Before Applying

Few Points to make priority list, for intern and post intern vacancies of doctors.

INTERNSHIP APPOINTMENTS

This is the year that you work with your maximum capacity when compared to the rest of your carrier. But in this period you are handling a less responsibility than MO s and SHO s. Here you will be trained for one medical subject and one surgical subject. You are supposed to make your priority list once they give you the vacancy list, within 1 or 2 hrs on the day that you are requested to apply. Therefore you have to have some idea about the stations that you are going to apply, beforehand. Unlike post intern appointments, here the vacancies are called only for teaching , general and high grade base hospitals only. All the hospitals in the Colombo district is given as single group, and you might have to work in two hospitals in that group 6 months each. You will not select the subject (or the unit) with this list but only the station. You will be allocated to the relevant unit, (medicine, surgery,paediatrics or gyn and obs) on the day you visit there, depending on the shortages and (most of the time) your merit rank and mutual preferences of your group.
In a teaching hospital or a general hospital you will be much busy only on casualty (admission days)and post casualty days, it may be 2,3 or 4 days a week, yet you may have to cope up a big workload on that day. In a base hospital where there is a single unit in each category, there will be daily admissions, but your ward will not be crowded and you may not be overloaded with work.
When selecting the units, it is important to think about your plans for further studies. Also there are some fields that are worth to be covered than others. If you are selecting paediatrics you will feel very comfortable when dealing with children later on. Sometimes you might get a short PBU training in paediatrics which makes you handling babies with ease, in your profession and your perosnal life as well. By doing gyn and obs you will learn how to manage a child birth with minimum available standards, even in a peripheral hospital. By covering these 2 appointments you will feel confident to work in any unit in the area of the country you want, once you apply for Post intern appointments.Having said that I must mention if you have done medicine in internship you will be fluent in managing different medical emergencies as a medical SHO and you will work well in paediatrics also , but after a short experience.Same applies in surgery for Gyn and Obs and much more experience is needed. In a base hospital, ( where blood bank MOs are not doing night shifts) you will get a short training on cross matching. But they all may be important to you one day.
RHO period also important. Try to select a field that you haven't covered before. In your intern, RHO and early post-intern period, having covered paediatrics and Gyn and Obs, if you can cover any field with critical care (eg.SICU,MICU,Anaesthesia, ETU), you have touched the all the difficult areas in medicine that need special skills of hand, and you will feel confident to work in any unit in the country, like a commando soldier in the battlefield.
Internship is hard, but you will not be tired with your heart, the more you work, more you will be satisfied with your job.

POST-INTERN APPOINTMENTS

Here you are appointed to more peripheral hospitals in the country, and you have to cautiously select the station and the unit.There are number of factors to think before applying, within 1 or 2 weeks given to you.

1) Transport

It is important which mode of transport you are using. It may be your personal vehicle, bus or train, or 2 of above. Here the time taken and availability of a mode of transport matters than the distance. Although there are hospitals of 3 1/2 hr reach, even 200km away from your home, there may be a peripheral hospitals in your next district with difficult transport. Bus services may not be available in night hours, and roads may be flooded or covered with mist in rainy days, which makes it difficult to reach even with your private vehicle.

2)North and East Hospitals

By working in hospitals in North and Eastern provinces, you are allowed to apply for annual transfers within 1,2 years. Yet this may highly depend on the replacement of the MO s of the station your station. Also north and east special list is planned be inactivated in near future. If they have not mentioned about it in your vacancy letter, it is safe to contact Ministry of Health (0112 694033) for verification.

3)Further Studies

If you are planning further studies, better to prefer a unit relevant to your subject that enhances your experience. Other than that I recommend selecting a Teaching or General hospital, even hundreds of miles away ( If you are qualified to apply with your merit) than selecting a base or rural hospital in close proximity to your home. In teaching hospital with high turnover there are young MOs and SHOs who are engaged in some sort of study, where you will eventually feel like working when fallen with them. On the other hand in many peripheral hospitals most of seniors may not be interested in further studies,(yet they will support you to studies). But if you have a strong desire to study this will not matter.

4)Shift duties

In some units you will be doing shift duties(usually 6h, rarely 8h) as MOs. Eg. Anaesthesia, SICU, MICU, ETU,PBU, SCBU, Blood bank etc.Here you can freely change your shifts with your colleagues,to get off days, within their standard limits. On the other-hand if you are working in a ward you may have to be present for the ward round every morning, you may have to cover clinics, and the whole day and night should be covered on your on call day. If there are only two SHOs in the unit you will be on call every other day. (Eg. Surgery, Medicine)

5)Clinical exposure

As MO s of some of the units you will get a minimal clinical exposure. (Eg. Pathlab, Microbiology, Blood bank, Radiology) But in some of them you are not having night shifts and you will be off in all Sundays and public holidays.If you are busy with your personal and family issues these units seem better for you. But for many of  MO s it gives a less job satisfaction as they rarely communicate with patients.

6)Skills on critical care

By working in a critical care unit (Anaesthesia,ETU, SICU,MICU) for 1 or 2 years you will get an outstanding skill, when managing critically ill patients, which is highly recognized both nationally and internationally. In the Annual vacancy lists you will see relatively a large number of vacancies in these areas each year and you will be welcomed for these fields in many developed countries after completing there licening exams.

7)Salary issues

Most of the time by doing shift duties you can claim less extra duty payments, and much less in the units with less clinical exposure.It is prominently seen in the units with a large number of MOs. You can claim more by working in a ward setting. But this may be varied into some extent depending on the station. Also there may be a some delay in receiving extra duty claims, and the other issues dealing with salaries, in some base and peripheral hospitals, compared with hospitals ruled under line ministry.

8)Other factors

Climate will be important if you are applying for stations highly above sea level and distant north and east stations.You might have to work with different people with different social norms in different areas of the country; that also have to be thought of. But 99% of people in rural areas will consider you as their god.You must take special care when applying for undesignated posts. Sometimes you will be an MO (Medico-legal), or MO (Gyn and Obs) or you may have to work for some other units also, other than the one you allocated.

Take your time, relax and make your best priority list. After making the first, go from top to bottom, comparing each station with the one above and one below, also compare the each post in single station that you have selected as you might not get a chance to correct your mistakes for the next 4 to 5 years. Get the necessary up to date information, and the opinion of your colleagues and your seniors. If you are not having a source of information, get the contact number of the hospital and ask one of the SHOs and MO s or Nurses there, but be tactful to understand while on conversation, whether he / she encouraging you genuinely or not.(Contact numbers of all Hospitals in each district is available here). Although you are stressed-out in some situations, the more you work more you will be satisfied as you are still in your late twenties or early thirties.
 Finally, think more on your service and welfare of patients than your own comfort and income. Best of luck !!!


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