One of the traits which has been going away from me has been my motivation. For particular things - especially regarding my family medicine higher training - they have been put off so many times. Even this blog entry has been put off for several weeks, maybe even months. It has come to the stage that my psychiatrist had to add bupropion (Wellbutrin), an anti-depressant usually used to help people quit smoking, to improve my motivation. Although this has helped a little, there is still stuff left to do.
So why am I so unmotivated to do anything about my family medicine higher training? Probably it is the lack of drive which is a factor. My family medicine higher training is not compulsory to be completed. I can still practise in Hong Kong without it. My level of pay won't be as much as doctors who have completed the family medicine higher training and passed the exit examination but the money is still nothing to scoff at. It is comfortable to live on, I have no debts and no-one that financially depends on me. My chances of promotion within the department will be zero without the resident specialist title but I'm not worried about that - I would hate the added responsibility and doing stuff such as seeing patients in specialist clinics and attending meetings.
Even getting up in the morning, knowing I have to go to work and see patients, requires serious willpower and motivation. There are many times I lie in bed thinking if I can pull a sickie today and then I realise the reason I have gone part time is so I don't want to do this.
To be honest I fulfilled most of adult ambitions in becoming a doctor. When I was a teenager, I was naive to think I could fulfil most of my goals: 16 A*'s at GCSEs, 6 A's at A Levels, get into the University of Cambridge to study medicine, get married at 25 years old, have children by 28 years old and win the Nobel Prize for Medicine and Physiology by 40 years old. During my depression years, when I was deferring studying and repeating years, all I wanted to do is graduate and become any doctor. Now that I've achieved that, what is left to do in terms of big goals? I don't expect even to have sex, let alone hook up, get married or have kids.
There are other goals which I want to do, which strangely I am more motivated to prepare for: take a 3 month European trip, get a Diploma in Tropical Medicine and Hygiene so I can volunteer for Medicins San Frontieres and, finally, do the research so I can emigrate to Australia or go back to UK. But even then the motivation is not immediate.
For my family medicine higher training, I have still got to record my consultation videos. This is the part I am most dreading, since it requires me to converse in Cantonese at length, something I'm not comfortable doing. I have to enter 600+ patients' data for my clinical audit and I've only done 100+ patients. I have still got to prepare for my practice management assessment, which I haven't even started. This requires me having to fix any problems with my clinic settings, such as making sure the cardiopulmonary resuscitation drills and fire drills paperwork is in order, which it isn't and I have been sitting on this for the past year. The lack of drive goes in hand with the lack of consequences - there is no punishment if I don't fulfil my higher training.
I think it is an effort related matter regarding my motivation. There are some things I don't want to do. Going out to gatherings on Meetup such as "British Born Chinese and Friends" and "Social Scrabble Club" requires me to hop on to public transport for one hour or more, which I find hard to do. Yet going to volunteer for Hong Kong Dog Rescue is something I do regularly, probably because it is only a 15 minute drive from home and I can park for free.
Probably I should give in and say, "Look, I don't envisage me staying in Hong Kong in the near future. Completing my higher training and taking the exit examination, which I will probably fail, will be pointless."