highs, low (and everything in between) in my working life as a doctor in Singapore, why not check out my ongoing monthly series!

At the start of September, the current batch of local House Officers changed over to their second postings, and with every posting changeover comes with a massive wave of anxiety, stress, and self-doubt – it’s completely normal, I’ve been there too.

I hadn’t expected to be approached by a small handful of House Officers/HOs who wanted to find out about what would happen if they quit Housemanship, as well as the bond-breaking process. And who better to write about this than someone very nearly tapped out of HOship and then eventually resigned?

Sure, the phrase ‘breaking bond’ may sound taboo, but for every person who DMs me, I wonder how many others might also be curious about these topics but too afraid to ask, so I’ve decided to share all my available info in this possibly politically-incorrect post, to help you make a more informed decision).

So here goes nothing.

Should I quit Housemanship?

The first few questions to ask yourself when considering quitting Housemanship:

  1. Which aspects of the job are absolutely unbearable, and are they temporary (a bad posting, team, monthly roster), permanent, or concerning your wellbeing (mental health conditions)?
  2. Is there anything worth staying on for? What was the one thing that helped you hold on for this long?
  3. Are you or your family financially able & willing to break the bond?
  4. Would you prefer to take a period of NPL (no-pay leave) to think things through?
  5. [For guys] Have you completed NS?

I can’t understate the fact that quitting Housemanship is an irreversible decision, and if you do decide to quit, M0HH will purportedly make you sign some papers stating that you can’t ever resume HOship (which means you will never be able to practice as a doctor in Singapore).

For local graduates, surviving 1 year of Housemanship is the only thing standing between you and Full Registration, after which you’re allowed to practise unsupervised, so I’d strongly recommend at least finishing Housemanship within a year (more on why I specified ‘1 year’ in the next question).

If you decide to quit, you’ll be allowed to serve out the 5-year bond period with immediate effect, in various health-related ministries/national agencies or National Service (for the guys who have yet to complete it) – I’ll touch on this in more detail later on.

For Singaporean IMGs/International Medical Graduates, it won’t really affect you as much, since there’s no bond. For those who signed the 3-year bond in exchange for 3 years of discounted overseas tuition fees, my IMG friend mentioned that the bond costs $50k in total (compared to local grads, where each year of the bond is valued upwards of $100k).

If you want to quit and find jobs in the country you graduated from/any country that recognises your degree, GO FOR IT!! Some acquaintances and former IMG House Officers in my year did quit midway through the year, to seek employment overseas, and they’re much happier for it.

What happens if I take a period of no-pay leave?

Earlier, I mentioned that local graduates have to complete Housemanship in 1 year in order to obtain Full Registration.

Sometimes, people are granted exceptions to this rule, especially if your Housemanship was extended due to hospitalisation/surgery, but if you take NPL for personal reasons or mental health conditions, things are a little less rosy.

I asked M0HH HR about this when I was seriously considering taking a break to weigh all my options and for a temporary mental health respite (after completing my first HO posting in a department known among juniors for its toxicity…you can read about it here), but was informed that if I chose to go on NPL, I would only be granted Full Registration after an extra 1-1.5 years (i.e 2-2.5 years after graduating).

That made me stop short and decide to just push through the rest of the year, since I was still coping fine but just felt fatigued and burnt-out*. I was very fortunate, in that my 2nd and 3rd HO postings were enjoyable and felt like heaven in comparison, so everything (especially my mental wellness) was upwards from there!

*I only had an acute stress reaction directly caused by that first posting (not any chronic or serious mental health condition). If you have mental health conditions that require psychiatric follow-up or long-term medications, a break might benefit your health and long-term well-being! Remember to put yourself first, because no job is worth dying or hurting yourself over.

While researching my options with regard to quitting Housemanship, I spoke extensively to 2 seniors who had left HOship a few years prior. What they had in common was that they had tried so hard to continue working as House Officers, taking multiple stints of NPL between and during postings, but ultimately made the choice to leave.

