Follow our socials and be sure to subscribe to our podcast on YouTube or other streaming services!

| Apple | Spotify | RSS | YouTube | Linkedin | FB | IG | Tiktok |

---

Watch The Episode

About Our Guest

Xiao Yue is a Malaysian medical student currently pursuing her MBBS at Universiti Malaya. Curious, reflective and always keen to explore the realities behind a career in medicine, she is interested in the different paths that doctors can take and what life in healthcare actually looks like beyond medical school.

Outside of medicine, Xiao Yue is also a Youtuber/podcaster – check out her channel at this link – and enjoys having conversations about education, careers and the experiences that shape the choices we make. Her journey as a medical student has given her the opportunity to explore different healthcare environments, including gaining exposure to medicine in Singapore, and to think more deeply about what she wants her own career in medicine to look like.

Synopsis

What is it actually like to be a doctor in Singapore? In this episode, Faith and Isaac sit down with Xiao Yue, a Malaysian medical student, for an honest conversation about life in medicine across the Causeway. We talk about the culture shock of entering the medical workforce, navigating the very specific hierarchy of house officers, medical officers, registrars and consultants, surviving 24-hour calls, and the small mistakes that every new doctor seems destined to make.

We also get into the less glamorous questions: Is the pay actually worth the hours? What does work-life balance look like when you’re doing multiple calls a month? Should Malaysian doctors move to Singapore? And if you do move, how do you build a life and support system from scratch? Along the way, we compare some of our experiences of working in Singapore with Xiaoyue’s perspective as someone still studying medicine in Malaysia.

Finally, we look back at our own first days of housemanship and ask what we would do differently if we could start all over again. Spoiler: probably less panic, slightly more coffee, and accepting that you don’t actually need to arrive at the hospital at 5am. For anyone considering medicine, housemanship, or moving countries for their medical career, this episode is a candid look at what happens once the glossy medical-school brochures stop being relevant.

---

---

Episode Transcript

Isaac
Hello, I’m Isaac

Faith
And I’m Faith, and welcome to the We Didn’t Plan This podcast.

Isaac
Today we have a very special guest on. This is Xiao Yue from across the Causeway, second year medical student, a serial podcaster like ourselves, something we could definitely never have done when we were at the same age.

So we’re very, very happy to have you here today. And in this episode, we’re going to be talking lots about the Singapore healthcare system, a little bit about the Malaysian healthcare system as well. And what are some of the questions that we both want to hear from each side of the Causeway?

Faith
So Xiao Yue, would you like to start?

Xiao Yue
Okay, so hi everyone, it’s a pleasure to be on this channel. You know I was actually a fan of their channel, so every time I was studying, or preparing to sleep during my exams, I just put on their podcast. And it’s so relaxing and I feel very heard. Our topics are a bit stressful, sometimes we complain about the system, doesn’t it scare you a bit? Okay, a little bit. But it’s nice to see that there’s a conversation about these things that we don’t usually talk about in medicine. Yeah.

Isaac
Yeah, and I’m also very heartened to hear that my voice isn’t, like it is to myself, the sound of sandpaper scratching on metal. But let’s hop into it.

Faith
So, okay, my first question of the day is, what was your biggest culture shock when you started working as a doctor?

Isaac
Out of the one dozen, I would say the biggest cultural shock would be navigating the workplace hierarchy. I think something interesting that we don’t see as much in other industries. I mean, I’ve worked in several part-time, full-time jobs that are non-medical in nature. I think the interesting thing in medicine is that there’s one place outside of the police or the army or the firefighting force that you have such a clear you know like this is my houseman, this is my medical officer, this is my registrar, this is my consultant and then the consultant should never directly talk to the house officer even though the house officer is taking care of those people’s patients so that was quite interesting

Faith
The Consultant will tell the Registrar and then the Registrar will text you about it.

Isaac
And then there’s like 10 WhatsApp groups because there’s one WhatsApp group with the juniors, etc. And I mean of course in every job when you enter as a junior you are not expected to sit with the CEO for coffee and banter about their children but it was quite interesting because I mean you don’t see this much in other entry level jobs. What about you?

Faith
Sorry yours is very complex, yours is “cheem”. Mine is just simply the working hours. Certainly for someone who would always, you know, I’ve never pulled an all-nighter prior to working as a house officer and then suddenly it’s like, oh, you’re going on call. You’re going to be awake for like 24 hours plus a bit, straight and you have to function and not kill someone and be responsible and, you know, your phone is just blowing up the whole night. I was like, oh my gosh, how are we going to survive how many years of this and what is it going to do to my health and sanity? Yeah, I think that was the biggest culture shock, adapting to the hours and the physical toll that it took on us.

