FM Residency: Six months later, older and hopefully wiser

Welcome to a little blog on what I’ve been professionally up to in the last six months, Maybe it’ll give you an idea of what Family and Community Medicine is like here in the Philippines. Maybe it’ll inspire or scare you off. In any case, hopefully it’ll be a smooth read…

I haven’t written anything that isn’t a case report or presentation script for weeks and weeks. Even my journal’s been left alone. Oops.

Someday I’ll have the emotional energy to write a more introspective piece. For now: my memories.

In this blog post slash photo gallery:
1. Five big moments I live for
2. The moments I can live without

Before anything else, thank you to my family for being a constant source of inspiration and support, to my friends for always keeping in touch, to my co-workers for sharing and carrying and brightening the load, and to our patients for being our partners in whatever passes for our health system.

The five moments I live for

It’s hard to remember the good over the bad. There’s the stress of adulthood, and the career-specific anxiety over having to care for other people’s actual lives. The world isn’t helping.

But there are good days too. And the good, even in their smallness, can be enough.

#1: Direct patient care in the outpatient clinic, ambulatory care unit, and pay floors

Essentially: out of the hell that is the UP Health Service and into the Family Practice Center / Ambulatory Care Unit… And then everything else that followed in the last five months.

It’s less of a moment and more of a vibe.

For context, I spent the first month of the year as part of the ‘organic’ or main UP Health Service team. As part of the response to the COVID surge around that time, our consults were all via telemedicine. And all of our consults were COVID-related. Nothing else.

January 2022: first weekend of the year with Joe and Kata (also spiritually with Berty, not in picture). No direct patient encounters, no holistic care, no considerations for wellness, almost zero learnings (outside of data management and COVID pathways). I’m surprised we made it out sane.

Surviving my way to the next rotation —actual consults in the Family Practice Center— was a balm to the soul.

(Read here: FM Residency: From 0 to 100 real quick)

February 2022: Mostly teleconsults, but at least it’s not COVID-19. Featuring some of the best people I was still only getting to know at that time. If you asked me then, I could probably only name… 50% of the people in this photo lol. Well, I could definitely name my batchmates Kenneth, Kata, Paige and Berty, and FPCO Ma’am Jan, who held my hand especially through the more troublesome MHR consults.

Also, it’s the month of love!!!
March 2022: Actual face-to-face encounters! Down with telemedicine at this point. With the COVID-19 surge dying down a little bit, I finally got to meet more new patients in person, instead of the awkward call-then-followup combo of the previous month. Extra thankful at this time to Ma’am Eka (an ASMPH alum / inspiration), and also sir Nato and Ma’am Kim for the perennial good vibes.

And yes, we look cute in pink.

For the first few months in the outpatient clinic, first-year residents have to refer all of our patients to a consultant or to a third-year resident. This kind of learning opportunity and guidance is one of the reasons I set my eyes on residency instead of moonlighting. There’s only so much you can do with self-directed learning and online clinical practice guidelines. Our patients deserve only the best.

April 2022: A little wiser, a lot sturdier, and definitely… more tired. Haha! I love the outpatient clinic (it’s what I see myself doing as a clinician in the future), but three months non-stop is also tiring. My seniors are a champ for making it through April, which also saw a couple other big changes.

But what doesn’t change is (1) how much I love Ma’am Mara’s sense of style —prints don’t work for me, but they definitely do for her (leftmost), and (2) how much I love mock neck tops. I digress.

The Family Medicine Clinic really opened up to face-to-face new consults some time around March. Around the same time, the PGH ER also started opening up —and that meant spending weekend duties and some weekday shifts in the Ambulatory Care Unit.

Welcome to the Ambulatory Care Unit! This was taken sometime last month. The actual first months of the Ambu post were way too chaotic to snap a good picture. Cheers to our series of stellar SASODs (second-year Ambu queens) — Ma’am Mara, Ma’am Sitti, Ma’am Harlene, Ma’am Kim (in this photo), and now Ma’am Karina! And also to our stellar interns. :)
Ambu life, aka ergonomics, who is she? Always inspired by my batchmate Paige to stay hydrated and limber. Not that I always get eight glasses in a day… Asian squats count as an exercise, maybe.

