For Future Doctors: General Misconception of being a doctor Part 2
My first Part of this topic attracted more than 600 people to visit my blog in a day. Today, I post my second part of my discussion for your reading.
1) Being a GP
As I have written before in my MMA articles, the future of GPs are bleak. If you think that you just want to complete your MBBS and open up a clinic, then I think you are misinformed badly. Many GPs are suffering nowadays. Many have even closed their shops due to severe competition. GPs, not only have to compete with their fellow GPs but also with private hospitals, government clinics, pharmacy and traditional medicine sellers. The scenario has changed as I have said in Part 1. You are also strictly regulated by the Private Healthcare and Facilities Act which was implemented from 2006 onwards. Many GPs are only earning a net profit of RM 10 000 a month which is ridiculous compared to the amount of work that you are doing. Imagine that you have to work from 9am to 10pm daily including Saturdays and Sundays, especially during your early days. That’s the reason why you notice less and fewer doctors resigning from the government sector to set up their clinic. GPs are now moving from urban areas to sub-urban and rural areas to open up their practises. There may be a better market for GPs in these areas compared to town areas.
2) Being a Consultant in a Private Hospital
Only in medicine I can earn RM 50 000/month when I work in private hospital? I had many friends and budding doctors who feel that medical specialist earns the highest in private sector compared to any other profession. Again, I would say that you are mistaken. Even though you may be right in terms of the earning capacity but what you are not aware is the fact that the private hospitals DO NOT pay us a salary!
Basically you are NOT employed by the private hospital. You are just running a clinic as a self-employed person in the hospital. Whatever you earn is the consultation/surgical fees that you are charging the patients. In fact, the hospital takes 10-15% of your consultation fee as their administrative fee. Furthermore you also need to pay a rental for the clinic space that you are renting! The rental can range from RM 4000 to RM 8000/month. Yes, if you are an interventionist/surgeon or have a lot of patients, you may earn as high as above but at the same time you can also earn very much less than expected depending on the number of patients that you see for that particular month. You may even end up earning less than RM 10 000/month at times! Again, with more and more private hospitals coming up, the competition will be greater and the income of each doctor in each hospital will definitely drop even further. Remember, if a patient’s hospital bill for an admission is RM 5000, only less than 25% of the bill is the consultation fee which belongs to you, of which the hospital will take another 10%!
Also, when you are in a private hospital you are all alone. There are no junior doctors to help you. You need to do all the procedures by yourself and must be available at all times to entertain any medical complaints from the patients (even in the middle of the night). It is not just a matter of running a clinic! So basically you can only charge a patient when you see a patient for consultation and that is your salary!
And also don’t forget, for you to reach the status of a subspecialists before going full-time private practise, it will take at least 12 years following undergraduate medical education, a total of 15-17 years !! By this time some of your fiends will be earning much more than you and driving bigger cars and going holidays all over the world. Many of my friends who went on to do IT, accountancy etc etc had become company managers and directors by the time I finish my subspeciality. They have started to enjoy their life when I was just beginning to think of earning money.
3) TV programmes : ER, CSI, House etc
Don’t get carried away by watching TV programmes like ER, CSI and House. Things do not work the way it is shown on the TV. I had one budding doctor who said that she wants to become a forensic pathologist. I am sure she was influenced by CSI. In Malaysia, the reality is, any forensic pathologist just sits in the mortuary the whole day. They hardly go down to the scene of the crime. Furthermore, if you do attend a court case, you will be tortured by the lawyer. BTW, don’t think we have all the high-end technology in our mortuary like what you see in CSI. In Malaysia, forensic pathologist doesn’t work in a police department. You are just another specialist in a government hospital forever, as you won’t be able to go private. Malaysian law do not accept a report by a private specialist.
4) Patient’s demand and increasing medico-legal issues
Many doctors are being sued nowadays. This happens in most developing or developed countries. Gone are the days where patients will forgive and forget. Even the government is asking all doctors in civil service to take their own indemnity insurance as the government may not be able to cope with the legal suits. The cost of insurance has gone up tremendously especially for surgeons and obstetrician. For Obstetrician, the yearly insurance stands at RM 40 000 – 50 000! So, don’t think that the public has high respect for you and thus they will not take any action against you. A small mistake can land you in court and your entire reputation will be affected, no matter how many life’s that you have saved.
I am sure I would have made a lot of you very depressed by now. Please do not do medicine for the reasons that I have mentioned above. You will regret it later. If you really have passion for medicine then by all means, go ahead. I give the same advice to all parents who seek my advice regarding medicine. But always remember, no matter how much passion you have for medicine, it is still a job for you to earn money for a living. Once you are married and have children, money will be the most important factor no matter what you think now.