Xiao Yue
Maybe that means that like medical students should sleep later, like maybe sleep at 4am.

Faith
Yeah, start training your endurance. Once a week, you pull an all-nighter, then you’ll be prepared for a house officership.

Isaac
Have you pulled an all-nighter before? You seem like a very good student.

Xiao Yue
Well, actually I have. When I was preparing for my exams right, so maybe for two weeks straight, I slept at like 8am.

Faith
Oh my gosh, you studied through the whole night?

Xiao Yue
Yeah, yeah, until 8am. And then I’ll wake up at like 2, 2pm to continue studying until 8am the next day.

Faith
Oh my god, your sleep cycle, you’re the most dedicated Med student.

Isaac
Respect, respect. You are so hardworking.

Xiao Yue
It’s also with procrastination, like sleep time procrastination and everything. So maybe I’m prepared, I don’t know, who knows. But I don’t think anyone’s prepared for 24 hours straight.

Faith
So having heard of what medical training is like in Singapore and having experienced it yourself for this past couple of weeks of shadowing is there anything you think Singapore gets right or wrong, that Malaysia could learn from and vice versa?

Xiao Yue
Okay one thing I think we could learn from is the hierarchy side of it because I find that in Singapore the teams that I followed after rounds every day, the consultant would like go for coffee together and then maybe do some teaching, some sharings and we also had departmental meetings where like different teams come up with their own interesting cases or like, they have like a learning objective. Maybe one way is interesting cases and then it’s like focus on pathology. Yeah, so every way is different.

So I like that. that’s sharing and interaction between teams to sort of like share about this medical knowledge. Yeah, for this, I don’t think we have it in Malaysia, but we have something called Continuing Medical Education, CME, in Malaysia, which is something similar, but I haven’t been to a CME session yet. Yeah, so I cannot really comment on that. But this is something that definitely surprised me about Singapore.

Isaac
So it feels like you liked the junior-driven teaching, the peer-to-peer kind of education.

Faith
Kind of like the community, right? Like just being chill with your consultant, grab a drink.

Xiao Yue
Yeah, it also was a bit more, I think a lot more relaxed because I feel in Malaysia, everyone is rushing for time. I mean, we can’t help it also because of the manpower shortage. Yeah, maybe it can be tackled with time.

Isaac
And I mean, I think about that preclinical education thing a lot also because, I don’t know, do you feel like when you went from year two to year three, you were very well prepared for it?

Faith
Honestly, not really. I mean, they teach you in theory. You know the knowledge and you’ve maybe examined patients. But when it comes to actually seeing how a team operates and learning everything while studying, it doesn’t prepare you that well.

Isaac
Yeah, right. I remember when I was a student, then they let you follow these teams. And then in the morning, maybe you first see the patients with them. But then you kind of get it. Then after they say that, “Oh, okay, I’m going back to do changes.” Then you always wonder as a student, like, “What are these changes that take 8 hours to do?”

Xiao Yue
Actually, I still don’t know.

Faith
It’s literally just ward work. It’s literally just admin or like, you are called to update the family or you go and take the bloods or you push them down for a scan.

Isaac
When you start, you realise there’s more than enough things to fill your day.

Xiao Yue
After rounds, the MO was like, “Oh, actually, we don’t do much after what?” We’re just waiting for the exit. I was like, hmm? Everyone is so busy. What do you mean you’re just waiting for the exit?

Faith
It’s just miscellaneous paperwork that takes up like half the day.

Isaac
You don’t need to learn how to sit around and put up a whatever whatever. Enjoy it while you still can.

Xiao Yue
Okay, so what’s a mistake that new doctors commonly make in their first year?

Isaac
Out of the dozen mistakes that one makes in the first few weeks of any new job that you take, I would say it’s just missing out little things. Because you, as a first-time doctor, don’t have a full picture of what’s happening to one particular patient, for example. You don’t know what, at the point where you turn up for work on the 25th of June, you don’t know what happened to the patient on the 24th and you don’t really have the best mental picture of what’s supposed to happen to them on the 26th.

You don’t have a mind map of like, you know, if this thing was done yesterday, a scan or whatever, who or what might you be expected to follow up on. So a lot of times when you start the job, you do a lot of just, this person says you do this and you type it out and then you go and do it. And in that whole process, some things do get missed.

You find your own way of remembering them. you remind yourself but I think being able to remember all the small little things and all the individual steps I think that’s a very big first obstacle. What about you?

