rAdIoLoGy NoTeS 12 - Dra. 6/28/2008 05:20:00 PM

The subtitle of this post happens to be one of my less irritating current pet-peeves. A certain radtech has started calling me "Dra." (Yes, you do pronouce it in the way you spell it... Not "doktora", but "dra") and everybody else in the department is joining the bandwagon... Of course, it means "doktora", but alternate meanings are as follows: "drama queen", "dramatics", "hydra"... Oh, the list could go on with a lot of smart-alecky staff around you (although, the last one actually came to me in a conversation with the radtechs... ). I guess that's precisely what you get if you're the only female resident in the department training for a male-dominated specialty...

I studied elementary and high school at an exclusive girls school. I took biology as a preparatory undergraduate course for medical school in a female dominated class. In medical school, approximately 70% of our class consisted of female students. My senior clerkship group (in my part of the country, we usually refer to it as internship), consisted of five females and only three males. When I did my internship (in my part of the country, we refer to it as post-graduate internship or pgi), my first group was all-female. In my second group (I did PGI mid-year) I had only two male groupmates (and one of them is an outed homosexual, the other one, people had been speculating on for a time, though he now has a girlfriend). I have more female friends than male friends. I also lend a hand to a foundation that specifically caters to female youth. I was definitely in for a culture shock of sorts...

I actually applied for residency at two hospitals, and at both hospitals, they asked me whether or not i was married, or had plans to get married, musing on the possibility that I might get pregnant while doing my training (the other residents will have to cover for a pregnant radiology resident doing and supervising radiographic procedures due to fetal risks). Then, at the other hospital I applied to (not the one I am currently working in), one of the interviewers specifically stated that in a span of two or so years, they had two residents resign, and both of them happend to be female. At the back of my mind, I was already thinking that they won't accept me (which was a blessing in disguise since I was more keen on doing residency where I currently am now). That was exactly what happened although I think my gender was not the main reason (I think they were more keen on accepting the other two applicants who had their PGI in the same hospital).

When I did begin residency, I had to adjust to a predominantly male work environment. There is only one female radtech in general radiology (the rest of them are in the women's imaging center), and only one female interventional radiology nurse. I answer to only one female radiology consultant. The receptionist and secretaries though are all female. At our monthly meetings with radiology residents training in our city, I found out that only two of us are female, and she is already about to end her training while I am just starting mine. Hopefully, more females will take up radiology in our place in the years to come. Otherwise, I will have to contend with the fact that I'll be the only female radiology resident in the years to come.

I still detest having to listen to my seniors and other staff comment on the way certain females look/dress/etc. Sometimes, they start talkig about their night out at some lewd place (Do they sometimes forget there is actually a female working nearby or is it just to irritate me?) I still put my foot down on any joke or conversation in any shade of green (Totally inappropriate in any working environment, or any environment for that matter even if to some, the mere fact we are in the medical field, anything goes in that direction...).

The equipment are actually more tailored to be handled by male staff. The fluoroscopy machine's image internsifier is bulky, heavy and a little difficult to manipulate, more so if it gets stuck in one place ever so often. The lead gowns are heavy. The cassettes are also heavy. Giving an intravenous push of contrast also requires some degree of force. Preventing a hematoma after taking out a femoral catheter also requires some force (Perhaps that's why the interventional radiologist has not yet asked me to remove a femoral catheter from any of his post-coil embolization patients?) In the first few months, our chief resident has occasionally joked that I consider working out to build some upper body strength.

Not having had a female radiology resident for the past three years has sort of confused the nursing staff. Just one of the many cases to point:

Department Receptionist: Doktora, telephone call.

Me: Hello, Ma'am?

Nurse: Who's this? I'm looking for the radiology resident.

Me: Ma'am, this is Dr. J.A., the radiology resident.

Nurse: Hello, Ma'am, we have a referral for Dr. --- at room --- for ultrasound-guided liver biopsy.

Me: Who's the primary atttending physician?

Nurse: Dr. ***

Me: Ok, I'll inform, Dr. ---.

Nurse: Who's this again, Ma'am? Are you going to tell the radiology resident?