The amount of money you are spending to do undergraduate medicine alone can easily be used to start-up a business! Most private medical colleges in Malaysia charges about RM50 000-90 000/year which comes to about RM 250 000 to 500 000 in total, not including accommodation and food. You can easily safe this money, do accountancy/engineering/designer etc etc and use it later to start your own business venture. Don’t you think it is a better option? To get back the investment that you have made for medicine will take another 20 years, not including the money that you need to spend for postgraduate education!
Let me tell you, the money now is not in professional field. If you are smart and only want to earn money, please try technical studies like architect, interior designer, accountancy etc. This is where the money is! If you are good, you can easily become a manager or director of a company by the age of 35.
Oh thank you very much for this depressing post. It’s more depressing when i’m about to graduate in less than one year. Future looks bleak eh?
Atleats it will make you to be prepared for the challenges that is awaiting you!
Thank u Sir for sharing this information…i hv 2 yrs more to go be4 i complete my medical degree and i really need to think of some alternative so that i can keep up a good earning for my living…
thank you sir for ur great advice!
i will definitely ask my juniors to view ur blog before taking up medicine.
have a nice day!
Dr,
Is that true at year 2015, health care market in Malaysia going to have more oversea Hospital or health care group due to globalization agreement?
We was told by DG during a session in my faculty last month.
mean that more competitive in private practice?
Actually after reading Dr. opinion, I think more of my friend will go for Singapore. Since our hand is no being appreciated and we unable to learn much here?
However faculty is trying to brain wash us, and make procedure delay to keep us in Malaysia. Even DG also didn’t care much about our leaving which he reply in that session. But still our Dean and some senior consultant is very allergy about this.
Is that being not patriotic if leaving Malaysia for future aim?
Lot of feedback in saying leaving Malaysia is just betray the country.
isn’t most of the consultant also done their postgraduate oversea? why they so worry about we won’t come back to serve the country? Is that because we really will be attracted by Singapore system and refuse to come back?
nis, you are cute.What to depress about? That is our life in future. Doctor was not a professional position to be respect anymore, we just a service provider, to serve people. Somehow you still have chance to change course now.Oooops.
Life change fast within 5 yr of life we in medical faculty and those are something we can’t control.
Yes, you are right. I did not mention this in my article but it is coming soon! Foreign doctors can come and work here soon without any restriction but still need to get MMC registration.
Most people who go to other countries to work never return!! The prospect of specialisation and perks are much more better than in Malaysia. Furthermore, they appreciate the doctors better than us.
That’s the reason they try to brain wash you now itself, so that you never set foot in Singapore!
http://pagalavan.com
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This is so depressing. I’m going to graduate in 2 months time and all this while I’ve already doubting that this is the life that I wanted. I really dislike the life being a medical student and now as a doctor to be? Thinking of the life that is waiting ahead as a HO is so much worse. For the time we spent working, the money we earn is not as great as my parents had thought. I rather had a lower pay with a life that I could have free time for myself to do things that I actually wanted to do. Too bad it is already too late. I had come so far before I realized what I actually wanted. I hope that when I look back later in life, I will not have regrets as much as I have predicted. Thanks for sharing the truth with us. I hope that the juniors would find this out and realize what they wanted before they set foot in medical field.
To Joann,
Nothing is too late. I’m in the service for 3 years now. I’ve seen many of my colleagues leaving the medical profession for greener pastures. Many thought that if they had studied medicine for 5 years, it is ‘sayang’ to let go. Better let go before you become bitter for the rest of your life. You are still young. The world is there for you to explore. Don’t be tied down at such a young age. It is possible to chase your dream if you think that medicine is not your cup of tea… My friends have done it and they are enjoying their lives now. Cheers!
lol~ Thanks! That sounds comforting. But I think I’ll continue with this until I find greener pastures. At least I’ve to wait until I save up enough to do something of my choice.
Thanks for this very enlightening article. I am now at the end of my compulsory service serving in East Malaysia. At this moment in time, I have realized that being a Dr is always about passion. The passion to serve. With low returns. So unless if your father is a millionaire, or you are due some inheritance that is worth a lot, being a doctor will only bring you added pressure, without any of the financial benefits. With so many medical schools mushrooming, we will definitely be faced with a surplus of doctors. And like all surplus goods, just ask anyone what they think about goods made in China.
