Whether you are a medical student or someone who shies away from the doctor, you’ve probably wondered what it’s really like to work in the healthcare field at some point. Or perhaps you’ve questioned how true are scenes from medical dramas like Grey’s Anatomy or The Good Doctor.
Well, we’ve spoken to a few of Ramsay Sime Darby Health Care’s top specialists to gain insight into the routine and reality of working as a healthcare professional in Malaysia, particularly in the private sector. In this edition of our Ask A __ column, three experienced doctors share a day in their life, how they chose their medical specialty, and other career-related queries.
Dr Salehuddin Samsudin
Consultant Paediatrician and Neonatologist at ParkCity Medical Centre, Kuala Lumpur
Tell us briefly about yourself and what you do in the medical field.
I graduated from the University of Bristol in 1999 and continued my Paediatrics training in the UK until I became a Consultant in Paediatrics and Neonatology. I came back to Malaysia in 2012 to help establish the Paediatric Department at ParkCity Medical Centre where I treat sick children and specialise in small premature babies.
How and why did you choose your medical specialty?
I was always drawn to working with children because they are unique and amazing little people. Paediatricians are often little kids at heart and we allow that little kid inside us to guide us on how to interact with children and see the world through their perspective.
Every child is different but they are all fun to work with. Children can get very sick quite quickly, but with the right treatment, they can also recover faster than adults. Seeing them bounce back all healed and better after the treatment is extremely satisfying. When they give you high fives and hugs or cute little cards or drawings—that makes it even more worthwhile.
Walk us through a day in your typical schedule at the hospital.
Every day is slightly different. I would normally start seeing patients at the ward around 8.30am onwards and start clinic at around 9.00-9.30am. Sometimes we get called to attend emergencies in the Emergency Department or attend the delivery of a newborn baby in case a baby needs resuscitation or immediate treatment after birth. We often have meetings at around lunchtime as part of our other hospital commitments but this will have to be delayed if we are occupied with patients. Some days I have full-day clinics that could finish at around 5 or 6pm, if not earlier.
I’ll make it a point to go home for family time and come back to work in the evening or after dinner to do a second ward round. We also have to attend to patients who require specialist care 24/7—even when we are not on call sometimes. So a paediatrician’s work is never truly finished.
What do you find most challenging about your role?
Children often are unable to tell you what is wrong with them and you need to be careful and use all your available skills and expertise to ensure nothing serious has been missed. The greatest challenge is if we diagnose a child who has a terminal illness and is likely not going to survive despite medical treatment. Treating the child also involves communicating effectively with the family and helping them to gain access to the necessary professional support networks like Palliative Care Team or Hospice.
There is this notion that doctors become desensitised to death and diseases with more experience and exposure. Is this true and how do you deal with it?
It is very hard on us paediatricians—especially for those who have children of our own to deal with these situations but I am grateful that I can draw strength and spiritual guidance from my Islamic faith. To be a good doctor, one must always retain a sense of humanity and compassion. A good doctor must always keep learning and consider death as a point of spiritual and professional reflection.
Every healthcare provider should be allowed to grieve in our own way and identify if we can improve further both spiritually and professionally. Seek professional help if needed and support other colleagues. Only then can we have a meaningful and fulfilling life as a healthcare worker.
How do you cope with the challenges and parts and parcels of your job?
I count my blessings and try to keep enjoying my work. Despite any challenges or hardships, I am fortunate to enjoy what I do and grateful that I have a supportive team at home (my wife and kids) to go back to every day. To me, being a paediatrician (plus a parent) is the best job in the world!
What do you wish you knew before joining medical school or choosing your specialty?
I wish I knew that it’s not just a career but a lifetime commitment. As a medical student, it’s okay to dislike some medical specialties because it doesn’t suit you but they are all valuable gems that you will come to realise later.
Based on your expertise, do you have any advice for the public on how to take better care of their health?
Listen to your children and recognise signs of illness early. Keep their vaccinations up to date. Supplements are usually not necessary in children unless there is a clear recommendation from your paediatrician. Healthy foods and lifestyle (rather than unnecessary supplements) better contribute to a healthy childhood and beyond. Remember: children are our future.
Dr Thamarai Velan
Consultant General & Hepatobiliary Surgeon at Bukit Tinggi Medical Centre (BTMC)
Tell us briefly about yourself and what you do in the medical field.
After graduating from medical college, I obtained a master’s degree in General Surgery, followed by a fellowship in Hepatopancreatobiliary (HPB). I worked as a consultant HPB surgeon in several public hospitals before joining the private sector.
My HPB sub-specialty is focused on treating diseases or conditions related to the liver, gallbladder and pancreas. General surgical conditions like appendicitis, colorectal cancers/diseases, hernias, haemorrhoidal diseases, thyroid and breast diseases also come under my general surgical domain. Even though I am sub-specialised in HPB, I also treat general surgical cases.
How and why did you choose your medical specialty?
I believe it is a noble profession that helps to alleviate pain and suffering of patients and families. Most importantly, it gives me great pleasure to help and treat a fellow human being. No other profession has this unique quality of caring for others as the medical field does. I have always been very passionate about giving and caring for others, a trait that I carried from my dearest parents and their upbringing.
Walk us through a day in your typical schedule at the hospital.
I usually start my day at 8am, when I will first review in-patients through my desktop at the clinic, taking notes of their latest investigation results (blood test and imaging) and noting their progress in the wards. Thereafter, I start my morning rounds—assessing the patients clinically and deciding on the next course of action. If they need surgery or endoscopy, it has to be scheduled or referred to other specialties if needed.
