Tshering, who trained in Bangladesh, Japan, Australia and the United States, began his political career in 2013, but his party failed to make headway in that year's election.
After losing, King Jigme Khesar Namgyel Wangchuck commanded him to lead a team of doctors and travel with the monarch's entourage to far-flung villages to provide free medical treatment.
Now as prime minister, he spends Saturdays treating patients referred to him and Thursday mornings offering medical advice to trainees and doctors. Sunday is family time.
Back in the prime minister's office, a lab coat hangs on the back of his chair.
This, he said, serves as a reminder of his election pledge to focus on healthcare.
Patients don't have to pay directly for healthcare in Bhutan, but Tshering says that much more remains to be done despite important strides in medical treatment.
While the country has seen major improvements in life expectancy, a reduction in infant mortality and the elimination of many infectious diseases, the number of lifestyle diseases -- including alcoholism and diabetes -- is on the rise.
"We must now slowly put more focus on secondary and tertiary healthcare," Tshering said.
Under the PM's knife
At the hospital, Tshering's patient, a 40-year-old man named Bumthap who underwent a five-hour bladder repair surgery, told AFP he was pleased with the results.
"Now that I have been operated on by the prime minister, who is considered one of the best doctors in the country, I feel more relieved," he said.
Politics, the prime minister said, is a lot like being a doctor.
"At the hospital I scan and treat patients. In the government, I scan the health of policies and try to make them better," he said.
"I will continue doing this until I die and I miss not being able to be here every day," he added.
And on the days when he drives his car around the capital Thimphu -- instead of using his official chauffeur -- an-all-too familiar urge takes hold of him.
"Whenever I drive to work on weekdays, I wish I could turn left towards the hospital."