There is still hope. Not from the money perspective of course. But hope for the future of this profession to regain its dignity. That is to be closely regulated and to close done most of the medical schools to make it a noble profession again and provide better QC. But we all know that will not happen, especially when money is involved. One day, the lives of the decision makers will be at stake when they are faced with this mass produced doctors. IF they cant send their relatives to overseas in time.
Money earned will just be a number in your bank account. No doubt a big one. But one live saved, will save and touch the lives of many. A much more rewarding experience.
In East Malaysia, most of the patients here still respect us. From the rural folk to the city dwellers, life here is better, not polarised. Respect is given where is earned here unlike in the West.
Being a doctor is all about our attitudes. Come what may, even if there is a surplus of doctors if you can shine and raise above the rest, you will gain what is rightfully yours.
Keep up the struggle and never regret your decision. Having said that if you do not have the passion to serve, please quit now or do not bother taking up medical studies as the journey is one full of hardships with very little rewards in it.
All the best to those graduating. To those thinking about CONvincing your children to take up this profession. Please have a heart and allow your children to pursue the area of their interest.
hi,
I read a couple of your articles and they are sadly true. It makes me heartbroken to see how Malaysia is striving to be ‘developed’ in the 2020 vision (is it going to happen or is it just another hoo-hah). My husband and I just moved to the US for his residency. I graduated from Biotechnology degree. Just a few months here and I noticed the difference in medical care and the quality of training provided here compared to in Malaysia. Residency training puts you under the supervision of at least 1 senior attending and 2 senior residents everyday. They also have weekly reading assignments, monthly assessments and exams, journal clubs and 3 times per week of up-to-date medical information conferences. Plus, you are required to keep yourself updated on recent medical knowledge by accessing journal databases provided by the teaching hospital. Although the work load is high, but i can see the satisfaction from my husband when he comes back from work after seeing patients and learning abundantly from his senior co-workers. Does this quality of education ever happen in malaysia? Guess not.. we simply don have the brain-power to teach…Plus, also because of the poor quality in government hospitals.. most of the ‘interesting’ patients (good teaching cases i meant) are running away to private hospitals for better medical care. So, if there are no patients to care for, how can these housemen doctors learn? They will just have to be content with managing day-to-day cases like DM type II.. This situation is not just in the medical field, but in many other science field in Malaysia. For instance, private colleges produce graduates in food technology, biotechnology, medical biotechnology, environmental biotechnology and the likes… but these graduates end up with no where to go…If you continue in the academics field, your work will be largely research and research funding in Malaysia is limited, hence your salary as a technician will be around RM 1200-1500 and your work will be on a contract basis (2-3 years for finishing a project). Then, you will have to hop on to another supervisor for another new project. As a contract worker, many researchers don’t even get EPF from their employers. As a result, many of these science graduates end up as bank finance officers.. share brokers…insurance agents.. or mostly as science marketing officer where he/she sells science equipment and consumables…These people earn at least 2-3X more as compared to the poor researchers who worked more than 12 hours per day in the laboratories… sadly… a lot of people have to succumb to money because of the high inflation in Malaysia…
After reading all your insider feeds on how government is running the hospitals, i felt gloomier for Malaysia’s future generation of healthcare. Should we return to Malaysia after residency becomes another important issue to consider….
your are spot on! we have so many redundant courses in our universities. Imagine there are 9 universities offering “Aeronautical and aerospace Engineering ” course!!!! Are we an aircraft/rocket producing country? most of these graduates got no where to go. Most of them will end up becoming teachers, just to get a job!!! wonder why our education system is screwed!
I’m just about to start houseman here in Malaysia. I don’t think i’ll be changging my profession. But is there any other advice that you could offer? How about working in Australia n other countries?
As I said, your degree need to be recognised in Australia in order for you to work there. If not you need to sit for the AMC exams before applying for a job in Australia.
For some reason, I am not surprised after reading what’s been told here.
I’m an undergraduate medical student and will be graduating within 10 months.
I’ve thought so much on what’s gonna come right after grad school and believe me, it is sure hard to survive the speck of reality in medical field. The workload, the working atmosphere, public demands and medico-legal issues, they won’t stop coming in and I believe it needs more than just passion to be a doctor.
My highest gratitude to you, Sir, for posting this article. 🙂
Thanks. I just wanted to let everyone know that it is not as rosy as you think, especially parents who keep forcing their child to be a doctor!
Dr Paga , it was an article well written and right on time . Being in the private hospital practise for the past 8 years i do have to agree with what you have mentioned . It is definitely a situation which needs to be addressed and you seem to have done just that . My two cents worth , for those at the crossroads please do medicine if you really have a passion for it as with any other field hard work will be rewarded . Especially when you love doing it . But know what you are getting in to .
