The Path to an Established Career in Medicine

In my previous post, I talked about going on a tour in a local hospital led by two medical residents (Ken and Jeff) and put together by an undergraduate club at UBC.  I explained my interest in a career as a physician and then briefly mentioned the themes of structure, agency, and autonomy, using an example from the tour.  In this blog post, I would like to write about the process to an established career in medicine in relations to two of the aforementioned themes: structure and agency and using my favourite reading (The Sociological Imagination) from our seminar this semester to analyze my thoughts.

 Photo: midwifery.ubc.ca

Working 70-80hrs/week 

A recurrent topic that both Ken and Jeff brought up was having 70-80 hour work weeks.  As residents they work 70-80 hours per week with a possibility of having additional hour devoted to research work which may add up to a 100-hr work week.  As a response, I tried to challenge them with the question, “How do you keep yourself healthy while trying to keep others healthy?” It just didn’t make sense to me that the job of medical residents and doctors is to keep people healthy and cure patients, but while they’re doing that, they’re asked to work 70-80 hour weeks, to work on-call, to work overnight, to do all-nighters, to skimp on sleep….. In response, Jeff described to us times that he would not have worked-out (exercised) for months and that he hasn’t cooked his own food in three months.   He told us that it is important to be adaptable because this is just something that you “adapt to.”  He then dubbed this work-life style an “old system.”

Relocating to rural areas to work

Jeff talked to us about his desire to work in the northern areas of BC, such as Kamloops, after he completes his residency.  My question, of course, was “why?”  From what I heard, his biggest reason for working in the interior is for the work variety and calmer lifestyle that it would provide.  Whereas in a big hospital in the metropolitan areas there are different doctors working in different units, instead, working in the rural areas would mean that one doctor could be moving across all units and following all the patients. He also mentioned that there are “more things you can do” and “it’s easier to do things.” By that, I think he meant that the system is less bureaucratic and more flexible, hence easier to navigate, work around, and to do things.

Working in a big hospital

Ken on the other hand, gives off a more ambitious and driven sense of character, and is firm about working in big hospitals.  His two main reasons for doing so are: (1) he wants to deal with kids who are super sick (these residents are pediatricians) and (2) he is really keen on the academic side of things and doing research — big hospitals and big cities would have the resources to assist him with grant-writing and open up to him a network of people relevant to his research work.

Tips for Applying to Medical School

A big question that we had as a group was about the process of applying to medical school.  On this topic, Jeff and Ken had similar insights.  Both of them agreed that you need to “jump hoops” and “play the game.”  They say that the admissions process is to find the right people.  Here are a list of inspiring messages I got from them:

  • be honest, genuine, and straight-forward
  • don’t contrive / blow-up or magnify your work and/or accomplishments
  • “If you’re in it [going to medical school] for the right reasons, it’ll show [in your interviews]”
  • be excited
  • be yourself!

Jeff also told us about how we wasn’t like most of the other medical students who were overachievers to begin with.  However, after being in medical school he started following the “culture” and tried to do many things too – trying to “find his place in the world,” but he ultimately burn out.  With that, he leaves us with some life advice:

-> “Don’t sacrifice your happiness for your future” 

 Photo: newcw.phsa.ca

This reflection makes me think about  a quote from C. Wright Mills: “The first fruit of this imagination – and the first lesson of the social science that embodies it – is the idea that the individual can understand her own experience and gauge her own fate only by locating herself within her period, that she can know her own chances in life only by becoming aware of those of all individuals in her circumstances”

Throughout the three four examples I gave above, I see strong interlinks between structure and agency.  In the quote above and in Mill’s (1959) The Sociological Imagination, he discusses how people are living and making choices under the influence of the current time period and organizational structures.  Working 70-80 hour weeks – is it really a choice? Relocating to rural areas – is it really a choice? Working in a big hospital – is it really a choice? Or are these “semi-choices” or “choices under circumstances” Why must we “jump through hoops” and “play the game” in order to get into medical school? What are these “hoops”? What is this “game”? These are all questions that, I pose to the reader, you – to think about, discuss, and answer.

And the question for myself – who am I, this person who wants to do what to get where [medical school, a career in medicine]?

