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About Our Guest
Dr Ruan Qing Zhao (@qzruan.md) is a Singaporean physician whose career has taken him from Singapore to the UK and now the United States. After studying medicine at University College London (UCL), he completed his residency in anesthesiology at Brown University before pursuing subspecialty training in interventional pain medicine.
He currently practises at the Providence Veterans Affairs Medical Center, where he helps patients manage chronic pain through minimally invasive procedures.
Synopsis
Faith and Isaac sit down with Dr Qing Zhao, a Singaporean who took the well-worn “study hard, serve, come home” script and quietly rewrote it. What started as a choice between NUS and a scholarship-free gamble on UCL turned into a decade-long odyssey across the UK and US healthcare systems — three attempts at US residency, two rejections, and a five-year stretch where nothing felt certain.
In this first part of the conversation, Qing Zhao gets brutally honest about the year he stopped believing surgery was for him, the phone calls with family who couldn’t fully understand what he was chasing, and the week he — a self-described non-religious person — actually prayed after a dream residency spot fell through. We also get into what it’s actually like inside a US general surgery residency, why he eventually pivoted to anesthesia and then into interventional pain (a field most people in Singapore have never heard of), and how he landed at Providence Veterans Affairs Medical Center hospital, wedged between Boston and New York.
It’s a conversation about identity, timing, and what it costs to keep betting on yourself when the answer keeps coming back “no” — right up until, eventually, it doesn’t. Part 2 picks up where this leaves off, moving from career into the more personal side of his story.
Episode Transcript
Isaac
Hello, I’m Isaac.
Faith
And I’m Faith.
Isaac
And welcome to the We Didn’t Plan This podcast. So today we have a very special guest with us. This is Qing Zhao. He’s a Singaporean who studied medicine at UCL, went on to do his residency in anesthesiology at Brown in the US, and is now practicing there in the field of interventional pain. It’s the first time I heard of that subspecialty, to which I have many many questions.
I think overall in this podcast we’ve been talking a lot about pathways and where life experiences take us and I guess through a very healthcare specific lens, what does conventional or unconventional look like and is there even such a thing? And I think in that typical medical narrative of study hard, come home, serve, bond, Qing Zhao over here definitely did the study hard and then less of the latter two.
So today we’ve got lots of questions and he’s one of those people with one of those really interesting stories that will take a little bit of time to unpack today. So, Qing Zhao, maybe you could give us a quick run-through of your journey so far.
Qing Zhao
Yeah, absolutely. Thank you so much for having me, Faith, Isaac. I was told that I’m the first invited person now, so I’m glad to be playing that role today. And yeah thank you again for that nice introduction. So yeah so the journey was pretty complicated and obviously I was just like you know Faith and Isaac, a student here in Singapore.
I went to Chinese High School and then I went to Hwa Chong Junior College so basically you’re a neighborhood new Singaporean guy. There was that the moment where you know choices were made when I was serving NS and there was option of either staying on and going into NUS. At that time, there wasn’t that many options in terms of medical schools to go into. So I got into NUS and I was also given the option of traveling overseas to the UK.
At that time, my consideration was that I’d been in this country for a long time. I know the educational system and I wanted something that’s a little different. And I did foresee myself practicing overseas, especially the US, because that’s always been my goal. And going to the UK is probably that additional step that takes me a little closer to my final goal. So that was the reason why I sort of ventured overseas. So I finished my NS, which was, well, a lot of people didn’t understand, because everyone in my unit was like, you know, why? We were given that option of deferring, why don’t you just leave? But, you know, I finished the two years and decided to go to the US. What happened after that was pretty complex. I don’t know whether I should be talking about all of it right now.
Isaac
Yes, all of it, in juicy detail.
Qing Zhao
Okay, great. So that might take some time. So I was at UCL, I was in London for five years. And after graduating, I stayed on as a House Officer equivalent and served in the NHS. So at that time, the thinking was, you know, I’ll get my GMC registration, which is basically the same thing as what you guys have got here in Singapore. So to be registered under the NHS system and then travel to the US.
