IT is that time of the year again, where top scorers post-Sijil Tinggi Persekolahan Malaysia and matriculation courses compete for limited seats in critical courses at local universities.
The government is unable to provide places for everyone, especially when the number of top scorers seems to increase every year.
With astonishing regularity, almost all top scorers in the science stream want to pursue medicine. Reasons range from wanting to do the noble thing and serve the public and a lifelong ambition, to parents' wishes and job security. That prestige and good income are serious considerations are often not stated.
As a senior doctor in the public service for the last 15 years, with exposure to teaching medical students, and temporary involvement in the private sector, this obsession is puzzling.
It is acknowledged in the medical fraternity that there are too many doctors and too many medical schools, almost 40-odd in the country, churning out some 5,000 doctors every year, one of the highest per capita in the world. Approvals for private and public medical schools in the last decade had contributed to this.
Many private colleges lack facilities and do not have enough senior lecturers. They usually take the easy way out by "hitching" on to a nearby public hospital. This saves costs of employing lecturers, as the colleges usually engage the public hospital consultants to do the teaching on a part-time basis.
Although frequently denied, service to patients is disrupted to a certain extent in public hospitals as doctors teach when doing their ward rounds and clinics prior to attending to the patients' needs, hence the Ministry of Health's (MOH) recent circular that prohibits doctors from teaching during office hours.
According to the Malaysian Medical Association (MMA) June 2013 newsletter, there were 28,309 medical officer posts available in 2011, with 21,765 already filled. The remaining 6,544 vacancies should have been filled this year, considering the annual number of graduating doctors.
The figures were presented by MMA president Datuk Dr N.K.S. Tharmaseelan during its 53rd annual general meeting recently. He also stated that the number of MOH hospitals in 2007 was 130, increasing by only two hospitals to 132 in 2011, a time gap of four years. Fact is, we are just not building enough hospitals to place and train all our new doctors. Thus, job security in the medical field has become a fallacy.
This will inevitably happen as entry qualifications into some medical schools have been relaxed to fill up numerous available seats. For example, in some departments in a hospital, there are 30 to 40 house doctors, with the heads of department being unable to remember their names or faces.
For those who intend to become specialists, there's not much good news either. According to MMA, in 2011 only 690 medical officers were offered post-graduate medical programmes in local universities.
In the private sector, there is an "overload" of doctors. Private hospitals, which are essentially business entities, do not actually employ doctors but hire them on a private contractor basis. They will continue to do so to enlarge their income pool. This has resulted in too many doctors trying to meet the needs of the minority group of patients who have insurance coverage or the funding sources to pay for private medical care.
Those aspiring doctors among top scorers should think carefully before opting for the medical field. This letter is not meant to dissuade students from pursuing medicine but to encourage them and their parents to think about issues affecting the profession today which can help them in making an informed decision.
Dr B.A. Kareem, Penang New Straits Times Online Letters to the Editors 20 Aug 2013