Reference: Mills, C. W. (1959). The sociological imagination. Oxford University Press.

Autonomy in the Medical Profession?

This drizzly afternoon, I rushed to the bus loop from class in order to make it to a tour of a local hospital put together by a student-run club at UBC whose mandate is to help students in their process of pursuing a certain health profession.

We were met by two residents (graduated medical school students who have begun practicing in hospitals/clinics) at the lobby of the hospital.  Both residents are males in their fourth year of residency — one had a staff identification badge hang down his t-shirt whereas the other had a stethoscope around his neck and was dressed in a neatly pressed dress shirt.  Let’s call the former Jeff and the latter Ken.

In the past year and a half, after hurdles and hurdles of career choice challenges and changes, I developed an interest in becoming a doctor.  There are various reasons why I think may be a suitable career choice for me (without thinking about my uncertainty of my capabilities in the natural and physical sciences for now).  Amongst the passion of directly help people, the excitement for science, the ability to earn a living wage, and the respect, a big draw for me was the autonomy I perceived that a career in medicine would entail.  To put it into picture, I have been (day)dreaming about how nice it would be to be a family physician/GP and be able to focus my time, attention, and efforts on helping patients without having to worry too much about living up to the expectations of supervisors, following bureaucratic rules, and navigating professional relationships with co-workers.

Hearing from the residents today made me feel a little grey as while Jeff was showing us around and telling us about his experiences in medical school and being a resident at the hospital, these words he spoke jumped at me:

  • protocol
  • procedures
  • divided
  • paperwork
  • culture
  • process
  • system
  • adaptable
  • protected time

These are all words that I would say can be related to bureaucracy and more pertaining to your class theme, structure versus agency.  Jeff used the word “protocol” when he showed us around the maternal care room.  In the maternal care room, there is an apparatus that you use to revive a newborn when he/she stops breathing (please excuse my faulty explanation). When he explained this to us he pointed to the poster on the wall which states the protocol, or what procedures the doctor should follow in such an event.  He said to us something along the lines of, “It’s here because you won’t have time to think, they just want you to follow the instructions and just do.”  

In my next blog post, I will expand on my thoughts about agency, structure, and the process to a career in a medicine.

Chinese or Canadian or CBC or…?

I would like to start my post this evening with the question: what does “co-ethnic” mean?  These two weeks, the theme for our seminar has been race and ethnicity.  More specifically, as part of this week’s readings, we are looking at a couple of research studies done by Dr. Eric Fong at the University of Toronto and Dr. Elic Chan, who is an honorary research associate and sessional instructor at our very own university – UBC!

In their article, Fong and Chan gave an overview of past research, findings, and theories involving co-ethnic clustering. Then, they talked about their research on Chinese and Indian immigrants who settled in Toronto.  Back to the question I posed in the beginning — what does “co-ethnic” mean? It is simply when you have people of the same ethnicity together.  In the case of “co-ethnic clustering,” we have people of the same ethnicity coming together and living in the same neighbourhoods. They then go on to discuss factors that contribute to co-ethnic clustering: co-ethnic preferences, economic resources, and the use of co-ethnic information resources. Their findings show that co-et

Ethnic preferences (the favouring of amenities that are relevant to their ethnicity, such as Asian malls) and using co-ethnic resources – specifically Asian real-estate agents – were predictive of co-ethnic clustering.

This article led me to ponder about my own ethnicity and how that affects my choice of people I hang out with.  A few weeks ago, I attended an event on campus in which the purpose was to bring together Chinese-speaking international students to talk about their identities in light of the Occupy Central movement in Hong Kong.  With the exception of the Mandarin for Cantonese Speakers class I took in first-year, this was the first time I got together with so many Asian people all at once through by the factor of Chinese-speaking.  This makes me think about ethnic-clustering (mentioned above).  My reasons for being there though, were different.  One reason was to support friends who were there, but other reasons included interest in the topic.  Discussions focused on self-identity.  Participants were all from Asia – Hong Kong, Mainland China, Taiwan, and I was the only Canadian-born-Chinese.  I identify with Chinese culture and values, but not with Chinese as a nationality as I’ve never been to China before.

