October 2005

Well I've finished more cruises as junior doctor, visiting some of the same ports in the Eastern Caribbean as my first few which has given me an opportunity to visit some of the places I did not have time to get to before due to time constraints or having to stay on ship. I've been using travel guides to find some alternative places to visit further from the port. These include differing styles of churches, forts and view points. It's nice sometimes to get away from the hordes of tourists (see pictures).

It's also been a change on the medical staff side. My new senior doctor onboard is Dr Colin Cameron. He's a Glasgow graduate, did his surgical training in the Wessex region and in the small medical world that we live in, knows most of the medics I know around there so have lots in common. Being a previous renal transplant surgeon came in very handy soon after he arrived as we had a renal patient with CAPD peritonitis.

Other interesting cases include a woman with pancreatitis who had a full cardiac check-up for epigastric pain just before she got on board, and a hepatitis case of unknown cause with right heart failure that we had to evacuate by air ambulance from Princess Cays.

Speaking of which, Princess Cays is an island we visit on each cruise that the company owns and as part of our medical service, we man a first aid post (see pictures), dishing out band aids and cleaning and dressing minor wounds. Anything else and we send it back to the ship to be seen. However, I have had some excitement with a possible PE, deep scalp lacerations, and a near drowning. Not quite Baywatch, but the setting is similar!

Another medical duty I have had to do is give lectures on awareness and prevention of Norovirus. Every set of new contract crew members must attend a talk about the symptoms, signs and health risks associated with the highly infectious virus. Essentially the crew is told about meticulous hand cleaning and attending the medical centre with any diarrhoea or vomiting. The last thing we want is an outbreak where the whole cruise can be cancelled or the medical department ends up seeing hundreds of cases. A short lecture every 10 days seems a small price to pay for the prevention of such an event.

A further duty that I did not expect to do, but find interesting and useful, is crew rounds. After every full drill, officers have to visit the cabins of crew members to inspect their cleanliness and safety, and report any breakages.

Enough about duties and work for the moment and more about the perks. If you hate cooking, washing and clearing up, then this is one reason you would definitely want to work on a cruise ship. We have a steward that cleans up, makes your bed, brings drinks and food you have ordered to your cabin and will take your dirty laundry away to be washed and ironed! You can more or less eat anywhere on the ship, so if you enjoy your food, there is a lot of choice.

Ship's doctors can use most of the passenger facilities provided it is not to the detriment of the passengers (shoving a granny off an exercise treadmill does not go down well!). I mentioned in my previous installment about status and the many advantages that come with this. Certain places can only be accessed and used by officers of your rank and above, such as bars, restaurants and boutiques. You can have an account where money does not change hands, but you sign for things, and you also get 25% off all goods purchased.

Another nice perk is getting family and friends on a cruise with you. You have to finish your first contract and be two months or so into your next one before being able to do this. However after that, first relatives can come on board for only $1 or £1 per day, and friends for a bit more, but still cheaper than paying as a full fare passenger. This is all subject to availability and the discretion of the passenger services director, but being a senior officer helps your cause. In your leave, you can also choose to cruise on another ship as a passenger for a small fee per day which is again subject to certain terms and conditions.

The final luxury is the pay. Although perhaps you may not earn quite as much gross per month as a basic salary (depending on you grade and salary of course at home), the fact that you don't actually spend that much, especially with most of your food supplied, free accommodation and transport to places, means you will save money. Also, if you work for two contracts (about eight months), you are entitled to get your tax back. You are not however paid during your leave, so you have to make sure you don't do too crazy on your return! The last money bonus is the commission. As a junior doctor, you will receive 6% of the professional services charged. This means in some circumstances when you are extremely busy, you can possibly double you basic pay.