For Future Doctors: Housemanship, Medical Officer and Postgraduate Training (Part 2)
It has been more than 2 weeks since I last posted on this topic. I have been quite busy lately with increasing workload in my hospital as well as some renovation work going on in my house. In this Part 2, I will write more about what to expect after finishing your 2 years Housemanship posting in Ministry of Health.
1) Compulsory Service
I am sure everyone knows about the compulsory service for doctors in government service. According to Medical Act 1970, a medical graduate has to undergo compulsory service with the government for at least 4 years. This includes the Housemanship which is now 2 years. This means that you need to serve the government for another 2 years before you decide to leave the service.
2) District/Rural postings
As I have said in my first part, after completion of your housemanship, you will likely be transferred to rural clinics or district hospitals. With the recent influx of large number of doctors, almost everyone will be transferred to rural areas, mainly Sabah and Sarawak. You can see this from various letters posted in almost every newspaper recently, embarrassingly by parents of “so-called” grown up doctors!
From my experience, district posting is a wonderful experience. Working alone without anyone to consult immediately, gives you a lot of experience. Remember, other than X-rays and some simple blood test, you don’t have anything else in these hospitals. Usually there will be about 3-5 Medical Officers (MO) in each district hospitals. When you are “on-call”, you are all alone and need to manage the A&E department as well as all the wards including obstetrics cases. It is really scary at times, especially if you are working in district hospitals which are far away from the nearest General Hospital. If you are preparing to sit for any exams then this is the time to do your revision as the workload is generally lower than in general hospitals.
The same goes for those who are posted to health clinics (Klinik Kesihatan). These clinics are usually situated in rural and semirural areas. Most of the time there will be 1-2 MOs in each clinic. The major bulk of patients that you see in these clinics are antenatal and outpatient cases. There will also be a lot of administrative work to do in these clinics including school visits, running various health campaigns and public health talks. In cases of any outbreaks, you will be called to assist in containing the outbreak. Basically you are the primary healthcare providers. Many doctors do not like the administrative work that they are supposed to do, and the meetings that you need to attend!
Even though it is a good experience to do rural/district postings, please do not stay long in these clinics/hospitals if you intend to do postgraduate studies. A maximum of 1 year should be adequate. The reason I say so is because you will lose the momentum to further your studies after some time of good life in these centres. Since the workload is lower, you will get carried away with relax life compared to your housemanship training.
This rural/district postings are usually given extra points when you apply for your Master’s programme even though it does not guarantee a place. At the same time you can use your free time to prepare for your exams like MRCP Part 1, MRCOG Part 1 etc etc. After passing your Part 1, you can request to be transferred to the General Hospital for continuation of your training. Again, this may become a problem in the future as the number of post may be limited and it may be increasingly difficult to get a place in bigger hospitals.
I think people who grumble about going to rural and district postings should just give-up medicine. If you choose medicine to help and treat sick people, then these postings is where you really see the real life of people. You will learn a lot about their social life and the struggle they go through daily which you do not see when you work in general hospitals. You will also realise that people here appreciate you better than urban people. I would advise each and every doctor to do rural/semirural and district postings for at least a year after completing your housemanship.
Next: Postgraduate training…………………
[...] Part 2 [...]
hello dr!
im currently a 4th year medical student~
may i asked ur opinion regarding housemanship?
i’ve been thinking a lot after 4 weeks attachment in gov hospital for my elective.
as u said dat, housemanship is the critical time for a dr b4 they get the license to kill, so, what do u think if a fresh grad do their houseman in sabah n sarawak hospital?
i heard from my seniors they are superb bz, n they get to do many procedures there.
so is it true? n do u think it is worth it for a fresh grad to go there to gain experienced?
Working in Sabah and Sarawak use to be very busy with full of experience but not anymore. I heard that with current situation of housemanship glut, even sabah and sarawak is becoming full of housemen. So the situation may not be the same anymore.
Good Day Doctor
I am a currently 3th year medical student .I have the
chance to further my studies to warwick UK .
My main concern is that will i be able to do my housemanship at UK after i have done studying over there and will i be able to do postgradaute at Uk right after that .
Thank you so much for your time doctor
Getting housemanship post in UK is difficult nowadays because of the new immigration laws implemented from 2007. UK citizens and EU citizens will be given priority. Even if you get a place for housemanship, there is no guarantee that you can continue to speciality there as it depends on contract renewal basis. In fact, recently there were talks that UK may send back all overseas students immediately after finishing their educations which means they may not give you a job in UK.