Faith
Yeah, because I mean certainly for the first time you’re in charge of managing like what maybe 6-10 patients on a ward round you’re just thrown into not really the deep end I mean we would have experienced it a little bit during our final year internships as local grads but even then it’s still overwhelming because the department already has their SOPs and the way that they function and you don’t know head, don’t know tail, there’s no context. And there’s also a fear of being seen as incompetent because you ask too many questions. So, it’s like at the same time you need to clarify, you need to find out what’s going on, but you’re like, should I text my senior? What if they think I’m dumb and I haven’t studied?

Like, should I ask them, do I order this medication or that one? But then if you order the wrong one, they also still scold you lah. So, it’s like where do you strike the balance?

Xiao Yue
Do you find that there’s like different challenges in different departments? Like for example, this department follows this SOP and this gets like drastically changed in the next department.

Faith
Yeah, I mean across different hospital clusters and across different departments, like the way medical departments versus surgical departments operate already is like worlds apart. And the way you talk to the senior or present a case could be very, very different.

Xiao Yue
So you need to like keep that all in your mind.

Faith
Yeah, like you have to codeswitch and like know the context.

Xiao Yue
Okay, this next question might be a bit too invasive but…

Isaac
Ask away, invade, invade, come.

Xiao Yue
So do you think the money is actually worth the cost of living and hours?

Faith
For you as someone who is still working in the system right now, Isaac, as a medical officer, is it worth it?

Isaac
There’s a short answer and a long answer.

Faith
Give us a medium answer.

Isaac
The medium answer is that for now it is. Why do I say that? Because there is definitely a pay gap between let’s say what I earn at my level and peers who might have studied the same amount of years or worked the same amount of years etc. But at the same time, it depends on what kind of demons you choose to battle as well.

I would say that for someone who hates talking to people and finds interaction with patients, clients, etc. a huge, huge pain, then obviously medicine sucks. But for someone who prefers something or rather someone who, like myself, does not like drafting long pieces of writing, someone who does not like entertaining 10,000 bits of information about one single task then actually medicine is quite fun because you can you know you deal with individual patients you wrap things up fast you move on you see an evolving situation things like that so i think it’s very adjusted to the enjoyment of the job and number three it’s also based on what your long-term career goals are so perhaps to me it’s worth it because i see stability in the career path for the years ahead, I also do see different opportunities. And to me, what I think is most important for my long-term growth and development is possibility.

I don’t think that it’s more important to get one single career where I will definitely earn $5 million a year if I work for 30 years. I prefer and value a career that opens multiple doors for me to be able to create an impact on people in many different ways. So maybe yes.

Faith
Yeah, I mean, I will also say yes, it’s worth it. Because I mean, when you’re inside the system doing the terrible hours and not earning as much as your peers in like finance or law, of course, you can feel salty and really like, why am I doing this? But if you think about, you know, career big picture wise, I think there’s no other job that is as fulfilling and as secure and that still pays pretty well. And like now as a GP in the private sector, I decide my hours and I get paid a good hourly rate. and the ability to navigate my career and explore side quests without financial stress, it really, I mean there’s no other job that I would rather be doing.

Xiao Yue
But how was the work-life balance like when you were still working and also for you now?

Faith
It was bad, depending on how many calls you have to do in a month. There was one time I had to do seven or eight calls in a month, there was zero work-life balance, it was pure survival. Like every three, four days you are dreading a call again and you’re just trying to recover from from the previous sleep deprivation, the sleep debt never gets repaid.

Isaac
I think it’s undeniable that medicine is one of those careers where the physical amount of time you spend at work is relatively long unless you want to compare to lawyers or investment bankers. But at the same time, I suppose you balance that out with things like how available do you need to be when you are not physically in hospital, which the answer is like practically not at all because there’s someone always covering the patients whether it’s the on-call or whether you are there yourself. So I guess it’s different kinds of challenges that you face.

Xiao Yue
Would you personally hesitate before recommending like a Malaysian grad to move over to Singapore?

Isaac
I’m very pro-“people moving abroad to explore their horizons” in general.

Faith
Yeah, I’m also supportive, like just try it.

Isaac
But as long as you don’t come here thinking it will solve all your problems, The same way I wouldn’t tell a Singaporean “If you want to study, you must go overseas as long as you have the money, or you shouldn’t” I think as long as you know exactly what challenges you’re walking into, then I think it’s fine.

Faith
Yeah, just have a healthy dose of realism and pragmatism You’re not going to like heaven all of a sudden But it is possibly better, and the money is better too, so that helps.

Xiao Yue
Also, for Malaysian doctors or any other IMGs moving over here, Ii’s difficult to establish your life all over again because you’re building everything from scratch. So what do you think can help when you’re trying to build a support system?

Isaac
Well, I think building a support system, first of all, involves finding communities both inside and outside of work. I think that’s the same even when you’re in your own home country, I will say, because I suppose you go through experiences in medicine that only your colleagues might understand. At the same time, moving to a new place, you see so many things to adjust to, right?

