Dr Moratwe Masima, A Driven Dreamer

From her achievement as the Miss South Africa runner-up in 2021 to her impactful roles as medical doctor, health advocate and social media influencer, Dr Moratwe Masima is determined to redefine what it means to be a health professional in the 21st century. 

In this episode of Awakening Doctor, we explore her commitment to living an intentional life, the courage to dream big, and the tension between perfectionism and vulnerability in choosing to define success on your own terms and in the public eye. 

Dr Masima opens up about the pressure she experienced as a first-generation medical student, the impact of early encounters with the fragility of life and death, and the stark contrast between her naïve expectations of medical school and the harsh realities of clinical practice and the medical curriculum - an important forewarning for anyone in the early stages of considering a career in medicine.

We explore her aspirations for a non-traditional career path, the role of risk and failure in attaining her goals, and her approach to balancing authenticity and professionalism on social media.

Join us for an inspiring conversation about self-belief, perseverance, and the power of dreaming big. Dr. Masima’s story is a message of hope and encouragement for anyone seeking to carve out their own unique path in life.

Chapters

• 0:00 Journey of a First-Generation Doctor
• 3:22 Redefining Success as a Doctor
• 14:39 Navigating the Challenges of Medical School
• 28:51 Reflecting on Medical School Experience
• 39:34 Navigating Medical Risks
• 47:30 Navigating Professionalism and Personal Identity
• 58:32 Evolution of Medical Training and Values
• 1:04:27 Navigating Toxicity and Social Media
• 1:15:10 Embracing Failure and Dreaming Big

Transcript

Dr Maria Christodoulou: 0:00

That's a lot of responsibility to carry as the firstborn, right? I think I'm identifying a little bit because I was also the firstborn and also the first doctor in my family. There were quite a few after me. What in your mind makes it harder for someone whose family haven't been to university? What's it like to be the first generation to have that opportunity?

Dr Moratwe Masima: 0:23

I think that it puts a lot of, as I said, pressure on you to really excel. You don't have a choice but to be excellent, because there's so much riding on you, there's so many people that are riding on your success or your story of success, because it's never been told before. I remember when I did Miss South Africa, my entire community of Matatiele... We have a little Shoprite in the centre and people went there, bought tickets for me and voted for me, even though that was their last cent. They just made sure that they were out there supporting me, no matter what. And when they watched me on the stage, they all just sent me the videos of them screaming in the living room rooting for me because they couldn't get to the venue themselves.

Dr Moratwe Masima: 1:08

The venue was in Cape Town at the time, and those are the small things that really resonate with me to show that it matters. Chasing your dreams matters, kind of being different, and thinking out of the box does matter. It's made me somebody that isn't afraid to fail, because I've had to be on a stage in front of millions of people basically, because people from around the world watch Miss South Africa and so I can speak in front of anyone now.

Dr Maria Christodoulou: 1:39

Ja, I imagine that's a steep learning curve, and I think it probably takes a lot of courage. I don't know if I'd be brave enough to do it.

Dr Moratwe Masima: 1:41

I think it's something that actually ties in with me being a doctor. I think that something happens to your brain when you see so many people take their last breath. People just have really difficult lives and I think you see people at their worst as a doctor, and it's something that's really taught me to cherish every single moment. And I've taken it and almost ran with it, in the sense that I just think I only have this one life and I need to maximize it as much as possible. And some people don't understand it when I say it, but it's just something that I just feel has really powered my desire and my motivation to better myself.

Dr Maria Christodoulou: 2:18

Welcome. I'm Dr Maria Christodoulou, and this is the Awakening Doctor podcast, a space where we discover the personal stories of those who work in the medical and health professions. Join me as I explore the hopes, the fears, the aspirations and the real-life challenges of those who carry the title, responsibility and privilege of being a doctor. J oining myself and producer Amy Kaye today is Dr Moratwe Masima, a young doctor who completed her community service last year and is currently working as a medical officer in a public sector hospital in Gauteng. Welcome, Moratwe, it's lovely to have you with us here today.

Dr Moratwe Masima: 3:02

Thank you so much for having me. I'm really excited to be on the podcast.

Dr Maria Christodoulou: 3:06

Great, well, we're happy to have you and hi, Amy, it's nice to see you again.

Amy Kaye: 3:09

It's nice to see you, Maria. Nice to meet you, Moratwe. Welcome.

Dr Moratwe Masima: 3:13

Thank you, nice to meet you.

Dr Maria Christodoulou: 3:16

So where should we begin? Where do we start to tell the story of Dr Moratwe Masima?

Dr Moratwe Masima: 3:22

I actually am originally from Midrand, Gauteng. My parents are from the rural Eastern Cape, in a very, very small rural town called Matatiele, and I was fortunate enough to be born actually in the hospital that I ended up being an intern at. So it was quite a full circle moment. I grew up in a very happy, healthy family environment and decided that I really wanted to work hard in school, because, growing up in a middle- class family that also has the background that we do have of previous disadvantage, there's just a lot that you see and want to make better for your family. So I decided that I would work really hard in high school and I got a scholarship to go to Stellenbosch University to study medicine and that basically leads me to get into medical school, which I attended for six years. A v ery grueling, difficult six years where I think I found myself and also lost myself and I moved back to Gauteng.

Dr Moratwe Masima: 4:23

I then did my internship for two years and then one year of community service in psychiatry and internal medicine and now I'm a medical officer, currently in family medicine and also pursuing the business side of medicine. I am going into aesthetics and I call myself a medical influencer because there's actually a lot of things that I do outside of my job that are medical related. I love giving educational videos on social media because I think there's so much that is out there that is definitely not factual and not from healthcare professionals, and I think it's afforded me a beautiful career opportunity where I get to work with different brands now. One of the most recent ones was the United Nations. I work now with ProfMed as one of their ambassadors, so, yes, I have a very full plate.

Dr Maria Christodoulou: 5:11

When we met the other day, you told me that you don't think of yourself as a typical doctor. Do you want to say more about that?

Dr Moratwe Masima: 5:17

Yes, definitely. I don't think that I'm the most typical doctor, because I think I felt the urge already in medical school that I just want to do more than just be a clinician. I see the value and I see the beauty of being a clinician and I do think that I have those specific characteristics that make me a good doctor. I'm empathetic, I'm knowledgeable and I'm just somebody that really wants to be better for my patients every single day. But I've always had this inkling that there's something more out there that is more exciting and also just really fulfills my creative outlets.

Dr Moratwe Masima: 5:52

So I entered Miss South Africa in my first year of being a doctor, which is a very scary thing to do, I think, not only just for myself but for anyone. I was doing 24- hour calls and having to do a photo shoot the next day and still smile and still look as fresh- faced as everyone else. Being in Miss South Africa really taught me how to be a really good time manager, but also how to work under pressure, because I had to be perfect at everything, not only at work, but perfect in front of the camera, perfect in front of South Africans who are judging you and also looking at the other contestants that I was competing against. There were nine other beautiful women that were just as capable, and it was just a very life-changing experience. I think that it's made me the person that I am now. I'm able to handle high-pressure situations quite well, but I also have to teach myself not to take on too much, because then I burn out. It's quite an interesting journey.

Dr Maria Christodoulou: 6:54

I'm sure and I'm intrigued by the part of you that says you know you have to be perfect. You have to be perfect at work, you have to be perfect in front of the camera. Do you feel that you're perfect?

Dr Moratwe Masima: 7:04

I do not feel that I'm perfect, but I do think that I have aspirations of being perfect. As impossible as that sounds. It's not working well.

Dr Maria Christodoulou: 7:15

So you were a runner up in the Miss SA, if I remember correctly.

Dr Moratwe Masima: 7:19

Yes, yes, I was runner up. I was runner up with another contestant. They chose a top three that year and we worked with the Miss South Africa organization for a year as brand ambassadors. So I had to do collaborations and work with different brands like Mercedes, a variety of different makeup brands like L'Oreal. It's been a beautiful journey, filled with ups and downs. It's been interesting.

Dr Maria Christodoulou: 7:45

You said that it's played a big part in who you are today. So what did you learn about yourself in participating in a competition like that?