So right before I graduated, I took my USMLE step one. And after graduating, I think it was during my FY1 year, that was when I took my step two. So I fulfilled the basic initial requirement of ERAS application, which would then allow me to do residency in the US. The initial application was successful only for a non-categorical spot, so it was only a one-year contract. It was from one of Harvard’s affiliated hospitals, so I traveled to Boston for the first time.
I finished my first year of general surgery residency, but I was having a lot of difficulties integrating into the system. I would say both knowledge and practical gaps in terms of what’s expected and what we actually know coming through the training in the UK. It’s very different from the expectations of the US system, both in terms of what you’re expected to know because of the way the residency is structured there.
Medical students already know exactly what they’re going into, right? So yeah, there isn’t the house officer, the housemanship, you don’t bounce around different specialties. They’re very focused, so they’re already very into the subspecialty or the specialty that they were going to apply immediately after graduating. So we were on different levels and I was struggling quite a lot. And also in a completely different environment and in the high pressure system of the Harvard network. I wasn’t performing very well. So it was not unexpected. They didn’t extend my contract.
So what happened after that was I went back to the UK, tried to get my bearings right again to decide if the US is still the right way to go, and if surgery is still what I wanted to do. So I stayed there for about a year or so, working as a Senior House Officer again in a surgical role and then I decided to try again so I went to the US. A second time starting off as a research fellow, so I had the title of a clinical research fellow and was fortunate enough to be reabsorbed back into the Harvard system.
So I was working for the plastic and reconstructive surgery department at that time and then that led to my second residency which was again unfortunately a one-year contract in general surgery in New York. So right around that time there was a lot of political instability in the US in the sense that the Trump government came into effect and there was a lot of resistance towards absorbing foreign positions at that time. So despite having been given a lot of promises, unfortunately, that contract never really materialized.
So, you know, there was the second kind of stop in my training where I kind of had to take a step back. I again chose to go back to the UK because it was a familiar environment for me to kind of, you know, rethink whether this is something that I should still continue, you know, to pursue. And so, as you can see, you know, so there’s been a lot of stops along the way and there was a lot of internal struggles and people were asking questions. By people, I mean my family. “What are you trying to do? You’re pretty comfortable in the UK wanting to stay there. What’s this back and forth thing? Do you want to come back to Singapore? What exactly is going through your mind?”
At that time I made a little promise to myself that I’ll probably try one last time. If it didn’t work, either I’ll go back to the UK and just be comfortable in that kind of environment, or maybe reassess the situation and come back to Singapore.
What made that difference at that time was I was exposed to a different group of attendings or consultants. I was still in pretty close contact with the group of ICU physicians at Harvard when I came back and was talking to a lot of them and ICU physicians, a lot of them had anesthesia background. So I spoke to them and said, maybe it’s more of an issue with the kind of people that you’re with and the kind of vibe that the department is giving you.
It’s always going to be tough traveling overseas into unfamiliar territories but it’s helpful having a department that’s supportive and your surgery can be quite intense right wherever you go yeah so in terms of expectations um and also um when it comes to you know the more political part of you know being absorbed as part of the community being a foreigner to start with i think you know there’s there’s just more there’s probably more stress involved you know in in departments where they don’t have a lack of you know people trying to enter you know surgery i think it’s just more competitive in that sense.
So anesthesia is probably a little more laid back. You know, you can still, if you like working in the operating room or in the operating theater, you know, why don’t you come back as an anesthesiologist? So that’s when I kind of, it took a lot of time because I’m sure, you know, you guys know when you’re set on a certain specialty, you probably do want to achieve it, right? At any point in time when you do make that change, you know, you kind of have to, you know, talk yourself, convince yourself, you know, that this is, you know, something that’s work well.