I read with great interest your commendable article after it was brought to my attention. Just to state at the outset that I practise in the UK, and perhaps I could give my two penny worth how things compare from a slightly different perspective.
However, first thing first, let me tackle a few issues. I couldn’t help but feel there is a fault in putting forward the passion argument. For crying out loud, how many 19-year-old truly have an idea about what medicine entails unless there is a family member in the medical fraternity. Looking at it from a pure economic point of view, medical graduates still have the best paid job. Just google it and there are a few articles which will vouch for this. Now, I am under no delusion that it’s hard work and if someone does the sum, the hourly pay is no better than a lot of other jobs, taking into consideration the time / frustration involved in post-graduates training and exams. But doctors are still a reasonably well respected profession, decently paid, could make a significant change to patients’ life, have much job satisfaction and earned more trust than a priest or the police… in the UK…that is.
I have little doubt the quality of the medical training in most of these medical colleges that sprang up like mushrooms on a wet field is below par. One could hardly blame them, as I am almost certain there is much pressure both economically and politically. There are still a lot of foreign doctors in Malaysia, and the MOH and MOE probably teamed up to reduced the threshold for establishment of medical colleges. I could see there already has a surplus of HO’s. Somehow the employment abyss has to be plugged – preferably by local growth doctors.
This has happened to Germany. Malaysia will undergo the impending metamorphosis. The would be an exodus of doctors to other countries. Forced by the will to survive they will save up / borrow and pay to sit entrance exams in the UK, Australia, US or another greener pasture. Those who can’t make it will keep trying until their finance or drive dries out. One just have to have recognised training if they are in Malaysia, if there can’t make it into one because of some quota, then pursue a post-grad qualification e.g. FRCS and MRCP.
Medical profession is a marathon. The rewards come after a long arduous run. Your average consultant makes a decent living only in his late 30’s/40’s. Medicine doesn’t take passion – it takes stamina.
For those who are about to graduate or feel they are a mere speckle of dust on the career hierarchy take heed. There are other avenues you could explore if you feel that the medical line is not for you e.g. pharmaceutical industry, management consulting. Those who wants to keep running, be patient, you will one day reach your destination. Be realistic with yourself, you are not an investment banker, so don’t think of making lots of money. A decent career should provide you with sense of satisfaction, the joy you achieve went a patient’s life is saved, their blindness cured or a dying man’s pain made better however infinitesimally small. We all can’t always find the job that we love but perhaps we could try to find the love in the job we do.
This is why I wrote the article. I want to make the budding doctors to realise what lies ahead if they choose medicine. Many do not know about it when they call or talk to me. I hope that i would have made some of them realise the hard work that is involved in medicine. It never ends.
Unfortunately, in Malaysia, doctors are not the best paid job. As I have mentioned in my comments before, doctor’s basic salary is just less than RM200 more than a pharmacist(in civil service). In private sector, you are not paid a salary.
Actually there are not many foreign doctors in Malaysia currently. 8 years ago, the government recruited many foreign doctors from Pakistan, Myanmar, Egypt and India. Many of them left back to their country or went elsewhere within the first 1-2 years. They said that the salary that was given to them is not compatible to the workload (BTW they were paid much better than the locals!) Also the fact that in Malaysia, you would not be able to get your PR/citizenship easily. Even if you are married to a Malaysian, it will take more than 10 years to receive your PR status!
I agree that medical colleges are presssured to produce doctors but quality cannot be compromised for quantity. I also agree that many have begun to sit for entrance exams for other countries especially Australia and US. There’s going to be huge problem in postgraduate training in Malaysia in few years time as we do not have the capacity to handle it. For your information, FRCS cannot be done in Malaysia anymore. The college do not recognise any training centres in Malaysia. Same will happen to MRCOG soon as there are not many MRCOG holders in practise to supervise you. Only MRCP will still stand.
Thus, the situation in Malaysia is really different. Many choose medicine for a comfortable life and to make money. This is not the case anymore. Furthermore, education is not free in Malaysia unlike some other countries. Even, in public universities, the fee is just subsidised and not free. That’s the reason I said whether it is worth the money spent when you are not going to get the return when your sole reason for doing medicine is for guaranteed life and money!
I know of a world renowed Professor in a local university here( now retired) whose 3 sons never did medicine! They saw their parent’s (both professors) struggle and hardly spent any time with them during childhood as they were mainly taken care by maid and in-laws. It is pure hard work and you won’t have much time to spend with your family.
Hello Sir..