Dr Moratwe Masima: 7:53

I would say that I learned that I'm very resilient. It brought out the most either vulnerable parts of myself that I didn't even know existed, mainly because I had to be honest with myself and realize that I can't do it all.

Dr Maria Christodoulou: 8:09

You wanted us to start telling the story at the beginning, with your childhood, and you said your parents were born in the rural Eastern Cape. You grew up in Johannesburg. Tell us a bit about your family, about what it was like to visit friends and family in the Eastern Cape, but also how many siblings you had. Tell us a little bit about where you grew up and what that was like.

Dr Moratwe Masima: 8:29

So I'm actually the oldest of three children and being a firstborn daughter is very, very daunting and stressful, as most people would know, and there's a lot of pressure that is put on the firstborn. And I think that that's also the reason why I ended up going into medicine in the first place, because in a lot of families, especially underprivileged backgrounds, you have the sense that there's only certain career paths that are worthy. You're either a lawyer, an engineer or a doctor and nothing else makes sense and because I come from a long line of people that unfortunately did not get the chance to go to university or even get proper education. My mom is a teacher, for example. My dad is self-employed, he's in business. I felt the need to almost prove myself that I could do hard things because no one else had done it before in my family.

Dr Moratwe Masima: 9:19

I am the first doctor i n my entire family. T here's not even a single person that I could look up to and say they have achieved. I don't want to say the level of success that I have, but I've had to be my own beacon of hope. It's been quite a jarring experience, it's been humbling, and I think that it's also been something that I've had to learn comes with a lot of sacrifices, because I am learning on the go and because of that I make mistakes sometimes. Sometimes I don't have time for family and people don't understand, and a good example is doing 24-hour calls and not being available for Christmas holidays or weddings, birthdays. Family members don't understand that sort of stuff because no one else has ever been in healthcare except for me.

Dr Maria Christodoulou: 10:07

That's a lot of responsibility to carry as the firstborn, right? Yes, I think I'm identifying a little bit, because I was also the firstborn and also the first doctor in my family. There were quite a few after me, and what in your mind makes it harder for someone whose family haven't been to university? What's it like to be the first generation to have that opportunity?

Dr Moratwe Masima: 10:31

I think that it puts a lot of, as I said, pressure on you to really excel.

Dr Moratwe Masima: 10:38

You don't have a choice but to be excellent, because there's so much riding on you, there's so many people that are riding on your success or your story of success, because it's never been told before.

Dr Moratwe Masima: 10:50

I remember when I did Miss South Africa, my entire community of Matatiele. We have a little Shoprite in the centre and people went there, bought tickets for me and voted for me, even though that was their last cent. They just made sure that they were out there supporting me, no matter what. And when they watched me on the stage, they all just sent me the videos of them screaming in the living room rooting for me because they couldn't get to the venue themselves. The venue was in Cape Town at the time, and those are the small things that really resonate with me to show that it matters. Chasing your dreams matters, kind of being different, and thinking out of the box does matter. It's made me somebody that isn't afraid to fail, because I've had to be on a stage in front of millions of people basically because people from around the world watch Miss South Africa, and so I can speak in front of anyone now.

Dr Maria Christodoulou: 11:43

Yeah, I imagine that's a steep learning curve and I think it probably takes a lot of courage. I don't know if I'd be brave enough to do it.

Dr Moratwe Masima: 11:49

I think it's something that actually ties in with me being a doctor. I think that something happens to your brain when you see so many people take their last breath. People just have really difficult lives and I think you see people at their worst as a doctor, and it's something that's really taught me to cherish every single moment, and I've taken it and almost ran with it, in the sense that I just think I only have this one life and I need to maximize it as much as possible and some people don't understand it when I say it, but it's just something that I just feel has really powered my desire and my motivation to better myself.

Amy Kaye: 12:27

It's so interesting that you mentioned how being a doctor helped you be on stage in front of millions of people, because I read somewhere that, biologically, people are more afraid of public speaking than they are of dying. That's a fact. Most people are less afraid of their own funeral, than speaking at their own funeral. And, biologically, the reason why people have such high anxiety or fear or panic attacks when they have to do public speaking is because, however many hundreds of years ago, the only time that people had to stand in front of crowds of people was when they were going to be put to their deaths. Biologically, your body is going, I'm going to die, and that's why you have that feeling. So it's so interesting that you've flipped that. So, instead of going I'm going to die, you go. Well, I'm not going to die. So, yes, what's the worst that could happen? I'm not at death's door, so I wI"Not a dead store, so I won't die.

Dr Moratwe Masima: 13:21

That's such an interesting story. I did not know that.

Dr Maria Christodoulou: 13:24

I was going to say, t he one strategy I use to manage my own anxiety and that I often recommend to clients is like when the mind's racing ahead into the future and worrying about all sorts of crazy shit, then I go is anyone going to die? And nine times out of 10, the answer is no. Sometimes, in the line of work that I do, it might be true that someone is going to die. Then my anxiety is warranted and then I need to pay attention to that. So it's a little bit different. So here you are, growing up in this environment where there's pressure to succeed, where you feel pressure to succeed to make life better for your family and to rise above the circumstances you've grown up in. What takes you to medical school other than you could be a doctor, lawyer, engineer? Why medical school?

Dr Moratwe Masima: 14:05

That's such an interesting question because I don't necessarily follow the I would say, the prototype of why most people became a doctor. I think that I just really was drawn towards science-related topics and subjects. In high school I thought I was going to become a chemical engineer. I actually shadowed chemical engineers only, and I think it was in matric that I got the opportunity to go to Stellenbosch for a week, and that was just an eye-opener for me that there was the career obviously being a doctor.

Dr Moratwe Masima: 14:39

My perception of a doctor back then was my GP, and that was the only person that I knew that was a doctor.

Dr Moratwe Masima: 14:46

I didn't have much insight other than, okay, they work in hospital, the shows that you watch on TV, but I know nothing else about it.

Dr Moratwe Masima: 14:53

So that week at Stellenbosch actually made such a big impact on me because I realized that I have the desire to make a difference and make an impact, and I also want to integrate that with science in some sort of way, and I thought that it was a good combination of the two.

Dr Moratwe Masima: 15:12

I do wish, however, that I had more exposure to it, because I think that working as a doctor now is very different to what I envisioned as 18-year-old Moratwe, because I'm 28 now and that's exactly 10 years ago that I made that decision. It's also quite jarring that we expect 18-year-olds to know what their life purpose actually is, because you change as you grow and a lot of people, when they choose medicine, feel pressured that they can't leave or they can't make different choices because you chose such a noble profession. There's certain aspects that have drawn me to medicine, other than just wanting to make a difference in people's lives. There's a certain level of financial security that it brought that I think I felt that other careers potentially might have not, but we all know now that the situation has changed completely and the landscape has changed as well, so it's quite interesting how life evolves.

Dr Maria Christodoulou: 16:05

So what did 18-year-old Moratwe think medical school was going to be about?

Dr Moratwe Masima: 16:10

I just thought that it was me studying all day. So I actually love studying, I sit in the library, I don't mind sitting for hours and reading through anything, and so I envisioned that process and I envisioned that as my university experience. I did not envision myself going into hospital, and I know it sounds abnormal because it doesn't make sense. Of course you're going to go into the hospital, and I think it was in second year that we started our exposure to practicals and it was just quite an overwhelming feeling, walking into the wards, seeing everything, because public hospitals especially when you're that young, I think, first time, I was 19, that I saw someone get resuscitated in the casualty and I think that that was a very overwhelming feeling and it really opened my eyes to what I've signed up for, because I was already in second year.

Dr Moratwe Masima: 17:08

It's going to be very odd to turn back and say maybe this is not for me, because I always think about that patient, because it was my first time that I witnessed someone dying. And I think when people always ask me, how does it feel being a doctor, or how does it feel seeing someone die, it's such an odd thing w hen I don't show emotion the way I used to. Y ou just become desensitized. There's patients in the ward as I mentioned, I was in internal medicine and there's resusces every day in the ward. You resusc for 30 minutes and whatever the outcome is is the outcome, and then you have to move on to you 30-plus patients that are still waiting for you, and casualty is calling and the nurses want a drip, and so you just learn to cope. I do think that I enjoy medicine now because I'm out of internship and out of community service. I think that being a little bit more autonomous is better for me.