So I went through the internal struggle and then decided to apply to Anesthesia. And once again, still very lucky. Harvard was still very receptive and there were people who were there that knew me since the first time I went as a surgical resident. So they were very helpful and very supportive. So I did manage to get into a categorical spot the third time that I applied and that was what led me to finish my training in Boston and I did my interventional pain fellowship at Cornell in New York so that was you know the other part of the training that there was now you know kind of more seamlessly completed you know with residency and direct you know transition to fellowship, and yes currently I hold my appointment at Brown University which is in Providence, a much smaller city between New York and Boston, and that’s where I’m practicing now.
Isaac
Wow, there were many chapters to that story.
Qing Zhao
It took a lot longer than expected, right?
Isaac
No, that’s a lovely story. And I feel that one thing that really stands on was, despite all the ups and downs, there was a really consistent or very determined part of you that said, I’m making it across the ocean, one way or another. I’m wondering what was that driving factor and did it evolve across time? Was it the same thing that made you go at it the first time, the second time, and the third time? And even, I suppose the dream was probably even there when you were in your army uniform somewhere, right? So what was that dream and did it change?
Qing Zhao
Yeah, I think that’s a great question. As you progress through your medical career, because medical careers are unfortunately very long, your training is going to take up most of it, right?
As you get older, your priorities change. So I’m pretty sure it’s the same for both of you guys, that when you start off young, right, you have all the energy in you, and you probably want to do the toughest thing, to get through the toughest challenges and rise to the very top of that peak, right up that mountain.
So that was what I was like. I was considering crazy specialties like neurosurgery, plastic and reconstructive surgery, general surgery, I wanted to do surgery. And at that time, my understanding, which I would want to argue that it’s probably still true that the rigor of that training in the US is not really it’s just not comparable to training anywhere else it’s just different yeah I wouldn’t say that hours put in is longer I mean the hours are crazy but I’m sure in Asian systems it’s you know it’s not easy either but it’s just you know the the system of residency that almost has like it’s very it’s almost has a very unique attraction.
Just by being called a residency program, it had this draw, at least for me at that time. So that was the initial drive and even going to the UK was part of the plan of making the transition, going to the UK and then going to the US. It wasn’t the end goal of staying in Europe. So that never really changed. But as I did surgery, as I interacted with the people around me, then I kind of realized that you change in accordance to the kind of community you’re in.
I mean, surgeons are very driven and I think they’re remarkable people being able to operate in that sort of high pressure environment. At the same time, they’re pretty quirky, right? Right? So in order to excel in that kind of environment, you’re going to have to become one of them. Right? And then it becomes a personal choice of whether, as you progress along the way, whether that’s something that you’re comfortable with.
I think, again, there’s no right or wrong. You can evolve as a person and adopt those features as you go along. I think, deep within, I don’t see myself as having that sort of personality. So I think that was what led to the change in finally or eventually accepting another specialty. But I think the initial drive never really changed, but it does have an expiration date.
So you can be super driven, you can throw everything into this ultimate goal that you have. But I think it’s intelligent, it’s smart, and it’s also prudent to have a date of expiration. You’re never going to be in a very tough spot, I think in terms of not having a job or not being able to support yourself as a physician anywhere in the world. But there will be things that you have to give up if you were to want to attain a certain level of proficiency recognition or a certain level of, I don’t know, I guess you can call it prestige at certain places. And so there will be things you have to give up.
And then as you age and as you get more mature, you start doing these equations and doing these calculations in your head. And it’s up to you to decide whether it’s worth it. So I think I didn’t progress through my training in a very smooth manner. I think a lot of people will think that the time that I spent wasn’t the most worthwhile, which to some extent I agree. But I guess all of that kind of culminated into who I am today. And I guess I have no choice, right? Time spends time spent. You spend that time anyway, right?
Isaac
Some people might say, you know, I love how this surgical thing is a completely universal experience. It’s good to know that. I say this because my very first intern year houseman posting was surgical. I remember the exact same thought in the exact way you described it run through my head because it’s not so much that I didn’t like the people. I don’t think anyone was overly nasty or at least that, I guess to some people it’s very lucky already.
