I REFER to the report, “Unfit to be doctors” (Sunday Star, March 20), May I as a practising doctor, who graduated from a public university in Malaysia more than 35 years ago, make a few pertinent comments?
1. Medical schools overseas fall into two categories namely (i) recognised medical colleges, i.e. medical schools whose curriculum and training of students are deemed to be of an acceptable standard by the Malaysian Medical Council (MMC) and Malaysian Qualification Agency (MQA).
Graduates of these medical schools are guaranteed a place in government hospitals to do housemanship; and (ii) unrecognised medical schools that do not meet the above criteria. Graduates of these colleges need to sit for an entry exam here to be trained as a house officer.
2. Leaving aside the fact that there may be students whose entry requirements may not have warranted a place in the medical programme overseas in the first place, which needs to be addressed, are we saying that students who have managed to pass the recognised medical school’s exams, or alternatively the entry exam set in Malaysia, are now suddenly not fit to be doctors? If such is the case, then something is wrong either with the criteria for recognition of these medical schools or the standard of the entrance exam held in Malaysia.
3. The case of the local private medical schools making a hue and cry over the entry requirement, though valid in some respects, is more of a “sour grapes” attitude. Local medical schools have their own set of problems in spite of charging exorbitant fees. The fact is the MMC and MQA do not have a policy of making public their investigations into medical schools, hence these escape public scrutiny.
4. The problem involving the house officers is not their entry requirements into medical school but rather the atrocious nature of the Malaysian House Officer Programme. Where they graduate from has little to do with it. After all, these overseas medical graduates have graduated from a recognised medical programme or have successfully passed the local qualifying examination.
5. No other group of workers or professionals are subject to such abuse as the house officers working in government hospitals. The Health Ministry once advocated an eight-hour shift for house officers but this idea simply disappeared into thin air. Instead, in almost all hospitals house officers start work by 6am, some even 5am, and work till 9pm. When they get home, all they can do is sleep off their tiredness before the slog starts again the next day.
Where is the time to read up on their cases and discuss among their colleagues?
6. Worse, while at work, they are subjected to all kinds of abuse by their superiors, especially by their own medical officers, who shout out and call them names in front of patients. Nobody realises that housemanship is a period of transition. It is no wonder that they are so fearful of consulting their superiors and would rather risk making mistakes. Morale is low and incentive to study, question and learn is suppressed.
7. Does any hospital have a formal programme of teaching or clinical-pathological conferences geared towards house officers to keep them intellectually interested?
8. With nowhere to turn to and fearing victimisation if they voice their grouses, the houseman years deteriorate into a nightmare, such that some opt to drop out or even contemplate suicide.
9. The Health Ministry knows all this but due to the current budget constraints, it will not admit more house officers into the ranks to make it a less onerous system. How is one to pay for more doctors’ salaries when the poor civil servants must have their uniform allowance?
10. Medicine is not for geniuses unless you are doing medical research. Most medical conditions are mundane and can be routinely handled. Even if you have forgotten the dosage of a drug, with a smartphone the information is available in an instant. No one is beyond competence if a sympathetic and structured module is formulated. Hence, this clamour of “unfit to be doctors” is a red herring for a failing system.
11. Instead of these wasteful two years, it is time for a residency programme be instituted. All medical graduates should take an examination based on which they are allocated residencies in the specialities for which they have an aptitude.
Unfortunately, this may never materialise in this country. Failing this, it is hoped that a humane and thoughtful programme be instituted so that all house officers can achieve their potential. Concerned Doctor Seremban The STAR Home > Opinion > Letters Wednesday, 23 March 2016