Dr Maria Christodoulou: 18:06

So what was it like to witness that first resusc and to see a patient die? I think there are probably 16, 17, 18 year olds right now who are thinking about medical school, who haven't thought about those things. How did you make sense of that experience? How did you make meaning of it? You talk about now, kind of not responding in the same way emotionally. So when you look back, what was that experience like? What did it really mean for you?

Dr Moratwe Masima: 18:30

I think that it just highlighted the gravity of my decision and the gravity of the profession that I chose. It also made me work harder because I think that in medicine, when I mentioned at the beginning, that I feel like I need to be perfect at work and you also need to be perfect in front of the camera... T o a certain extent yo u do need to be perfect at work because you're working with human lives, and so that incident scared me because I remember that I had an exam, probably on the Friday, and this happened on the Tuesday, and I hadn't studied as hard as I had wanted to, and I remember going back to my res room later that day and burning the night oil because I panicked and thought to myself I cannot be the doctor that lets someone die. And that was one of my first thoughts. The second was, this is a scary job, and I think that's when I started realizing just how heavy of a profession it is, and I also started noticing my friends.

Dr Moratwe Masima: 19:36

We did not have good coping mechanisms at all and a lot of people just thought they were fine, but they actually weren't. A lot of people in medical school were on antidepressants or anxiety medication and that was almost the norm, and I think it just highlighted the gravity of what we see and how much it affects us. But a lot of the times you just sweep it under the rug or you keep it moving because you are in a cohort of mostly highly intelligent people that have worked hard to get to where they are and it's very difficult to be vulnerable when you are a part of the top students of the country. There's a lot of expectation from you.

Dr Maria Christodoulou: 20:15

Right. What do you wish you had known at 18 that you didn't know?

Dr Moratwe Masima: 20:21

I wish that I had known that there's different ways to get to where you want to be. I think that with myself, I have been redirected so many times in my life and in my career, not by my own doing, but by God's will. There's certain things that I've tried that have just not worked out for me, but I knew that I wanted a certain outcome, and years later I only see now that I'm actually going towards that outcome, but it's coming in a different way, and I think that I would tell 18-year-old Moratwe that she doesn't need to force, she doesn't need to follow this one life path, because there's other ways to be successful.

Dr Maria Christodoulou: 21:03

Does that mean you might have made a decision not to finish medical school?

Dr Moratwe Masima: 21:07

I think that I would have made the decision to not to sign up for medicine, a ctually. I think that I would have just been as happy as an engineer and I think that now, especially now, there's so many ways that you can make impact. I go back to what I said. I wanted to make a difference in people's lives, and I think that my perception of making a difference in people's lives was physically. Now there's so many ways you can do that. We have access to social media where you can share things and be your authentic self, and it can actually make a difference in someone else's life. You can work with nonprofit organizations if you really want to. There's so many different avenues.

Dr Maria Christodoulou: 21:47

So if you could rewind the clock, what would you do? Chemical engineering, or is there something else that you might pursue, knowing what you know today?

Dr Moratwe Masima: 21:54

Knowing what I know today, very interestingly, I think I would have gone into something like coding, AI, and the reason why I say this is because the world is changing, whether we like it or not, and actually, my brother is a software engineer and he works for Momentum, and my sister also is studying coding. S he's actually in matric at the moment and she's studying coding and I'm just so intrigued by what they talk about and the fact that they can develop apps and websites in like a day. It's exciting for me and I think that I've always just liked that sort of stuff, but I always stopped myself because back then, when I was 18, these careers were not lucrative and these careers basically didn't exist.

Dr Maria Christodoulou: 22:43

I was gonna say, I'm sure when you were 18, 10 years ago, I don't think we were talking about AI the way we're talking about it today.

Dr Moratwe Masima: 22:48

No, no, we weren't, and so I definitely am a girl in STEM. Regardless, I think that I would have fallen somewhere in this vision of either health technology or science.

Dr Maria Christodoulou: 23:00

So how did you get through medical school? What was that like for you?

Dr Moratwe Masima: 23:14

Medical school was difficult. M edical school, honestly, I think medical school changed me for better and for worse. I think that the first year was challenging for me because I had to transition from being a top student in high school to being in a sea of great people and top students as well in their own schools, and I found myself struggling to keep up with the workload. I found myself struggling to keep up with the change of environment.

Dr Moratwe Masima: 23:34

I grew up in Midrand. Now it's a bigger suburb, but back then it was a relatively small suburb. Moved all the way to Cape Town, away from my family, and I was just in a foreign place and had to make it work and all of these changes just overwhelmed me. I'm actually surprised that I made it through first year without failing anything, because there were so many people that, in my year, that didn't make it or had to repeat something and you know, being, I would say, type A, that is your biggest fear is failing anything really and I got through first year. Second year was slightly better. Still a lot of workload, but I think I was starting to get a hang of what university is actually about. And then I think third year was when I started having difficulty with just being in medical school. I don't know how to put it. It came to the fact that we had just so much workload that you would feel overwhelmed. And I remember thinking to myself I need to go see a psychologist because I was on the brink of burnout and on the brink of a breakdown. And the difficulty with being in that situation is that you see everybody else and you think that they're doing well, or you compare yourself to others when the marks come out, you're just a number, but you can actually see other people's marks and you see that, oh wow, people are actually surviving this place and you're just scraping through. Another problem for me was that I couldn't actually relate to anyone back home. So I would call my mom and tell her my issues, but there would be no resolution to it because she didn't understand she truly could not understand what medical school feels like.

Dr Moratwe Masima: 25:16

I think that only people who've gone through medical school understand just how much despair you can get through and just negative feelings about yourself that you can start to develop because you feel like you're not good enough, regardless of how much work you put in.

Dr Moratwe Masima: 25:33

And I think that was a difficult thing to accept and go through, because I was working so hard, my marks just weren't reflecting that, and that was difficult. I think third year was also the first time I had to rewrite a test. N ot a module per se, but a test, and that was also a very humbling experience. You get the email that says you didn't pass and so you need to rewrite, and then it's embarrassing, firstly because you're now going to walk into the examination room with everybody else t hat's rewriting. It's quite a humbling experience, but I've learned to shake the feeling of shame. I think that back then I really cared a lot about what people thought about me and my ability, and I think I put pressure on myself as well because, as I said, I was on a bursary and there was a lot at stake. My parents couldn't afford my university fees and so I had to make it work.

Dr Maria Christodoulou: 26:30

And was the bursary the reason you went to Stellenbosch specifically? I was curious about why Stellenbosch, all the way from the Midrand.

Dr Moratwe Masima: 26:36

Yes, yes, yes. So Stellenbosch definitely was not my first choice. I had applied at actually all of the universities in South Africa. I think I applied at seven universities for medical school, but medical school was actually my second choice. First choice was chemical engineering and at some universities I got in for chemical engineering. I think the University of Pretoria I got in for chemical, and UCT as well. And then my first choice for medicine was UCT. I think it's just the perception of prestige that people have regarding UCT. You read and it says it's the best university in Africa and you see the beautiful pictures and the mountain and everything and you just think UCT is the answer.

Dr Moratwe Masima: 27:22

And then, of course, I got offered the Stellenbosch University bursary and I had a difficult time deciding whether I was going to go to Stellenbosch or not, especially back then 10 years ago.

Dr Moratwe Masima: 27:34

There definitely still was the perception of what racial experiences am I going to go and experience there?

Dr Moratwe Masima: 27:41

And I come from Gauteng, where people are quite open, everybody lives quite peacefully with each other most of the time, and I just couldn't imagine myself putting myself in an environment where I could potentially be discriminated against simply because I exist the way I exist. And that was a tough choice to make, because I didn't want to change my perception of myself and I didn't want my environment to change the perception of myself, and I chose Stellenbosch just out of the fact that I knew that I would come out with my MBChB at the end of the day and whether it was from Stellenbosch or UCT, I would still be a doctor, regardless of whatever experiences I would encounter. But I would say that I actually don't regret going to Stellenbosch. I ended up really enjoying it and I think that the experience made me appreciate where I come from a lot, and also I do think that Stellenbosch does produce really great doctors. I think that we're thrown into the deep end very early and there is merit to that. A s much as we suffer through the process, I do believe that I'm a better doctor for it.