But I felt as if there’s a personality type. There’s a certain way you act even distinct from other positions. And I felt as if it wasn’t even, I think what it really felt in terms of the local flavor of it was – so I went to Chinese High and Hwa Chong as well – and I felt like in real terms, I would have to be that same anxious young 17, 18 years all the way until the end of my career to succeed in that. And that kind of excluded for me. Not that I think my much more hardworking and intelligent colleagues can do a much better job than me.
But I guess going off that, you mentioned that throughout this whole period you were asked questions or at least there was some doubt much of which was internal but much of which came from people around you, be it colleagues, be it family. What were some of the most difficult ones that really made you reflect and you had to reckon and say that I’m gonna do this anyway?
Qing Zhao
Right I see. I think it’s probably from family because you know colleagues you know they’re all in different you know parts of the training if they’re not physically with you at that point in time you’ll probably know your you know the stress that you go through and you know the very complicated thoughts that you have to kind of battle with in the middle of the night family the i think the the difficulty with with family is that obviously they’re always going to be you know in that very sort of precious part of your heart.
I mean whatever they consider, it hurts not because you couldn’t achieve the goal yourself, but it’s actually that you cannot make them understand why is it that you’re going through all of this, because it’s the same issue, right? They’re not really in your shoes. They can’t really understand why you’re doing all these things. But at the same time, you’re compelled to have them, I suppose, at the very least take on maybe five, ten percent of what’s going through your mind every day, just so that have been kept in the loop.
So you give them the benefit of doubt that they understand. But at the same time, you know that they’re never going to be able to understand. And in my situation – because my dad is actually a physician, too. He doesn’t practice in Singapore, but he kind of knows the ins and outs of being a physician. So the difficulty is explaining it to my mom. She does Chinese traditional medicine and things like that, but if you haven’t gone through the training of Western medicine, it’s not something that people really understand.
So yeah, I think family is the toughest, but at the same time, family is also what drives you at the end of the day. Even though they don’t understand everything they’re going through, they’ll be twice as excited for you when you’re making your third application through the ERAS system. They might not know what you’re writing about in your personal statements or who are all these people that you’re trying to contact to solicit letters of recommendations, but they’ll be 10 times more excited than you when the results can come out.
And if it’s successful, that’s what you’re praying for, that you’re accountable for both yourself and all these people in the background that’s supporting you. So yeah, I think family is the toughest. and it’s not a word or a sentence or a question that they pose you, it’s just everything that’s around you that’s internal and that’s always going to be a part of you.
Isaac
It’s always the entire state of mind that’s happening in that instant. And it sounds like there were lots of ups and lots of downs as well. Was there a particular moment that was the best moment in all those years, despite the fact that maybe at the point in the future wasn’t clear. Third application, fourth application, end application. But it sounds like there was definitely some great moments during that as well. Are there any moments like that that really stuck with you?
Qing Zhao
Yeah, that’s a good question. You know, surprisingly, the sort of greatest, the most positive moments didn’t stick as much as I thought that they’re going to do. Having gone through this whole journey, I think the first time when I applied to the US was 2014. And when I did get acceptance into residence, it was 2019. So it was five years in between when I was traveling back and forth.
And I was also hoping that when I do get, you know, that letter that says, hey, you know, you’ve matched, that that will be the moment. But then it became it was almost like a self-fulfilling prophecy, right? That you know that it’s going to happen. And everything kind of culminated to that point where when it did happen, it didn’t kind of explode.
So what I did remember was the moment when I was the most down though. And I recall, I think it was the last time I was, I really, I think it was right before when I made the transition and decided to apply to anesthesiology. The very last ditch attempt I made at surgery was a transition from a general surgery resident to a plastic and reconstructive surgery resident.
And there was one spot that was left open at Yale at that time. and I managed to get to the last stage of the interview and so it involved, it would involve a change in residency program and it will allow me to you know more seamlessly proceed into a PGY3 year so without the first two surgery years being discounted for so there would have been a great opportunity and yeah I remember going you know through to the very last stage of the interview I think there were like five or six people that were also there and at the end of the interview. Everyone got invited back into the room and said, “Good job, we’ll reconnect with you at some point in time.” Which never happened.