Thanks you so much Doctor .
I will consider on that . Do u have any advice ???
good evening .
i am from Pakistan and i am going to complete my MBBS degree from Dalian Medical University of China. how can i apply to get internship ( houseman ship) in Malaysia or any other country ? please guide me for post-graduation
thank you
Internship in Malaysia is only open to Malaysians unless you are married to a Malaysian. For any other country, please contact their respective medical council to see whether your degree is recognised by that country.
hi dr. i’m MO in a district, i wanted to share my feeling. i agree with u that rural posting is interesting but if something wrong happen, we r the first to be blame. this is the reason i dun like to work at district. somemore, the bigger hospital sometime will trouble us for asking y we didnt do this or that..we only hv 1 MO in district with the help of MA and 1 nurse, if the casualty full of crowd, we will become more and more stressful.
good day doctor,
im extremely in a stress condition now. i just completed my 6years medical studies from a university from indonesia and currently working as a houseman in a hospital in selangor. i feel like i have forgotten everything. it’s been already 3 months since i started to work and i have been “missing in action” for almost 1 and half months. day and night im thinking whats wrong with me. nearly all the MOs and specialists got angry with me. i get stressed up when i on call alone in a ward of 28 patients. i totally lost interest to continue this job.
in school i had been one of the top student and i got 8As in SPM and 4As in STPM. what’s went wrong with me? y i couldnt do this job since nobody has forced me to do this course. it was my ambition to be a doctor.
please doctor i realy need assistance to solve my problem.
This was the main reason why I wrote all these articles. In my experience, you are not the only one that I had come across with this problem. Many choose medicine without realising what it really means. If it was your ambition and you were well aware of the situation then I don’t see why you are unable to con’t with this job. Unless, you thought that being a doctor is just like sitting in a clinic and seeing simple patients?
I really do not know how to help you. Probably you should see a psychiatrist in the hospital. Usually, my advise if you really can’t con’t, is to quit! No point occupying a post in your hospital if you are not going to come to work. It will only make the rest to be unhappy with you.
Good Morning sir,
I am from Pakistan i am going to complete my MBBS degree from Dalian Medical University of P.R.China in this June 2011,i want to do housemanship in malaysua. please guide me , any help will be appreciated thanks
Housemanship in Malaysia is only for citizens and foriegners who are married to Malaysian. This is because you need to join the civil service in order to do housemanship.
and how i can find a malaysian lady for marriage ?
plenty of them in Malaysia! ha ha
Dear Doctor,
I am in the final year of medecine from a reputable college in Khartoum, Sudan. I am interested in doing my housemanship in UK.
Please advise what to do.
Thanks and best regards
please check whether your degree is recognised in UK, if not you need to sit for the PLAB exam. Furthermore, not easy to get a job in UK if you are outside EU.
hello sir,
im going to finish housemanship soon.i would like your opinion regarding future in becoming psychitric moedical officer and what is the demand in oversea since i would like to go abroad.and what are the exams i need to sit
please reply soon
thank you
hello sir,
i am an indian citizen,finished my MBBS degree in india last april in recognised institution of malaysian medical council.am married to malaysian citizen 3 years back…now am staying in malaysia…i have no working experience yet…i think its difficult to find a job in malaysia without working experiance….i have already completed one year compulsory rotatory internship in india…am i eligible to do housemanship in malaysia?to whom i should contact if to do housemanship? i need your advice regarding this and your valuable suggestion regarding post graduate studies.
please reply,
thank you……
Please contact Malaysian Medical Council for registration. If they request you to do housemanship then you need to apply to Ministry of Health to do housemanship on contract basis. Since you are married to a Malaysian, this is possible. I have written about postgraduate studies in my blog.
Thank u sir..
Dear Dr,
I am a district medical officer and I would like to share my personal experiences. I agree that district/rural posting is a valuable posting but best to confine it to just ONE year (if you managed to get the approval of your pengarah/ HOD that is, to apply out).
