kheru2006 (kheru2006) wrote,

Keeping high standards

Flood of mediocre, undertrained doctors detrimental to nation

IT is the stuff of dreams and fantasy for a newly industrialised country (NIC) like Malaysia to have the complaint of having "too many doctors". Where other NICs and developing countries struggle to provide enough doctors for its population, Malaysia's problem seems to be how to limit the number of graduates its medical institutions churn out every year. Logically speaking, there cannot as yet be too many doctors.

The World Health Organisation's recommended doctor-population ratio is one doctor for every 600 persons  and  Malaysia's ratio  stands at 1:800. The plan is for us to attain the WHO target by 2015; but, increasing physician figures are expected to gallop us to a 1:400 ratio by 2020.

The concern, in part, is if the gallop continues unabated, how do we employ all these medical graduates? Having given out licences for medical colleges to set up shop, the expectation seems to be that it is incumbent upon the government to ensure that the graduates have jobs to move on to. In an ideal capitalist world, there would be no such obligation to ensure the livelihood of the newly graduated, nor that of their alma mater.

In a truly competitive market, an oversupply would act to separate the wheat from the chaff, ensuring that patients get quality doctors. Full acceptance of such a reality would then encourage subsequent batches of school-leavers to really consider whether they have what it takes to make the cut.

If only things are that simple. The increase in graduates means that more newly qualified doctors are flooding a finite number of training hospitals, jostling for access to patients and hands-on experience, just as they would with cadavers in medical school. Coupled with the brain drain of senior doctors to the private sector and, thus, the quantity of experienced mentors, this influx negatively affects the quality of doctors issued out to the field.

That there are too many housemen in hospitals, and that the compulsory service period has been cut down from three years to just one, with the possibility of it being waived altogether because of insufficient places, is indicative of the extent of the problem. And releasing insufficiently trained doctors into the market can hardly help.

That the Health Ministry is considering increasing the (very mediocre) entry requirement into medical colleges will partly address the problem. To further stem the tide, a standardised qualification examination run by a national body ought to be established, rather than leaving it to colleges to issue such "access cards".

The medical profession is deeply respected because of the level of skill required to shoulder the heavy responsibility over human life and well-being. WHO target or not, that high benchmark should be maintained.

New Straits Times New Straits Time Online Opinion Editorial 17/11/2013
Tags: doctors, medical

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