Doctoring is a calling, but there can be times when medical personnel feel called to another mission or direction amid their journey. What happens then? Here, SMA News features four authors who have generously shared their journeys as well as advice for others who may be facing such a dilemma in life.
Yau Teng Yan
I have always had a deep interest in healthcare. Looking back, I was highly inspired by my father, a doctor who is still practising. I remember vividly when I first told him that I was going to apply for medical school. He asked if I was absolutely sure about it and whether I would rather consider other career options, and shared that medicine was a very challenging path. As a teenager I was stubborn of course and stuck to my decision. I have no regrets that I did.
After housemanship, I spent a good part of my six years working in the field of diagnostic radiology. Radiology was intellectually stimulating investigative work and it was nice to be at the cutting edge of technology to support clinical diagnoses. But there came a point where I felt I wanted more. I wanted to be able to positively impact more people, and was frustrated that I was not able to scale my time up to do so. My impact was limited to the number of patients I could see (or number of CT scans I could read) a day.
This led me to go on a year-long break from clinical medicine, which has since extended to almost six years. Together with my partner Nawal, we started a healthcare technology company five years ago where we are building the world's largest real-world evidence platform for neuroscience and chronic diseases – to accelerate research and development in new therapeutics for various disease areas, including depression, schizophrenia and diabetes.
I did not realise it at that time, but I was driven by a personal vision. A vision to use my skills and expertise in a unique way to bring different people together to solve complex healthcare problems. My current work is very cross-functional. I still use my clinical knowledge to guide our teams – to ensure that the work we do and products we create are grounded in medical science and are relevant to the various stakeholders, especially clinicians. But a larger part of my work now involves skills that I was not taught specifically in medical school – building and managing teams of people, operational management, strategic thinking and planning, and making business presentations and pitches. It was (and still is) a steep learning curve and there are constantly new things to learn which keeps me excited and growing.
The skills and experiences I picked up from medical training have helped me immensely in this career detour. Medical training provided me with various mental models to use when approaching difficult problems – to be systematic and analytical. Ambiguous business problems can be approached in the same way as we doctors approach a diagnostic problem of a patient with fever of unknown origin or abdominal pain – do a good history and examination, conduct relevant investigations (gather data), come up with a list of differential diagnoses (probability analysis), treat, and consider other diagnoses if the patient does not respond (adaptability).
Another important thing I have taken away from medical training is the ability to work and perform in highly stressful situations. As doctors, we have all had to go through years of working long irregular hours, rigorous training and multiple code blues on a bad night call. This builds in us an inner resilience, a perseverance which I greatly appreciate. It lends us confidence to handle difficult situations outside of the hospital. Few things can be more stressful than a patient collapsing on you unexpectedly, and everything else seems relatively minor compared to that!
Lee Guo Rui
In my free time, I occasionally sit back to reminisce the journey that I have embarked upon when I entered medical school 17 years ago. What first started as a passion for the art of medical practice evolved over the years into a love for the ever-advancing frontiers of medical technology.
Venturing beyond my comfort zone
Three years into my residency training with the department of radiology, I was presented an opportunity at managing general practice clinics in the capacity of a medical director. Having nestled comfortably for over seven years in the restructured hospitals, it was a tough choice between the pursuit of cutting-edge diagnostic technology and the chance to run my own business, attending to the concerns of patients who come through my clinic as well as managing the day-to-day operations. I am now thankful I chose the latter.
Over the span of 18 months, a close-knit team of doctors and founders grew the group from three clinics to a chain of 12, allowing me to hone my skills in business management. It was at that point I was offered a chance to take a dive into the fast-paced world of telemedicine and set up a practice of my own.
Telemedicine and last-mile solutions for health screening were novel ideas in 2017. These new operational concepts enabled GPs to consult patients via a telemedicine application, enabling the dispensation of electronic medical certificates and delivery of medications to the patients. Mobile phlebotomists could be scheduled to perform home- and office-based health screenings at the convenience of patients. Follow-ups could then be made via video consultation. This allowed clinic owners to open longer hours, tapping on a pool of doctors to cover them remotely and also extend their reach to patients across the island!
While I was eager to spring into action, I was also filled with nervousness from challenges that faced my team. Introducing these modules into unchartered waters and applying for the regulatory sandbox was daunting enough, let alone the responsibility of designing a viable business model to fulfil my duties to the company.
Embracing change
The journey from conceptualisation to the execution of my "hybrid clinics" and "nurses on wheels" model was fraught with unexpected turns and surprises. Through this, I understood the regulatory processes better and made a vast network of like-minded individuals from all walks of life. I even had the opportunity to integrate a telemedicine-enabled chronic disease management programme into a life insurance plan offered by a leading insurance brand.
Once again, I have embarked on yet another exciting new path, introducing a novel holistic step-down care model for pre- and postnatal ladies. Carefully extracting the essence of seasoned specialists in the fields of medicine, nursing, dietetics, hospitality and gastronomy, my team has set out to blend age-old traditions of confinement with outcome-driven practice, offering peace of mind to parents and grandparents alike so they can truly savour the joy of welcoming a new life into their family.
