KEY POINTS:
There are few careers with the level of responsibility and accountability of a doctor. The stress, long hours and demanding environment mean few people have what it takes.
General surgeon, Graeme Washer, says that despite some hefty salaries, doctors don't choose their career for the money.
"I don't believe that very many people, especially these days, would do medicine because it's the best paid job. It isn't the best paid job."
A full-time hospital specialist with 12-13 years experience can make $160,000 to $200,000.
"In some specialities in private practice, there is serious money to be made. A busy operating gynaecologist could probably earn $500,000 or $600,000. A busy orthopaedic surgeon in full-time private practice is probably earning more than that."
But despite the high pay and the high status of a well-respected job, there is a worldwide shortage of doctors. Washer says the pay is not that high compared to other highly qualified professionals.
"The work is demanding. It's highly accountable. The hours are long. The work is not easy. If your highest salary is your goal, medicine is the wrong choice. If money and lifestyle are your primary aims, medicine is definitely the wrong choice."
Washer decided medicine was for him when he was about 15 years old. His father had organised a holiday job for him working in a laboratory. Then Washer went through the experience of having his appendix removed, and he was sold.
"I went into medicine because it's what I wanted to do. It was a fascination with the science and the kind of work that I would do. I would work with people, but there would be an academic and a scientific approach to that."
Doctors are a rare breed. They have a certain driven personality type which helps them tolerate the intensity and stress.
"We're people who demand a lot of ourselves. We're people who work hard. We're very much type A's. We get frustrated with ourselves. We get impatient with ourselves. We take a lot of it personally when people are at us, and some people crack."
Like any intense profession, Washer says the key is to look after your personal life. Guard your time off. Rest, relax and exercise.
"If you're not physically fit, if you're not mentally healthy, you could go down, and doctors do. And unfortunately, sometimes they become a danger to the patients before anybody realises that they are going down."
But Washer says despite the drawbacks, he still can't think of anything he'd rather do.
"I'd do it again. There are days when I wake up and think, 'There has got to be something easier than this. I mean why do I bother? This is too hard. It's just too demanding'."
The process of becoming a doctor is likely to weed out anyone who doesn't fit the mould. It's six years of intense study and training which could leave you with up to $100,000 in student debt.
First you need a basic university degree which is typically a Bachelor of Human Biology.
In years four and five you'll do two clinical years as a student and then sit your student exam. In year six you work as a paid trainee intern under supervision. At the end of year six you can qualify as a doctor.
But you're not allowed to practice medicine for another one or two years until you become fully registered. Most doctors then do postgraduate training and sit a qualifying final exam before being nominated and elected a fellow of their specialist college.
"It's ferociously competitive to get into ongoing health sciences training. There are a limited number of places in medical school," Washer says.
Today's doctors don't have to face the ridiculous clinical rosters Washer faced straight out of school. The medical established has learned that a 120-130 hour week with endless on-call hours is not healthy. Dr Washer's hours now are a little more humane.
"I get to the office at 7:30am. I'm seeing patients at 8:00am or in the operating theatre. I'll be lucky to get out of there before 6:00pm."
On top of the long hours, there is the emotional stress of telling patients the news when it's not so good. But Washer says there is actually a kind of privilege which comes with interacting with people on such an emotional level.
"We do it because it's a tremendous career if you're passionate about it, and you have to be passionate about it. I can't imagine how you could still do the job if you weren't passionate about it. Unless you really believe in the job that you're doing, it's just too hard."
Washer says that people who do not work in medicine don't quite understand the level of accountability doctors are subject to.
"It's not a perfect science. You won't always get it right. You will make mistakes, however clever and experienced and qualified you are. You will get it wrong sometimes. You will be accountable for that."
Doctors are answerable to the Medical Council, the Health and Disability Commissioner, and their own professional organisation. And the government continues to complicate things.
"General practice is becoming increasingly unattractive as there is more and more bureaucracy. There is more and more government interference with primary care. General practice is not a very popular option. And it's the least well paid."
It's little wonder then that there aren't more people wanting to be doctors in New Zealand.
"Successive governments in this country have been remarkably slow to accept that if you don't train more graduates, you're going to end up with the workforce problem that is now a reality."
Interventional radiologist Brendan Buckley is meant to be part of the solution to that problem. He moved his young family from Ireland to Auckland a couple of years ago to work in the public healthcare system at Auckland City Hospital.
Buckley uses minimally invasive treatment with lasers to destroy tumours. He says one of the most frustrating things about a medical career is seeing his friends' careers outstrip his own.
"You're in your early 30s or mid 30s and you're still sitting exams where most of your friends are well settled into their careers, bought a house, they've got a car."
Buckley works around 50 hours per week and is on call one weekend per month. He says New Zealand doctors are poorly paid comparatively to other countries.
"Colleagues in Australia look at me and they say, 'What are you doing there?"'
Buckley has asked himself that same question.
"If I was to go to the States now, my salary would go up at least four times. If I went to Australia, it would double. If I went to Ireland, it would triple."
Buckley stays in New Zealand because he is raising young children and came here for the lifestyle choice. But he says he wouldn't actively be encouraging any of his children to go into medicine.
"If they showed an interest in medicine, I'd be very clear about what it involved. I would point out the most arduous aspects of it and if they still wanted to do it after that then I think they'd be prepared to go the distance."
But Buckley stands by his decision to become a doctor.
"Where I am now, I would do it again to end up where I am now but halfway through there were numerous times that I thought that this hasn't been the wisest career choice."