So that was the week, I mean I’m not a religious person, but that was the week when I actually prayed. I can’t remember to which deity or which god, but I did. And when it didn’t happen, when it didn’t materialize, that was the moment I remember being the most down. It was towards the end of the five years when I was traveling back and forth.
So it was pretty close to when I then succeeded in getting to the anesthesiology spot. But yeah, that moment I will always remember. And I was in my car alone and I was shouting to myself. I was going 90% insane. It lasted for a very short period of time. But that was very memorable for me. So I think there’s not going to be a big up if there hasn’t been a big down. before so it’s all relative. So yeah it’s interesting that I don’t remember that much about you know when I got the letter that said you got accepted but it was this that I remembered that happened right before.
Isaac
And it sounds like you’re so close. I know. So close. I know so close. And I mean out of all of that right it feels as if you’ve gotten through a lot of storms and a big storm that was. Tell us a little bit more about where you’re at right now at this point time and how you’ve sort of sub-specialized and what keeps you going in the field you’re in right now?
Qing Zhao
Yeah, good question. So anesthesia is pretty common and I think everyone knows what anesthesiologist or anesthetist does. You get put off to sleep, right? Yeah, so in different ways and forms. And what I found interesting given that I had all this background in surgery because even in the UK, I was kind of semi-independently, you know, taking out appendices and gallbladders. So I do, I mean, I did have a reasonable amount of surgical skills on board.
So the reason why I went a step beyond anesthesia into interventional pain is because interventional pain allows you to do certain procedures, which are small surgeries. So this is an area that’s interesting. I know it’s very common in the West, including Australia, but in Asia, interventional pain is not a big thing, which is why I guess the two of you haven’t heard much about it. So for the bread and butter things that we do, it’s strategic injections, mostly into the spine. So we essentially deliver steroids, local anesthetic, close to nerves. And most of the time, it’s into the epidural space. We don’t really go into this intrathecal space much, but in the bag, it’s mostly epidurals and if we can’t identify the nerves that’s causing issues then we do peripheral nerve injections too.
So it’s a cross between interventional radiology and also orthopedic spine or neurosurgery and that’s sort of the bread and butter interventions that we do. If you want to be a little more adventurous, which is what I strive to be, then you can do smaller surgeries. I don’t know whether you guys have heard of of neuromodulation and neurostimulation. So it’s almost like the spine version of deep brain stimulators, right? So you can stimulate the spinal cord too. And because anesthesiologists are meant to be so good at accessing the epidural space, right? Yeah, so that’s the reason why we do these two, so that we can safely place leads that’s close to the spinal cord.
And we kind of marry that up with small surgery, just like how cardiology puts in all these implants and the devices for pacing. We put in small battery packs in the lower back or in the buttock area so that the entire circuit completes and you’re essentially driving a little stimulation up and down the spine using these devices. So that’s a little more niche, I would say. Not that no one does it here in Singapore, but I think very few. And that’s the area of my specialty that drives me more to anesthesia because anesthesia is more common and I suppose there’s less… I mean there are some specialties in anesthesia but it’s less of my interest and this interventional pain is almost completely different from anesthesia so almost having two different specialties.
Isaac
That’s really interesting. And I think thinking between systems over here, there comes some of that under anesthesiology. Correct me if I’m wrong, but a lot of it seems to be spread across the other relevant specialties.
Faith
It’s normally not under Anaesthesia directly. You’ve managed to blend your passion for surgery with your current specialty.
Qing Zhao
Right, right. So I think what happens in most places is not all anesthesiologists would be comfortable doing implants and doing the cut-downs and doing the tunneling and things like that. But that skill should still be taught when you’re doing a fellowship and then it becomes a personal option whether or not you want to do it. So a lot of anesthesiologists do cooperate with either orthopedic spine surgeons or neurosurgeons and they will do the cut-downs whilst the anesthesiologist places the leads. So that still happens everywhere, it’s just whether you’re comfortable doing both parts yourself.
