Merry Christmas to all, and to all a good night

It’s the season of giving, also the season of receiving, marked by our usual rampant consumerism. Traffic and cashier lines lengthen as we scramble to find the perfect presents, decorations and baking supplies. The festive season is more frustrating than celebratory. Isn’t that right, Mr. Grinch?

But as little Cindy-Lou Who reminds us, Christmas is more than just packages, boxes and bags. In the spirit of the holiday I want to share ten things I’m grateful for in this maddening season.

1. Despite the upward spike in crime in St. James my family and I have so far been spared from any direct attacks of gun violence.

2. I can afford to by Christmas presents for the people in my life. Just a few years ago, I would never have been able to.

3. Barbados and a few other Caribbean countries voted against Trump’s Jerusalem agenda in the UN referendum. They give me hope.

4. Technology helps me stay in touch with friends who are travelling the world. Kind of like if the Wise Men had Skype and Amazon Prime.

5. Even though I don’t own a car, I have unrestricted access to one. And even though it isn’t perfect, it’s never left me stranded.

6. 2017 was a year of plenty forward momentum in my career. I am grateful that I continue to grow and learn so much as a primary care physician.

7. Christmas breeze ah blow! I am very grateful for my water heater that saves my toes from frostbite.

8. I recently got an oven and I look forward to brushing off my rusty baking skills. I am grateful for the promise of Christmas cookies.

9. A lot of people I know have to work this Christmas, especially at the hospital. I’m grateful that my Christmas holiday involves staying home, sipping tea and petting my cat.

10. These candles are making my house smell like warm cozy Christmas nights, and I love it.

What are you grateful for at this time of year?

Reflections and Re-purposing

It’s officially a year since I left hospital medicine and ventured into the clinics and primary care. Like Lot’s daughters I never looked back to watch the world I once lived in burn, almost literally. I’ve wholeheartedly embraced this strange new territory and I’m coming to think of it as my home.

There’s a lot going on with primary care in Jamaica. One news story just a few months ago reported on the high level of dissatisfaction patients have with the way service is delivered. Primary care is plagued by low resources, for a number of unfortunate reasons. And primary care as a system is badly fragmented. There are many gaps in this new world.

When I walked sprinted out of secondary care I did it with a vow in my heart: I would try as hard as I could to prevent the untimely deaths and strokes and heart attacks that were caused by manageable chronic diseases. I was eager, I was willing and I was hopelessly naive. Stepping into clinic was like being splashed in the face with cold water; determination would only take me so far, about as far as the burnt out bridges of patient behaviour and system capacity. My sprint slowed when I realized this could not be the only direction I expended my efforts in. I needed to study the system to understand how to improve it.

So I began to learn, as much as I could and as often as anyone would let me. I didn’t just start to learn about holistic patient care, I started reaching for every training session that passed my way. The closer I got to the source, meaning the Ministry of Health, the more I was able to identify the gaps between protocol and reality. We play a hard-core game of Chinese telephone with our standards that usually ends with the front-line health care worker simply doing the best they can with what they have. This system was a mystery I was determined to unravel, and that curiosity illuminated an unexpected career goal.

I love organization. I love rules and protocols and standards and guidelines. It tickles my fancy to improve system efficiency, to find innovative and easier methods to meet goals and targets. And as it turns out, all those things that people in high school called me weird for liking are actually super important to the world of work. Those skills and interests can translate into actual jobs, with the right qualifications to back them up.

So it seems that after all these years of worry about a loveless career I am now falling, stumbling, eagerly crawling toward a purpose that resonates with my own ‘weird’ frequency. Hurrah.

If It’s Monday this must be Lucea

You might be wondering where I’ve been and what the hell I’ve been up to. I’ve been wondering that myself. My absence from this space hasn’t so much been a lack of things to talk about as feelings of uncertainty “am I allowed to talk about that?”. I will say that the confidential nature of my job isn’t exactly conducive to a personal blog, especially when most of the things I want to talk about are not always ‘fitting’ for ‘doctors’ to talk about, and I feel like my insignificant opinions carry more weight now. Self-censorship is hard to get over.