Me(now a little bit irritated): Ma'am, this is Dr. J.A., the radiology resident.

Nurse: (Pause) Ah, ok, Doctor.

Some female patients undergoing more delicate special radiographic procedures (i.e. a hysterosalpingogram) do appreciate that the resident around is female. At one time, a patient did request for a female resident. It was a good thing that it was also my assigned day for special radiographic procedures. I have no qualms about doing a urethrogram on an adult male patient though. It is part of my job, and anyway, more likely that not, the staff around are also male. At one time though, while supervising a voiding cystourethrogram, I decided to leave the room while the radtech was doing overhead films as I thought that the young boy might have inhibitions on urinating while an unrelated female was around.

I still get a little irked when some patients still refer to me as "Miss" or "Ma'am" while I am wearing a doctor's coat. I guess the average Filipino mentality still thinks females in white at a hospital are nurses while males in white at a hospital are doctors.

A Doctor's Value 6/07/2008 10:28:00 AM

I am relatively young in the world of the medical profession, having just received my license to practice a little over a year ago. And with that came automatic membership into the local medical society under the Philippine Medical Association. Until now, I actually have no idea what their activities for doctors is, although I recently heard about some symposium in our place, which I'm not sure any of the other young doctors were able to attend. For most of us residents, the next time you usually here talk about the PMA is when someone is about to take the specialty board exams (i.e. the chief resident in our department) and finds out he/she needs to pay the requisite membership fees for the past 3-5 years which he/she was not faithfully remitting to the society. After that , probably you won't hear much about the PMA... you'll hear more from the specialty societies...

I'm sorry that I still have to figure out for myself exactly what they are doing for us and what we are doing for the Philippine Medical Association in turn. Honestly I'm clueless... So, I really can't say anything more based on personal experiece.

I hate to say it but the fact that a lot of the doctors in their mid-30's to early 40's are taking up nursing to seek greener pastures seems to say volumes about the state of the profession. Maybe they don't feel their family will be secure with them staying and practicing their first profession in the country?

Fewer students are deciding to take the additional 4 years of medicine plus one year internship to get that M.D., and of these, probably 3/4 (I'm stating this as a reality in terms of my own class- CIM 2005) will be aiming for the USMLE and other foreign board examinations with the intention of settling elsewhere for good.

The few of us left doing our residency training are probably also thinking of doing further studies abroad (that's one option I'm personally inclined to) and probably settling somewhere else in the near future (Personally, I'm not inclined to the option of permanently renouncing my citezenship, but it's not something I'm totally ruling out either).

So, what's the value being put on us? Maybe it isn't that much. I know residents in the capital are paid a paltry. In our part of the country, most of us are paid a little higher (can't complain about my own salary as I get to save since I work pretty near where I live with my family and can save on some expenses) yet there is still a general dissatisfaction about the income that pervade (i.e. a co-resident of mine having plans to get married next year is taking up a side-line job just to afford to pay for the wedding expenses). When you go into sub-specialty training locally, you still get paid a paltry sum... Then, when you start your practice, it's another story... A friend and college classmate of mine, also planning to go into residency training in radiology stated it plainly when she told me: "You know, we will probably have to set-up a diagnostic center together..."

So... Maybe I am a bit worried with regards to the financial side of this profession. Still, I think it is a pretty noble endeavor, although reaping the rewards of the time, effort and finances you have sacrificed are a long time in coming or won't come at all. Afterall, we touch on something basic in a person - health. Sometimes, it is not just the physical side of the person that you touch but also one's mental, emotional and spiritual well-being. Still it is a way for one to earn a living so one has to be able to determine the pros and cons of determining the right professional fee for one's services, or maybe decide to charge nothing at all.

Somehow, I have always sort of counselled most of my younger friends not to enter medical school by presenting the hardships that are in the way. My advice though is seldom heeded as just this school year, I happen to have two good friends who are not about to heed my advice by beginning their freshmen year of medical studies.