I finally got some time to explore PGH outside Room 216 and the Ambulatory Care Unit when I rotated in the pay floors last May. Helping handle continuity patients admitted under the service of our Family Medicine consultants is a different experience.

May 2022: my partners in Ward 12. I loved rotating as Pay Jr. Aside from getting to appreciate the different styles of our consultants in terms of managing inpatients, I also got to be more comfortable interacting with my co-residents! And with sleeping in ward 12.

Shoutout to Ma’am Abbie (my senior partner in musubi and coffee), sir Epi (thank you x infinity for being cool and also for the tech support), Sir Ray (topnotch conversationalist and part-time IM rotator), Ma’am Sitti (SHPM and also multi-tasking queen), and sir Ronan, my senior resident (who codes video games???).

Lots of love and may you continue to all eat good food.

June 2022: Back in FPC. June saw me working through a pretty significant milestone (which will come around in a bit) while trying to battle burnout and ennui. It all worked out. I’m still pretty fine.

Family and Community Medicine is about holistic, preventive and patient-centered care. The three rotations I’ve been through so far already illustrate the many faces of our healthcare system. Family physicians can see patients when they’re well or stable at the OPD, when they’re in need of acute care at the ER, and finally when they look for more intensive management and coordination of care as admitted patients.

Honestly cannot wait to rotate and serve in our partner communities!

#2: Partners in care

There are a lot of things I can say about my experiences as a clerk and intern in The Medical City (and I have said them in this blog, in like 10,000 words total at least), but what I want to say now is that I love the idea of the hospital’s tagline —The Medical City: Where Patients Are Partners.

Because patients are our partners. It’s their body, it’s their life, it’s their health. Doctors and nurses and the entire healthcare industry can only know and do so much.

So I love it when patients are proactive in their care, and when they show the willingness and drive to make an actual physician-patient relationship work in the long run. And I love it a little extra when they show their appreciation through gifts.

The first tokens I’ve received from patients at the FPC OPD. I don’t eat a lot of food, but I always make a point to add a couple hundred more calories per day if they’re gifts from patients. Our patients don’t pay anything for the OPD consults, as is only right, so going out of their way to buy and bring gifts make me feel a little something. Like I have a heart, maybe.

These shows of appreciation are only second to the disbelieving “thank you, wala na bang babayaran?” we get from discharged patients at the ER. Yes you do deserve free healthcare. We all do.

#3: Now an earning adult!

I worked part-time most of my way through the last year of college until third-year college for shopping money. But it was barely any money —I got PHP1 for every 2 words I submitted, leading to the most convoluted run-on sentences you’ve seen. Still made it to through the SEO checker though.

Anyway! So this is the first time I’ve ever been a proper salaried adult. And most people who know me know I’m not particularly frugal. No apologies.

I may or may not be occasionally late to paying rent. Lol.

First treat. Once I received my first every salary back in March, I immediately invited my family to lunch. My mom even whipped out her “I raised an Atenean doctor” shirt.

I’ve yet to to treat my other tuition fee sponsor though. Someday, kuya!
Outfitting a condo unit: not easy. Also pretty expensive. But ultimately…… super fun and fulfilling to see pieces come together. I’m highkey obsessed with these pretty and versatile trolley carts.

I’ve been going home for a night or two almost every weekend recently. I kind of lowkey miss the days when UPHS duty had me stuck in the condo cooking up food in my tiny kitchen.
Outfitting… myself. The natural consequence of disposable income + a love for beauty and fashion. I’m still a big fan of the linen basics brand bymeadow and Uniqlo.

#4: Clinical case presentation (it takes a village)

The clinical case presentation is one of the capstone projects required of first-year residents. (The other one—the research capsule—is eh. Save me.)

I got lucky enough to be the first in the draw. Ha!

