Being a fashion designer vs. Being a Doctor in Uganda

A little known fact about me:  when I was deciding what I wanted to do following high school graduation, I had strongly considered applying to Parsons or FIT with the goal of going into the fashion industry.  Being practical, I decided to attend a regular 4 year college to keep my options open.  In addition to loving fashion and clothing construction, I also loved science and knew that medicine would not be feasible with only a Parsons or FIT background.  At some point in college, I finalized the plans to go to medical school.  I knew the training would be tough: four years of non-stop studying followed by slaving away as an intern and resident.

Though my journey to become a physician was by no means easy or without its challenges, I tip my hat to the Ugandan medical students and residents.  Why? Because if I had to do what they do to become a doctor and get paid the salary that Ugandan physicians get paid, you surely would be wearing the spring line from the Sheryl Natasha House of Fashion instead of reading a blog written by Sheryl Natasha Young, MD.

After secondary school (or the equivalent of high school in the U.S.), the Ugandan students who qualify will enter medical school.  There are some private as well as publicly funded spots for these schools.  After medical school, they enter internship year.   One intern can be responsible for twenty to thirty patients. An internal medicine intern training in the United States is limited to providing ongoing care to a maximum of TEN patients.    

The work of an intern involves evaluating patients, drawing blood, inserting tubes for feeding or urinating, communicating with families and a laundry list of other duties.  This makes for very long hours.  The days off are limited.  Per one intern with whom I recently worked, he had no days off in the preceding 7 weeks. They get paid the equivalent of $250 per month.  From my observations, the interns work and function without consistent supervision, education, or support.  

After internship year, the intern may go into general practice in the community or return to obtain more training as a Senior House Officer (the U.S. equivalent of a resident).  This involves working long hours supervising interns and providing care to a large number of patients.  Because this training is seen as Master’s level program, the Senior House Officer pays for his or her residency training.  This was astonishing to me as I could not ever fathom paying to do residency.  Though I did not get paid much during residency, the fact is that I got paid.  And my salary was sufficient for a decent standard of living. 

After finishing residency, Ugandan physicians then go out into the world to make $700 per month.  That’s less than what I made as a resident and less than what a moonlighting hospitalist in the U.S. can make in one 12 hour shift. Many Ugandan trained physicians will leave the country and go to places such as Rwanda, where they can make $2000 per month.  Those that stay hold more than one job to support themselves or go into research. 

The collision of a harsh training environment, brain drain, and poor compensation results in a milieu in which patient care can get lost in the crossfire.  In realizing this, I now have a better understanding of some of the things I have seen in the hospital.