I think the event and the class discussions have really connected for me in that I’ve been asking myself questions of my identity and how I come about to hang out with friends that I hang out with.  For example, I often see many Chinese students clustered together or athletes clustered together. My reason for clustering? Mainly as a result of work/volunteer and class involvement!

Source: Eric Fong and Elic Chan, “The Effects of Economic Standing, Individual Preferences, and Co-Ethnic Resources on Immigrant Residential Structuring” International Migration Review 44(1): 111-141.

Entering a “Foreign Territory”

My Experience at a Social Club Ice Breaker on Campus

In the beginning of this school year, a couple of classmates and I decided to attend the ice breaker of one of the most well-known social clubs on campus.  I still remember the apprehension that built up as the event approached.  It was a combination of feeling excited about what’s in store and anxiousness  about being there.

The moment I stepped into the registration area, I felt a rush of nervousness despite the high positive energy that the club executives were giving off.  Only after seeing my classmate there did I feel a little bit less nervous.  I tried to act as casual as possible when getting myself a name tag in order to conceal my uneasiness.  It felt strange because when engaging in on-campus activities, I had often been on the host side where I was part of the group running the event.

The second time I felt strange was when I entered the venue where the ice breaker was to take place.  The room was already filled with people, chatter, and laughter.  Immediately I felt that I didn’t fit in.  After we watched the introductions to the club and a game started, my classmate and I left the venue together because we did not feel like participating anymore.

When we debriefed about our experiences and talked about how we felt, we realized that we felt uncomfortable for different reasons.  My reason was “I’m dressed differently.”  What I meant by that was literally that my clothing was fitting in with the rest of the participants at the event.  I felt that I was dressed a little too formally than everyone else.  However, I soon acknowledged to my classmate that I do realize that this is solely my own feeling – no one made any remark about the way I dressed nor did I feel that they looked at me in any way that elicited those feelings.  I knew that the reason I felt that way was due to my previous “knowledge” about how the club is perceived by others and how I didn’t fit into that description.

In the end, my classmate and I decided to head back to the ice breaker where we stayed until the event finished.

ubc

Relating this Experience to our Class

When I did the reading, “Guyland” by Michael Kimmel, I thought back to this experience.  For class, we read chapters 1 and 4 in the book.  In Chapter 1, Kimmel talks about the notion of “Guyland.”  “Guyland” is a phase in the life of males (in Western society) in which as boys, they become men.  Males in Guyland are mostly “white, middle-class kids; they are college-bound, in college, or have recently graduated….” (P. 8)  Concurrently, Kimmel speaks about Guyland as if it was a physical space.

After discussing about fraternities, in chapter 4, Kimmel writes about how college girls find their identities in their sororities in relation to these males.  Kimmel writes as though these girls are entering the physical location of “Guyland.”  The girls can choose to be either a “bitch” ¨(please excuse my language) or a “babe.”  The latter “ does not model herself on a guy’s expectations of her, but rather on her own expectations of herself,” (P. 249) and as a result they are shunned and ridiculed.  To be a “babe” one must comply with the expectations and social norms of the sisters and brothers.  For the girls, their first time entering Guyland is very unfamiliar to them, and the choices they then make have a big impact on their identities and how they are perceived by others.  In a similar yet non-identical way, I felt as though I was entering a “foreign territory” when I entered the event venue.  I was constantly thinking about how I was presenting myself and whether I should engage in activities (such as chants and photos) that I did not feel comfortable engaging in.  Thankfully, throughout the event, regardless whether I participated in the activity or refused to take part, the club members and event participants were non-judgmental and did not look down on me.  I felt respected regardless of the choices I made.

This is also a topic of structure versus agency, where this social club is a structure and everyone within it may or may not have agency depending on how the person personally feels.  For example, when I left the event out of nervousness, I chose to leave the event because I personally felt that I didn’t belong because of my preconceptions of the club.  The structure, or my preconception of the club, came into play with my choice or actions, or my agency.

To conclude, I must say that the social club I mentioned in this blog post is very different from Guyland in that basing off from my observations from the ice breaker event, the social club is an open and inclusive club and will not coerce club members and event participants to do things they don’t  actively nor passively.

 

Source: Kimmel, M. (2008). Guyland: The Perilous World Where Boys Become Men.