Questions from a student to a missionary doctor

A student doing research on medical missions has written me to ask some questions. I figure I’ll answer them here, in case anyone else is interested and to make it easy for me to answer similar questions in the future. So here are your questions, Ji Kwon, and my (brief) answers:

What is the nature of work of a pediatrician and a missionary?

Well, those are certainly two different questions, maybe because you’re asking about “a pediatrician and a missionary” as if it is one career title. I’ll separate those two pieces in the rest of your questions.

A pediatrician is a doctor who has specialized in taking care of newborns, infants, children and/or adolescents.

I’ll answer assuming you are asking about Christian missionaries, since that’s what I know about and can answer. A missionary can mean lots of things, but a quick summary might be that a Christian missionary is someone whose career or job is in some way focused on proclaiming the good news of Jesus and the way he taught. Usually we use the term for someone working in a culture other than his or her own, but that’s not always true.

At the end of his ministry, Jesus handed over his ministry to his disciples, telling them “Therefore go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything I have commanded you.” This statement is often taken as the fundamental charter of Christian mission and contains several main points:

• Go – we’re directed to the world, not to stay on one location only
• Make disciples – Disciples means followers, people who live like Jesus. This is important, because it means that we are called not just to make people “Christians” who identify with a religion, but people who live out the teachings of Jesus. Obviously, that is a lot harder and more wonderful mission than making “converts.”
• God’s kingdom message is for all the peoples of the world, not for East, West, rich, poor, or any other group alone.
• Baptizing them – Baptism is an outward sign both of turning back to God (repentance) and of a formal commitment to life in the family of believers in Jesus. In this context, I think it also represents the fact that good news of Jesus begins with the fact that every person needs to turn from his or her own sin and receive God’s forgiveness and spiritual life which he made possible through the life, death, and resurrection of Jesus.
• “teaching them to obey everything I have commanded you” – this restates and emphasizes the point about making disciples; it’s not about making converts, but people who know and obey the way of Jesus.

What sorts of requirements are there in order to be a pediatrician?

I’ll answer this for the USA, but requirements in other countries will be somewhat different.

• Graduation from medical school, typically four years of university following a four-year undergraduate degree.
• Completion of advanced training (residency) in pediatrics, generally three years long. This involves on-the-job training in the main areas such as caring for sick newborns, adolescent health care, infectious diseases, neurology, cancer, allergy, genetic and congenital problems, child development, cardiology, and so on. It also includes lots of work with hospitalized children (including those in intensive care) as well as outpatients and healthy children. See here for the official details.
• Passing the exams and licensing that go along with medical school and residency.

What sorts of requirements are there in order to be a missionary?

The main requirement, of course, is that you yourself be a believer in and disciple of Jesus. In the broad sense, all disciples are missionaries. In the narrower sense, though, of those whose job or career is proclaiming the gospel in a different culture, it depends on the organization you work with. Some people are sent by their own churches alone, some by a denomination, some by another organization, while some people simply go on their own.

We work with Serving in Mission, and you can see an overview of our requirements for service here. All missions require (or should require!) their members to have basic Christian beliefs, knowledge, and a life that shows a commitment to discipleship.

Depending on the organization, country, and type of work, it’s common for other requirements to include

• Academic preparation for the job (teaching, medical, technical, or whatever). Many organizations require at least an undergraduate degree or equivalent for most position. Many if not most long-term missionaries either have a graduate degree when they apply, or obtain one along the way.
• Adequate education in Bible and theology. This varies with the group and the position, but often a year or more of college-level Bible and/or theology studies are required.
• Evidence of the personal qualities needed for living in cross-cultural situations in general, and in the selected culture in particular. This can include psychological profiles, cross-cultural training programs, learning how to learn a new language, and so on.
• Approval and support of one’s local church.
• Willingness to raise the needed financial support, unless you’re applying to an organization that has the resources to support you directly.

How did you decide to become a pediatrician?

I’ve always had an interest in medicine and thought about becoming a doctor. I started off on a career of psychology and counseling, but then switched to medicine. When it came to choosing a medical specialty, I chose pediatrics because I liked children (doubtless the most common reason!), saw that it was upbeat compared to a lot of areas of medicine, and because it was clearly important for international health care.

What made you to decide to become a missionary?

Probably the most important influences were my parents and the church where I grew up. My parents, mostly by example, taught me to be interested in the world outside our borders and to care for the needy. The church was very involved with missions and gave young people a chance to interact with missionaries and to get experience themselves.

What is the most challenging factor about your career?

The most challenging part of being a pediatrician in Evangel Hospital was the limited resources. Coming from medicine in the developed world, it was very hard to work in a setting where not only advanced technology but even basic infrastructure and health-care training were lacking, and where the most basic medical treatments such as oxygen and antibiotics were often beyond the financial means of the patients.

How do you overcome the challenge?

Partly by learning how to do with less, partly by find ways to make more resources available, and partly by having to live with lower expectations. However, I can’t say I really overcame the challenges as much as coping with them.

Is your job what you imagined it to be when you first started your career?

In many ways, my career as a third-world pediatrician was what I expected. Probably the biggest difference is that I had not imagined the degree of obstacles caused by corruption and inefficiency at so many levels.

Do you plan to stay in that career until retirement?

Well, over two years ago I took a leave of absence from Evangel Hospital and medical work. I may return to some aspect of health care, but I doubt I will return to the same position (full-time hospital pediatrician) I was in for the previous 16 years.

If so, why? If not, why not?

Partly because my personality, learning-style and working style are more suitable for an IT position (or combination) and partly because I simply got burned out in the position I had … a whole other topic.

Could you please tell me good things and bad things about your career?

• Saving lives. Sometimes doctors joke about going to work to “save lives,” because for most of us it’s not something that happens very often (depending on the specialty and position, of course) and because there is such an abundance of medical resources. But every day in a third-world hospital we see the direct connection between our work and saved lives—not only deaths avoided but also health and productive lives restored.
• Seeing children come in very sick one day, and going home perfectly healthy a day or two later.
• Being able to provide medicines and care to bring back health to children with HIV.
• The smiles and happiness of parents when their children are healthy.
• Children are basically fun and friendly.
• Africans are very relationship oriented.
• Having children die. Even though my pediatric training was largely with the sickest children (cancer, liver transplants, congenital heart disease, severe prematurity and so on), we had far fewer deaths than in my work in an African hospital.
• Preventable deaths. It’s bad enough that some children inevitably die, but when it’s due to mistakes, shortages, mismanagement, and so on, it’s even harder. Often parents don’t bring their sick children for medical care until it’s too late, and sometimes severe problems are missed by the medical personnel.
• Lack of resources, as I talked about earlier.
• Being in a health-care institution but having little input in how it is run.
• Realizing that most of the work we do is necessary only because people don’t have the basics – food, education, sanitation, clean water, immunizations, and simple health care.

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