Dr Maria Christodoulou: 28:51

And your experience of Stellenbosch. I mean, you say now that you're not sorry that you went there. You had a perception of how it might be and some concern about how you might experience it. How different was it to what you imagined? What was different, if anything?

Dr Moratwe Masima: 29:05

My perception of it was based on what I saw on the media. So the news, every time you saw anything regarding Stellenbosch University, it was something racial happened. It was just always quite negative in that sense. I think that, firstly, the medical school is away from the town. We're actually based in Tygerberg, and I think that that potentially made a difference because I was surrounded by people that were from... Majority of us actually were from different provinces. Almost all of my friends that I ended up making there were from Limpopo, North-West, KZN, also some from the Western Cape, of course, and a lot from Gauteng. So I think a lot of us had similar experiences of coming from a different province and coming to the medical campus. What also helped is the fact that I do think that being healthcare or health professional students may have made a difference, because I think that we are taught to be empathetic. Not everybody is and not everybody has that experience at all. But I think it does kind of contribute to your experience that you are supposed to be kind to people and you can't just discriminate. But what I do think, what I experienced in the hospital setting was very different. In what way? It depends on which hospital you were placed at for which rotation.

Dr Moratwe Masima: 30:25

There were certain rotations that we had to leave Tygerberg and go to, for example, Paarl or Worcester or Ceres or any other place, and I vividly remember in my family medicine rotation having to go to Worcester. Just the stark differences started to show that I'm really in almost like a foreign place. Firstly, the ward rounds were being done in Afrikaans and I did Afrikaans in high school, so it's not even that I didn't understand what was going on, but it was just the clear disregard for everyone else that was in the ward round. So the students that didn't understand Afrikaans, it was myself and my clinical partner and, I think, another student, and we were all black. And even if you did raise this concern, they would almost like oh yes, sorry about that, and then they would change to English. But it would happen so often that you would stop trying to correct them.

Dr Moratwe Masima: 31:23

And I remember I almost felt so disillusioned that I went back to the res that we were staying at and I was just like I'm not going to even try anymore, I'm not going to try to answer questions, I'm just going to go sit in my little corner, because that's clearly what they are trying to do. That's how it felt and I just remember thinking to myself I just need to get through this block, leave this little town and go back to Tygerberg as soon as possible. That was basically just my perception of the whole experience. It was not pleasant.

Dr Moratwe Masima: 31:54

I think another thing is, when you are isolated like that in certain towns as a student, you not only experience it in the hospital environment, when you do go out into the town itself and you're wearing scrubs and, for example, I remember vividly going into a Pick n Pay with my clinical partner. W e were both wearing scrubs and people just were staring at us l ike we were so alien and, I don't know if it was simply that we were wearing scrubs and that we were potentially doctors that people just couldn't make sense that how are there black doctors? I don't know how to put it. Another incident was working in casualty in Paarl and patients specifically requesting that no, they don't want you, they want that other doctor and they will point to your white male colleague, and those were the things that always just made me think, am I in the right place?

Dr Moratwe Masima: 32:55

I don't feel like I belong.

Dr Maria Christodoulou: 32:57

Sjoe, I'm sorry that happened to you. That's really hard.

Dr Moratwe Masima: 33:01

Oh no, it's okay. It's taught me to stand up for myself, let me put it that way.

Dr Maria Christodoulou: 33:06

So what were some of the highlights of medical school for you?

Dr Moratwe Masima: 33:09

The highlights, honestly, are that I made lifelong friends. I think that when you go through something as long as six years with people, you see them grow from being 18 and you leave medical school at the age of 24 as young adults, and it's definitely been something that I've cherished, because they have been my support structure from the moment I walked in the res room feeling timid and shy and scared to make friends to now even working as a doctor. One of my colleagues who's currently in urology, I'll ask some questions. Somebody in pediatrics I'll ask for help, because I know that I'm not as knowledgeable on these particular topics as I used to be, and I think it's those small things that have really just made me feel like it was a group effort. We all kind of carried each other to the finish line, especially in final year, because we could all see how exhausted we were. But it was the late night group study sessions during COVID, because my class was the class of 2020 that graduated during COVID. We had our final year... We had our final year during COVID. While everybody else in the country was in lockdown, we were called back to university because they said all final year medical students need to go back to their university to complete because we need you as intern doctors.

Dr Moratwe Masima: 34:33

I remember feeling so isolated because we were away from our families. We all did not know how COVID would turn out. We had our classmates succumb to the COVID-19 virus and we were the people that were going into the wards, exposed to the virus and had to come back and study and just envision that we're going to graduate and our families are not going to see us graduate. I still feel so hurt by that. I have my certificate and I've put it in a beautiful frame and everything, but I don't even have proper graduation pictures at all and I've always told myself that I need to at least take a graduation picture for myself, just for that memory, because you go through those six years and you work so hard and at the finish line there was nothing for us. How did graduation work for your class? We just had an oath-taking ceremony, but that was online, and then we had like a group picture in our gowns, but... A my's laughing.

Amy Kaye: 35:37

I had a similar experience, so I also didn't get to go to my graduation and I also have that regret of like, I worked so hard, I didn't get that. We all have that image in our mind of being handed that certificate.

Dr Moratwe Masima: 35:52

Yes, exactly. This is it, and I think for me what was so painful was my parents not seeing me walk on the stage. I've always just had this dream of making them proud and happy. I mean, I know that they were because I ended up graduating anyway, but it was just that moment that we didn't have.

Dr Maria Christodoulou: 36:13

I don't know if I've spoken about this on the podcast before, but on the day that I graduated, I was also the first generation to go to medical school, and my grandfather, who grew up in a very small rural part of Cyprus, was very proud of the fact that my brother and I were in medical school by that stage and we were the first generation to get to go to university and, of course, the first doctors.

Dr Maria Christodoulou: 36:34

And so he traveled all the way from Cyprus to be at my graduation and he would have been in his 70s at the time. And then we sat in the hall at Stellenbosch and the audience was asked to please hold back on clapping, because there were so many of us that it takes forever if they clap each time somebody gets called up. So they said that we'd read the names and have everybody go past, and once the whole class had got their degree, then the audience could clap for everyone in one go. And my grandfather just could not contain himself. He flew up when they said my name and he started clapping and going bravo. It's taken me years to actually realize what it might have meant for him to witness one of his grandchildren cross the stage and be capped as a doctor. I do think you lost something and I think it's okay to be sad about that.

Dr Moratwe Masima: 37:31

Yes, I do agree. Luckily, I just completed my HIV diploma, so I will definitely be walking on the College of Medicine's stage and my family will be there. Excellent, tell us more. Why HIV? I did my diploma in HIV because I was in internal medicine last year and, as I said, I am now in family medicine, so it's an important diploma to have. HIV medicine is ever-changing and I think that it's one of the most important diplomas if you are going to be in a medicine or medical stream. So if you want paediatrics or internal medicine or family medicine, I think even psychiatry, it could be quite helpful. If I were to specialize because I haven't decided yet if I want to specialize, I would have probably chosen dermatology. So I do need my diploma in HIV if I do go into dermatology.

Dr Maria Christodoulou: 38:16

Say more about that. Why would you need the diploma in HIV? I'm sure there's people that don't know.

Dr Moratwe Masima: 38:20

Oh yes. So there are specific prerequisites that you need before you're accepted as a medical officer in a specific speciality. So if you want to go into anaesthesiology, then you need to do a diploma in anaesthesia. If you want paediatrics, then you need to do a diploma in child health. So for dermatology, there is the diploma in HIV that you need to do. Diploma in allergology is also quite helpful. You need research experience as well and some MO time in dermatology, which is very, very hard to come by.

Dr Maria Christodoulou: 38:53

I will admit that in preparing for today's conversation, I googled Dr Moratwe Masima and I found your YouTube channel, and one of the videos that you've made there was talking about what it's like to be exposed to HIV as a doctor in the clinical setting and to need to take antiretrovirals to protect yourself when you've been exposed. How often has that happened to you?

