hi, as a consultant:
consultants are expected to round patients every day.
expected to work at least one out of both weekend days.
for medicine:
on call 1 week per month (stay in call but all private patients are yours the next morning and you must personally see them every day and make decisions about their care. can have up to 12 -15 private patients that are yours till they discharge. which may take months)
neurology:
stroke call (thrombolysis call) means you are at the beck and call of EMD which usually refers rubbish like hypoglycemia as stroke without checking blood sugars. or seizures -> Todd's paresis. usually get called 3-4x/day on a weekend. 1-2x overnight. must come back to hospital.
surgery:
consultant does not stay in. occasionally gets asked by registrar to come in for difficult ops (more common than you think maybe 1x/month)
psychiatry:
stay in call. you get phoned by MOs on call to clear cases.
EMD:
still do nights. occasionally see patients if shift is busy. 8 hour shifts, usually go home on time or 1 hour late.
hope this helps.
assoc. con pay: 9000 - 11000 (depending on how many posts you take up/hats you wear)
con pay: depends on what you can negotiate and what field you practice in.
MEDICINE:
MO pay: i passed my MRCP, waiting for promotion to "senior resident" aka registrar and i just got a letter saying next years pay as a registrar will be 6000/month take home. right now my pay is 4100 basic/month. 3-4 calls/month, average 15-20 patients seen overnight.
by the way, i reach work at 7 and rarely get home before 6. SOMETIMES i get to eat lunch.
SINGAPORE VS UK:
i was in the UK for paces course and was shocked at:
1. good life of MOs/Reg in public service
- was told that you can cancel operations so surgeons can leave work at 5. in singapore ops go on through the night til the next morning. no stopping. vertebroplasty can be done at 4am.
- if patients come in at 430, they are simply not clerked till 5pm, and the on call does it. fat hope in singapore. if pt comes in on the dot at 5, you stay until the pt is settled.even if it means bringing them to ICU at 8pm.
- air way team and code blue team in UK takes over most resusc. if pt collapses in your wad at 459pm, you jolly well stay and resusc even if it means you go home at 11pm. as far as i understand in the hospital i was attached to "off work" means "off work"
2. fact that patients are extremely polite
- i have been shouted and screamed at by patients and physically attacked in MICU several times
- patients expect that when they "want to see doctor" during ward round they get to see the doctor STAT even if you have 20 patients left to see
- patients demand to be seen in the EMD for rubbish and ARE NOT TURNED AWAY
-> example: in P3 i was seeing a patient who came to EMD for a small (1mm) splinter embedded in her palm. no blood. she was running her hand down the balustrade and it got stuck in. instead of fishing it out with a needle she came to hospital. she spent 5 minutes blasting ME for waiting 2 hours. i fished it out using a blue needle (16G) in 30 seconds. she came in to EMD so she could "claim insurance". in UK these people are laughed out of hospital and told to fly kite.
- patients are pretty gracious in UK and are able to express themselves in a mature manner. even if they can be a little bit judgemental/quasi-racist ("your english is so good, doctor!")
3. patients are well-educated and able to comply with medication
- it's sickening to see how many patients come in again and again with fluid overload from medication non-compliance/fluid restriction noncompliance and expect that "hospital will fix them"
- in singapore elderly people (who are often dumped to nursing homes) defer to families who really don't give a rat's arse about them for every single little thing. and 4 sons will inevitably come up with 4 different decisions and for some reason it's my job to coordinate a conversation between them. multiply by 20. even for things like an I&D. not to mention DNR/no intubation/CPR.
4. NO MRSA OR VRE
- we have entire wards full of them since every mother's son wants "the best" you start with piptazo and escalate rapidly.. in UK i undersand you have to discuss with ID before using vanco. i give a shot of vanc to every dialysis patient with a fever. as a result patients are frequently very ill and often fungemic nowadays
5. DUMPING SYNDROME
- families going overseas for a holiday will dump their elderly relatives in EMD with non-specific symptoms (faves are: SOB, LL weakness, "functional decline"), be uncontactable for weeks, then demand that we transfer a patient to a "cheap nursing home" - wait is 6 months. "oh can we leave him there then". patient develops multiple problems - hospital acquired pneumonia/UTI/NSTEMI -> "oh it's your hospital's fault".
6. UNGRATEFUL
singaporeans are ungrateful people. "oh it's your job doctor to update me at 7pm". NO IT IS NOT. MY JOB IS TO TAKE CARE OF THE PATIENT. "oh doctor you get paid so well. please you don't understand how hard it is to take medication regularly" NO. I HAVE THOUSANDS OF PATIENTS WHO ARE ABLE TO TAKE THEIR MEDS WHEREAS YOU ARE NOT. YOU ARE THE PROBLEM, NOT ME. "i had to wait 1 hr 30 minutes to see you! i want to complain" THAT'S BECAUSE THE 30 PATIENTS THEY BOOKED INTO 15 SLOTS IN A TWO HOUR SPECIALIST CLINIC SPENT 5 MINUTES COMPLAINING TO ME ABOUT THEIR WAITING TIME TOO. IF YOU DON'T WANT TO WAIT, GO PRIVATE. OR WALK OUT.
I COULD CARRY ON...
PLEASE GUYS. JUST STAY OVERSEAS. LEAVE US TO OUR MISERABLE FATE.