Yesterday I got quite angry. Very angry. I’m frustrated because medicine has had me chasing goals that move an inch forward every time I come close to them.

First medical school, then internship for registration. But then I realised that you need two years clinical experience for almost any job or specialty. So I completed that, but now as of the year I completed most specialties have changed their requirements to ask for three years clinical experience before applying.

Now you also need to have completed a Master degree for most.

I got into GP training, and the original requirement was two years in the hospital plus certain terms – medical, surgical, paediatric, emergency.

My lacking term was paediatrics, so I enrolled in a diploma of child health which, originally a few years ago was enough to get through.

Now that’s not enough anymore. Plus as of October last year, you need to have extra paperwork done as well.

Then, I was told that the various rotations I had done may not be counted, such as night shifts covering the hospital and intensive care. Because they’re not applicable to GP apparently.

I was told I may need to go back to hospital.

This is after getting through the GP applications, entrance exam, and interviews. I got my first preference and was given a spot in the college, yet my introduction interview was not very supportive or positive. Basically it pointed out all the things that I lacked for going ahead, and that it wasn’t enough.

When I raised the fact that a lot of the extra requirements seem new to me, they responded that “it’s meant to be hard”.

I was also told that of my two years of training, I’ll need to spend one year working in a region completely outside of the city I’m in. It’s not a huge deal maybe, but for me it’s just making me think more and more, why am I even doing this? I’ll need to relocate my family for it, and for what?

When is enough enough?

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What am I still doing?

Theoretically, yes I could file this extra paperwork. It’s a few months of effort to get accepted completely and have my prior learning approved.

Actually, I believe they would accept me, because the amount of GP applicants has dropped drastically. No one wants to do it. Why? Because GP is a lot of responsibility. You see undifferentiated people and often don’t have adequate support. There’s a lot of uncertainty, plus you get paid a fraction of what you get as a much more junior position with way less stress. Other doctors look down on GPs, the general public make fun of them, you get called ‘lazy’ or ‘straight out of med school’ even if it took you five years to get there.

GPs are also one of the most sued specialties.

On top of this, you’re limited to 15 minute consults to say hello, get to know someone, and figure out everything going on with their health.

There’s little time and you’re pressured to see as many patients as you can, as it’s fee for service.

Fee for service: payment for providing individual services.

Capitation: flat amount per patient per month for all services received within clinic.

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Less about the medicine, more about the billing and litigation

Increasingly, I’m seeing medicine become less about the patient and medicine itself. It’s more and more about the billing codes, item numbers and mitigating litigation.

A true conveyor belt of see as many patients as possible in x amount of time. For me, it doesn’t feel like I’m really helping anybody.

The benefits seem to be reducing while everything else gets harder

As the specialties make their requirements increasingly more exacting, I think back to how most GPs currently graduated from medical school and went straight to GP.

In the “old days” you graduated with an unrestricted provider number, and could be a GP straight off the bat. I don’t condone that, but now I feel these very same people are creating new rules for us every few months.

It’s not just GP, it’s every specialty.

When you’re making sure you meet the goal post straight up ahead, and reach that point to find it’s now miles away. What do you do?

What if you have nothing more left to give?

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Nothing more in me

I’ve realised that while I can file the paper work, I really don’t have it in me to fight that battle anymore.

For starters, I don’t even want to do it.

Which is a slight barrier to starting a training program that on all accounts is very demanding.

My supervisor advised that I can ‘just do another hospital term’ if I wanted, to definitely meet the new requirements, but what he doesn’t understand is I really cannot. Physically, mentally, emotionally, I cannot go back to a hospital. It broke me, and it may sound dramatic to some, but I was rock bottom. I don’t want to feel like that ever again.

GP training seemed like a good idea for me to do, to finally become a specialist, but I’m doing it for the wrong reasons. I don’t want to be a GP. I just want to have a specialty, to prove to others that I can do it.

Okay, I got in, I’m about to start in a few months. But it’s not what I want to do. I even asked if I can defer starting, you used to be able to. But now not anymore. Another change.

I really think that I’d rather do anything but medicine currently. I know what I actually would like to do, and it’s time to pursue this. Medicine is just not for me. Yet I’m scared, very scared to close that chapter so soon. As a junior doc. But if not now, when will I do it?