I’m sure I want to quit/I’ve exhausted all options and I really want out, what lies ahead?

Last September, I remember spending most of the month emailing back and forth with a MOHH HR staff, asking her what other options I’d be offered to serve out the bond.

At that point in time, I was labouring under the misconception that the bond was $800k+ instead of $500+k (because of #fakenews I saw on an SG med meme page), so I thought it would make more sense to spend 5 years in a less burnout-inducing work environment, rather than be subjected to another 5 years in mostly-hospital settings (since clinic-based, lab-based or non-clinical MO postings are relatively rare, and I already knew from M3 that I loved clinics and didn’t enjoy ward-based practice nor being on call).

HR explained that there were some options in which I could serve out the bond, so here’s a quick summary:

  • Upon quitting Housemanship, guys have to return to NS to complete their remaining years, but the great news is that it’s included within the bond
  • The bond must be served in the public sector, in health-related roles within agencies like MOH & AIC, or hospital administration. The rationale for only allowing you to seek jobs related to healthcare is that you must still use your years of medical training and clinical experience in some capacity
  • You’ll be allowed ~3 months to find and select a job in the above sectors (the bond won’t start till you start working), with plenty of guidance and assistance from the lovely folks in MOHH HR

Perhaps the most important thing to consider is your lifelong financial situation. I said it once earlier on, and I’ll say it again: quitting Housemanship is irreversible, and once you walk away from it, you’re likely to be earning less than your Med friends for the rest of your life (although you might have more work-life balance than them).

The salaries for the roles above are based on civil service pay and pay grades, starting at approximately $4k/mth, with annual increments and civil service benefits/bonuses.

For comparison, House Officers have a take-home pay of $3.2k (after CPF, before adding on call pay), and Medical Officers get around $4k. In the private sector, it’s a lot more…I’ll be sharing the numbers in another post in the Chasing Careers series, so stay tuned.

Long story short, while the idea of safer working conditions and better work-life balance was really attractive to my burnt-out self at that point in time, I knew I would regret walking away from Housemanship every day for the rest of my life (because I do enjoy the work + financial stability). A mere 8 months of Housemanship against a lifetime of regret? It was a no-brainer, so I decided to stay until at least the end of HOship.

How much does the bond cost? Will I be able to recoup the cost?

Liquidated Damages (LD) is the fancy term used by Master M to describe the cost of breaking the bond. And being someone who likes planning ahead, I emailed the admin staff to confirm the approximate sum during Housemanship, so I had many months to plan my departure.

You’ll have a month to repay the full sum/bond, so be sure you have the amount ready to go before even sending notice! If you fail to pay off the full amount within the 1-month grace period, the outstanding amount will begin accruing an interest rate of 5.5% per annum.

A few little birdies have also told me about a special M0HH repayment plan that allows you to pay off the LD in installments over a marginally longer period than the 1-month I was granted. Unfortunately, I only have scant details and hearsay to go on regarding this option, so do contact M0HH directly to find out more! (and please share the info with me so I can add it to this post)

For the NUS/NTU Class of 2021 (my batch), the total LD is ~$520k for 60 months, pro-rated for the number of months left.

It’s no small sum, and a lot of people probably have better things to do with the money. But since I’ve chosen to be single and commitment-free for the foreseeable future (+ live with my parents), I decided – with the blessing of my family – to take the leap*.

*mainly for sanity + significantly improved physical wellbeing + exploring non-medical career paths

If you/your family is able to pay it off without taking a significant loan, it’s really not a dumb financial decision, even if it may seem that way. At ~$8.6k/month, it’s a sum that can be recouped in the private sector in about half your remaining bond duration (working ~40-45h/week), so no fear! And if you’re used to 80-hour work weeks in the public sector (but I don’t recommend wrecking your health further + endangering patients), imagine pulling those hours for fair wages? You could pay it all off in months.