Dr Moratwe Masima: 39:15

That has happened to me exactly three times. The first time it happened to me was fifth year of medical school, in obstetrics and gynaecology, and I think that that is actually what started my disdain for obstetrics. I've just not liked it since then. I was delivering a baby and I remember not having a visor on. I had placental fluid fly into my eye and I remember not panicking at the moment, but I do recall finishing with the delivery and thinking to myself okay, I need to do something about this, because the patient was HIV positive. Yes, she was taking her ARVs, but I still felt uncomfortable, and so I alerted my registrar and then they took me to the nurse and I had to do the whole occupational health situation where they take your bloods. At the time, what they used to do is that they would give you a three-day course of the ARVs and then you would have to go to the doctor and then they would give you results. Then they would give you your 28-day course of the ARVs. Now they just give it to you straight up.

Dr Moratwe Masima: 40:24

The second time was as an intern doctor, also in obstetrics and gynaecology, but that was a needle stick injury. It was around 3am in the morning and I was trying to take blood from a patient and of course I pricked myself because I had not slept for the whole day and I was taking blood in basically the dark because there was load shedding and this patient was HIV positive and not taking any treatment and so of course that definitely scared me and I had to be on the ARVs. The third time was in community service internal medicine i n the wards. I think we were doing a resuscitation and of course resusces are chaotic. Someone is screaming in the one corner, the nurses are running around trying to get the medication. You're trying to be on the patient's chest giving CPR, someone is on the oxygen and I remember taking blood and then pricking myself in that situation because it was such a small room and there were too many people around and so I had to once again be on another course.

Dr Moratwe Masima: 41:32

There have been quite I don't know how to put the feeling when you have to do your follow-up visits and do a repeat HIV test. You really do sit with yourself and contemplate what happens if it does come up positive. I think the chances are 0.3% according to literature. In fact, it's higher chance to get hepatitis over HIV, but you know how it is. We're always so afraid of HIV and I think that actually me doing the diploma helped me a lot with my potential perception of HIV as well, even as a doctor. I don't think that it's necessarily that, oh my goodness, I'm so afraid of this one disease, but I do think that people especially just feel like it's a life sentence. And HIV medicine has come such a long way. S uch such a long way that I don't think that I would respond the same way that I did before i f it did happen again. I would still obviously have a bit of fear, but I think that back then I genuinely felt like oh, this is the end of the world.

Dr Maria Christodoulou: 42:38

And I guess it's easy to say that you might react differently now because you're not in the situation. And I was thinking, as you were telling us the three examples, that you tell the stories quite matter-of-factly, and I remember my own first injury, which was also in obstetrics, so clearly there's a trend there. But I was assisting in a caesarean section and the surgeon was busy suturing the uterus and the suture went right into my finger, through the glove, into my fingertip, and in those days we didn't know as much about HIV as we do now. T hat would have been in the late 80s, early 90s and I had to go and report it and fill in all the paperwork and get tested and I had to wait a month for my results and I had to take the ARVs in that time and sjoe, it was like a daily panic because as you say there was this perception that it was a death sentence, not just a life sentence.

Dr Maria Christodoulou: 43:30

So what do you do with all the feelings that come up for you in those situations? Because you described a couple of I almost want to say horror stories, really scary situations to be in. F rom stressful resusces, to the first resus, the first death, a couple of exposures to HIV. What do you do? How do you get up every day and keep going and stay positive and optimistic.

Dr Moratwe Masima: 44:00

That's actually a very, very good question. So I think that for me, I learned to develop coping mechanisms in university because I could tell that if I don't do anything about them now, they will come back to haunt me. I tend to be quite an avoidant person, so I don't like to confront negative feelings, whether it is crying or conflict.

Dr Moratwe Masima: 44:18

I will run away from, and I think that I had to be quite self-introspective about the fact that I can't run away from my mental health. And one thing that I have gotten into the habit of doing is definitely starting my day or my morning correctly and with a routine. I typically work out or go for a walk, meditate for at least five to 10 minutes. Occasionally, I journal. I've also just recently started seeing a psychologist, but that is only because I want to have a mouthpiece t hat is not my own and that is not somebody that I know, because I think that talking to friends or talking to a partner or talking to family members, they have a specific perception of you, and I think that something that somebody has told me recently is that I present myself as somebody that is perfect. And so you will go through my social media and I think everybody does this, but I think that I have a specific way of doing it because I want to seem professional, but also relatable, but also friendly, and also a doctor at the same time, but also friendly and also a doctor at the same time. So it's quite a complicated perception to have and to kind of put out into the world. It's helped me get to where I am, in the sense that I do get a lot of opportunities because of the way I'm perceived, and that is the reality. People see a beautiful picture or me wearing a fashionable item or me talking about, for example, HIV, or I'll talk about HPV, and there's just a certain perception of, oh, she's doing great, she's fine. But the reality is that no one is perfect and no one is fine. Well, most people have some issues, whichever season they're in, and I think that it's something that I've been very honest with myself is that it is okay to actually reach out for help if you don't feel okay. And I think that for myself.

Dr Moratwe Masima: 46:14

I got a job recently as a medical officer, just now, in June, and the transition has been actually more difficult than I thought it would.

Dr Moratwe Masima: 46:24

I was unemployed at the beginning of the year with the rest of my class. The 800 doctors who didn't have jobs, ja. Yes, I was definitely one of those, and I think a lot of my colleagues actually still don't have jobs. But I recall starting work and feeling this pressure, this pressure to perform, this pressure that, oh, my goodness, I'm so lucky I got a job, which is the truth, but now there's the stress that you to keep it and the stress that you're now. You are an independent practitioner and so you are expected to be a lot more experienced than, for example, an intern, of course, and so I just found that I was a little bit more hard on myself than usual and certain things that, as I've mentioned, I don't respond to certain life events like I used to, and that worries me a little bit, and so I think I do need to at least speak to someone and see, I guess detailing something like this all the stories I've told you to someone else that I don't know would make a bit of a difference.

Dr Maria Christodoulou: 47:30

You spoke earlier about getting to a point, I think in second or third year, where you were close to burnout and you realized that you needed help. Did you get help at that time?

Dr Moratwe Masima: 47:40

There was a counselor on our campus. I think I saw her once, but I didn't go back.

Dr Moratwe Masima: 47:47

What stopped you from going back? I think at the time I convinced myself that I was fine and I think that was a mistake. I think that especially back then, there was a perception of if you are struggling in some sort of way in medical school, you are weak and that you won't be a fit doctor because things get worse from here. And that is actually a lot of what people say. Someone in medical school, someone in internship, will say they're struggling and their seniors will just say, oh, just you wait, it actually gets worse. As a registrar, it's worse than this.

Dr Maria Christodoulou: 48:32

Sjoe. Y ou told me the other day that you quite enjoyed the theory and you know you've said earlier that you're a science girl that that would always have been your inclination. But then when you got into the clinical years, third year, it was like a huge shock for you.

Dr Moratwe Masima: 48:54

So the second year exposure isn't as, I would say, bad as you get higher up into medical school. So I think it was fourth year that I realized just how a doctor actually functions and how they actually work is not what I saw or had in mind. I just thought, oh you know, I'm just going to study and then I'm going to walk on the stage and I'm a doctor. I didn't realize that even as a student, you would do 24 hour calls and that you would come across your registrars and they would be absolutely exhausted. Some of them actually just showed so much disdain for the situation they were in and the way they treated the patients as well. It would show up in that way. The way they treated us, the students as well, would just be an indication that they don't actually enjoy what they're doing, and that's what scared me. I really didn't want to end up like them.

Dr Moratwe Masima: 49:45

It's quite difficult to envision something else for yourself when everybody else around you is going through the same thing, and I think that's why, when I did start seeing that there's other avenues in medicine that I can almost dabble in, it felt scary and almost like I would be judged by other doctors, because no one else was doing that, and I think I made a TikTok last week. I was giving tips actually on how to improve your prospects of getting a job in this particular TikTok and it had so much engagement and so many people were actually thankful that I made that information available for them, because I think that doctors also tend to be quite private people or we don't like to share things, and I just shared my journey of how I got a job in the first place, what I did with my CV, how I highlighted certain things, what I did with my references, and I was very honest and said I'm actually a very public facing doctor. I have a YouTube channel. On one day I am literally in front of the camera and on the next I am putting up a drip on a patient and a lot of people would look at me and say she's not serious. I don't know how to put it.