But I’m back. Because I feel as if I will burst if I do not write or yell something into the void. More catharsis than infomercial, this writing for me is therapeutic and I ask that you allow me the space to untangle my wrapped-up tied-up experiences.

My life these days is a delicate balance of work and school and relationships. Adulthood has a lot to do with balance, and I tend to measure my success as an adult by how well or how poorly I keep all these balls in the air. (Spoiler alert: I do not juggle well).

Moving up the career ladder from Senior House Officer to Medical Officer came with a new batch of responsibilities. This might seem logical to you, but I was wholly unprepared for later working hours, deadlines, reports and programme coordination; getting a new clinic off the ground, meetings with international stakeholders and the subsuming world of regional politics. It’s more than a mouthful, but it’s work that I’m excited about: making an impact on patients’ lives, experiencing infrastructural issues firsthand, being in a position to effect change, however minimal. I feel like I’m laying the foundations for the rest of my career so even though the building blocks might be heavy this groundwork will pave the way for something glorious. I hope.

In the same breath, I have been lucky enough to get a scholarship for an online Diploma programme taught by UWI St. Augustine. It’s a year long programme in the Clinical Management of HIV (an area I have grown very attached to) and I am in month two. I am discovering never before seen time management skills. They’re still new, like a foal on wobbly legs, but I haven’t missed a deadline yet which means progress. Yay, personal growth.

But like any of those ‘pick two’ triangles, one side just can’t seem to fit in with the rest.

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My grandmother likes to complain about, among other things, the way I seem to be too busy to spend time with her. To my credit as a granddaughter I only screen about 10% of her calls and I see her almost weekly but I’ve noticed that parents and grandparents get more sentimental as they get older. I also missed my best friend’s birthday because I forgot to account for time zone differences and I haven’t seen my other close friend in months because of our crazy schedules (she’s a new mom and I work in a different parish). The point is that balance gets harder as you get older, and if like me you didn’t have much practice before it will take a lot of stretching to get it right.

I’m not including moving house and furnishing a new apartment, keeping my cat happy, maintaining a healthy relationship with my partner, trying not to kill the houseplants or my second and third jobs in the hospital and elsewhere because that’s another mouthful. It gets stressful and frustrating and I’m constantly questioning whether I’m making the right choices. Sometimes it’s hard to tell, especially with all the background noise of the rest of the country and the wider world. Violence, bullying and bigotry seem to be run of the mill these days but I still have to follow through on the paths I choose to tread.

Of course there are times when I drop the ball, when I miss the mark for perfect daughter/partner/colleague, times when I have to say no for my sanity instead of saying yes for a million other reasons and the negative self-talk threatens to drown me in tears. But I am learning that adulthood, at least for me, means walking on these wobbly legs until I’m strong enough to gallop in the direction of my dreams.

 

Unlearn: Self-Love is Paramount

Often as children in Jamaica we are not taught to love ourselves. The prevailing mindset is that children should be seen and not heard, displays of emotion are frowned upon (worse if you’re a boy) and the needs or wants of a child in a family with many older members are usually overlooked.

Contrast the technicolor televised images of my childhood where Foreign children are raised with so much self confidence it seems like entitlement, where people are consoled when they cry and where parents/extended family seem attuned to the emotional needs of the younger relatives.

Because I had the privilege to be exposed to this alternate experience of childhood, I was aware that the way we do things here is not necessarily the best way. I also had the opportunity to observe the difference in outcomes when children are raised in a loving and nurturing home instead of a yard where every man is for himself, and I remain convinced that the way we parent in this country is largely responsible for the way we deal with the deeper problems that plague our society.

But why is this relevant.

