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Growing up with doctors as parents was always something I struggled with: they were always working late shifts, constantly traveling to medical conferences and all the conversations at the dinner table revolved around words I didn’t understand. As the years went by, I noticed I had become progressively more disenchanted with pursuing this career and whenever others told me their interests and asked for advice, I struggled with finding anything positive to say. So, I thought, who could give my colleagues the valuable advice they most definitely deserve? A doctor!
The following segment consists of the translated version of the interview I did with urologist Carlos Oliveira, with detailed aspects of his individual practice, the reasoning behind his career and what he has to say to prospective medical students, both inside and outside of Brazil.
B: Hello Doctor Oliveira, how's it going?
C: Great! Thanks for having me!
B: I'd like to ask a few questions on behalf of our school newspaper, the Student Scoop.
C: No problem!
B: First, what is your specialty and what kind of medical training have you received?
C: I'm a urologist, graduated at UFBA, completed a fellowship at Hospital Servidores do Estado (Rio de Janeiro, RJ), and after that completed a post-graduate urology program in Germany. I also got a doctorate in the Federal University of Germany in Manz and spent the following year in Milan where I specialized in kidney stones. Currently, I work at Hospital Aliança, either with scheduled appointments or in the ER for urology-related emergencies.
B: Please describe a typical work day - or as typical as it can get - for you
C: *laughs* Well, yes, medicine is definitely something that is very particular to each field, but generally this is my schedule: usually I'll work one shift - either in the morning or in the afternoon - with scheduled appointments - and I usually make the other shift available for surgeries and emergency-related affairs. Before I go home I have to check on the post-op patients, which usually varies in hospitals so I have to go to whichever unit they're in (this varies from Hospital Aliança to Cardio Pulmonary or even Hospital Português), which means I usually get home at about nine or ten at night.
B: Interesting… So what led you to choose medicine as your career, and specifically urology?
C: Medicine, I think, was always something I dreamed about as a kid. At some point during my childhood - it might've been high school, I don't really know - in my suburban little paradise of a hometown *laughs*, we had this group of visiting doctors coming in for volunteer work and I vividly remember being so intrigued about what they were doing and I wanted to be like them so bad! I wanted to help people and work around them… Actually, my older sister always says it was something I started talking about at an even younger age, but I don't really have any memory of that so… Urology, well that started because you know how it is, a lot of the time when doctors start out they feel compelled by surgery; I've always thought of surgeons as the "cowboys" of medicine, they have the power of immediate resolution, which was always something I'd admired. During the whole process of training I started getting interested in general surgery, and all my professors and other instructors convinced me that general surgery, as it had been in the past was now becoming a dying profession, since everything had become so compartmented in terms of how many body areas you can focus *laughs*, I mean nowadays you can be a brain surgeon specialist, a cardiothoracic surgeon, breast surgeon, etc. and it's almost a necessity in the evolution of medicine to compartmentalize everything. The "head-to-toe" doctor of the past was a necessity at the time because it worked, but now we don't really need that anymore so we're scrapping it as time goes. For urology; well, I got an internship opportunity for this area in specific as I was deciding what area I wanted to specify in and it really caught my attention. It wasn't just the urological part of it, but also the genital and intestinal bits. Urology involves men, women, the old, the new, and that variety of patients really interested me, you know?
B: For sure! The Student Scoop wants to know: what characteristics do you find crucial to make a "good doctor?"
C: First of all, they really have to have a solid ethical foundation, a set of values in which they stick to no matter what situation they're put in. Furthermore, it must be an individual who is genuinely compassionate, who is willing and is encouraged by working to help others. I don't condone any practicing doctor that doesn't respect that principle and doesn't do it from the goodness of their heart. Of course, unfortunately, there's this cultural aspect that dictates that this career brings immediate social prestige and financial reward, but I don't think that should ever be the motivation for pursuing this career. Those people who follow that path end up unhappy and a lot of the time unsuccessful, because this is really a career that you dedicate your entire life to. You have to love medicine, and you have to want it that bad.
B: How was the process of embarking on this journey of training and studying you mentioned earlier?
C: I’ve actually always been interested in graduating in something I found perfect, in the sense that I wanted to be a good doctor and I knew that I’d have to study more for that to happen. So, when I came back after having finished med school, my father wanted me to go back to my hometown to show off his doctor son, and in that moment I told him: “I’m not done yet, I want to keep studying. I don’t want to get rich, I don’t want to go back to that place. I’m going to finish my fellowship.” Why did I do that? Because, when you finish med school, you might have your diploma but you don’t really have any practical experience and all the theoretical stuff you know really isn’t enough to actually start treating people. So the fellowship program offered me, as it offers any other, gives you the opportunity to perfect your skills and you’re guided through the actual hands-on practice. This is usually when you start gravitating towards an area you’re more interested in, one that fits more with the way you work and what you’re interested in. This is also a moment where you get in contact with several patients and you get the opportunity to participate (while learning amongst several experienced individuals) in the process of treating. Through these fellowships, you generally have several experts that have specialized in diverse areas and you get to add to your progress. A lot of the time, after a doctor finishes their fellowship, they usually think “well now I must be ready to actually start my career,” and really, you can do that.
