From an outside perspective, medical school and the first years of someone’s medical practice in the Philippines might look busy, but still manageable—just another field, like any career, busy blocks punctuated by weekends of adventure, family time, and more.
Lived reality says otherwise.
This is not to discount the capability of our med friends to manage their life beyond the walls of a hospital or clinic—but there are challenges specific to medical school and medical practice that outsiders do not see. Each day for a med student or young doctor has specific challenges, and the marathon from medical school to a lifelong practice comes with endless sacrifice. Each time a med friend does manage to show up to a reunion, gathering, or occasion, they had to sacrifice something or choose to take on more work later.
Each day for a med student or young doctor has specific challenges, and the marathon from medical school to a lifelong practice comes with endless sacrifice
And if you live with or know someone in medical school, or if you yourself have been through it and is establishing your practice and career, then you’ve probably experienced conflict surrounding occasions and presence
On roles: A medical hierarchy
Medical school is not just a post-grad study; it’s a series of post-post-graduate studies. It can be likened to getting a PhD after an MA, but on steroids (to my anesthetics residency friends, sorry for the metaphor).
First of all, we might mix up the terms describing the stages a doctor or aspirant is in:
• Clerkship: usually refers to their last year in med school, or their first exposure to hospital duty. At this stage, they mostly observe how a hospital runs, tailing interns and residents.
• Internship: has a noticeable bump in duties from clerkship. This stage usually occurs between the last year of med school and the medical board exams necessary for becoming a licensed doctor (MD).
Not only is an intern doing the rounds in the emergency room (ER) and wards, but whatever free time they have goes to review classes and self-study, tackling everything they learned from first year.
• Residency: begins once they pass the boards. This is when a doctor truly becomes answerable to their patients and the hospital they represent.
You’ve likely met a resident in the ER; they were the doctor who took on your case after the interns screened you and noted vitals (as the clerks nodded in the background). Only board passers can be residents.
This stage has an exponential jump in accountability from internship and clerkship. Once they’ve determined the specifics of your situation and administered initial treatments, a resident often refers you to their higher-ups, the consultants, for specific procedures.
• General practitioner: Some doctors opt not to take residency and start a career as a general practitioner, often moonlighting in different hospitals and clinics instead of being tied to a single institution.
Back in the day, general practitioners were often the barrio doctors handling any and all cases from live births, surgery, flu, and the occasional gunshot wound, but as medical knowledge and safety standards have expanded, more doctors have increasingly been drawn to specialization.
• Consultant: After residency, a doctor is now a consultant, a fully-fledged specialist in their field: OB-Gyns, ophthalmologists, surgeons. They all made the cut after a grueling three years and another round of study and exams.
Nonetheless, all this comes with final accountability. Any decisions made for patients—to operate or not, to send home or not—are made by the consultants.
• Fellows: Consultants who opt to dig deeper and study the ins and outs of a specific ailment or condition within their field of practice. After two more years, they finish as fellows.
Consultancy is a better era than residency, though, with more breathing room and work-life balance, as many of my friends who’ve passed residency are now in their running/climbing/Pilates era, tying the knot, or traveling.
On terms: A healer’s vocabulary
There are also time-bound terms indicating if a trainee is done with work or about to go to work. In reality, these terms are for the people who care for them to know what to expect.
Someone who’s pre (pre-duty) usually has the most alertness and strength, but their energy and headspace are psyched for the work to come.
And then of course, there’s duty, which can last anywhere from 12 to 36 hours. The workload for this varies between the internship and residency eras. Even when they’re “from” and free for about eight hours, a resident might be doing admin and paperwork—the form-filling that follows patching up patients.
Thinking about holding an important conversation? You might have to consider if your med friend is “pre” or “from.” Inquiring about this seemingly simple state has been a big help in relating to friends and family in med
Someone who’s “from” finally has free time and has likely scheduled time to catch up with friends during this period. The other side of the coin is that they’re often running on little sleep and much fatigue.
Thinking about holding an important conversation? You might have to consider if your med friend is “pre” or “from.” Inquiring about this seemingly simple state has been a big help in relating to friends and family in med.
Sometimes, a medical aspirant or resident might have a normal, actual weekend—coinciding with Saturday and Sunday. This is the Golden Weekend. Normal life can resume somewhat; you’ll have a better shot at inviting them to brunch. They might even join a race, go glamping, or simply catch up on missed Netflix seasons.
Still, it’s telling that what’s a normal weekend for us is a special occasion for them. And this is usually followed by a long period of duty to allow the doctors—who were on weekend duty—their own time to rest.
On time: A place at the table despite an empty chair
One of the bigger adjustments families with sons or daughters in medical school make is expectations during holidays. In most settings, the non-appearance of family members on important occasions like Christmas Eve, a matriarch’s birthday in her 80s, or even a wedding, can be seen as scandalous.
But the reality is that medical students—especially those in their internship years and early residency—have a very limited schedule. They’re often doing wetwork at the frontlines with nurses, taking on late hours, messy cases, and often being assigned on the least preferred days: duty on Christmas or New Year’s Eve, Eid, Labor Day, and the like.
One of the bigger adjustments families with sons or daughters in medical school make is expectations during holidays
Even in more casual occasions, friends and family eventually learn to flow with the arbitrariness of a student or doctor’s schedule. This usually only lightens or gets more “normal” when a doctor becomes a consultant, but that’s usually after eight to 11 years of training after one’s undergraduate years.
On the other side, many doctors and medical students share a common regret of being there for the parents and loved ones of strangers in their most vulnerable moments—rushing to heal and save lives, yet struggling to be there for their own relatives.
For example, my sister and I have had weekends where she’s already in a sundress and nice heels, with our favorite dishes in mind, hoping that the homily is as good as the movie we’ve reserved tickets for… only for her to get a call from the nurses’ desk, all as she hurriedly changes into scrubs. Our catch-up after weeks of not seeing each other still pushes through—albeit in the McDonald’s across the ER.
Even in more casual occasions, friends and family eventually learn to flow with the arbitrariness of a student or doctor’s schedule
But that’s life. We laypeople may also have to accept stepping back in relationships where we once were the primary source of comfort. In my case, I’ve had to accept that my best friend now turns to our other friends in med school for the latest chika or for a weeknight pick-me-up at a bar or cafe.
We don’t talk as much as we used to in high school, but once I’ve accepted that there are struggles I cannot fully relate to or pretend to give comfort to, I’ve realized that the warmth never left—it only evolved.
Bonus: One superstition you must never cross
I like to wish people well. It’s one of my love languages as a writer—getting into their shoes, understanding their worlds and their language, and thus meeting them where they are. Nonetheless, despite this good intention, I did violate one taboo laypeople who love meddies must at all times be mindful of: Don’t precipitate a toxic week!
Don’t say something like: “I wish you have the strength to take on the patients”—because then, they strangely do end up getting difficult cases. It’s enough to simply say: “Have a good week!”
Fact-checked by Alex F. Vergara, MD
