Obstacles & options in pursuing medical professional career

Vijay Sardana MD,DM( Neurology)

Professor & Head of Neurology, &Chairman Medical Education Unit

Govt. Medical College, Kotavsard@yahoo.com

The Noble Profession of Medicine

“There is no career nobler than that of the physician. The Progress and welfare of society is more intimately bound up with the prevailing tone and influence of the medical profession that with the status of any other class…”

Elisabeth Blackwell, MD, 1889

Medical profession

Intellectually challengingFinancially securePersonally rewarding

Stages of career

EntryEstablishmentExplorationSpecializationMastery

Today's successful doctor

ClinicianAcademicianManagerFinancial ExpertCEOFamily care ProviderSelf care taker

Desirable basic qualities for prospective Physicians

intelligencescientific interestphysical & emotional strengthGood communication skillcommitment to put service to others firstEngage in complex problem solvingLife long learningability to tolerate uncertainty & frustrationsocial awarenesscreativity

Medical professional carrier: Potential obstacles

Tough competition in PMTLong & demanding UG courseDifficulty getting PG & choice of specialtyPost doctoral courses - bottle neck possibilityEstablishing & maintaining practiceKeeping updatedlong working hours, Stressful conditions Coping with governmental & corporate bureaucratic

obstaclesIncreasing litigations

Doctor : Facts

One of the every three dissatisfied due to lack of time for themselves or their families

Average life 10 year less

Depression 4 times higher than general population

US- Physician suicide 3 time than general population

10% - Develop drug addiction

Females in medicine: problems

Carrier affected by marriage

Difficulty balancing between family & carrier- one can’t be superDoc, superMom and superWife

Academic & financial achievements affected

Have to compromise in-

choosing a specialty

limiting the work

Obstacle: Initial euphoria after admission

Obstacle: Inadequate knowledge about carrier options after MBBS

Carrier options

GraduatePost graduate

Graduate options

GPJob- State Govt

central Govt

PSUs

RMO in nursing homes, corporate Hospitals

Post graduate options

Further post doctoral coursesJobspractice

Carrier options

Private solo practicePrivate group practiceCentral/ state Govt non teaching jobsPSUsCorporate hospitalsTeaching jobs

Govt / private medical college

full time / part time

practicing / non practicingAbroad/ overseas

ABROAD OPTIONS

GulfUSAUKNew Zealand/ AustraliaMauritius / African countries

Factors influencing carrier choices

Inclination before starting MBBSExperience in specialty during rotationRole models in profession/ collegeSpecialty prestige/ social appreciationFinancial rewardsProfessional independenceResponse of specialty patients to treatmentParental preference

Obstacle: Inadequate knowledge about pros & cons of different options after

MBBS

Components of a good Job

• Economic – Salary & facilities• Job security• Good working condition• Status• Growth Opportunities• Recognition of work done• Challenges of work

Job satisfaction among Doctors

69.5% –satisfied (AIIMS)

Medical doctor in Armed Force – 40% Choudhary et al MIAFI 2004;60:329-32

Initial satisfaction high , falls > 35 years, again rise later

Madan N. job satisfaction among doctor in a Tertiary Care Hospital jk science:2008,10(2)81-83

Judge your alignment with your job

• Am i passionate about what I am doing ?

• Am i using my talent and strength ?

• Am i happy in my work ?

• Does it bring joy & fulfillment ?

• Am I Earning what I deserve ?

Improve or change

Obstacle: Many of us are confused about what is success

Doctors : Definition of success

Having lots of patientsNew car/plot Every year/lots of moneyPublishing papers in journalsTeaching students

Success

• Wealth• Recognition• Good health• Good family• Happiness• Satisfaction• Peace of mind

“Progressive realization of a Worthy goal” -Earl Nightingale

Success- Determinants

• Not determined by how we are doing Compared to others , but by how We are doing compared with what we are capable of.

• Successful people compete against themselves.

Obstacle: Belief that money is synonymous for success

Theories of Motivation

• Mosley's theory – Hierarchy of Motivational Need - Physical Need – Food, clothing, sexual urge

- Safety - Shelter, security, Health

- Social - Friends, family, love

- Self Esteem - Recognition, Achievement - Self Actualization

Money can buy….

• Amusement, but not happiness

• A Bed, but not sleep

• Books, but not wisdom

• Companions, but not friends

• House, but not a home

• Medicines, but not health

Obstacle : many of us are not motivated

Motivation

Motivation – Drive that encourage action or feeling. Process of inducing and improving anyone to perform more productively and efficiently.