Isaac
And I guess you’ve traversed two different systems from across the pond, right? Are there any really big differences that you notice between your experience in the UK and the US? Because I mean, it wasn’t just school in the UK. You actually spend quite a lot of time in surgical training as well. And yeah, are there any really big differences in the systems? I hear these days a lot of NHS trainees and UK medical graduates are trying to make it somewhere that’s not the NHS.
Qing Zhao
So the NHS is in big trouble. And part of it is also affecting training, unfortunately. The UK style of training is obviously the old school style of training where the length of training time doesn’t matter that much, where you get training everything. That’s not in existence anymore. But I think what remains is unfortunately the duration of training, which doesn’t, the long duration of training, that doesn’t focus as much on the personal needs of the trainees.
Yeah, so what happens in the UK is that when you graduate, so it’s a similar thing as in Asian systems where you continue to rotate right through different sub-specialties. That alone is not a big problem for me because the medical degree is an undergraduate degree, right? For both the UK and Singapore. So you’re really very young when you’ve graduated. So it makes sense for you to continue to rotate, to get the experience and to mature as a physician. So that in itself, I don’t have any issues with. It’s what happens after that.
So the quality of training that you get as a senior house officer, as you go into your SHO years in the UK, where you get, unfortunately, shuffled from hospital to hospital every four to six months. At least at that time, that was true for me, where you have to move to a different location every six months or so. You meet with a completely different team.
The amount of training that you get is highly variable depending on where you go, because there isn’t a fixed curriculum while you’re performing a training. No one checks on you, especially for surgery, where the number of cases you do and the kind of cases you do is very important, right? And you keep a close eye on how much you’ve done and what you’re lacking in. In the UK, they do do that, but at the end of your training. Whilst you’re doing your training, no one keeps a close eye on the amount of exposure you get. And also how much dedicated training you get. Dedicated in the sense that how many people are actually in operating theater with you. Because I remember holding cameras all the time. My name is still on that case, but I don’t know how much I’ve learned from those. So that’s the huge difference.
In the US, everything is super regimented, which is why when I first spent time in the US, I realized just how different the quality of the training is. you’re set an exact number of cases to do. Every period during your training, you have to do a certain number of X or Y cases, and you have to be the primary surgeon in a certain number of cases. So all of that is being very closely followed.
The reason is because ACGME, which is the umbrella that manages all the training hospitals in the US, they check in with the different hospitals every year because all the trainees have to perform a survey at the end of the year to say, “Was I trained well? Did I like the training?” And the hospitals are really eager to please their trainees, because if you do get marked down on these surveys, you lose your funding. So, you lose your funding, you lose the number of residents that you can then recruit every year.
And that’s a big deal for the US because residents generate a huge amount of income, whilst at the same time not being paid too much. So it eats into the profit margin. So it is really in their interest to make sure that the training is good, that the trainees are kept happy and that they meet all these criteria. So I think, unfortunately, in the US everything is a lot more profit driven because all the hospitals are private except for the VA system that I work for. So it’s got a very different kind of framework.
In the UK, unfortunately, when everything is nationally funded, they probably don’t get the impetus. And I don’t ever recall doing any survey that talks about how well you’re training, how well the programs are while you’re training. So unfortunately, without their feedback, there’s no drive to change. And I think that’s the biggest difference between the two programs.
Isaac
it sounds like there’s even in a slightly twisted way, a very good alignment of incentives over here. And I mean, here in Singapore, they tried, I think they’ve been trying to go with the ACGME for the past few decades or so, right? One can see in our future careers how that might or might not pan out. And I guess one last question to top off that whole conversation about your career until today, right? You mentioned that you practice at the VA. And can you tell us a little bit more about what a day in your life might look like? I think it’s something that doesn’t really exist as the VA system, but also the field and your daily clinical practice might be unfamiliar to a lot of local listeners as well. So we’re very interested here how that looks like.
