This career we call medicine has so many taboos, so many topics everyone seems to avoid talking about.

Like how much we’re really making. Or how to move up the career ladder. Like private practice, emphasis on the private. Or pension schemes and permanent appointments. Like opportunities for postgraduate study. Or the nepotism this country wears like a second skin.

When we get together as a group we’re always talking about wacky patients, the dire lack of resources, horrible bosses or survival stories. Advice is limited to clinical discussions, and a lot of the mid-career medical professionals seem too busy trying to further their careers to steer a junior down the right path.

In the ‘glory days’, medicine was an apprenticeship. Younger doctors worked closely with their older counterparts, learning everything they had to teach about the human condition (medical and social). At the same time, medicine was a lot more paternalistic with physicians adopting an almost godlike role in society. So some change is for the better. But now most doctors play their cards close to the vest, for some reason reluctant to share their hard-earned wisdom.

It’s true that the world of medicine is significantly more competitive now than it was fifty years ago. You can’t throw a stone in Montego Bay without hitting a doctor’s office (some charging a measly $1000 (USD$7) for visits). While medical schools continue to graduate hundreds of hungry indebted interns every year. In Jamaica where everybody haffi eat a food the stiff competition breeds contempt and secrecy, jealousy and sabotage.

But to what end?

The crab in a barrel mentality of stepping on a brother just so you can move up a scant centimetre on the socioeconomic scale is not going to work in the long run. Resources and opportunities shouldn’t be so scarce that we have to fight to the death for them. Information ought to be shared equally, not bottled up and parceled out to a privileged few. Younger doctors should not be forced to reinvent the wheel when there is a wealth of experience available for tapping in to.

We’re told, work hard and you will be rewarded. We’re told, if you want good yu nose haffi run. We’re told, I went through the struggle now it’s your turn. No support, very little encouragement, and everyone more tight-lipped about career advice than a gang of Sicilian mobsters.

Maybe I’m too young, too idealistic, too millennial to simply fit right in as another cog in the nepotistic hamster wheel of capitalism that Jamaica seems stuck on. Either I’ll find a way to make the system work for me, or get flung violently off the ride like the broken ill-fitting piece of machinery I really am.

Only time will tell.