Catalyst

Physician motivation

“determinants that drive performance of a task, independent of the resources and knowledge available”

Motivated person

• Look for the better way to do a job

• More Quality Oriented

• More Productive

MOTIVATION

• External – Fear motivation Incentive motivation

• Internal - Comes from within- Pride, sense of achievement & fulfillment, belief & responsibility.

Physician motivatorsIntrinsic Serving peopleWork interestCareer growthAbility to support oneself & familyAutonomyEmpowermentSocio-culturalRespectSocial rewards

Physician motivatorsorganizational

Opportunities for higher educationGood working & hygienic conditionsPersonal safetyGood professional experienceGood payFinancial incentives other than pay

Obstacle: lack of positive attitude

Attitude

• Way a person feels, thinks & behaves towards a particular issue.

- half full-hall empty

12__suraj_ki_garmi_se.mp3

Positive Attitude - Benefits

• Pleasing personality

• Energizing

• Inspiring

• Problem Solving

• Increase work output

Attitude

Job/promotion/success

- 85% Attitude - 15 % Intelligence & knowledge of specific facts $ figures

• Education - Almost 100% teach facts & figure

12__suraj_ki_garmi_se.mp3

Elements of success

Attitude

SkillKnowledge

Attitude formation of a Physician

Medical studentAltruismRole models behaviorPrevailing commercialismWork environmentSocial and political environment

Attitude : Be Optimistic

• Be so strong – nothing can disturb your peace of mind

• Talk health, happiness & prosperity to everybody

• Look at sunny side of everything

• Think best, work for best & expect best

• Spend so much time improving yourself that no time left to criticize others

• Be equally enthusiastic about other’s success

Obstacle : Failure to identify & avoid draining force- negative people

Influence of Friends

Our friends are not what we want but kind of people what we are

• Man is recognized by his friends

• AVOID Negative friends

How value system change

Intolerable

Acceptable

Involvement

Constant Exposure

Constant Exposure

Self justification

‘Frenemies’

Positive

• Part of the answer

• Has Program

• Let me do it for you

• Difficult but possible

• I must do something

• See the gain

• See possibilities.

• Hard arguments, Soft words

Negative

• Part of the problem

• Has excuse

• Its not my job

• Possible but to difficult

• Something must be done• See the pain

• See problem.

• Soft arguments, Hard words

Positive

• Firm on values, Compromise on petty things

• Don’t do it to others what you would not want to do to you

• Make it happen

Negative

• Firm on petty things, Compromise on values

• Do it to others before they do it to you

• Let it happen

Obstacle : we don’t use common sense with knowledge

“ The education of the doctor which goes on after he has his degree is the most important part of his education”

John Shaw Billings

Knowledge Vs Wisdom

• Common sense – 6th sense - Ability to see things as they are and do them as ought to be done.

• Abundance of Common sense - Wisdom

Who is educated ( Socrates 470 – 399 BC)

Those-

• First who manage well the circumstances which they encounter day by day, judge situation appropriately as they arise & rarely miss the suitable course of action.

• Next Who are honorable in their dealing with all men, reasonable with their associate as is humanly possible.

• Furthermore Who hold their pleasure always under control, not unduly overcome by their misfortune

Who is educated ( Socrates 470 – 399 BC)

• Most importantly- who are not spoiled by success, hold their ground steadfastly as wise & sober minded man.

• who have character which is in accord with all of above-

These are educated – possessed of all the virtues.

Obstacle : we are not willing To Pay The price for our dream

Obstacle: we settle for less - become expert in the field

Obstacle: we try to take more than we give

Give more than you get

• More valuable, regardless of nature & place of work• Give more confidence• Superiors & Colleagues start respecting you• Produces pride & Satisfaction.

Obstacle: Tend to find substitute for hard work

Hard Work

• Average person - Put 25% of energy of ability into work.

• Albert Einstein – “I think I used about 25% of my intelligence capacity during my life”

• William James – Human being use only 10-12% of their potential.

LUCK

• If you want to fail, believe in luck. If you want to succeed, believe in the principle of cause & effect, and you will create your own luck.

“The harder I work, the luckier I get” - Samuel Goldwyn

Obstacle: lack of persistence & perseverance to retain career commitment

Persistence

• Nothing will take the place of persistence. Talent will not- nothing in more common than unsuccessful people with talent. Genius will not – Unrewarded genius in a proverb. Education will not – The world in full of educated derelicts Persistence and determination alone are omnipotent. Clavin goolidge

Obstacle: No hobbies & friends outside medicine

Carry home

Medical profession is intellectually challenging, financially secure & personally rewarding

Always see sunny side of medicineAlways follow role models & successful people in

professionStrong commitment & perseverance are key to

successBelieve in reasoning and scientific cause & effect

relationship

Thanks