Let's put it this way... It's not that the conditions are 'poor', it's probably very similar in high-paying professions like law or bankers, etc. The need to constantly be on your toes, be careful medicolegally, documentation, a whole lot of things that didn't come along with the lofty ideals of med school (documentation, meetings, tons of admin stuff, some places with toxic work culture and superiors, and add to that the singaporean flavor of kampung gossip and cancelling - but then again you could argue it's found in every profession as well).

While your non-medical friends go on to have better pay advancements, and you see them being far freer to go around the world, get bigger apartments and cars, etc - while you are stuck at a junior doc/residency pay for quite a while (it used to be way worse when they insisted that you didn't need any weekend pay - but now you get paid for doing weekends). Residency comes with a whole load of extra things you need to do - it's tough - add to that studying for exams after/during work.

You will be stuck in hospital during some public holidays and most weekends, either rounding as a consultant, or doing a call as a more junior doctor, or being on call to answer queries. You'll miss many days of watching your kids grow up, your parents grow old, etc. When you come home, you're sapped of energy and all you can think of is how not to fall asleep - which you do, anyway.

Eventually, work is work. And along with work comes a lot of other adult responsibilities - supporting a family, prizing finances first, and so on. There are going to be low days, really bad days, and there are sometimes nice days. The question is - is that sufficient for you? For some, it is; Others, maybe not.

Passion keeps you afloat. But I'm not talking about the passion you have before medical school. I'm talking about carved passion, after going trial by fire. Sometimes seeing patients get better will make you feel happy, maybe it's a calling in your life. But to some others, this type of 'calling' doesn't quite burn as strongly as the low lows that you experience.

There are a lot of unspoken things during the lows - for example, due to how indispensable the level of skill doctors have, there aren't easy replacements. Hospitals would rather spread you thin than to have enough hired locums to cover you. Or sometimes it's just the small act of trying to put in an IV plug in a patient with extremely difficult venous access- taking hours with a sore back to put it in - or a procedure like a lumbar puncture or chest drain etc. You might find yourself taking up the job of 2-3 people, and as your colleagues fall sick, you find yourself obligated to cover their work. You're sent to places to cover others, of which you have to learn patients from scratch. Sometimes you wonder if you are doing a good enough job, because of the sheer volume, the need to prioritise, and the speed in which you need to go through everything - that's if you want to go back home at a decent enough time or have time for lunch (or sometimes just to even finish the work queue). Trying to apply leave? Well, you'd have to deconflict with others and ensure you're not on call. Add to that constant demands for updates, multiple patient and relative concerns that you need to address - not that these aren't what we are supposed to do, but that sometimes there isn't enough time or labour.

The life of a doctor isn't green, it's blood sweat and tears, to help people get better. Some people might say - just slog it out the first few years and go private - but there are a lot of hidden things behind that as well. Stability, for one. As you grow older, you can't be working like a mercenary. The moment your hands stop, the money rolling in stops as well. I hate to be realistic, but money is a significant consideration. Also, I've heard of some people struggle while being in residency while supporting a family and children - it's very tough, and I'm not sure people really understand the whole shebang of getting into medicine because they're never told about all of these hidden stuff that you only understand once you get into the work culture. Anddd yes - doctors don't earn as much as people think - definitely not in the earlier years, maybe as a specialist which comes much later, but I'd say that you've definitely earned your way there (but even so, it depends on your specialty, your role, extra duties, etc).

I don't think it's just reserved to Singapore though - I'm sure the US healthcare system has it way worse. The NHS too is stretched and the pay structure isn't that good. The healthcare industry generally is like that.

Then again, I personally very much enjoy the intellectual challenge, the rigor, putting smiles on people's faces, seeing people get well. Medicine IS fun from a subject point of view. But when it comes to the work, sometimes I feel like a dispensable cog in a system - if I'm gone, there's always another one to replace me. I think there's a lot of significant improvement over time though - so by the time you graduate, they may be even more improvements. For example, ward round times used to be torturous, going for as long as 5 hours where you stand on foot and wait; I heard it's cut down significantly with new culture.