I am currently undergoing my final year studies in medicine.. I found the article useful in giving me an insight on what to expect from the field of medicine.. I just would like request something here.. With all your knowledge and work experience Dr, i really wish that you would write an article about the positivity of being a dr in Malaysia, sans the discussion about passion, but a lot more on practicality.. I really would like to know what can i do in order for me to keep this profession and earn a decent living.. In other words, on how not to make the 6 years struggle during my undergraduate study a waste.. Thanks a million Dr.
Yes, I was thinking of writing something about what you mentioned but unfortunately there is nothing much to write about except for satisfaction of treating patients. Anyway I will write something soon.
BTW, who says that your struggle ends after 6 years! You have a long way to go, my friend!
those in medical fields know about it. those not in the field do not. should publish or advertise in newspaper. perhaps some concerned consultant should come out with the money to advertise in The Star? =)
Actually, what I wrote has been written in newspapers before especially in letters column. Unfortunately people either don’t read newspapers nowadays or do not want to believe!
I read your articles (both part 1 and 2) with great interest. I graduated from foreign university in 2008 and started housemanship in a state hospital in Malaysia after graduation.
During the course of my housemanship, I always pondered what will my future be like if I were to continue working in Malaysia, especially with the current exodus of junior doctors (eg. 4000 new doctors joining housemanship in 2010 alone). Many of my friends were pushed to local KK’s and district hospitals right after completing 2 years of housemanship and were expected to manage patients by themselves without any senior doctor advice/help. On top of that, the ones working in KK had administrative jobs too apart from clinical duties. With the exodus of doctors too, the probability of getting the local Masters’ programme and subsequently subspecialist training would be even lesser.
With the above issues in mind and also a host of other issues alongwith, I believed that I would never get proper medical training in Malaysia at a post-internship leverl. I decided to leave the govt service when I managed to secure a post-internship medical training position overseas. Here, the junior doctors like myself are at least being supervised by a more senior doctor all the time, even during on-calls. We have CME’s, journal clubs and protocol days 3 times a week where we update ourselves with the latest developments in the medical field. The local health board is also very supportive and pays for the membership exams and all the training courses we need to go for. Although it not as good as residency training in the US, its way better than in Malaysia as most junior doctors are usually just left in the lurch.
I need to agree on this. I worked in Singapore for about 2 years and definately you can see a big difference in training and CME activities. In Malaysia, you need to train yourself. NO proper structured training is given, including for post graduate and subspeciality.
Master’s quality is also deteriorating. There are no good teachers and supervisors in the local universities nowadays. Mostly “half past six” tutors! Most of the old and good ones have either retired or left to private sector. Master’s has just become another extended undergraduate programme! 100 in 100 out! It use to have 50% failure rate in the 80s and early 90s but due to government presure, the universities had no choice but to pass everyone to increase the number of specialist in the market. Another “false” impression to the public. MRCP has always maintained their standards by only passing about 45-48% of the students in every exam!
I will wriring few more articles on these issues soon.
Just my 2- signatures-in-the-log-book-worth…………..
Your articles are spot on, let’s all swallow the bitter pill!
There is nothing rosy about the medical profession in Malaysia other than the satisfaction of treating your patients. Housemanship or shall I say ‘hardship exposure’ here is one where there is no training at all. You are only a clerk – in fact one specialist in Ipoh used to call us ‘Porters’. 15 yrs ago housemanship was such – I dread to think how it will be now! Merely increasing the duration to 2 years is just a trick to make use of HOs for another round of abuse! I would definitely discourage anybody aspiring to choose the medical profession even if they had a passion for it!
Hello, i’m a 4th year medical student, doing my clinical years in kuala terenganu GH, i totally agree with the 2 article you have posted, but in my opinion i think the overflowing of HO is probably due to foreign med undergrads especially from russia, indo, etc…
my question is that in anyway by your knowledge, whether the gov will someday reduce or prevent student do study their
undergrad degree there?
to my knowledge it seem those who study from russia or indo, their standard seem to be lower when compared to the local uni. eg. their exam is on subject base, so if they pass for eg anatomy in their year 1, they will need not to take the exam again, where else here, most med school exam are intergrated i.e you need to re study the subject(s) to take the yearly exam, in clinical years the rules apply but only for clinical subject.
I don’t think we can blame these students from russia and indon for the surplus of doctors in the country. We have about 30 medical schools in Malaysia alone! Even if each produce about 100 students a year, it is already 3000!But I do agree that their standars are below par.
We cannot prevent people from doing medicine elsewhere but the government may introduce a common entry exam for all graduates including the local graduates soon. This will hopefully prevent substandard students.