My training from medical school and radiology has definitely given me an edge in managing my projects, allowing my core offering to always revolve around the provision of excellent and holistic patient care.
Dr Zubin J Daruwalla
Which stage of your medical journey were you at when you made the decision to depart from medicine? What changed your mind?
I left my full – time job in the Department of Orthopaedic Surgery at the National University Hospital almost four years ago in July 2016. At the time that I left, I was going into my final Accreditation Council for Graduate Medical Education accredited year of the NUH Orthopaedic Residency programme and had already been awarded the degrees of MCh (Orthopaedics) and MMed (Orthopaedics) by the Royal College of Surgeons in Ireland and the National University of Singapore, respectively.
Several reasons existed for my decision to leave. First and foremost, I have a creative and innovative mindset, with many of my friends and colleagues referring to me as a healthcare futurist. What I soon realised however, was that this was often frowned upon by many (at the time) who did not believe in what I did – that we needed to rethink the future of healthcare and health industries. We needed to work towards allowing technology to complement rather than replace our clinical practices. In the private sector however, locally as well as globally, things had already started to evolve.
Why did you decide to enter your current vocation/field?
During my residency, I became a Clinical Ambassador to Singapore's first digital health platform, MyDoc, which subsequently triggered my passion in digital health. Over time, learning more about healthcare technology and how it was transforming patient care for the better only got me more excited. This pull factor, in combination with the push factor of several policy changes continually shifting the goalposts of residency programmes in Singapore, made me actively explore alternative career options that would provide me opportunities to make a difference while maintaining some form of clinical practice. During the year-long exploration, I saw examples of the bigger differences I could make outside the system, at a population level. This really sealed the deal for me.
Ultimately, I accepted an offer where I had the opportunity to build and grow PwC's Health Industries practice in Singapore and Southeast Asia.
What advice would you offer to someone considering a non-medical path for themselves?
They say hindsight is twenty-twenty. Switching careers is daunting, especially as practising clinicians. Advice I would give all my doctor friends and colleagues considering a switch in their careers to a non-medical one would be:
- Think long and hard on the career switch you are considering. The grass is not always greener on the other side and all that glitters is definitely not gold. Why are you looking to leave? What are the push and pull factors? Be objective and think things through.
- Spend time exploring the options. Do your homework and understand what the jobs actually entail and whether you have the right skillset(s) for them. Speak to people in similar organisations and roles that you are considering to get a better grasp and understanding of things.
- Do not expect to parachute into a senior position just because you are a doctor. The extent of the advantages of being a doctor is dependent on the organisation and role, as well as whether your clinical insights and experience actually add value.
- Decide if you want to give up clinical practice completely. This is very important because many organisations and roles may or may not be able to cater to this.
- Look for a boss, not a job. This is something I would say applies to all jobs and industries. Find a coach, a mentor. A good one.
- Dream big and do not let anything anyone says or does hold you down. In the words of William Arthur Ward, "If you can imagine it, you can achieve it. If you can dream it, you can become it."
Ethan Seow
Which stage of your medical journey were you at when you made the decision to depart from medicine? What changed your mind?
I spent five years in medical school followed by two years on a leave of absence, when I ran my own business and worked part-time as a musician. I was prepared to return to school, but as I was about to go in for an extra month before school started, I realised I could not do it anymore.
I entered medical school because of psychiatry; I had fallen in love with it as a teenager. I was passionate about mental health, psychology and psychiatry because of my affinity with people with various mental illnesses. I would often support and guide them through their toughest times and I wanted to do that in psychiatry.
However, returning to medical school reminded me of the gruelling hours, inability to connect with patients because of the rigours of the career, and conversations I had with doctors who burnt out along the way because reality and expectations did not match. I saw myself in the burnt-out doctors and realised I did not want to be one of them.
Of course, it would have been nice to say that I persevered, but the five years in medical school already took a toll on me and drove me to depression. When I realised that I did not have the capacity to maintain that passion in me, I left. It has since led me to who I am today, which I would honestly say I'm proud of.
Why did you decide to enter your current vocation/field?
My current work is an extension of my love for mental health. Since I left medical school, I focused on building educational and people-centric businesses that better mental and emotional wellness. Whether it was through music, education, technology or business, my goal was to improve the lives I've touched.
I founded my company two years ago to target psychosocial problems in the workplace and found us focusing on the fundamentals of the problems – culture. That was how I found myself starting a new project to help people with office politics.
One of the biggest gifts from medical school was the ability to think algorithmically about challenges and problems. The diagnostic methodologies that I gained from my days in medical school helped me tremendously in being laser-focused on finding problems in the company culture.
Today, I empower people to rise above office politics through my platform The Office Matters, while consulting for companies to develop cultures of trust, initiative and collaboration.
What advice would you offer to someone considering a non-medical path for themselves?
Here is my advice that doesn't look like advice (just like what a therapist should do).
The most important question I asked myself was "who do you want to be when you're 30?" To leave medical school is tremendously difficult because of the social, emotional and financial sacrifice it would take. But if you look at who you want to be in five to six years' time, you would know what the right choice is – whether medical or not.