Dr Moratwe Masima: 51:01

I almost had this feeling, especially in internship when I had Miss South Africa and I was on television or anything like that, I almost felt like I had this internal pressure that I had to show that I'm intelligent and so, if I was asked a question, I would ensure that I'm studying the previous night, because I didn't want to be seen as incompetent or not smart enough. Just because I'm a pretty face, it doesn't mean that I don't deserve to be here, and it's been an uphill battle. Honestly, I don't think I've mastered it yet, but yeah, I think I'm still learning. Honestly, I'm still learning about myself. I'm still learning about where I actually envision myself, because I think that what I want for myself might not exist yet. I don't necessarily have like a mentor or a role model that I look up to and say that is what I want, because the things that are out there are very traditional. It's either you become a paediatrician or a neurologist, and that's just you. I think that even if I did specialize, I would see myself as wearing multiple hats.

Dr Maria Christodoulou: 52:09

What do you think has made it possible for you to have that perspective? Because, as you say, there's a lot of the traditional. You finish, you qualify, you specialize and you go into one of the traditional disciplines. What's made it possible for you to imagine things outside of that domain?

Dr Moratwe Masima: 52:24

I think that it's me actually seeing that things are possible that other people told me that they weren't. S o a good example is me making additional money outside of my day-to-day job. A lot of people automatically, when I do tell them that actually I do make money from social media, I do get paid when I work with a brand, they're so shocked they actually can't fathom that that's actually how things work now. Just this past month I've actually made almost close to what I earn working as a doctor, but working from social media campaigns or even from YouTube, and that, to me, highlights that there's a changing world and I don't need to fit into this box where people tell you this is the only way to get there.

Dr Moratwe Masima: 53:14

I think that honestly, I take a gamble on myself every single day, but I think I go back to the first statement I made, which was I genuinely feel like I only have this one life and I cannot fit into people's perception of me. I can only follow my intuition and my intuition is telling me that I'm on the right path. because you do not want to be perceived as an incompetent doctor, because when people Google you, patients will Google you, your potential employer will Google you. I've had to be very careful with ensuring that I don't blow the lines of professional versus unprofessional. It's actually been something that I've had to almost train myself to do.

Dr Maria Christodoulou: 54:18

I love that. I wish I had known that at your age. I think it's amazing that you know that at 28. I really do.

Dr Moratwe Masima: 54:21

It takes self-belief, but also just knowing that you're taking a risk, because at the end of the day it is a very inconsistent field. Being on social media is a scary thing, because you do not want to be perceived as an incompetent doctor, because when people Google you... Patients will Google you, your potential employer will Google you. I've had to be very careful with ensuring that I don't blur the lines of professional versus unprofessional. It's actually been something that I've had to almost train myself to do. [Dr Maria Christodoulou" It depends on people. People have a very odd view of doctors. I think the public does put doctors to a specific, a higher regard. I think that if you're on your social media, for example, smoking or something, and you have doctor in front of your title, because I have doctor in front of my social media accounts and the reason why I do it that way is because I do know that I have a good mix of health information, a good mix of lifestyle content that I kind of mix up with health information, and so I've built my brand around that. I can't, for example, post myself in the club because I have put the title doctor in front of me. And yes, we all know that people go out and have fun, we are young. But because I have branded myself a certain way, I have to hold myself to a certain level and I think that's what I would say makes things professional and unprofessional. If I had a private account and it was just me and my friends, I wouldn't have minded.

Dr Maria Christodoulou: 55:21

Right. I think that for me, it's always really interesting to consider what we mean when we say professional and how so often it's supposed to exclude anything that makes us human. My first example of that... So when I first studied coaching, I was in a private practice and I closed the medical practice and started a coaching practice, and it was a very new field at that time. Health coaching was not very well known and I had created a couple of social media, and in those days we didn't have Instagram and Facebook, it was pre those days, and I don't even remember which platform it was, but on one of the platforms I dared to write a little bit of my personal story and in there I shared about burnout and I shared about depression, I shared about being divorced and I shared something of my family background. And this post was out there.

Dr Maria Christodoulou: 56:07

And then I got appointed to design a curriculum at Stellenbosch University. So suddenly I was employed at the medical school and in that time I agreed to present an abstract at a conference and I'll never forget that the person who was going to introduce me at the conference pulled me aside in the lunch break. He'd obviously gone online to search for information or Google me, and he advised me very strongly to take down that personal story because it was not appropriate. Oh, wow. I t was not me in a club or me with a cigarette dangling from my lips. It was me sharing a personal story and he told me that if I wanted to progress in the profession, if I wanted to be an academic and it was my first year back at the medical school after many years, that he thought it would be prudent to take down that post. And I did. I went home in a complete panic and I deleted anything remotely personal about myself on the internet.

Dr Moratwe Masima: 57:11

Yes, that's such an interesting story actually, and I think I share similar sentiments when you share a personal story about potential mental health struggles. It's actually something that I was detailing to an intern that I was working with and they had asked me a similar story of how do I keep the balance between sharing my personal life and being vulnerable and being seen as relatable as a doctor and also just as a young woman because I am a young woman that's going through life and learning and also trying to still stay professional. Because what if you do want that registrar post at some point and the consultant that is vetting you is looking at you and another candidate? And I was quite cognizant that I've always been very aware that I try to stay clear from certain topics like mental health or my personal mental health.

Dr Moratwe Masima: 58:01

I would not speak about that. I would potentially talk about oh, you know, I've had a really difficult call and this is what happened on the call, but I wouldn't talk about how it affected me because I always thought to myself, what if this comes back to me and they watch a video and they see, oh, this person doesn't cope well in highly stressful environments, I'm not going to employ her, and I think that it's such a sad thing about our field. We are very hard people and we are hard on each other and ourselves.

Dr Maria Christodoulou: 58:32

Well, when you spoke earlier about how the registrars often take it out on the younger doctors and it becomes very evident that they're unhappy in their job, I always find it fascinating that every generation of doctors will complain about the consultants or the registrars that they work with. How does it happen that young people who were so miserable as interns or as medical officers then become registrars and become those people that are making life difficult for the younger generation? What is your explanation of that? How do you make sense of that?

Dr Moratwe Masima: 59:03

So I've actually had almost like a 50-50 experience. I've actually had registrars that for some way and some miracle, they have maintained their love for what they do and are still very, very kind doctors and are willing to teach, and I think that is something I've always gravitated towards. People that are willing to teach, because we do not become great doctors by people shouting at us and berating you for making a mistake or not knowing something. I will always remember the registrars and the consultants that would always sit us down and actually take us through something, because those are the people that actually make you a better doctor. I personally feel that we do have a new generation of doctors that are a little bit more aware and are actively trying to not repeat the mistakes. I do think, however, there will always be a level of toxicity in medicine.

Dr Moratwe Masima: 59:59

I don't know how we combat that. It is the fact that we just have such little resources and you're just expected to smile and take it. Regardless of whether you didn't sleep the whole night, whether you saw 50 patients and you didn't have anything to eat the night before or even had time to go to the bathroom, you're still expected to smile and take it, and I think that changes you. That experience changes you as a person, and so I actually don't blame the people that change, because, unfortunately, you almost go into this mode where you just need to get to the finish line, and how you get there you don't care. At that point you're just trying to preserve yourself and just graduate.

Dr Moratwe Masima: 1:00:48

What keeps me going is that I truly believe that I want to live a passionate and exciting life. I see myself achieving things that I don't want to say right now, because I think that I want to show it rather than say it, and I think that I'm a woman of my actions and I really think that I'm driven by just living a full life in every aspect. So I don't let my career define me. I don't let people define me. I'm just driven by being excited by life. It's important that you self-introspect and you realize what actually brings you happiness. And for me, just recently, starting in my work now, I've realized that because I work less hours, I don't do calls anymore, by the way, I only work from Monday to Friday, I have my weekends.