Most of the time I write because I hope that something in my words will resonate with the right person at the right time. Hoping the current of the universe will push this cobbled craft to the person who needs it when they need it most. A lot my posts start their lives as ‘what I wish someone had told me’ and I’m vain enough to believe that if I needed to hear this, then someone else does too.

So this is relevant because we need to be reminded that it is okay to love yourself. The lessons I learnt growing up as a child in Montego Bay (bloodthirsty and falsely cheerful Montego Bay) are lessons I had to unlearn as an adolescent (and which I’m still unlearning as an adult): sadness, disappointment and insecurity are not things to be ashamed of. Wanting affection, support and stability is not a sign of weakness.

Lessons I am working hard to teach myself are exercises in self-care, developing my psyche and feeding my soul. Giving myself permission to make mistakes, backtrack and be better than I was. I’m being deliberately vague because this process is different for everyone, and in the various stages of your life self-care means different things.

But everyone should start from a position of unconditional positive regard for who they are. There will be aspects of yourself that you think are flawed and fucked up, there will be voices in your head with many negative comments (likely honed from a lifetime of hearing  those comments out loud) but the first step is to open your arms and love yourself.

It is okay to love yourself; it’s actually a good thing. It doesn’t mean you’re prideful or you won’t get into heaven; it doesn’t mean you’re conceited or you think you’re better than people. And newsflash: negating your self-worth will not make people like you more. The sooner you learn this the better.

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Oh, Say it Ain’t ZOSO

The latest buzzword in the Jamaica crime scene is these Zones of Special Operations (ZOSO). ZOSO is an Act recently passed by Parliament which allows for the use of “special measures” to uphold public law within “certain geographically defined locations”.

At face value this Act sounds like an Act of Discrimination, like the Prime Minister is giving the security forces full permission to kick down people door and mash up dem tings, but only within specifically designated areas of course (aka ghettos). But according to the Jamaica Gleaner, the Bill is trying to balance the need for extreme measures in the battle against crime and violence with the fundamental need for the protection of citizens’ rights.

On September 1 the PM declared Mt. Salem, St. James the very first ZOSO. Acting on information that was later challenged by residents of the community (backed up by the Councillor for the area), Mr. Holness may well have moved somewhat rashly. But despite the less-than-sinister statistics, Mt. Salem is still perceived as a tension-driven melting pot of criminal activity. Driving through that community just last week I heard one woman cussing another spit menacingly, “You feel seh ah you one know gunman!”

So there is no question about the need for increased police attention, even with a police station already on the main road. What I do feel needs to be questioned is the approach to the citizens on the left and right sides of the Mt. Salem main road. And yes, I’m talking about a literal representation of the ubiquitous class divide.

After you pass the hospital, on the left hand side going into Salem the side streets display large, well-painted two and three storey houses. There are garages with cars, the houses are populated by a mainly middle-aged and retired set of citizens, and the streets themselves are paved (for the most part) and wide enough to accommodate two lanes of traffic.

Flip the script, and observe the right hand side of streets. They are narrow and winding, descending sharply into one way lanes and dead ends. There are two and three storey concrete structures at the intersection yes, but as you advance further along, there are more board houses, less space for cars to fit and a dramatic increase in shady characters lurking on street corners. Some taxis don’t even carry people here.

Obviously infrastructural problems have played a huge role in this divide, and real estate prices drive people left and right as their pocketbooks allow but my real contention is that there are two very different classes of citizens living in Mt. Salem and my concern is that one set will end up with the “special measures” while the other enjoys the “protection of citizens’ rights”. So far I haven’t heard anyone cry foul (quite the opposite) but in these cases the voices of the downtrodden rarely make it past the streets where they are stepped on.