For Duke-NUS’ Class of 2021, my friend mentioned that the LD is $750k for 48 months, a much steeper monthly cost; so I’d think twice about breaking that bond so early on. But on the bright side, each year of your indentured servitude is more valuable than that of an NUS/NTU graduate’s?! (but who are we kidding, slaves are all equal)

I’m sure I want to leave, so how do I break Master M’s chains?

In case you’re not in on the joke, Master M is how we (both ‘slaves’ and ‘former slaves’) refer to the entity/organisation to which we signed 5 years and our lives away to.

If you’re thinking of heading down the same path as I did, this is a safe space and you are far from alone. If you want to read about why I chose to break my bond so early on, this link will take you to my 3-part Great Resignation series!

While I don’t have official numbers, many others have also broken free (in our batch/Class of 2021, as well as a large handful of our seniors). Around half of the seniors I’m friends with had also broken their bonds with 2-3 years to spare…and half of them are in Aesthetic Medicine now. The rest of us mostly work as anchor GPs in clinics, locums/freelancers, or in telemedicine. One friend of mine even left to do medical consulting and IT.

Once you’re sure that you want out and have the financial means to do so, you can begin your 1-month countdown!

The process goes a lil’ something like this:

I left out the administrative details, since they involve lots of names and people’s job titles, but if you email anyone from MOHH HR they’ll be able to provide you the exact details.

  • Serving notice + clearing your leave
    • I emailed my HOD about 1.5 months in advance, to inform him of my last day (which I picked to be the last day of my interim posting) and clear my leave. It was easy and didn’t inconvenience my department, since I wasn’t leaving in the middle of the posting and creating manpower issues
    • The process of resigning took less than 5 minutes. I sent in my resignation email at 9.15am (yes, I kept all the receipts), and at 9.20am, the ‘guy up there’ replied and accepted my resignation…
    • During the 1-month notice period, you can’t use any Annual Leave (or other forms of leave, unless your HOD approves), so be sure to clear as much as leave as possible before serving your notice. Any claims, prorated salary and unused leave will be paid out to you in one last paycheck from Master M
  • Admin stuff
    • Filling out some offboarding forms and confirming the amount owed, overall a pretty easy process. You don’t have to physically go down to the office to sign any forms, everything is done online
  • Paying the liquidated damages/LD
    • You’ll have a month from the official last day to complete the payment of the liquidated damages/bond money. You’ll have to increased your bank account’s daily transfer limit to a ridiculously high sum, then cautiously transfer the full sum over a few days (or maybe just a day if your LD is <$100k). With each transfer, it felt like I was buying a year of my life back

And soon enough, you’ll be joining me and countless other doctors in:

What’s next?

Once you’re free, you’re free to locum legally (for as many or few hours as your heart or wallet desires), work as an anchor GP in a clinic chain of your choice, or just take a breather/sabbatical for a while. Whatever you decide to do with the extra years you’ve bought back is up to you – for the first time in your life, you’ll be well and truly free. Congratulations! (and I’m not being sarcastic)

If you’re like me and are also exploring the idea of venturing into other non-hospital based clinical careers or maybe entirely switching to a non-clinical path, fret not! I’m currently working on a post in which I’ll share about some realistic alternative career options for med grads in Singapore, as well as their approximate salaries (since $$$ seems to be the second most common thing I’ve been asked about since resigning).


Be sure to follow me on Insta or Facebook to be the first to read my new posts! If you have any more questions, just leave them in the comments section below and I just might add them into this post. Until next time~

xoxo,
Faith

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P.S. I don’t make any money from running this blog, so if you’d like to support my writing and help me bring even better content to you, you can buy me a coffee/donate on Ko-fi!


| About | Facebook | Insta | LinkedIn | GitHub |

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:

xoxo,
Faith

Join 3,643 other followers

P.S. I don’t make any money from running this blog, so if you’d like to support my writing and help me bring even better content to you, you can buy me a coffee/donate on Ko-fi!


| About | Facebook | Insta | LinkedIn | GitHub |

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:

8 responses to “Chasing Careers \\ “I want to quit Housemanship” + breaking the bond + other FAQs”

  1. Thanks for the post! Wanted to ask, what about NPL after HO-ship, i.e. to take e.g. 2 months off after HO-ship instead of doing an interrim posting, how open is Master M to that?