And whether it’s people from your own home country or whether it’s through a hobby, a sport or something else, finding a new group of people that you can bond with. I think those are very crucial protective factors. I mean, as the National Day songs go, Singapore is a land of immigrants, right?

So in a lot of my daily work and all that, you know, you see so many people who’ve come here from other countries and really, really found a way for themselves. And I think that comes by putting in the effort to find people who are like-minded, putting in the effort to, I guess, be open to those conversations. But it’s tough.

Xiao Yue
Do you think it’s easy to build rapport with your colleagues, both inside and outside of work?

Isaac
Okay lah.

Faith
I think a lot of people trauma bond. If the posting is very tough or you’re stuck under a mean consultant or whatever, or you’re staying back to nine eating supper together because you know, the list was long, you will inevitably end up talking about your lives, what’s stressing you out about the job, and I mean, maybe they will “jio” (invite) you to hang out over the weekend. You can make friends.

Isaac
But I also have to say, us medical people, we are not very socially well adjusted.

Faith
Yeah, it depends. Depends on who your coworkers are. It depends.

Isaac
I mean, I think the quirks of this profession is that it’s generally a bunch of us who spend so much of our life just “head buried in a book”. So maybe compared to some other work environments, you don’t have people who are as outwardly friendly, you know, come have an office potluck kind of stuff. But I think there are a lot of very sincere people around and we welcome people from our walks of life.

Xiao Yue
Okay. That being said, what would you do differently if today you were to restart your first day of housemanship?

Isaac
Oh my god, I wouldn’t have woken up so early. I was so paranoid.

Faith
Wait how early did you wake up?

Isaac
I woke up at…

Faith
5 am?

Isaac
Yeah, exactly 5 am.

Faith
What posting did you start with?

Isaac
It was surgical.

Faith
Okay, surgical. 5 am honestly is a safe time.

Xiao Yue
How far do you have to commute to hospital? Half an hour?

Isaac
Okay, so 5 minutes. Singapore is a small country.

Faith
What time did you get a hospital?

Isaac
I got there quite early because I was really paranoid that I would have to do a million things or I wouldn’t have any idea how to maneuver. But the fact is that we were shadowing for two or three days before that. So I really was genuinely being a bit paranoid and there was a lot of supervision on my first day. So I should have just chilled out. But it was a bit of first day jitters as well.

Faith
Fair enough. Oh my gosh, what would I do differently? Oh my, I think I’ll just drink a lot more coffee. You just need to do anything to stay awake, stay fresh.

Xiao Yue
You know when you take bloods for a patient, your hands are like… trembling

Faith
Actually, we’re very lucky. We didn’t really have to take bloods that much because, thank goodness, our nurses are godsend. They do a lot of the blood taking and ECGs and everything for us.

Isaac
Our nurses are very good at bloods. When they call us and say, “Doctor, need help with difficult bloods”

Faith
If they can’t do it, then who can?

Isaac
Correct, correct. I rock up there with the ultrasound machine in my right hand. The bed gets pumped all the way to the top. I tie them with like two torniquets and I slap it like nobody’s business.

Xiao Yue
To wrap it up, so can you say one word for your first year working as a HO? Just one word.

Isaac
Eye, hyphen opening.

Faith
What? What? What?

Isaac
Eye-opening.

Faith
Eye-opening. Okay, fair. That’s one word. You stole my word. I was just going to say something that’s like, it’s in equal parts like, oh my gosh, what? I just put myself through but also like, heck yes, I did it. So it’s exciting, exciting.

Xiao Yue
Okay, she just said, eye closing.

Faith
Okay, right, eye closing after you come back from a call. You just “peng san” (knock out). And then eventually, it’ll be your turn soon.

Xiao Yue
Oh no!

Faith
Are you excited after hearing all that we’ve said?

Xiao Yue
Honestly, yeah. Because they say people grow through hardship, right? So I’m excited to see who I turn out at the end of it. If I manage to, you know.

Isaac
You’re very positive. The kind of person I will be at the end (of Housemanship).

Faith
Yeah, positive.

Isaac
Okay, very good.

Faith
Hired, hired. And yeah, that’s it for this episode. Thanks for tuning in and we’ll see you in the next one.

Isaac
Goodbye everyone.

---

Follow our socials and be sure to subscribe to our podcast on YouTube or other streaming services!

| Apple | Spotify | RSS | YouTube | Linkedin | FB | IG | Tiktok |

Want to support our podcasting side quest? Leave a tip/buy us a coffee via our Ko-Fi; even a dollar would be cool! 🙈