What ZOSO excels at is highlighting the blurred geographical lines of Jamaica’s class divide. It is a truth universally acknowledged that beside every uptown is a ghetto: Ironshore has Flankers, Westgate Hills has Mt. Salem, Mango Walk has Paradise and Norwood. . . The list goes on, and this is just in St. James. But as time has progressed, social climbers (including scammers) have managed to straddle these communities and erase the demarcations. ZOSO is a potent and pointed reminder that “ghetto people” are considered criminals before they even open their mouths. Reminds me of that Etana song.

Ultimately, I don’t think ZOSO will be an effective crime-fighting strategy. It is too much of an acute solution to a long term problem, too much of treating the symptom and not the disease.

Man goes to the doctor and says Doc, I have these headaches. Doctor says, Take these painkillers. Man dies of a brain tumour*.

What have we learnt?

Crime and violence in our society is directly related to our social infrastructure: education, employment and parenting, underlined by systemic political and judicial corruption. Opportunities for legitimate engagement are scarce while guns are plenty and every little boy is raised to be ‘tough’. Legal jobs grant you enviable social standing but it’s the under the table stuff that sends your kids to offshore schools. This culture is entrenched and serves far too many powerful people for it to be overturned overnight.

But that doesn’t say we can’t try.

In his Letter to the Editor, Dr. Canute Thompson expounds on the theory that attacking these root causes will ensure a sustainable decrease in crime statistics. He lays out an innovative approach to community development involving skills training and infrastructural reform. Granted it raises a whole new set of questions, but it’s a solution that just might make Jamaica the place of choice to live, work, raise families and do business.

–*–

*I am compelled to disclaim that headaches are not usually the presenting symptom of a brain tumour. Not every headache needs a CT scan. The point is that you need to rule out a more serious problem. /medic

House-Hunting in Mobay: Part Deux

If you haven’t already, start with Part One here!

Now that you have your game plan, it’s time to dive into the apartment search. But where do you even start?

Scour rental ads in the newspaper classifieds

Western Jamaica, the Mirror is your new best friend. With three publications per week, the Western Mirror is replete with ads from landlords all over St. James, Hanover and Trelawny looking for prospective tenants. Some days (like Wednesdays and Fridays) and some months (like September/January) carry more listings than average. So grab that red pen and start circling because these apartments and homes move faster than Time and Patience bread.

Don’t be afraid to look online

In the beginning I was skeptical about finding a place to live online in Jamaica, let alone Montego Bay. But the top real estate companies have outdone themselves, and the online offerings from the websites of Coldwell Bankers, Victor Brown & Associates, Century 21, and Hoshing Realtors among others are usually quite extensive. Just make sure to sort by price from ‘low’ to ‘high’.

Keep your eyes peeled

Bulletin boards and notice boards are usually filled with boring ads and weird services but it’s possible to find a gem underneath all the irrelevant papers. I found my first apartment in Mobay on a bulletin board at work – very lucky!

Call and/or talk to people

Word of mouth is one of the best ways to find a new home. Put your social media to good use and crowd-source some apartment or house options. Chances are someone in your friend group knows someone who knows someone who can hook you up. Whatsapp groups can be invaluable in this respect – if the group is somewhat professional members will sometimes share helpful information like rental offerings.

Think slow but move fast

Because listings can appear and disappear in less than 24 hours, it can be tempting to make snap decisions just to secure a spot. But this is generally impractical (especially if you’re house-hunting for more than) and will almost always lead to regret. I often hear stories about tenants who stay for just a few months then pack up and leave because the rent was too high, or the situation was inconvenient.

If there’s no penalty for breaking your rental agreement (which usually lasts at least a year) and if you love the hassle and stress of moving then apartment hopping might be just up your alley. For the rest of us who plan to remain stationary for a year or so, it pays to look twice before you leap. If your current situation is uncomfortable but not life-threatening (whether your life or the life of the landlord who you want to murder) it can be more beneficial to stay put until something that fits your needs comes along.

