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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!
Happy Chinese New Year and hope y’all haven’t eaten yourselves into a food coma. Even if you did, you still won’t have a higher glucose reading than the auntie in the Emergency Room who’s in diabetic ketoacidosis after eating 20 pineapple tarts, so don’t worry.
First things first, congrats to my friends & comrades working under MOHH on your pay rise!! I was elated when I saw the news on @updatemeprn‘s Insta story – we’re finally making enough waves to force the higher ups to listen to us, and hopefully more change is underway!
This month’s post is all about cognitive overload, differing objectives among locums (earning a lot vs having a good work-life balance), and why I’m choosing to work less.
The salary revision includes a new allowance for weekend rounds (they used to be unpaid), and a base pay increase ranging from $100 for PGY6s to $500 for PGY1s, resulting in an overall pay jump of up to 13% for House Officers (but less for Medical Officers).
In view of these salary increases, some of my friends asked if I regretted breaking the bond. Technically, if I want to be on par with my colleagues in the public sector, I’d have to recoup my monthly bond costs (to the tune of $8.7K) and match the increased monthly Medical Officer salary (of around $8k, including the new weekend allowance and higher call pay).
But my answer is still a firm #noregrets. Money is just a number, and I don’t want to become a person who chases money solely for the sake of it. I’m saying this from a place of privilege and being debt/commitment-free, so take my words with a pinch of salt.
At my good friend’s birthday chalet recently, a bunch of my doctor friends – a mix of House Officers and Medical Officers – sat around and began commiserating about their lives in the public sector. Y’know, the usual “I have to leave early because work starts at 6am tomorrow”, “My boss’ operation overran and I left work at 8pm”, and our all-time favourite line: “I want to quit”.
The topic soon shifted to my income as a locum/freelance GP, and we discussed if this short-term tradeoff that I made (for lifestyle/freedom/exploring other careers) was worth losing out on the long-term earning potential as a specialist.
Sure, my friends will definitely be millions of dollars richer than me if/when they become fancy schmancy surgeons in the private sector, but there’s no point in sacrificing my time pursuing something I’m simply not passionate about, just for money (which I don’t even spend that much of).
And for the record, other non-procedural specialties or senior doctors in the public sector will never earn that much, so to the non-medical people reading this, don’t think that all doctors are multimillionaires because we’re really not!!
differing objectives of locuming + why I’m choosing to work less
On the topic of money, everyone has different motivations and goals when working as a freelance GP/locuming, and all are equally valid (I’m not here to gatekeep).
For some context, locums are paid by the hour, so your earnings are directly proportional to how much you choose to work. Some ‘hustle’ hard, working overnight shifts in 24-hour clinics and make a ridiculous amount of money, while others work fairly regular hours, choosing to enjoy the work-life balance and flexible schedule.
Hustle culture and/or terrible working hours have become a mainstay in the lives of many young professionals (whether by choice or not), but I didn’t leave the slavery in the public healthcare system to become a slave to money in the private sector. This month, I averaged 40 hours per week – a far cry from the 60-80 hours I used to work in hospitals.
Even working just 40 hours a week, I felt breathless trying to fit my life, education, and 101 hobbies around my work schedule (while getting 8 hours of sleep). To be honest, that’s definitely a ‘me’ problem, because while I don’t consider myself a ‘hustler’ at work, I have a pretty eventful and self-inflicted hectic life outside of work. Oops 🙂
So in the anti-hustle spirit, I’m choosing to work even fewer hours in the subsequent months, so I’ll have more time to spend on the things I love!
There’s a brewing backlash against the hustle culture. Anti-hustlers on the rise have triggered a movement against hyperwork, rise, grind and overwork in the pandemic. The cult of hustlers is getting smaller in the era of the great resignation around the globe. The growing disquiet and unease in the hustlers club was highlighted as people opted out of overworked corporate life. The world witnessed a quiet rebellion against the culture that gave no work-life balance and believed if you snooze, you lose and other workaholic mantras that worshipped the cult of overwork.The Rise Of Anti-hustle Culture
More money is always nice, but having freedom and a chill yet fulfilling life is nicer.
adios cognitive overload
Cognitive overload is a leading cause of burnout, and I’m sure there’s no where it’s more acutely felt than in hospitals, especially among junior doctors. So, what exactly is it?
Cognitive overload occurs when a person is mentally overwhelmed due to imposing cognitive load beyond our capacity. This generally results in struggles to complete activities productively and successfully. Completion times are increased and usually at non-optimal levels of performance when we split our limited attentional resources.
Cognitive overload, if prolonged, could lead to high stress levels and burnout, with symptoms that put individuals at risk of mental disorders such as anxiety and depression. Studies have shown that people who experience long term cognitive strain increases stress levels and reduce work performance. This reduces one’s perception of work satisfaction and thus, levels of well-being.source
The starkest difference between clinic-based work and hospital work is the lack of cognitive overload, and boy oh boy does it feel like a breath of fresh air. In the clinic:
- You don’t need to worry if your patient will be stable (let alone alive) the next morning. Anyone who can walk into a clinic is quite well, and they’ll come back for a review the next day if needed, to tell you which medicines worked or what didn’t. And I always remind them to seek help at the ED if I’m not confident of providing optimal patient care to them due to the limitations of a clinic/outpatient setting
- You don’t need to worry about sudden changes in your schedule/working hours, and you can say goodbye to the monthly roster. The hours are fixed, and your assistants will help to close the queue if they estimate that you you won’t have enough time to clear the existing queue before your session ends. Yay to finally being able to plan things months in advance!
- You’re allowed to pause the queue. Some days, the clinic queue can be insurmountable and overwhelming. You finish seeing 1 patient but another 2 appear in your queue; finish those 2 and now there’s 4! The main perk of being in a private clinic is that at least you can stop the queue once it’s exceeded a number that you can reasonably/safely finish seeing, whereas in the polyclinic setting, I’ve heard horror stories over 100 people still waiting to be seen at 4.00pm (for reference, polyclinics technically close at 4.30pm…)
I suddenly had so much extra mental bandwidth and energy to simply…exist, minus the ever-present low-grade anxiety of ‘how early do I need to go into hospital tomorrow to pre-round my 10 patients?’ or ‘is the on-call keeping my dangerously ill patient alive?’
I also cancelled my work phone contract after finishing Housemanship, which ngl felt like the biggest power move I’ve ever pulled. I no longer had a boss to answer to (my only duty being to my patients), and I became my own boss. It’s a strange feeling, being 25, self-employed and truly free.
At any rate, if the GP lifestyle sounds a lot more appealing to you, or you’re simply feeling burnt-out from the months of overwork and cognitive overload, why not check out this post to see if leaving is the right path for you:
Looking for medical indemnity insurance to protect yourself from legal troubles? I compared various options and eventually settled on NTUC Income’s Medical Indemnity Policy for slightly under $1.4k annually for GPs. I’m helping my insurance agent out (he’s a nice elderly uncle), so just drop me an Instagram DM/email and I’ll pass you his details; he’ll handle the rest! 🙂
Anyway, that’s it for this month’s post, and we’ll wrap it up with my monthly song rec, About You by The 1975, my all-time favourite band:
Do you think I have forgotten
There was something ’bout you that now I can’t remember
It’s the same damn thing that made my heart surrender
And I miss you on a train, I miss you in the morning
I never know what to think about
I think about you
Thanks for journeying with me into the new year, and I have plenty more life & travel adventures lined up in 2023, so be sure to follow my Insta or like my Facebook page to stay up to date with my posts!
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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