Dear Dr,
i freq read thru star blog post, there will always be public who commented on current Dr who are being arrogant and always think medical as a higher profession than others. As a medical officer myself,although i strongly disagree wv such statement, cannot be denied that it highly represents current impression of the public towards us.
i decided to become a Dr since secondary sch. when i told others the reason behind that i choose this profession is to serve and to help those in needs,they always stared at me like i just come out from mars. i truly njoy my 5 yrs of medical training and despite the hard-work during housemanship, i njoy the 1 yr+ of learning process and being satisfied being able to equip myself to face the challenge in the future.
after HO period, i continue my service in KK. despite a lot of misconception from other colleagues and friends who work in the hos as work in primary health care is easy, the life here is even more challenging. im facing much higher mental stress not related to the workload or being afraid of mismanagement, but much more to the complaints by pt esp thos like to labeled themselves as ”educated” but were actually not civilized at all (as me and my frens always said). thos ppl who like to create a big fuss and complain things which is not true and the worst thngs is pkd who is not supportive.
sadly to say, now my job is more of ‘medication presciber” as pt do not need our consultation anymore mostly due to downgrading of Dr image by our MOH who always response relentlessly to thos complaints even though the Dr has done the right things. furthermore, drs were always scolded, shouted, humiliated by pt in the clinic , hardly any basic respect as human. this changes occur only within 1 yr after a change in our MOH policy as customers are always right.
think of it the only reason for me to think of pursue a postgrad degree in over seas is not the workload, stressful life or the salary, but of our gov policies and worsening in pt attitude that further impaired the quality of health care services, i felt very helpless as this is a progressive condition and i predict it will become much worse in the future. currently the only thngs that moving me on is my passion as a Dr which i wonder how long can i stand before it finally disappear.
I think it is not just the government policy as such. No matter where you work, patient’s complaint has to be taken seriously whether it is right or wrong. No matter which country you go, the situation is the same! This is something that as a doctor you must get used to.
As I said, don’t expect doctor’s to be highly respected by patients. The current generation of patients are demanding and sometimes disrespectful to doctors. As in many developed countries, the litigation rate will escalate. Even in MOH, the litigation rate is going up very fast. That’s why MOH is advising the doctors in government service to take your own indemnity insurance.
As a doctor , you should have expected this. That was one of the reason why I wrote these articles. Many people still has the wrong conception of being a doctor that you will highly respected, lot of money and good life!!
i thnk dr might hv been misunderstood. basically, i dun expect pt to respect us for what we hv done. what i mean is the basic human rights like how we treat other ppl nearby, such as not simply scolding, shouting, threatening and blaming for something we did for pt’s faith although explaination done multiple times. i thnk we still deserve the basic manners from public.i agree wv ‘No matter where you work, patient’s complaint has to be taken seriously whether it is right or wrong.’ but proper explaination hv to be given by the incharge to pt if investigation done showed any misunderstanding but not jz merely ask dr to apologize or admit their fault even though they hv nothng to do wv that.
just imagine that most of the dr now dun dare to treat properly and just merely follow what pt needs (although they noe its not right and explanation been given to pt) because of afraid of getting complaint and of cause the consequences of complain as well/ i dun thnk it will do any gud for our pt.
spot on..! shall I go back… or stay here for further training…? The head of paed department UM advise me to stay here…hmmmmm?
Thank you for writing this article, it’s very insightful and dispels a lot of myths and rumours about the profession.
I fully agree that there has been too much privatisation of the medical training in Malaysia over the last decade or so. And the government had done little or none to regulate the standards of the medical schools, and like you mentioned in an earlier comment, has also done little to regulate the standard of graduates from places like Russia, Ukraine etc.
The government has done little to attract good quality professionals abroad, and has also failed to acknowledge the needs of the current medical workforce in Malaysia. Many doctors are underpaid, overworked and are not in a generally good working environment. Mind you, doctors in other countries are also overworked and underpaid, but they have at least much better facilities and support system to work with compared to the ones in the public healthcare in Malaysia (sometimes also private hospitals lack the necessary equipment and facilities).
Keep up the good work and may you continue to spread the knowledge and truth about the medical profession.
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“If you really have passion for medicine then by all means, go ahead. I give the same advice to all parents who seek my advice regarding medicine. But always remember, no matter how much passion you have for medicine, it is still a job for you to earn money for a living.”