Having said all of that, as much as I love house-hunting and living on my own (with partner and cat in tow), I understand that we’re all at different stages. I’ve been lucky enough to have a job that lets me live where I want to live, and still put food on the table. (not Mango Walk Country Club money but I really can’t complain). I’ve also been lucky to have a partner who shares the financial burden. I’ve been lucky to find places to live that I have enjoyed, rented by people who were actually kind, if not 100% reliable.

You might have worse luck or you might have it better, but since luck is when preparation meets opportunity I hope these posts help you to prepare for whatever living opportunity comes your way.

Pax.

House-Hunting: the Mobay Edition

Finding somewhere to live is hard, whether you’re in university, freshly graduated or bouncing around with three kids and a stable career. Fortunately or unfortunately house hunting is something I love to do (is that weird? It’s probably weird), and I’ve picked up a few lessons over the years that I think can be useful to my fellow 20-something Montegonians (all five of you who read this blog, if so much).

I only hope that this two-part series will make wading into the waters of independent living a little less scary, and that it will be a guidepost along a path that can be confusing and muddled. If it’s not time for you to leave the nest for one reason or another, that’s okay. Work hard and save. Living with parents is by far the cheapest option – no rent, free food and your mom will probably do your laundry too. But if you absolutely have to get out there on your own, then maybe this little blog will help you do it.

General rules:
  • Be prepared to pay at least two month’s worth of rent up front (sometimes three). This is the rent for your first month plus a security deposit in case you ruin the place and don’t pay bills.
  • Take everything with a grain of salt. I’ve been told an apartment was on Brandon Hill and after following the directions ended up, disgruntled, in the middle of Farm Heights.
  • If it sounds too good to be true, it definitely is. Look for the catch.
  • Read that rental agreement cover to cover. Get any promises to fix things in writing before you sign. Document any pre-existing damage and make sure the landlord knows about it.

Once you’re ready with that rent money and a healthy dose of skepticism, it’s time to plot your game plan.

Pick an area and know your budget

The first step is to know how much money you can feasibly spend on rent. Be realistic here not ambitious. One of the awesome things about Montego Bay is that you can find a home for any budget, especially if you’re flexible. If you’ve only got $10,000 to spare you can still find a place to live. It will probably be a shoe-box but it will be your shoe-box.

A good rule of thumb is that your budget for rent and household expenses shouldn’t exceed 30% of your total income. Like the pirate code, this is more of a guideline. To find a more exact number, once you’ve figured out 30% of your monthly salary go ahead and subtract an estimate for your utility bills (if not included in the rent) and any associated costs of the rental home like maintenance fees and such.

Once you know what your budget looks like, go ahead and pick an area (or a few) where you’d like to live. Bear in mind that location is everything in real estate and nice areas usually come with really nice price tags. There are ways around this, like smaller homes in uptown areas, or sharing common spaces. Which brings me to my next piece of advice. . .

Be cautious about sharing utilities and common spaces

The first rule will help you in weeding out your prospects. Once you have an amount and a location in mind, you’ll quickly skip those listings that don’t match your specifications. But even though you might want to compromise on that one bedroom apartment in Westgate Hills where you ‘only share a kitchen and the light bill’ take a minute to think about what sharing a kitchen means: dirty dishes in the sink all the time, and people eating your food from the refrigerator. Sharing the electricity bill means constantly arguing over who burns more current. And if you’re anything like me 2AM on a weekday morning will find you angrily trying to calculate the estimated energy consumption of your toaster oven vs her microwave.

Just don’t give yourself the headache.

Be cautious about living with a landlord

People can be . . . sensitive about their homes. Which is understandable. But as a tenant it can be frustrating to have someone constantly looking over your shoulder. This might be okay if you’re a fledgling graduate just starting out in the world of independent living (almost like having a surrogate parental figure – if you have a good relationship!) but gets much more tedious once the independence really settles in. Their ‘friendly advice’ turns into nagging, and all of a sudden you’re desperate to move. My advice would be to avoid living with the landlord altogether.

