For those in medicine, becoming a specialist can feel like reaching a long-awaited milestone after years of training and preparation.
After completing medical school and the required general training, doctors can pursue postgraduate training in multiple fields within the areas of medicine or surgery.
Yet getting there can be a rough ride.
“Specialist training is brutal,” says consultant ophthalmologist and vitreoretinal surgeon Dr Mohanarasan Ratanam.
Plan your finances
Specialist training can come with a financial cost, especially for trainees who have to move between hospitals and pay for accommodation elsewhere.
Hospital Tengku Ampuan Rahimah paediatric surgeon Dr Abhirrami Lechmiannandan spent her master’s training moving between different parts of Malaysia, including Sabah, Sarawak, Kelantan, Terengganu, Kedah and Johor.
Each placement meant spending months away from home.
“Not only away from family, but paying six months’ rental for accommodation,” she says.
Dr Mohanarasan says trainees have little time to take on additional work that could help with finances, as juggling clinical duties and their master’s programme takes up most of their time already.
“I remember surviving on credit cards on and off, because there’s just not enough to go around,” he shares.
Knowing finances would be tight before starting his specialist training at Universiti Malaya, Dr Mohanarasan sold his car and bought a cheaper one.
He also purchased a condominium after considering its proximity to Universiti Malaya Medical Centre, rather than paying rent throughout his training.
The property later proved to be a worthwhile investment, as he sold it for a profit of RM190,000 after completing his studies.
Set family expectations
Specialist training can also put a strain on family life, particularly when doctors have to move between hospitals or spend long periods away from home.
Consultant neurosurgeon Dr Rakesh Rethinasamy says doctors should have an honest conversation with their families about what to expect before starting their training.
“You’re going to say goodbye to all your birthdays, holidays or any festival,” he says.
For those with families, spouses need to understand that doctors may not always be available for important occasions or family commitments.
“For the next four years, you’ll only be a semi-family member,” he jokes.
For Dr Abhirrami, specialist training has also meant making choices about family time without feeling pressured to keep pace with her peers.
While pregnant during her training, she was advised by one of her consultants not to rush to finish her course.
“You always want to graduate with your friends,” says the mother of two.
“But it is not a competition, it is not a race.”
Married to another doctor, Dr Abhirrami says balancing two medical careers requires flexibility and compromise.
“There must be a lot of give and take between husband and wife,” she says.
She also stresses the importance of having a wider support network, including extended family.
“Having your parents and your in-laws with you is the greatest gift,” she says.
For doctors who are also parents, Dr Abhirrami says parenting cannot be treated as a solo responsibility.
Couples need to share duties depending on each other’s work and training commitments.
“One person takes the other person’s duties for a while, and then you step in and take the duty for a while while your spouse goes on that journey,” she says.
“You need family support or a neighbourhood because it takes a community to raise a child.”
Learn from setbacks
The academic demands of specialist training add another layer of pressure, with trainees having to prepare for demanding examinations while continuing their clinical work.
Dr Rakesh knows firsthand just how challenging the examination process can be.
He failed his final master’s examination on his first attempt, despite believing he had performed well.
Six months later, he passed on his second attempt.
The experience taught him not to dwell on failure for too long.
“You’re going to take time to mourn that challenging experience you just had, and that’s okay,” he says.
“But don’t drag it on for too long, because the longer you drag it, the less time you have to prepare for the next round.”
Instead, he recommends identifying areas that can be improved and using the experience to guide preparation for the next attempt.
For Dr Rakesh, this meant thinking beyond simply passing the examination.
During the six months before his second attempt, he approached cases as though he were already a specialist, considering how he would assess patients, make decisions and plan their treatment.
The approach helped him connect his academic preparation with the realities of clinical practice.
He says: “Nothing ever prepares you for a final exam.
“You just got to breathe and be as confident with your day-to-day work as possible.”
All three doctors were speaking at the recent Disruptive Doctors Conference 2026 in Petaling Jaya, Selangor, during a session titled “Real Talk with Specialist Doctors”.
