Where do I go?

It is approaching the end of March.
This means I have about 6 months left of my housemanship...provided I don't get extended of course.
I'm currently half way through my 5th posting which is Obstetrics & Gynaecology; a posting I had intentionally saved for when I was competent enough to function independently as a houseman.

It is no secret that I enjoyed O&G as a medical student, and that I was considering to specialize in the field one day. Having said that, I didn't want to make the decision prematurely before actually working in the field, knowing full well that working in it is very much different that my student days.

The questions in my mind are:
1) Do i really want to go down this road?
2) Should I stay in PPUM as a service MO in O&G? (which i stand a good chance, because the O&G department has only 1 service MO at the moment)
3) Should I go out to other KKM hospitals, to gain experience and perhaps independence and confidence as Medical Officer?
4) Should I register and sit for the November MRCOG or should I sit/apply for Masters?

1) Do I really want to go down this road?
OK. O&G has always been a familiar field to me, thanks to my mother. She doesn't even seriously push me toward the field, I'm just drawn to it. More towards the Obstetric side (mother & child) rather than the Gynaecology side (reproductive health, cancers, etc.). Growing up with my mother, I know how demanding & stressful the field is. Not to mention the fact it is the most litigious specialty in Medicine, simply because everyone wants a perfect child, and needs someone to blame if/when something 'goes wrong'. At the moment, I don't have a family to think about...as in, I don't have a husband and a child whom I'm solely responsible for....So O&G makes perfect sense.

                                 

But what are my hopes, what are my dreams aside career ambition and the thrill-seeker side of me? I do want children. I am 28 this year. No two ways about that. Though friends & family don't take me seriously when I say it, I am considering adoption by the time I'm in my 30s.
Financial stability, independence, wisdom/maturity (hopefully) : it just makes sense.
But if i DO decide on going down this career path, i'd probably live the job.

2) Should I stay in PPUM as a service MO? 
Truth be told, I'm sick to death & claustrophobic with UM.
I have been in the UM vincinity since i was 18 and registering into PASUM. Add to that my prolonged stint UM medical school. Add on my 2 years of housemanship. There you go, 10 years if my life in UM and i'm not even 30.
Aside from that. The good part about staying in UM is that you learn from the experts, the frontliners of research and progress in the local setting. You are exposed to academia. resources are (somewhat) plentiful. You are trained the correct way right from the start and dont get the chance to develop bad habits. Senior colleagues are always around to help/guide, and you KNOW they are capable of teaching coz they are...well...lecturers!
                                 
Being a houseman in UM, i always hear my MOs complain about how castrated they feel because back in their old KKM settings they had more leeway and independence to do things as opposed to the setting in UMMC. They complain that housemanship in PPUM in crap, in a sense that we are pushed to the background doing running around donkey jobs and menial tasks instead of hardcore clinical learning and developing crucial procedural skills. They lament on being 'downgraded" : MOs doing HOs job, HOs doing nurses & PPK & clerk's job. And now myself as a senior houseman, I agree! I'm no more than a glorified phlebotomist & appointment secretary.
What they also say, here in UMMC we tend to over-order things, just because resources are available. Once again, I agree. The scan appointments I'm requesting for : I can't tell if these are standard practices or are they for research purposes. MRI/MRA Brain for every stroke patient? MRI Pelvis for a fibroid? Cardiac perfusion MRIs vs. Stress myoview (nuclear medicine) vs. CT coronary angiogram vs. Stress test vs. Structural Cardiac MRI for my cardio patients. Perhaps this may be due to my own lack of studying, but still, we do learn from our daily routines.

3) Should I go out to other KKM hospitals, to gain experience/independence/confidence as Medical Officer?
                                                  
This is just further add-ons to my previous point.
I remember back in first year medical school, my anatomy lecturer Dr. MK Bharti.
She used to say 'you have to become the doctor who can survive anywhere, the kind of doctor who can work under a coconut tree'. Meaning to say, rely on your basic knowledge, develop good clinical skills and not be dependent on the latest techno gadget and hi-fi trend, because you never know where you might end up and what kind of situation you may get yourself into.
I'm inclined to believe her.
Yes, I'd love to be a doctor with a specialized skill set....that's what being a specialist is all about.
But I'd also like to do justice to the title "Dr."- i dont think I've earned that yet, and I'd never truly feel like I've earned it if I dive into a specialty too early.
There is no right or wrong answer, however.....
                                      

I dream of getting myself involved in programes like these. I remember watching a ?documentary about Doctors Without Borders on Astro back when I was in high school, and it is truly noble what they are doing. Going to where help is needed the most, and this is exactly what I envision medicine to be.....
Not entertaining the primadonnas I meet in the wards, and the ungrateful write-to-media relatives that accompany them.
                                        
At the end of the day, I just want to do good.

4) MRCOG or Masters?
Truth be told, I actually decided to sit for the Part 1 MRCOG exam in November.
I thought there was no harm getting in gear back to studying, refreshing my knowledge, relearning the basics with new eyes.
I was just waiting for regitrations to be open in April.
I was looking at books online, and creating a shortlist of which ones I want to buy.

                                           

Then my Head of Department told me not to.
He says the ministry may be working toward creating a dual system of specializing, and having your MRCOG would 'disqualify' you from masters. Apparently what has been happening is that some candidates sit for both and when they pass their MRCOG, they quit the Masters program hence 'wasting' the space. I don't know how true that is.
He told me instead, to sit for the Entrance exam; a prerequisite for the Masters in O&G.

                                                         
Something I never considered. The Masters program is more rigid, structured, I think....like going back to school. I can always sit my MRCOG after completing the Masters program if I still want to. Masters, is recognized in Malaysia, and a few other countries. MRCOG is worldwide. MRCOG is studying at your own pace (within the allowable time frame & attempt limits), being in a recognized training hospital, joining/enrolling in revision classes and clinical workshops at your own volition. Masters, i haven't read much about.

And so. After all that.
Where do I go?