In the same vein, try to find landlords that are reliable and respectful. Avoid the ones who flake on fixing infrastructural problems, or go into your home when you’re not around. Ask other tenants (if you can) what their experience is like, and when you meet the landlord make sure their temperament is one you can work with.

Make a list of your preferences/needs

This helps to refine your search, and comes in handy when you’ve viewed a prospective home. After you’ve done your ooh’s and aah’s on the walk-through it’s important to drill the landlord with some hard-hitting questions. How stable are utilities? Is there parking available? How do you feel about extra guests or loud noise? Pets? Smoking? The list is endless and subjective. Knowing what’s important to you comes with time and sadly a little trial and error. The awesome thing about moving is if you absolutely hated something about your last apartment you can make it a definite deal-breaker with your next one. Hurrah for starting over!

***

That’s it for part one! The second installation, where I talk about how to find these elusive apartments, will be posted tomorrow. Stay tuned, and feel free to share your strategies for house hunting. Do you agree with me on the shared spaces? What was your worst landlord experience? Let me know in the comments!

 

“Senior” House Officer: Doc, where’s my steth?

Firmly in the category of Things No One Asked For (wedged between merchandising coffee mugs and your annual pelvic exam) this one is all about how I spent my Senior House Officer year. If anyone is still reading this to get some idea about medical life in Jamaica, you’re in luck. Everyone else, bear with me.

For my SHO year (the second year of relative supervision, coming after internship and before postgraduate study), I spent four months at the hospital in Internal Medicine and eight months in primary care bouncing around the clinics of St. James and Hanover. I had wanted an even six month split but the powers-that-be changed the schedule from two six-month rotations to three rotations of four months each, likely as an incentive for doctors to spend at least some of their time in primary care (which is woefully understaffed).

While I enjoy solving the diagnostic mysteries of Internal Medicine and relish the mental challenges of our limited resource setting, I did not particularly like my time at the hospital. One of the reasons is the aforementioned limited resources, which made it exponentially harder to get the job done (the job being getting the patient better and out of the hospital) but another more important reason was the unhealthy and sometimes toxic working atmosphere.

Doctors in hospitals across the world have to battle against so many barriers to effective patient care. Sure there are administrative and technical hurdles, but one of the most damaging and pervasive problems doctors face is other doctors. We can be unkind and unsympathetic toward our colleagues, we can be harsh and critical where kindness and compassion are needed. We can be overly competitive, deliberately misleading, and frankly aggressive. Specialties often argue instead of cooperating, departmental heads are sometimes overbearing and the support staff is at times less than supportive.

I frequently left work feeling like I spent the last 8-36 hours running a hamster wheel, exhausting myself and getting nowhere. For all my efforts I was yet to see any noticeable improvement in the quality of care being offered, and in fact quality of care was on the decline as Cornwall Regional was on the brink of a crisis by the time I had moved to my next rotation.

Unlike its older brother, primary care has no pretensions about the level of care it is able to offer. Clinics don’t promise CAT scans and then tell you the machine isn’t working; or promise urgent lab results that take hours to be processed. Primary care understands that its role is to prevent and screen, to catch the life-threatening emergencies before they become life-threatening. And that pace is so far suiting me just fine.

Hanover is the smallest parish in Jamaica, splitting its geography between enchanting sea vistas and rolling hills of green green bamboo. I spent my four months here really sharpening my clinical skills and patient interactions. I honed my management of chronic illnesses and developed some much-needed confidence (from all the time spent in clinic by myself because there weren’t enough senior doctors available). Hanover’s narrow, winding roads are where I learnt to drive and the country clinics reinforced all the stories I hear about the generosity of rural folk. I was sad to leave it behind.

