Between having to adapt to a freer schedule (yay!) and lack of tenure and hence uncertain economic capacity to feed oneself (yikes), having the status of a “recently graduated subspecialist or specialist” can feel like being stuck in a hazy intermediate state as I am recently discovering.

For most of us who will trail blaze the path of a physician for their families, it will be daunting. For those who will have a pool of patients to be inherited along with their family heirlooms, the challenges may be different, but not necessarily less difficult. As my current status is that of the former, I feel more qualified to speak for them.

Having been immersed in training for a good ten years, where academic and clinical skills were the focus of learning, I discovered a whole new world out here. For those who are still on their way, here are a few general tips from one who is right in the thick of things:

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1.Save up NOW.

Practice not living from paycheck to paycheck while you are still being given a regular salary. If you have connections and/or are lucky, your first job comes right at the heels of your graduation given you also send out your CVs early (check out item #4 later). If you are neither, then at least you’ve saved up. You’ll be surprised at how fast money dwindles as the cash flow ebbs during the first few months.

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2.Do NOT burn bridges.

This is not the time to go around saying “May the bridges I burn light my way”. One senior physician commented: “Not everything is WHAT you know, it’s also WHO you know.” While garnering awards and honors give prestige, a good work ethic and cultivating harmonious relationships while still in training will also score points, and sometimes matter more with your bosses and colleagues, who might eventually give you the break you need.

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3. NETWORK

Put your laptop or smartphone or tablet to work and network away! Headhunters lurk in professional networks like LinkedIn. Attend medical conferences and mingle, your friend might have a friend of a friend who needs someone with your credentials. Various specialty and subspecialty societies post their calendar of events on their websites, take your pick.

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4.Know and pay your TAXES

To paraphrase Ben Franklin, only two things in life are certain – death and taxes. With recent public pressure placed on the profession, we young doctors ought to take measures to not let anything besmirch our reputations – invaluable to clinical practice. Check out: www.bir.gov.ph for downloadable forms and their primer – more on this on my next blog ☺

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5.Options for sustenance other than your mom and dad

Clinical practice
– Hold clinics near your residence to save up on commuting/gas money, if you have only one patient in a clinic that requires you to shell out 100++ for miscellaneous travelling expenses, your take home might be a pittance…worse if no patients come, which will happen every so often…
– Multispecialty clinics abound in the metro and are also budding in many regions in the country – drop in on one and talk to the clinic manager to know their vacancies and fees
– Be patient with your patients, they will be an important source of referrals.

Clinical trial. Try your luck as a medical monitor in one of the CROs (Contract Research Organization) in our country, like Parexel, Quintiles, Covance and Exodon. Those who’ve had experience working on a trial will have an edge here. The pay is considerable and part of your job may involve travel abroad.

Company retainer physician. Check out http://www.aventusmedical.com. For a fixed fee, the hours may be exacting and the number of patients to be seen many, but this is one job that pays regularly so it works for the meantime.

Industrial clinics, Hospital-based wellness centers, Ambulance conduction, Emergency room physician.

Medical school lecturer/preceptor. A welcome break for those who miss the academe. When pursued seriously, you might find yourself part of the faculty. This means tenure and benefits.

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6. Endure

Be prepared for the times when your savings and mood dip. You’ll catch yourself thinking: “After 10 years of missing family events, wrecked sleeping patterns, physical, mental and emotional torment, this is what is waiting for us??” Just keep in mind that this limbo will not last. You are most definitely not completely helpless and you have the capacity to get out of it. They say all it takes is time, patience and the right attitude.

Occasional self-pity is normal but do soldier on, once you start earning and are able to give back to your family and the community at large, I am certain it will all be worth it.

For those who are or were in the same boat, feel free to add on to the list!