Despite that feeling, I had a stronger urge inside of me: I want to get out, I want to move away and learn even more. At first, I wanted to go to the US, as I’d gotten a scholarship to study English to actually be able to participate in a course in America, and so I applied to several universities, hoping that I’d be accepted somewhere. During that same time, I had been reading a couple of books by these german authors and I ended up being really interested in the possibility of studying in Europe, and so I applied, once again to several different schools. After this German university accepted me, as a student, I gained a scholarship funded by the Brazilian and German governments, and soon after finishing my fellowship I went to Germany. That process started with learning the language, as a fellow at the university, and that was an even more enriching experience because I got to experience this place that was bursting with knowledge that was coming in from all over the world, both from professors and from other students. So not only do you have the chance to experience a new language, a new culture, meet people with different backgrounds but also understand their logic and their know-how. At that time we didn’t really have the Internet - well, it was just starting to come about - and this generation definitely has more accessibility, but leaving Brazil in a moment I thought I had everything, this universe of possibility just opened up for me and I’d do it all over again if I had to. I think for an individual that is hungry for growth and expanding knowledge, studying abroad is definitely beneficial.
B: As you know, our school has a wide variety of students interested in studying abroad, and I personally know many of which are interested in the medical field, and I wanted to know what were your greatest challenges as a foreigner in a new country?
C: First of all, the greatest challenge for most - not to you guys, most of the time anyway - is language. At the beginning, you have to try as hard as you can to adapt to this new language, which for someone who hasn’t grown up learning it almost as if it was your own the way you guys have, can be really difficult. Then, there’s the cultural aspect, and at that time it was quite evident that, generally speaking, there was this unspoken barrier, between “them” and “us.” In several places of the world, just coming from where we come from can seem to others as if we have no value and we end up making twice the effort to prove ourselves. This can be really discouraging in terms of being in a new country because it makes the whole adaptation process harder than it should be because a lot of the time you really do have to make that extra effort, but only then do the doors start to open for you. I do think, that for me at least, as time went by, I was able to demonstrate that and actually feel like I belonged.
B: Finally, I wanted to ask, on behalf of those who are looking at medicine as a career path - either in Brazil or outside - is there anything you’d like to say to them?
C: First, it’s a huge decision. Although the world nowadays is significantly more open to infinite possibilities, you really have to listen to your heart when figuring out what is it you want to do for the rest of your life. In the moment you make that decision, I really encourage you to find ways to experience it, at a more second-hand view - maybe getting involved in volunteer work or listening in on university speeches or something similar because access to that can really influence your decision. A few of my colleagues for example, I vividly remember them not being able to be in the presence of blood or even seeing someone hurt, or they couldn’t bear to enter anatomy rooms because they hated the smell of formaldehyde - or something of the sort. Basically, you really have to get through a few personal obstacles to follow through with this career - or any other - because you’ll never find something that is just a bed of roses every day, there’s always a challenge awaiting, which is when deciding what your career is becoming so important. Once you’re sure you really want medicine, I say go for it. It really is a beautiful profession.
Once I finished studying for medicine and started practicing, I went to law school, just out of curiosity, and I think no matter what you do, it adds to your growth as a human being. I think if an individual decides to take the medicine route, they really have to devote themselves to it. You have got to study. I don’t mean you’ll have to abandon your life, your friends, your parties; you’ll have to, though, learn how to prioritize. You’ll have to choose between a party or being called in from the hospital. It might be Christmas, it might be New Year’s Eve, you might just be having a night out, but if you’re called on, you really do have to go. That is the reality of a doctor’s life. You’re stuck to it a lot of the time, which is why, once again, it’s so important that you’re sure it’s really what you want. By studying, by being eager to learn more and really going after it, that’s how you do it.
B: Thank you so much for sharing your experience, we really do appreciate your time.
C: No, thank you! It was a pleasure, really.
Speaking with someone with a different background than the one I'd been presented to by my parents opened my eyes in terms of the way I visualize this profession. One of the things Doctor Oliveira said that really speaks to several of our PASB students: "I think for an individual that is hungry for growth and expanding knowledge, studying abroad is definitely beneficial."
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