(Spoiler alert: I’m stationed back in Hanover for the foreseeable future)

The camaraderie and team spirit were like a breath of fresh air after Cornwall’s sometimes hostile overtones. I felt more comfortable offering care at a less urgent pace (even though we had our fair share of emergencies!) and I appreciated the opportunity to effect behaviour change before it got to the stage where tertiary or secondary care was needed.

Despite challenges with patients’ educational level and access to care I still believe that primary care is where our efforts need to be concentrated if we are ever going to make our country truly healthy.

But enough about me. SHO year is all about testing the waters and seeing where your passion lies. It’s about picking up skills you think are important and spending time with physicians or surgeons or anesthetists who you think can teach you a thing or two. Internship is merely meant to be survived; SHO is where you thrive. Attack the smorgasbord of hospital specialties like an all-you-can-eat buffet, or settle down to dine at one specialty for the whole time – it’s up to you. Just remember that along the way you’re molding yourself into the medical officer or resident who will be the ‘senior’ by the start of the next year.

What kind of senior do you want to be?

Oops, (UW)I Did it Again

Despite claiming in February that the refurbished halls will not priced out of the range of a student budget, the UWI has implemented a 30% increase in hall fees on the recently remodeled Irvine Hall, a traditional hall of residence at UWI, Mona.

Earlier this year, Principal Archibald McDonald asserted that the cost of the new fees would first be approved by the UWI council. But in July a group of students started a petition to protest the unfair price hike of 30% for the new buildings. Deputy Principal Ishenkumba Kahwa argued that the fee increase only affected the minority of students who would be assigned to these new accommodations, mostly those in their final year. He added that subsidies would be considered on a case by case basis, saying (unwisely) that there are student who can afford the new cost.

I have noticed over the last few years or so that UWI has developed the habit of using financial means as an unofficial matriculation requirement. I first noticed it with medical school where students who didn’t make the cut for the government subsidy would be offered a place at the full-fee tuition (meaning if you can afford it, you’re in). Then lately, their costs of accommodation have steadily been increasing, with the addition of several new (and therefore expensive) halls. The traditional halls like Mary Seacole, Irvine, Chancellor and Taylor were substantially less expensive, less well-maintained and had obvious limitations on number but they provided an option for students who needed on-campus lodgings.

While it is high time these older halls were refurbished, I do think more could have been done to offset the cost of refurbishing so that the student wouldn’t have to absorb such a significant increase in price. The cost of accommodations on campus increases annually anyway, but I can imagine that many students didn’t budget for this level of inflation. And it is unfair that final year students who should be concentrating on completing their degree are now forced to find extra funds to pay the raised price or risk being barred from their exams for owing money to the university.

It is unfair, but unsurprising. University is a business, after all, and the bottom line is profit. Those who can afford it will always pay, and it makes no never mind that we are once again headed in the direction of elitist education that is limited to foreigners and the upper class.

 

 

Sources: here, here and here.

Should you go to Med School? Probably not.

Medicine has long enjoyed its reputation as a distinguished and well-respected profession with an assortment of perks. Not just in Jamaica but worldwide, doctors rank up there with lawyers and politicians in the hierarchy of  ‘jobs you want your kids to have’. Children with even a mediocre aptitude for science get pushed into medicine and often for the wrong reasons. If you want to be a doctor because you “like helping people” or just so you can put that “Dr” in front of your name you probably shouldn’t go to medical school.

If you like helping people that’s awesome, but you have to be realistic about what exactly you’re working toward and what that work involves. (If you just want the fancy title, get out now). I’m not trying to discourage anyone from becoming a doctor but I do think it needs to be said that being a doctor isn’t for everyone. Similarly, being a garbage collector or plumber isn’t for everyone. And yet someone has to do it. You can appreciate this comparison once you understand that the way we ascribe meaning to jobs is totally arbitrary and ultimately pointless.

People who create immense joy and inspiration like musicians or writers are not revered or compensated equivalent to the value of the work they produce. Conversely our government leaders who exist to serve the tax-payers who elected them are revered and compensated entirely out of proportion to the work they don’t produce.

