As a Hungarian medical student, I’m in a very difficult situation. This topic is always alive and although I’m still so far from actually making this decision, I feel like I need to talk about it. Staying or leaving? I WOULD stay, I really would, if the system let me. I can only see the current situation and I don’t wanna be pessimistic but I just don’t see anything changing for the better in 3-4 years. Obviously, the main problem is that there is not enough money to keep hospitals going (renovations are needed EVERYWHERE, new equipment, medicine etc), hire enough staff (therefore not just the doctors, but the nurses are really overloaded – 1 nurse for 40 unaware patients is absolutely ridiculous). They work 12-14 unbelievably exhausting hours, they get upset and sometimes rude, they burn out and they don’t even get the money they deserve.
I bet everyone can tell at least one horrible story about our health care system – not the ones you hear on the news, the ones that actually happened to you/family member/acquintence.
So there are three options, if as a patient, you want to recieve proper health care. You can go to a fancy private practice – side note: politicians only go to these institutes so they have absolutely no idea what’s going on in a public hospital – and pay a fortune. Or you can pay parasolvency.
Let’s see an example, you are pregnant, and obviously you want to give birth to a healthy child in peace & safety. No matter what financial situation you are in, no matter if your doctor is in a private practice or in a mouldy hospital, you WILL pay. I find this habit SO humiliating and sad. I wanna be a obstetrician/gynecologist, but I don’t wanna be one whose patients feel like they need to pay 300€ for me to give them better care. I don’t wanna be in a place where I have to accept this payment to make ends meet. Whenever I tell someone I wanna be a ob/gyn, their immediate reaction: wow, so you want to be rich. No, I find this presumption offensive.
Third option is that you are in the right place. I am. (Not because the medical student stuff.) My mother works in a hospital as a legal expert, so whenever I need something, she contacts certain people and I can go to any doctor. I have to wait, but not hours. This is how it’s supposed to work for anyone.
So if you don’t have the right acquaintanceship or money, you’re basically fucked. Not in every hospital, not with every doctor of course, but it’s 100% that you will have a medical condition during your life that could have been solved easier, faster, better if you had either of those.
Now let’s see why I can’t really stay here after I get my degree.
Responsibility. As a fresh doctor, we have to choose a specialty, which we don’t really know about anything (4 weeks of practice is not so much). It takes years of residency for a general doctor to become an expert in something. In Hungary, it is not uncommon that residents are left without an attending in the ER during night shifts. So they may have to make serious, life-altering decisions based on almost no experience. That’s dangerous for the patients (and the doctor’s career). My mother heard a conversation between young neurologists – they ran out of medicine that is used to treat stroke patients (yes, in a hospital, they ordered supply weeks ago). They could do nothing. This is a situation that I don’t want to find myself in – not as a resident, attending or patient.
Independency. Is it too much that I want to be able to buy a car, a house, and travel around the world? That I don’t want to live in my mother’s house for the rest of my life? Because if I stay here in Hungary, there’s absolutely no chance that within a reasonable time I’ll be able to afford these things. Sometimes I think that it is natural for a young adult to want to build up their life. (At this point, we have to ignore those lucky ones whose parents buy them an Audi with a penthouse… that’s not an accomplisment.) My own happiness and goals have to come first, huh? Then, I remember an old lady basically praying to us “Please don’t leave us here to die.“. (That was the moment I decided there’s no way I would treat old patients in my career.) Okay, this is incredibly selfish.
But… in our psychology book, there was a long chapter about medical students and doctors, elaborating how and when I will burn out during the years. And saying that eventually stress would lead to suicide especially if you’re a doctor who also happens to be a woman. I don’t want that! I don’t want to be a life&patient&job-hating, self-admiring asshole, I want to do the things I want to be happy. And I want to deliver babies and save lives that can be saved. So I can avoid the burning outs.
A dentistry student told me this: “I want my profession to support my life, no to actually be my life.” She thought that it’s not possible to achieve this as a doctor. I have to believe it’s possible. Of course, I’m willing to make certain sacrifices to help people, but I still want to have my own moments as a person.
I know it may be too soon to think about this matter, but recently I’ve been seeing more and more on patients’ and on doctors’ side too. Because of my mother’s serious medical condition, I see a lot of rapacious doctors that leave patients (including my mom) in pain for weeks, without any sign of any desire to help. Because of my education, I realised that in Hungary, everyone is an alcoholic, they don’t care about their health, they expect their healing without doing a thing, they don’t understand what the doctor says – sometimes they don’t even listen, they can be rude, unrespectful, and annoying.
I’m not naive. I know that other health care systems have their own problems (in London, my cousin’s doctor couldn’t recognise a simple tonsillitis…), and not everything in Hungary is horrible (for example, if you get a heart attack, you may receive percutanous intervention within a 15 minutes drive! That’s very important and really great. Pathological autopsy rates are also outstandingly high, and it can help clinical doctors to not make the same mistakes ever again.). I just don’t think I wanna be in a system where if you want to afford anything, you have to accept parasolvency.
That’s enough for now, although I still have a lot of horrible thoughts about this topic and I feel bad about them. I want to be a good and happy doctor. Please, someone tell me it’s possible.
Here you can read about my Slovenian journey.