After completing ward rounds, I usually go to the doctor’s lounge for a short coffee break before starting my morning clinics. In the morning, I would often see roughly about five to eight patients, including those with appointments and walk-ins. If I have surgeries or endoscopic procedures scheduled for the day, it would be mostly done in the morning or just after my morning session.
Later in the evening, I resume my afternoon clinic from about 2pm until 5pm. Thereafter, my evening ward round follows, whereby I take note of patients’ progress for the day, report on any new emerging issues and arrange for appropriate plans to be carried out. Elective surgeries or endoscopic procedures will also be scheduled for the next day. Every four weeks, I will also have on-call duty to cover for any surgical emergencies that are presented or brought to the hospital.
What do you find most challenging about your role?
What challenges me the most as a surgeon is arriving at an accurate surgical diagnosis, after a thorough clinical history from patients, examination, reviewing biochemical and imaging results and executing the most appropriate treatment plan to the patient so that I can give the best treatment and help them to lead a quality of life.
There is this notion that doctors become desensitised to death and diseases with more experience and exposure. Is this true and how do you deal with it?
In my perspective, this is a very subjective question of one’s own experience. I have worked in the healthcare system for 26 years and learned to accept death as an inevitable part of life. However, being at the forefront of saving people’s lives, I do my level best and give the best possible professional help medically in terms of providing treatment, care and improving patient’s quality of life.
At the end of the day, doctors are humans too, so we have to learn how to cope with a patient’s death. Rather than feeling desensitised to death and suffering, I would prefer to say that I have learned ways to overcome it with much less emotion attached to it.
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How do you cope with the challenges and parts and parcels of your job?
In challenging and complex cases, I have the propensity to discuss them with my colleagues and get their input to arrive at a treatment option. Ultimately, what is most important is teamwork when facing complex surgical cases. This is to enhance the delivery of a safe and accurate treatment plan and avoid any adverse events that could potentially be harmful to the patient.
What do you wish you knew before joining medical school or choosing your speciality?
The work-related challenges that I/we often face at times can be mentally and physically exhausting in nature. Also, the increasing medico-legal implications, as well as unreasonable expectations from patients and families when dealing with medical/ surgical conditions beyond the doctors control despite the best optimal treatment provided.
Based on your expertise, do you have any advice for the public on how to take better care of their health?
It is important to develop a habit of practising a healthy lifestyle and enjoying everything that life
has to offer in moderation. This includes eating a balanced diet, maintaining a healthy weight, exercising daily or at least three times a week, and getting good sleep. Living life in moderation gives better and greater satisfaction, as anything in excess is often detrimental to our health.
Dr Zubin Othman
Consultant Cardiologist and Physician at Ara Damansara Medical Centre (ADMC)
Tell us briefly about yourself and what you do in the medical field.
I graduated from Otago University in 2000 and I’ve been working predominantly in cardiology since 2010. As a consultant cardiologist, my main job is to prevent and treat conditions related to the heart and circulation. As my subspecialty is in interventional cardiology, I may have to bring patients to the cardiac catheterisation lab to perform invasive procedures like coronary angiography, emergency coronary angioplasty, or stenting during a heart attack.
How and why did you choose your medical specialty?
Ever since entering medical school, I have been fascinated with the heart, and the intricacies in its design and function. Later on in my clinical (practical) years, time spent in the Cardiac Care Units seeing sick patients and their ability to get better with treatment and the occasional heroic procedures certainly consolidated my interest.
Walk us through a day in your typical schedule at the hospital.
After a good breakfast washed down with a triple espresso, I would review my patients in the ward before heading to the clinic to see my listed patients. Throughout the day, there will be referrals from other doctors and emergencies that develop in the OT, ICU or new cardiac patients who arrive in the emergency unit. I may also have elective procedures lined up at the catheterisation lab. Once a week, I would head to the cardiac unit in UiTM Sg Buloh to perform my role as a visiting cardiologist. My main role there is supervising young cardiologists with their invasive cardiac procedures.
What do you find most challenging about your role?
An ongoing challenge is facing the patient together with their family in situations where the heart is not able to be ‘fixed’ or treated. This is usually in the event of end-stage heart failure, or in the event of a catastrophic heart attack. An example that I clearly remember is during my early stage of cardiology training, when I had to tell a teenage girl that her heart was failing rapidly due to a congenital condition that sadly, could not be treated.
There is this notion that doctors become desensitised to death and diseases with more experience and exposure. Is this true and how do you deal with it?
It is partially true, and many factors determine the degree of desensitisation. It is then important to understand, that some degree of desensitisation within the boundaries of ethics and culture is required, as it enables the doctor to perform important tasks with clear clinical direction. An extreme example of what you don’t want to see is a doctor breaking down each time he tries to take a blood sample from a child. However, a robotic doctor would then not be pleasant to deal with in situations which require tact and clear empathy.
How do you cope with the challenges and parts and parcels of your job?
Your family, friends and colleagues are your support crew who are irreplaceable. I feel the ongoing drive to serve patients, even when things look helpless, combined with the faith that you have, puts you in a safe place as a doctor.
What do you wish you knew before joining medical school or choosing your specialty?
Good question. I wish I was taught about how to manage my time, finances, crises intervention, and how to deal with administration types. We may have been taught all of this, but it was possibly a lecture or group tutorial which I did not attend.
Based on your expertise, do you have any advice for the public on how to take better care of their health?
Look for balance in life, and work as hard as you can whilst thinking about others who rely on your well-being. Spend effort looking after your mental and spiritual health as much as your physical. Learn a sport that you can enjoy until you grow old; exercise as much and safely as possible, especially if you don’t work in a highly physical occupation. Eat a balanced diet with food that looks like real food. Stop smoking if you do, and don’t start smoking if you don’t.
For more Ask A __ stories, click here.
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