Dr Moratwe Masima: 1:01:42

I've realized just how much I love medicine again, and I've realized just how much energy I have when I see each patient.

Dr Moratwe Masima: 1:01:47

Even if I have a full day of patients and I'm really inundated with work, I just ensure that I make that patient interaction the best that they'll remember, because a lot of the times we forget that patients wake up early in the morning, at like 4.30 am to come see us and they have that small, maybe five minute interaction with you and that is what they remember forever and what you tell them as a doctor can be one of the scariest things in their life. For you telling them, oh, you've got diabetes, and for them, their parent died from diabetes. That is a life altering moment for them and I know that we typically just rush through certain things because we just want to get over it with and done, but I think that now that I have more time for myself and I'm not overworked, I'm actually a better doctor. It's making me excited to learn again. I'm coming back home and studying again, and I think that that was something that I lost in internship and CommSe rv. I was just so exhausted I barely studied.

Dr Maria Christodoulou: 1:02:45

And I'm sure there's people out there wondering so how is it that you don't have to work weekends and nights? Tell us a bit about how that works.

Dr Moratwe Masima: 1:02:53

In family medicine, but I sometimes work in some of the clinics and sometimes at the hospital. But I have opted out of commuted overtime because there is the option to opt out. The reason why I opted out was simply because I actually had exams - my diploma in HIV management, which I wrote - and I also have an upcoming examination in my diploma in mental health because I did three months of psychiatry last year, I just decided I might as well just write the diploma and I needed the time to study.

Dr Moratwe Masima: 1:03:21

So I just could not do overtime and study at the same time. So that's why I opted out.

Dr Maria Christodoulou: 1:03:29

I imagine those jobs are more readily available now that the public sector is struggling to get funding. It might be easier for them not to have to pay the commuted overtime, but then that adds to the burden of the doctors who are doing the overtime.

Dr Moratwe Masima: 1:03:43

Exactly. It was actually in our contract that they did not offer commuted overtime at the beginning, but now that more funding has come out, they have asked for people who want to do it.

Dr Maria Christodoulou: 1:03:50

What do you love about medicine?

Dr Moratwe Masima: 1:03:53

I love that medicine is ever-changing. I think that there's always something new to learn. What I learned in medical school, which was literally four years ago, has changed. I think that it keeps me on my toes. I love challenge and improving myself. I think that self-improvement is one of my life goals. I want to be the best version of myself, so I love that. It just teaches me something new every day. I think that it also reminds me how human I am and reminds me, I guess, how valuable life is, as I've said before.

Dr Maria Christodoulou: 1:04:28

Is there anything you dislike about medicine?

Dr Moratwe Masima: 1:04:30

The hours, the hours and the occasional level of toxicity, of course.

Dr Maria Christodoulou: 1:04:40

Do you have any examples of that toxicity that you'd be willing to share?

Dr Moratwe Masima: 1:04:44

Yes, I mean. I think there's a lot of toxicity in the sense that there are people that look down on you based on what level you're in. So a registrar or a community service doctor, which is so shocking to me, would look down on an intern or bully an intern in the same way a consultant bullying a registrar. Those are the things that I truly do not understand, and I think there's also a level of unprofessionalism that I've experienced where you would be discussing a patient with a doctor, asking for help and clearly needing the help, and they would just drop the phone on you. It's become a norm actually if, for example, you're stuck in a small place and you don't have the resources and you want to transfer a patient out who is quite literally dying on the table, and people don't respond to that anymore. So that's something I definitely don't enjoy.

Dr Maria Christodoulou: 1:05:35

I can imagine. A nything we haven't talked about that you want to share?

Amy Kaye: 1:05:42

There's something I've been dying to ask... W while you're in this difficult experience of medical school and it's so intense and so hectic and you've got all this pressure and you're trying to be perfect, how does the idea of I think I'll enter Miss South Africa come up? Where does that come from? Because it's like, sorry, what? Why?

Dr Moratwe Masima: 1:06:09

Oh yes, of course. I think I mentioned at the beginning that I tend to take on quite a lot out of choice and I always have to stop myself. I think even right now. I have a shoot tomorrow very early in the morning with a very big fashion brand and then after that I've got a campaign about period poverty, because I speak about reproductive health and I speak about educating especially young girls about their reproductive health. So I'm working with Spar and so I'm going to be attending a netball match and then I have to study as well because I've got my exams.

Dr Moratwe Masima: 1:06:43

But how I came about deciding to do Miss South Africa was, honestly, it was actually just something that I'd always wanted to do since I was very, very young. I was one of those girly girls that watched TV and saw the Miss South Africa women and thought to myself they are so well put together and they look so beautiful. But not only are they beautiful, they're also very smart, and I remember looking at them, especially when I was younger. There wasn't much representation back then in terms of body sizes, even skin colour, because I think back then there weren't very many women of colour that actually won Miss South Africa, and I just thought to myself well, if I don't see it, I'm going to become it. And that's basically what made me get the courage to enter Miss SA. And also, after medical school, I wanted to finish medical school first. That was my very first priority. I needed to get my degree and then I would pursue my other passions. Anything else you want to say about that Amy?

Amy Kaye: 1:07:42

So this podcast is all about changing perceptions of what everyday people think doctors are. I must say I had a perception of who I thought a Miss South African contestant was, or what kind of woman would enter a contest l ike that. Y ou've got all these perceptions of beauty queens and what that's about, and I've just been listening to all of your answers. I love the fact that your answers are quote unquote perfect. Like you answer everything l ike a beauty queen. You answer like you are in a pageant, like you have an answer for every single question. But I also love the fact that you're also incredibly authentic at the same time. So it's perfect, but it's also honest and it's real, whereas sometimes you have that thing where the answer is incredibly polished but it's quite fake.

Dr Moratwe Masima: 1:08:27

Yes, yes.

Amy Kaye: 1:08:28

You were talking about social media and people's perception of you and whether you would get a job or not, and I think that's very similar to politics. So you're not allowed to be shown being a human because that'll come and bite you later. And it's kind of the same thing where if you're on social media you have to be a certain way because that can come and bite you later. Another thing that I wanted to ask was I was, you've obviously got a very busy life and you're doing so many different things and coming across so many different people and you have a very different way of seeing the world and thinking.

Amy Kaye: 1:09:02

How do you deal with the social media aspect in terms of there must be elements of people around you that are jealous. There's cancel culture. People trying to sabotage and things like that. T he people who are taking out phones and sticking it in your face when like, actually, that doesn't work with my brand. How do you navigate that? Because I think social media is incredibly tricky in that way, where people think... especially when you're a public figure and then people think they own you and then they think they have a right to take a selfie or they have a right to film you.

Dr Moratwe Masima: 1:09:31

Yeah, so you're right. Luckily enough, that hasn't happened to me yet. I haven't been caught doing something that I probably would not want to be seen doing, but there has been... S ometimes th ere is a level of backlash on social media itself where you get negative comments. W here people will say I don't think a doctor should be sharing that, or just weird things, because, as I said, people have this perception that the doctor doesn't look like me and a lot of my videos I'm actually quite dressed up. I put on makeup and I've got like my hair in curls and I just I actually do look like a beauty queen in that moment.

Dr Moratwe Masima: 1:10:11

But then I'll be talking about something serious. I'll tell you to go get your pap smear all dolled up, and I think that there's a level of like people just have this weird thing where they're like no, are you sure this is a doctor? I actually had s omebody ask me, are you guys sure this is not a Dr Matthew situation? And I don't know if you are aware of Dr Matthew, but he was somebody that was on social media, specifically on TikTok, but he wasn't actually a doctor but was disseminating all of this information. He had hundreds and thousands of followers, almost 300,000 followers and he created this persona of being a doctor and it all came out that he actually wasn't and he had been going into hospitals. He actually went into Baragwanath Hospital, Helen Joseph Hospital, filming himself in the hospital in the casualty and disseminating all this incorrect medical information.