The learning curve initially was steep the first 6 months but soon a lot of dissatisfaction sets in for a few reasons:
1) You come to realise that you are stuck in “the blind leading the blind” rut. You have to follow whatever “common practice” in your district hospital even though it is wrong. Lest you step on the feet of the ‘Little Napoleons’ (refer to no 2)
2) A lot of ‘Little Napoleons’ (Senior MOs, usually the UD 48-54) who make your life miserable with their frequent “unrecorded leaves” or “pm off” and also “character assasinate” the more junior UD 44 MOs whenever there is a visiting specialist/ or specialist (in the larger district hospitals which actually have a some clinical departments, and hence has a Head of Department). These “Little Napoleons” will keep on peppering their sentences when trying to promote themselves, “Even though I’m UD 54, I have never taken EL….” when in actual fact they have taken numerous unrecorded leaves (Not even MC, mind you!) Also, these “Little Napoleons” will use up the bulk of the “Model Insan” (money meant for sending staff to courses to improve knowledge/skills) for not 1 but usually 2-3 courses/year. The rest of us have to use our own money to go for courses.
3) You frequently miss out on courses/CPDs which are usually held in the tertiary centres and there is usually hardly any CMEs held at district hospital level. If there are any CMEs at all – you do not get to attend because you are performing your clinical duties.
My hope is that all UD 44 MOs be automatically allowed to transfer back to the tertiary centre within a year and no longer be subjected to the mercy of the Pengarah. I can’t believe that it still happens even in the era of the glut of doctors. It would be better if a MO be allowed to apply for transfers directly via their respective Jabatan Kesihatan Negeri. Many of us desperately want to transfer back but because our pengarah of the district hospital refuse to sign or may even sign but the form doesn’t reach JKN, we are STUCK for a couple of years or sometimes even longer!
Yes, this is very common in districts and even klinik kesihatans. If you are a hard working one, you will be regarded as showing off and trying to bring down others. This is the culture in these places. My wife is in a KLinik Kesihatan. Any improvement that she wants to do to her clinic will be vetoed by the head, no matter what benefit it will bring to the patients!! That’s the norm in our government service. Either you join them or leave!
In government service, there is no such thing as automatic transfer. You are bound to the General Order. Thus, certain procedures must be followed. If your head refuse to allow your transfer, you can always make an appt to see the state pengarah and get his approval. Actually, the glut will only make this situation worst.
Dear dr, i currently work as a district medical officer in klinik kesihatan sabah. My posting in district area had already been 1 year and i plan to transfer to tertiary centre,actly i have read your comment regarding glut of doctors will make the mattter of transfering worse. Can you elaborate more on that. Tq
You must understand that once the posts are full in a hospital, you will not get a place. So, it depends on jabatan Kesihatan or MOH to decide whether you will get a place to where you apply.
Hello sir,
I’m Dr.A. Abdul Shukur an Indian citizen married to a Malaysian spouse ,posted previously to know about Housemanship practice here.. Thanks for your valuable information doctor. I have approached MMC and got application form for housemanship but not yet submitted…I just need to know whether there is any other option to register with MMC without doing Housemanship doctor?because, I have completed one year compulsory rotatory internship as a Resident Intern in india so why to do it again doctor….i just need to know your valuable comments for this sir..
Thank You…..
MMC will decide. Housemanship in Malaysia is 2 years and if I am not mistaken, internship in India is not considered in Malaysia. You can discuss with MMC.
Thank u sir…
i’m a medical officer. i have just completed housemanship. Has the compulsary service reduced to 3 years. it has been stated in pembangunan kerjaya untuk pegawai oerubatan di kkm that the minimum period to be in gov service is 3 years. is this true?
I am not sure. Are you talking about the old system or the new system. Previously it was 1 year HO and 3 years service. When the HO became 2 years, you only needed another 2 years of service. The total remained 4 years.
dear doctor, may i know how u confirm that u r really interested in this field before u step in this career…which has no U-turn…i want to become a doctor but i want to make sure that i had make a right choice…i am volunteering in a hospital… but i find it no use…
Tag yourself with a housemen/medical officer for 24 hours. Do this from department to department everyday. See what is happening in the clinics, OT and emergency department. Then decide.
Doctor,
I am currently doing my MBBS degree at Monash University Sunway Campus. I was just wondering if I can do my housemanship in India instead of Malaysia. I’m a Malaysian Chinese but I’ve always been interested in working in India. The least I can do is complete my housemanship in India. Do you think its possible for me to do so?
If I am not mistaken, India do not provide housemanship for foreigners. Furthermore, no one want to do housemanship in India as the salary is very low. Few years ago, HOs were only paid a allowance of 800 rupees!!. I also don’t think MOnash Malaysia is recognised in India. You need to sit for the entrance exam.