Your articles are very enlightening for us who are only beginning to take our stepping-stones in medical field. Indeed, reading them left us in depressions, but only for our own benefits to prepare ourselves in every possible way – physically, mentally and spiritually. Somehow, I finally accept that passion isn’t everything after all. This is indeed a quest of earning money. There was a point when I became so rage to learn the truth and start questioning myself is it wrong to learn what you want to and to become what you always dream of? This just made me teeter between becoming an idealist or a realist. But then, you just can’t stop feeling sorry for yourself and blaming the authorities for what is occurring to this nation. It really isn’t your fault that this happens. Still, there’s no point pointing fingers to others. You just have to learn to adapt with the current situations. Perhaps, those who are interested in politics and are reading this can make a mental note here. I’m 18 and I am determined to pursuit my ambition in this field, no matter how hard reality is trying to stop me from doing so. This path that I’m choosing is a road of struggles, hardships and sacrification. If you’re with me, I’m more than obliged to have you. My advice, start the journey with the right intention, find your motivation and never lose your passion. You’ll see that it isn’t bad after all.. once you realise that God is always there for you.
Dear dr,
I am really grateful for your effort of writing articles about medicine. I am a SPM leaver and I am lucky to get sponsorship to study medicine by jpa and another is engineering in United States. I am confused right now and I need to know about the future of being a doctor. I understand that being a doctor is no joke and it’s a long journey but the satisfaction is really huge. I can’t forget the expression in patients’ faces when I had my program pendedahan in the hospital. And I can’t help feeling proud of myself when a kid called me doctor. But I began to doubt my future if I choose to be a doctor after reading your article. Despite the declining quality of the system of houseman training in Malaysia, I have to come back to Malaysia because of the bond for 10 yrs! That means I can’t choose where I want to be for at least 10 yrs, not to mention the extra bonding period I have to serve for the master programme! And I know that there will be no entrance test for medical students to get a post for housemanships in Malaysia. So what do you think about that? How would it be possible if there is no test and in the same time there is a surplus of graduates waiting to be enlisted? It is really meaningless if I become one of those doctor who can’t even measure blood pressure and I am worried about that. Is it real that the future of doctors in Malaysia becoming so dark? Is it real that I would become jobless and have to wait for a post for housemanship? Should I take the engineering course because in that way I don’t have to worry about my job and I would get better pay in shorter time? I am really confused now…
Your program pendedahan is just too short for you to know the actual life of a doctor. If I am not mistaken, it is just a few days with rotation in few departments. YOu hardly see what is the real picture. Remember, you cannot cure patient’s illness most of the time. As a JPA scholar, one advantage that you have is that the government must provide you with a job due to your bonding. BUT that do not guarantee you a place for local Master’s programme. Yes, the future is bleak. Jobless doctors will become a reality. The time will come where the government will have no choice but to introduce entrance exam. If I were you, I wil take engineering in US where your job prospect is much better and can go anywhere in the world. It is not that easy with medicine where your degree must be rcognised by the country where you are applying for a job. Please read all my postings under ” For Future Doctor’s series”. At the end of the day, it is up to you what you want to do
Sir,
Do you think that the surplus of doctor in the future will affect specialist doctors such as a surgeon? Will there be a surplus of specialists also in the future?
At the moment there are severe shortage of specialists especially in government sector. Private sector is getting saturated in major towns. BUT the problem is not about surpluss of specialist but whether you can get a place to train to become a specialist. The number of post is very much limited with 6-8 000 doctors coming in annually! UNLESS the government comes up with anothyer great idea of producing specialist in large numbers in shortest time possible like our undergraduate degrees ( somehow I have a feeling it may happen!!). If that happens, I am sure many patients will leave Malaysia for medical treatment elsewhere!! quality will be equivalent to an MO!
Dr P and others may have different views on this, but this is my take. There are a number of factors that will affect specialist numbers:
1. Number of people doing specialist training
2. Private jobs available
3. Public jobs available
4. Movement of specialists from public to private
5. Variability in the different specialities
1. Currently, the number of specialist Masters training posts are much less than the number of houseman being pumped into the system each year. It is not easy to simply increase the number of posts – the fact that training is run by universities instead of independent professional colleges can be seen as a barrier. Only UM, UKM and USM are allowed to offer postgrad specialty training at this stage. Trainees need to have an adequate number of competent clinical teachers – most of these are located at the university’s home hospitals. The high turnover of specialists in public hospitals does not help – no continuity with variability in personnel will not help a trainee. Physician training can be done via the MRCP process although I would argue that just because you have passed the exam, it doesn’t make you as equal standard as someone who has done gone through the training scheme in the UK, where it is much more structured. Surgeons have to go through the Masters process. Other specialties have have their own little ‘lubangs’ – e.g. anaesthesia through ANZCA.