The bottom line is this: If you could be guaranteed the same amount of wealth and respect by working as a grass cutter (or any other underpaid job), would you still want to be a doctor?

If you said yes, be prepared for a lifetime of hard fucking work. Getting accepted to medical school is only the first hurdle, and it’s a pretty big one. You need the right grades and a decent collection of co-curricular activities. In today’s society it helps if you know the right people. The sheer number of applicants to medical schools annually is staggering; competition is fierce and it will be like this for most of your career.

Aside: If you don’t get into medical school it isn’t the end of the world. If after reading this article and doing your research you decide that you 110% want to do medicine there are ways and means. And you’re young, you have so much time. If after the soul-searching and the research you decide it isn’t for you then congratulations! Go do something that makes your heart sing.

Let’s say you get accepted to medical school here at the University of the West Indies. If your parents can’t afford to, you now have to figure out how to finance all five years of your education. A part-time job is out of the question because you won’t have the time, scholarships are hard to come by and student loans are expensive to repay. Where do you turn then?

Let’s say you decide to take out a student loan. Now you have to hit the ground running with your studies. Medical school is essentially a brain dump of information, most of which has to be memorized until you can understand it enough to apply it. There is constant competition among your peers in tutorials and exams and a stifling atmosphere of one-upmanship. The pressure to continuously outperform your colleagues rarely lets up. Starting here and continuing for a good half of your career, sleep will become a hypothetical concept.

Once you graduate, you’re staring down the barrel of what will probably be the worst year of your life. Internship is a grueling marathon of stamina and skill with the added weight of being responsible for people’s lives. And halfway through the year, if you took out loans, the Student Loan Bureau will come knocking.

If you decide to pursue postgraduate studies, you’re looking at another 3-5 years of school, loans and now trying to balance your family life (probably) with your career and education. If you don’t pursue postgraduate studies, your marketability plummets and your pay grade stagnates. Either way you will probably go prematurely gray from the stress of it all.

If you’re still not re-considering, you’re likely thinking one of the following thoughts:

But doctors are rich!

Unless they inherited wealth (which admittedly, a good many doctors do) doctors aren’t rich. For an average Joe from a lower to middle income family, it takes several hours of overtime to maintain the lifestyle the public usually associates with doctors, especially in the early years of a career. In the grand scheme of income rates, Jamaican doctors get paid very poorly compared to our international counterparts (even South African doctors get more money than we do). But there a lot of different factors influencing how much money you make, most importantly post-graduate study.

But doctors are well-liked/respected!

This is true to some extent. Certainly doctors have special privileges: people smile at you more (people smile at puppies a lot too), you can stand as a character reference (so can ministers of religion) and banks tend to want to lend you money (it’s a trap, Jim). But like Uncle Ben said, with great power comes great responsibility. And if you slip up even once it’s a long way down.

But doctors are _______!

It doesn’t make sense to generalize. The experience of the doctors you have so far been in contact with will not be your experience. The field of medicine is constantly changing and rapidly evolving. It isn’t now what it was fifty or even ten years ago. Technology makes things easier and harder, popularity and accessibility make competition a hundred times fiercer, and regulatory bodies have turned medicine into a business, always looking at the bottom line.

The volatile landscape of the medical profession demands a special kind of adventurous spirit who does their research beforehand. Map your territory. Talk to a medical student, talk to a young doctor, talk to an older doctor, shadow them at work, flip through a medical journal, visit a hospital. Get a feel for the shoes you’ll be walking in.

And after you’ve done all that, talk to yourself. If you have a keen interest in helping people, if you love challenges and relish hard work (and care very little for sleep), if you’re naturally competitive and have a good head for business with a passable understanding of the human body then medicine might be the career for you. Otherwise, set your sights elsewhere. Preferably something in line with your natural inclinations.

Might I suggest Banking and Finance?