What jobs have you had?
If I’m writing a piece based on that exact prompt—while weaving in the specific, real-world reality of my path—it would sound a little like this:
The Irony of the In-Charge: Balancing Millions in Responsibility on Pennies for Pay
There is a bizarre paradox in global medicine. If you look up standard calculations of what doctors “should” make, you’ll see figures from Western healthcare systems scaling into the hundreds of thousands of dollars. But if you look at the raw exchange rates and the baseline civil service scales of where I began my career as a Medical Officer In-Charge (MOIC) in Wangchu, it genuinely feels like looking at a statistic for the least-paid doctors in the entire world.
When I wrapped up my MBBS degree at the University of Peradeniya, I had a foundation built on global clinical standards. I knew what the workload of a physician demanded. But nothing quite prepares you for the sheer math of stepping into a General Duty Medical Officer role in a rural, 10-bedded facility in Bhutan.
High Stakes, Low Scales
In our setting, being “underpaid” isn’t just about a low number on a monthly payslip; it’s about the massive imbalance between compensation and responsibility.
The Administrative Burden: I wasn’t just walking into an exam room, seeing a patient, and leaving. As the MOIC, the entire facility rested on my shoulders. I was the chief clinician, the human resources manager, the logistics coordinator, and the institutional head.
The Scope of Care: From organizing comprehensive medical training sessions for hospital staff on high-stakes conditions like sepsis and antimicrobial stewardship, to handling everyday emergencies with minimal resources—the cognitive and emotional load was absolute.
When you convert a basic public service medical salary here into global currencies, it fractions down to a sum that wouldn’t cover a week of basic groceries in the countries where our medical textbooks are written. You are essentially managing public health infrastructure and saving lives on a budget that makes you look like the least-paid medical officer on the map.
Surviving the Disparity
How do you reconcile that? When the system compensates you so tightly that the workload and stress feel completely out of par with the pay, you have to build your own outlets.
For me, that meant channeling my energy into things I could control. I took my medical knowledge online, building Dr. Tshering Vlogs into a digital health education space that eventually grew to 10,000 followers. If the primary system wasn’t going to value the work proportionally, I would find value by educating the community directly through media and graphic design. I found peace in precise, quiet hobbies like Bonsai cultivation—a stark contrast to the high-pressure, low-reward atmosphere of managing a rural facility.
Turning the Page
Every doctor working under these conditions eventually hits a crossroads. The dedication to your home country and your patients is real, but the economic gravity is real too. The sheer exhaustion of dealing with tight bureaucracies while earning a fraction of global medical wages is exactly what pushes us to look toward the horizon.
For me, that turning point has arrived. This past job as a heavily underpaid General Duty Medical Officer provided a trial-by-fire leadership experience that money couldn’t buy, but it also solidified my decision to specialize. As I close this chapter and step into a three-year Diagnostic Radiology residency at Prince of Songkhla University in Thailand, I’m moving away from the survival math of general practice. The past job was a lesson in resilience, but the next chapter is about growth.