    Like

    1. Hey B! Only 1 person I know of had their NPL request approved – it has to be for ‘valid’ reasons. The one case I know of that was approved was because of a family member’s health issues (a doctor’s memo/verification is required). A few of us tried writing in for personal reasons like travel/elective surgery/just wanting a respite, but were rejected haha

      Like

  2. I’d like to stay anonymous for now > Avatar
    I’d like to stay anonymous for now >

    Hi, I’m someone who has no idea about the medicine pathway in Singapore. I got introduced to your blog by my sister who’s your junior in RI and is interested in medicine, and she’s sort of piqued my interest too but I feel like I don’t know enough to truly say I want to aim for medicine (and it is a lofty goal anyway).

    As I read this post, I realised I had no idea what the difference between clinics (?) and calls are? Whenever I think of doctors, I think of them on call. I’ve been keeping up with your blog and it seems that even the most passionate doctors dislike calls. Is it possible to give more details on what calls are like? 😮 and what’s the difference compared to clinics?

    Like

    1. Hey Anon, thanks for reaching out! Haha don’t worry, it sounds like you’re still pretty young and have a few years to go before making this huge decision, so it’s great that you’re here and doing your own research on how good/bad a doctor’s life is.

      There’s lots of other settings that doctors work in (eg. outpatient/polyclinic/GP clinics/Emergency Departments), but for the purposes of answering your question, we’ll just stick to inpatient doctoring: Calls were an idea taken from the US medical system, where doctors work around 24-36 hours straight, with no designated breaks or nap times. It’s the ultimate challenge – sleep deprivation + having to keep patients alive overnight.

      Imagine showing up to work for a full day (let’s say 6am-5pm), then going ‘on call’ from 5pm-8am. When you’re on call, you’re the first-line doctor in charge of multiple wards (which you may not even be in charge of in the daytime), and will be called to do anything from ordering medications or taking blood, to reviewing sick/bleeding/dying patients. The next morning, after your call officially ends at 8am, you may be fortunate enough to go home, but due to manpower constraints, most people stay for at least 4-6 hours more to tidy up their regular ward work (the ward they are in charge of in the daytime).

      After 24-36 hours of possibly continuous work, you’ll get to go home and be reunited with your bed. Oh, and this will happen anywhere from 3-8 times a month, depending on the department and manpower constraints…

      Clinics are basically the same as GP clinics/polyclinics, and are considered outpatient settings! The main difference is that clinics don’t have such acutely ill patients + operate during office hours. Hope this helps, and all the best!! 🙂

      Like

  3. Thank you for your detailed post. Just wanted to share that I was allowed to take 1 year NPL (i.e., delayed HOship) for mental health reasons, with support from my psychiatrist. As mentioned by Faith, my friends were also not allowed to take NPL for reasons like wanting to do missionary work, volunteer work, travel…

    Like

    1. Thanks for sharing and helping add to the list of ‘things that don’t qualify for NPL’! And pls take care @ TuneMyFork 🙂

      Like

  4. Hi Faith,

    I like your posts, specially so as you seems giving more info than usual medics!
    You mentioned in a post “…In the private sector, it’s a lot more…I’ll be sharing the numbers in another post..”
    Can we have that post?

    Best wishes.

    Thanks in advance!!

    Like

    1. Hey Zil! Haha glad you like my posts, and don’t worry, that post is coming in early 2023, so stay tuned! 😛 Merry Christmas and HNY in advanc~

      Like

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