Qing Zhao
Yeah, absolutely. The VA is a very unique system. It’s probably the closest system in comparison to nationalized systems like the NHS in the US. And it’s the biggest employee of healthcare professionals in the US. And they exclusively take care of the veterans and their family members.
So there are VA hospitals all over the country in every state, big hospitals, smaller clinics, and they’re all federally funded. So everything that I said before with regards to funding, this is a very unique system where funding comes directly from the federal government. And so unfortunately, that also means that it also adopts some features and characteristics of the NHS. Once you’re federally funded, the pace kind of slows down, the yearning for efficiency, no one drives as hard in terms of having to do a certain number of cases every day.
But I would still say that it’s a fairly reasonable system where the veterans get their health care. It’s just not driven the same way as privately funded hospitals where you’re really trying to fit as many cases as you can into a day. But it also means at the same time as a physician that’s practicing under a federal system, you have less flexibility in terms of what you can negotiate.
Once you’re in the private world, it’s really up to you to negotiate your contract. You can get very juicy contracts out of private hospitals. And even better, I don’t know about the locum system, right? So yeah, the locum system in the US is like a completely different beast on its own that you can really milk the system dry and earn many times what your colleagues are earning. But that’s a separate thing to talk about.
But once you’re in the VA system, everyone almost gets the same contract, depending on your level of seniority. There’s not much that you can change on that contract. You get a fixed number of working days that you have to satisfy in a year, every pay period. You have to work for a certain number of hours and that’s all fixed. There’s no difference in terms of your payment or salary. It’s not linked to the number of cases that you do. You just have to put in the time and it doesn’t matter whether you’re seeing one patient or 10 patients a day, you still get paid the same amount. The pace of adoption of newer technology is a little slower, unfortunately.
Once you have a bureaucratic system like that, it does take a little longer to try to get new technology through. But once the technology does go through, it’s less of an issue to continue to use it for patients because the patients themselves don’t have to individually go through the insurance system to get approval. So that’s again a very foreign concept to Singaporeans when it comes to insurance. And in the US, unfortunately, that’s a thing that patients and also physicians have to deal with to get procedures done, to even get medications prescribed. So insurance decides how much of those they’ll be able to cover and whether the physicians and the patients will eventually get the procedures that they want done.
So for me in this system, we worked out, I would say, maybe a 25-75% split between my anesthesia time and my pain time. So once a week, or rather one day a week, I do procedures for half a day. I see my pain patients for the other half of the day. For the rest of the week, most of the time, I perform full-time anesthesia. It’s not a very big hospital because it’s kind of between Boston and New York, right? So it kind of serves the population in between.
And it’s not a very acute environment, which works for me. I think I’m no longer in the right age group to work at that level of intensity. So you get all your bread and butter, orthopedic, general surgery cases, maybe a little bit of vascular cases, but nothing too crazy. And now we’re just starting to also kind of build a fixed neuromodulation time into that schedule of mine. So hopefully in the future, it’ll be a couple of days a week where I spend time in the OR doing my implants. It’s slowly working its way into the regular schedule. But at this point in time, it’s still kind of ad hoc. Whenever I have a patient, I request for surgical time and they give me a slot. So it’s pretty variable. But at this point in time, I feel that’s a pretty good mix for me in terms of volume of work and also time spent.
It’s a pretty good work-life balance once you’re in the federal system, compared to the private world. It sounds like the hours are a lot more manageable. Yeah, exactly. I think I’ve paid my dues with all the training that I had earlier. Many times over.
Isaac
So thanks for sharing all of that, from past all the way until present, what that whole professional rollercoaster looked like, and in two countries, maybe three if you include your formative years. And now, I guess, how you really found your place at your little nook and cranny, between Boston in New York. And it’s really, really interesting to hear about how you’re thriving in your own clinical area as well. So you talk about work-life balance. We are going to talk about that in just a bit. And we really want to hear about the life part. For this episode, we’ll come to a close. So thank you so much for sharing all about you as an MD. Thank you, thank you. Thanks for listening.
Faith
We’ll see you in the next episode.
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