Dr Moratwe Masima: 1:11:06

And so somebody wrote that under one of my comments and I genuinely was so shocked. But luckily there's some people that actually don't know me personally but they actually wrote no, we know her. She did M iss South Africa. You can check her. She's on the HPCSA registry and so there are some people that actually do come to your defense in situations like that as well. So, yes, it is quite difficult navigating the space. I think it's learning on the go, but I do think that I double- check my information. Even when I speak about certain topics, I need to ensure that it is the latest evidence-based medicine. I can't just talk about anything and just disseminate it, because, at the end of the day, there are doctors that are also following me and checking and looking at my social media, and I do not want to be anything other than honest and true.

Dr Maria Christodoulou: 1:11:55

So if I asked you to describe your brand, what would you say? W ho is Dr Moratwe Masima?

Dr Moratwe Masima: 1:12:06

I think Dr Moratwe Masima is a driven dreamer. T hat is the best way to describe it, because I think that I'm driven in that I'm driven in everything that I do and I think that I do everything with intention, because I want to have an intentional life. I want to live an intentional life. A dreamer is because I followed a non-traditional way of doing things. I have traditional aspects, which is my day-to-day job, which obviously is important and sustains me, but I have not forgotten about the young Moratwe that dreamed big and I think that I've honoured her as well and I've honoured that side of myself.

Dr Maria Christodoulou: 1:12:48

I love that, love the innocence of that. I'm so used to having conversations with doctors who are tired or burnt out or so overwhelmed by the responsibilities, and you haven't glossed over those. But you've also found a way to hold on to more aspects of who you are and what is important to you, and I think that that makes you a multifaceted human being, and maybe not that the others aren't, but that you're allowing yourself to follow other avenues and to express other parts of you quite openly and quite visibly, and I think that's rare. There's something really courageous about that. I've used that word a couple of times to describe you, but I think there's also something. It's scary.

Dr Maria Christodoulou: 1:13:25

You said earlier when I said something similar and you said but I doubt myself a lot, and that's what makes it courageous. Like if you were confidently cruising along, then there's no courage required. The fact that you're doubting and the fact that there isn't a map and the fact that you say quite openly that in your mind, one you don't have any role models. There's no one that I would look up to and go that's the trajectory I want to follow. That's what I want my career to be about. It makes you a pioneer. I feel like you're walking on the edge of a paradigm and you're going to be one of the forerunners of figuring out how we do this.

Dr Moratwe Masima: 1:13:57

Oh, thank you, I didn't think of myself that way.

Dr Maria Christodoulou: 1:14:01

One of the best words I've found to describe it, because a pioneer doesn't always sit comfortably with me, but the idea of being an edge walker makes sense for me. That resonates. Kind of walking on the edge of a paradigm, not quite sure what's next, but willing to take the risk, willing to dive into the unknown and explore and risk putting yourself out there and being judged and being criticized. I think that's awesome. So what's next f or Dr Moratwe? Y ou said you don't want to say too much about what you're dreaming of, but give us a hint as to what you're hoping would be next for you.

Dr Moratwe Masima: 1:14:33

So I would definitely say that it has something to do with being in a magazine, and just think of my age. That's as much I'm going to give, okay.

Dr Maria Christodoulou: 1:14:44

I'll let you get away with that. What advice would you have for a young woman who's at school at the moment and thinking about her future and weighing up the career options and considering things as diverse as chemical engineering and medical school.

Dr Moratwe Masima: 1:14:59

I think the advice that I wish I had was to do your research. I think that, yes, it's common sense, but I think that a lot of the times, when you are in an environment that maybe hasn't exposed you to those things before, you just feel that it's impossible to get any information on things. I think it might be slightly easier now. People are a lot more open and there's more information just on the internet about what certain careers look like. But with myself, I just almost took a leap of faith and just had to learn on the go. I don't necessarily have regrets about my choices in medicine. I don't think that I would be the Moratwe that I am now, and so I wouldn't change it. As much as it was difficult and as much as it is continuing to be difficult, because we're learning that doctors don't have jobs, we're learning that you need to keep studying forever and it really actually never ends. I accept those realities and it still makes me enjoy my job, regardless.

Amy Kaye: 1:16:02

I'm just actually really excited to see where you end up, because it's going to be really interesting. If you do things differently, it can be very lonely because there is no blueprint and there is nobody showing you the way.

Amy Kaye: 1:16:20

There is no guide. You are the guide, you are the one forging the path. It can be incredibly difficult because you can't really relate to people, other people, because you think so differently. You think differently to an outlier if you're on your own because you don't fit in, and I think it can be very tricky, but you are definitely somebody that is very inspiring. It's going to really help a lot of people. I can see that just by the way that you think and the fact that you are, like you said, you're a driven dreamer. Like, it's so important to have dreams, especially in this country where things can be so exceptionally hard.

Amy Kaye: 1:16:57

It's important that you can look at and go, well, if she's doing it, maybe I can do it, and not necessarily in the same way, but I love the fact that you're all dolled up while giving your medical information. I think that's beautiful, like why not? Why can't you be the beauty queen that's also really brilliant. That's the whole point of Miss South Africa. The whole point is to show like yes, you can have brains and beauty. You can do both. While you just have to be beautiful.

Amy Kaye: 1:17:20

So I think that's very powerful and I think it's just exciting. So congratulations. I just think you have such a beautiful, bright future ahead.

Dr Maria Christodoulou: 1:17:30

And for the people that are listening, Moratwe, if this is an opportunity for you in the sense that you have had a chance to share some of your personal story and reveal some of who you are, what's the one thing you really hope people will take away after having listened to your story?

Dr Moratwe Masima: 1:17:51

I think that one thing I've had to learn to do, it's taken such a long time and I think I'm still honestly working on it, is being okay with failing. I think in a world where you just see people that are being successful and winning at everything in life because they only post that side, it's so important to remind yourself that a lot of us didn't get here just because. I detailed the fact that I did struggle in medical school. There are certain subjects or modules that I really truly did not get. They just did not make sense to me, no matter how hard I tried, no matter how many hours I put in and I had to rewrite those exams. It doesn't take away from me as a doctor now because I had to go through that module again to be a better doctor, and I think that in the moment, it feels like your whole world is falling apart, but I know that it just made me a better doctor, and so I would say that people shouldn't be afraid to fail. I would say that people shouldn't also be afraid to once again dream. The failing and the dreaming are tandem, because when you dream, you are bound to fail at something. It's inevitable.

Dr Moratwe Masima: 1:18:54

On my journey to success, I envisioned obviously, for example, winning Miss South Africa. That was what I wanted. That is not what happened, and I think that I also had to sit with that and accept that I was so close, but I was also so far away and I think that was something that I also had to really accept that I may have not won, but I've gotten so much from it as well. That has made me who I am now, and I also probably wouldn't change the outcome, because who knows where I would be? I don't know if I'd still even be practicing as a doctor.

Dr Maria Christodoulou: 1:19:26

Wow, yeah. What's going to stay with you at the end of this conversation?

Dr Moratwe Masima: 1:19:33

I'm actually really, really glad that I took the opportunity to do the podcast. I think that it's also helping me reflect. It's quite easy when you're living your day-to-day life to forget that you've gone through certain things, and it's helped me reflect. It's helped me think about how, actually, I'm really grateful about where I am right now, because I was a 14-year old girl that didn't come from much and had to kind of find her way in this world with a lot of challenges and a lot of things stacked against me. And now I look back and I'm just like, oh, my goodness, I kind of did it. So, yes, thank you for having me.

Dr Maria Christodoulou: 1:20:14

Thank you for your willingness to be on the podcast and to share some of your story and, as Amy said, I think we're all going to be very excited to see what unfolds for you. And when I say that, I really want to emphasize that that includes the times when it's going to be hard. I'm not imagining that everything's always going to be perfect, but I think you have what it takes to navigate those things. I'm excited about what you will contribute to the world and what you will model for the next generation. So thank you for everything that you are and everything that you bring.

Dr Moratwe Masima: 1:20:47

Oh, thank you. Thank you so much. Those are beautiful words.

Dr Maria Christodoulou: 1:20:52

I'm Dr Maria Christodoulou and you've been listening to the Awakening Doctor podcast. If you enjoyed this conversation, please share it with your friends, follow Awakening Doctor on Instagram, Facebook and Spotify and go to Apple Podcasts to subscribe, rate and give us a good review. Thank you so much for listening.