I'm keeping my fingers crossed that my youngest sister (about to start 3rd year high school) won't follow the footsteps of this eldest sister... I still don't want anyone else in my immediate family to go through everything that I did to become a doctor and whatever difficulties I have yet to undergo to establish myself in my chosen profession.

rAdIoLoGy NoTeS 11 - The 10 Things Which Explain Why I Am Lucky To be Where I Work Now 6/03/2008 05:10:00 PM

I think it is about time I stop ranting and raving about the difficulties now that I am about to end my first six months of residency training... So here's a short list of why I am lucky to be doing my residency training where I am now surrounded by the people around me now in my work place.

1. I have only 4 consultants to whom I am answerable to and I already know their quirks and personalities.... I get along with all of them for the most part, and know that I can relax around them. If I make a mistake, I know for sure I will never be yelled at... mistakes will be pointed out to me as calm as possible.

2. I can vouch that my three male seniors care for me in their own way although they will try to get on my nerves at certain times. They sort of look out for me and advise me at all times.

3. As I am in-charge of the interns a.k.a. senior clerks rotating every fifteen days at our department, I also get to look out for two or three persons and help them to understand the intricacies of the different imaging modalities, though I don't entirely understand things myself either. I have always wanted to influence people in a positive way,a nd this is it.

4. By sometime next month, I may get an assignment to lecture before the second year and third year medical students of the affiliate university of the hospital where I work. It reminds me of my first career choice which I wrote down way back in second grade- to be a teacher, like my mother (who used to teach grade school before she chose to be a housewife). My father, an engineer by profession also used to teach mathematics part time to business and accountancy students of the university I went to in college. It sort of continues the tradition -> now I'll be teaching medical students, and for the first time, they will get to listen to someone who has gone through the entire process of problem based learning (PBL) give them a lecture. As one of our consultants just mentioned today, it's a practice for when you'll be "lecturing" the examiners when taking the oral examination for the specialty board.

5. Even if the mostly male staff (from the chief radiologic technologist of the hospital down to their probees... well even the rad tech interns occasionally...) will tease me to no end, I guess that somewhere beneath everything, I have already sort of gained their trust in my ability to take care of the work done... I'm starting to believe that everything they say is only part of their..."pag-lambing". And today marks the first time (I still can't believe it has happened though!) that none of them had made a teasing comment at all!

6. The secretaries and receptionists will talk... Then again, what else will they talk about now that I have told them point blank the real reason why I have no intentions of getting married (sigh!). As usual, people can't seem to grasp the concept of someone not being a nun , not living in a convent or wearing a habit and still not getting married for loftier reasons.... Maybe I still have a lot more explaining to do through my actions as well, which is a lot harder since the staff can get on my nerves.

7. Mama still packs me a great lunch everyday. I do need it. And so I am grateful.

8. I still get some occasional lull time wherein I can relax at my workplace.

9. I am at the coolest department in the entire hospital.... It has somewhat calmed me when I am particularly busy and moody at times.

10. The Blessed Sacrament is reserved 24/7 at our hospital's chapel... I can always go there to seek solace, or if I cannot do so at once, I can "fly" there in my mind's eye.

I guess, there is no more reason for me to be ill at ease, to be frazzled, annoyed and worried if I always keep in mind these 10 thing.s

Blogging For Me... 6/01/2008 06:24:00 PM

I started blogging when I read an article in the Philippine Daily Inquirer all about it. It was my in-between period after passing the board exams and beginning residency training then. And, so, I got hooked. I have been blogging more or less regularly for a little over a year now and nearing my 100th post.

I have always loved to write ever since I was a kid->stories, poems,essays, even some short novels, mostly unpublished. I became literary editor of our school paper in my senior year of high school. I also kept a diary more or less daily from high school until early college days. I now edit the semi-annual newsletter of Banilad Study Center. Though I never thought I would make it a career, writing was always my hobby, something I would have pursued if I didn't want to become a doctor in the first place.

The switch to the realm of the blog came natural for me who have long mastered the intricacies of doing things over the internet and emailing back when I was in college.

When Dr. Clairebear extended the invitation to "The Blog Rounds", I naturally gave it a try and came out with my first entry in its 5th edition, giving in more of my contributions and eventually hosting the 11th edition.