After several pints of blood, sweat and tears —helpful tips from seniors like Sir Ray and my buddies Ma’am Airam, Johna and Kim— criticisms and points of improvement from my mentor Ma’am Ella and the other Wednesday service consultants —encouragement from my co-residents, especially Kenneth— a ridiculous tech problem with my wi-fi failing at the last minute—

It’s done. Mark the date of my rebirth as the 9th of June 2022. Yay!

STUCK IN THE THROAT. But thank the universe the actual presentation went well with lots of engagement from the online audience, despite the Internet-related birthing pains at the start. Thank you again to Ma’am Ella and our other attendees!

I’ve never really been one for “mentors” throughout my academic career. Psychoanalysis suggests it’s because I’ve always been a pretty independent child when it comes to work; my mom was always too busy building wealth to actually check over our assignments.

But having the option to approach seniors and consultants is great. There’s a comfort in knowing there’s a culture of learning and even competitiveness within the department.

Miyerkules, BE THE BEST! We’re cute. This is cute. I suddenly love teambuilding and other formative activities.

As this academic year’s first interns’ monitor, I even have the opportunity to act as a guide of sorts to our junior doctors. The responsibility is a bit overwhelming, especially with everything else going on, but I’m really excited to take a more active part in this culture of learning.

Happy first day of internship to block Y (and Z)! Good luck to us all, and as always: happy aral.

Our faculty consultants are ringing up my Viber on a Sunday though… I see nothing. I am nothing. My comms systems are down and they do not exist.

#5: DFCM Teambuilding

A weekend with good food, fun team activities, and the sea breeze. Someday I’ll have the time and energy to clip together an aesthetic travel video.

Hashtag blessed. Hashtag thank you the department for making this happen.

Somewhere in Batangas —we stopped thinking about work, we played around, we had some fun.
SINAG, SHINE BRIGHT: This photo is everything. I love sunsets.

Also: I even got to ride a banana boat for the first time!!!

The right people can make or break a working environment. There’re always gonna be bumps on the road.

But I’m feeling lucky.

The moments I can live without

Where there’re ups, there will be downs.

I was thinking of devoting some time picking out some photos of the worst moments of the last six months, but I don’t really have the habit of savoring and documenting crises as they happen. I can barely remember specific moments.

But there are days where I feel overly stressed and difficult. Mostly I resent nights when I get home 8PM only to keep working until 11PM (ehem, Omicron surge of January 2022). Or even recently, when backlog papers at Ambu keep me glued to my laptop until 9PM.

Off duty at 9PM. Wrapping up endorsements and clinical abstracts is an adventure on its own. 0/10, would not repeat. Glad to have misery in company, I suppose.

And sometimes I want to scratch my head at the number of presentations we commit to every month. Last June, I was slated for my Clinical Case the first week, then virtual chart rounds the second, then an ambulatory ER case presentation the third. I was also up to present a case for evidence-based medicine appraisal on the last week, but the conference was fortuitously cancelled.

It’s hard to be a pseudo-Type A, enneagram Type 1, work-fast-to-rest-early kind of person when there are always so many things to keep track of…

I’m not alone in feeling this kind of burnout. Also: six months in, and my body is still protesting at the 7AM calltime. Or maybe it’s just been more resistant lately because of the cumulative stress.

Conferences make for some small moments of happiness though. Pair it with an Internet lag and you get this.

There are times when patient encounters break your heart, either with the permanency of death or with the shackles of poverty. There’s almost always nothing to do except to comfort.

But on the grand scheme of things, even heartbreaking moments have their sweetness, and difficult tasks carry their own rewards. Maybe these are less moments I can live without than they are moments I need to better appreciate the work of living. Maybe this is enough to keep me going.

(I really did go to DFCM for the relative life-work balance though.)

Until next time!


with love, your (mostly) friendly family and community medicine first-year resident.

p.s. hopefully I’ll get to write about the more practical things that have helped me survive the last few months. until then, follow me on instagram.

Say something back.

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s