2. More and more private hospitals seem to crop up. I have a feeling that it’s reached somewhat of a plateau in the larger cities, and expansion is mainly occuring in smaller centres that are growing in population. Most of these public hospitals are owned by GLCs, and you can come up with your own conclusions about that!
3 & 4. There is still a gross shortage of specialists in govt hospitals because they keep leaving to go to private. Once the private market reaches saturation point (it already has for GPs), this movement will slow down dramatically. The govt also has in its masterplan to build/expand 20 more hospitals that can take in housemen – which means they have to be staffed by specialists. There no way they can find enough specialists in time unless:
a) They hire from overseas (already happening – from Pakistan, Bangladesh, etc)
b) Private jobs dry up (might happen soon)
c) They increase training numbers (takes 4 years for the effect to filter through)
d) They make it more attractive to stay in govt service (don’t count on it!)
e) They take their own sweet time to build these hospital – might even be because they are running out of money (this may happen at the rate the BN is plundering the country – RM1.8 million for 6 facebook pages – what a joke!)
5. Different specialties will have different shortages, and these will be different in public and private between the specialties as well. For example, interventional cardiologists are slowly treating more conditions that used to be done by cardiothoracic surgeons. The rates of cancer may go up – or some wonder drug may be invented that kills cancer cells and you may need less oncologists. No one has a crystal ball.
Correction: Most private hospitals are owned by GLCs
Dear Doctor,
Do you think UPM produces good doctors?What is your opinions regarding UPM medicine program?
My cousin is currently a final year student in UPM, and the education in UPM can be summarised in a short sentence. Students keen to learn but too few opportunities, sometimes clinics cannot even accommodate number of students. However, for some reasons, the lecturers in UPM actually encourage their students to do elective abroad in countries with better healthcare systems. I used to see a lot of final year UPM students doing elective when I was in the medicine and surgery rotations. I thought that most of them actually knew the basics, but they clearly haven’t been practising much. However, most of them who turn up in the UK were actually very keen to learn, they attended wardrounds regularly, joined consultant teachings with the local students, offer to help out in procedures (or at least asked us to teach them) and some of them even sat for the end of rotation test in surgery. And to my surprise, a lot of them actually spend time reading in our library in the afternoon (very rarely do you normally find elective students in libraries). Given the opportunity, I think these students will make good doctors, but unfortunately, training in UPM itself is clearly inadequate.
Generally OK.
Recently I have few local university students attached with me for their electives. I used to have high regards for local grads from public university, as they seems to be better in terms of knowledge and attitude. Of course, having said that, local private uni too do have students with such qualitites. However, to my amazement, these students left me wondering what had happened to the teaching of medical sciences in our public uni. Knowledge of medical sciences that I learned in my first year of medical school seems to be something alien to them. They are simply not reading enough. Let’s not dwell into the clinical skills as maybe too early to comment on that considering they have just approached clinical years. I have tried in that two weeks of their electives drill in them the need to be strong in their foundation of medical sciences and learn how to apply clinically. But I am wondering what difference it will make for them to attach with me two weeks, but then thereafter back to the same system they are in again.
Recently, a local public grads who is a fresh house officer has made a diagnosis of febrile fit in a patient of 13 years old. Apart from that, the other officers of similar university with him too demonstrate worrying traits.
Something need to be done, but who will take the lead? Definitely, not us clinician who is already so busy with daily work, and now expected to correct the mistake or undo the mistake done during medical school years.
I do agree need to enhance and buildon their skills and clinical knowledge, but changing of attitudes and teaching medical sciences which should have been taught in school years, it is rather too much to be expected out of us clinicians.
As I said, generally all medical school’s standards are dropping due to lack of lecturers. Furthermore, the current curicullum is very much simplified and not like before. Less emphasis on basic sciences.
[…] almost 2000 views in a single day. At that time, my blog views were just less than 2500/month! My 2nd part published on 08/09/2010 shot the number of viewers to about 2800 in a single day. These 2 articles […]
[…] When I was in matriculation college, most of those who score 4flat would choose to take medicine. Not because they are passionate for the job but for some other reasons that would definitely make them regret. Anyway, I have some articles to recommend just for you to confirm that being a doctor is what you have imagined. There are really good ones from Dr. Pagalavan. https://pagalavan.com/2010/09/07/for-future-doctors-general-misconception-of-being-a-doctor-part-1/ https://pagalavan.com/2010/09/08/for-future-doctors-general-misconception-of-being-a-doctor-part-2/ […]