I like the idea of the blog rounds, writing on a theme and making it your own, setting your own boundaries. Somehow though, I find the once weekly schedule a little tight (even if one may or may not choose to blog on the weeks's topic anyway). Maybe a bi-monthly schedule for us doctors is more feasible?

I also like to read up on other people's thoughts on the different topics as it is a great way to find out more about someone you may not have yet met in person. You get a lot about his/her personality from the things he/she writes about and more or less find out more about the persons values and way of life.

I hope the blog rounds continue their discussions indefinitely into the near future with the hope that more doctor-bloggers will join our rounds.

Post-Script to My Best College Friend's Wedding 6/01/2008 05:32:00 PM

It's kind of odd that I only got to met her then husband-to-be in person (he's based in the UK where they plan to settle down eventually) when they were already sending out the wedding invitations. But judging from all I heard about him, I already had an inkling that the first guy to catch my choosy friend's heart would be the last one as well.

I would have had a chance to be at the wedding to (one of my seniors said that he would cover for me...), but I decided to finish the last special radiographic procedure for the day and miss the 3 o'clock wedding. If I had been there, I swear I would be crying my heart out.

She already knew I would be late for the reception, (my early Friday evenings are fixed for activities at Banilad unless I'm on duty...) but it didn't matter since I came to the wedding reception eventually.

Seeing her in that gown really tempted me to comment on its style (I had already warned her to wear a bolero at the church-she ditched that at the reception, though... but forgot to warn her about showing more skin elsewhere... ), but I decided to hold my tongue until later...

I then started to reminisce on how a friendship developed some 11 years ago when this other four-eyed girl in loose jeans and a shirt (just like myself) started hanging around my arm (literally!) and sniffing my hair (literally as well!).

On one jeepney ride in between classes (and campuses) I learned the telenovela of her family life, quite different from the normal humdrum one that I had. I was amazed that amidst it all, this was a girl who was determined to rise above her family's past.

We officially quarrelled for the first (I think, it was also the last time) from the stress of working on our baby thesis together for Ecology in 3rd year college. We patched up almost immediately.

I wrote several poems for her, but I still wonder if she was able to keep them all.

We started attending activities at Banilad together. She was one of the few people who new I was about to become an associate and let me go my own way. I'm sure she did not understand my decision entirely (eight years ago, I'm sure she'll agree how immature she was then....).

In medical school, she made more new friends, had different interests while I focused on my studies and slowly adjusting to my vocation. Somehow, we drifted apart, but still a certain connection was there whenever we start up a conversation again, just like we just talked yesterday.

I'm going to miss her when she moves to join her husband definitely, but right now, I savor the times we still text with each other now that we are doing residency training in different cities.

I guess, Angie, I'll always remember you as that four-eyed girl attached to my arm and sniffing my hair over my shoulder...

TIME TO GO ON A FOOD TRIP! 6/01/2008 04:58:00 AM

It’s just about time for us to cut the chitchat short, say grace and dig in! This banquet is officially about to commence!


MerryCherry, MD gives us a glimpse of how Kapampangans do their cooking in “Mangan Tamu”


Joey MD gives us a glimpse of her food choices in “Around Robinson’s Place Manila in 5 Days”

Noel gives us a sampling of international cuisine in his entry “Recent Acquaintances: Pastitsio, Kulfi & Cherry Garcia”


Dr. clairebear takes us down memory lane with this oh-so-familiar street food in “Fishball Memories”


Kittymama shares how Lasagna became her comfort food of choice in Garfield’s (Kitty)Mama”

Dr. Tes glorifies the quintessential Pinoy fiesta favorite and mainstay in “Lechon of my Life”


Got meloinks shows us his sweet side as he savors the sweetness of muscovado in “The Case of the Skin-Rejuvenating Chicharong Bulaklak and the Evil ‘Kamay’, which turned out to be Muscovado”

Ness teaches us the intricacies of cooking this native kakanin the old-fashioned way in “How to Cook Palitaw”


Your host, J.A. presents you with her favorite drink, on the house in “Ice Tea Girl”

I hope you all had your fill of our sumptuous feast. Thanks for joining TBR 11!

P.S. My apologies for failing to earlier cite Abner M. Hornedo, M.D.'s entry "Picky Eaters".