What if I plan to practice medicine in India? Do you think it is possible for me, as a Malaysian Chinese to do so? From what I’ve heard, it is easy for NRIs to do so. If they’re from a western country, they will even be given a high salary. I was just wondering if I can be a practicing doctor in India with a Monash degree.
Firstly I think you need to sit for their exam. Secondly I think what you mean is working in private hospitals in India where the salary is different. Lastly, if you intend to come back, there will be problems with MMC, you may need to redo housem$anship.
Even if you could get an internship placement in India there is no point in doing it as it is not recognized in Malaysia. Internship in India is kinda like part of the medical degree as you do not receive your MBBS degree right after passing the final exams. All med students have to undergo 1 year of compulsory rotating internship before graduation to be eligible to register with the medical council. Malaysian students in India who have completed their 1 year compulsory internship still have to go through the 2-year housemenship upon their return to Malaysia, no exception to this as far as I know.
If you would like to experience the Indian clinical training, try applying to elective programs in places like CMC, Vellore or KMC, Manipal/Mangalore, these are the foreigner-friendly institutions. But you will be treated as a visiting student instead of an intern.
I see. Thank you very much. What if I plan to practice in India after completing my housemanship in Malaysia? Do I still have to undergo the compulsory internship?
Found some information here that may answer your queries.
http://forums.studentdoctor.net/showthread.php?t=262729
http://www.indianexpress.com/news/doctors-without-borders/492799/1
Actually I have only heard of 1 Malaysian who had practised medicine in India. He is the current dean of MMMC, Dr Jaspal Singh, who did his MS(ENT) in KMC Manipal after graduating from the same college, then he went on to be a staff member in the same college for some years before returning to Malaysia. (I too am interested in knowing how his MS degree from India is recognized in Malaysia).
MS degree from India can be recognised here after 5 years of practise as a surgeon.
Thanks for your information sir. Is this still applicable as of now? Do you think it is worth doing MS here in India?
I am interested in surgical branches but unfortunately one has to wait for 5 years before being eligible to apply for master’s in Malaysia. I do sometimes feel that India has a fairer system than Malaysia. Everyone has to sit for the PG entrance exam and PG seats are only given according to the rank. Top rankers get whichever specialties they want while a low ranker has to resort to non-clinical specialties or not even getting a seat, this is fair enough.
I once thought of doing PG here in India but soon I dropped the idea for not knowing that the degree can be recognized in Malaysia after 5 years of practise.
The pathway that we can undertake is writing the PG entrance exam (for example, Manipal PG entrance), and if the rank is good enough like within 300 then there is a good chance of getting into the Master of General Surgery program, which is a 3 years program with course fees of around RM 400k. PGs are paid a stipend of 25k rupees per month. Upon graduation one can join the same institution as senior resident (3 years) and getting a basic salary of 60-70k rupees.
You can but it is a risk that you need to take. Things changes every day in Malaysia!!
http://pagalavan.com
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RM400k for a postgrad degree in India? What will your pay be?
WTF?? A postgrad system where the trainee pays for true training? Are you telling me those pompous higher ups don’t realise that postgrad surgery training is like an apprenticeship where service is provided and learning on the job forms the training? Every bead of sweat has a price on it.
There’s no way I would squander RM400,000 for that sort of ‘training’!
Private mah!!. The same is going to happen in Malaysia when KPJ and Vinayaka Mission university opens their postgraduate medical studies in malaysia! God knows what kind of specialists are they going to produce.
Yea the fees are too high but still there are lots of students breaking the heads just to secure a residency spot. And you do not get a seat by just paying the money, everyone has to write the entrance test and the competition can be so fierce that thousands of applicants competing for a few spots in the most sought after specialties like radiodiag, peads and ortho.
To get back the money that they have invested, some leave to the Gulf countries, some redo the surgical residency in US (with the MS degree in hand), and some join those corporate hospitals which treat only the wealthy ones.
Hi doctor..I need your advice. I’m a final year medic student & will be finishing my studies soon. As u said, under the law, a medic graduate must undergo the housemanship + 2 years of service in the govt hospital. My question is, how long can I postpone my registration for the housemanship after my graduation? I plan to take up some language & communication short course as for my own preparation before I proceed into this profession.
At the moment there is no law to say how long you can wait BUT things may change in the future when the number of post are limited. Furthermore, the longer you wait, the more you will forget and when you start your housemanship you will end up with a lot of problems in terms of knowledge
Appreciate your advice.Thank u.
Hi Dr. i read and heard that DNB is recognised outside india in many counteries.can u plz tell me in what counteries DNB is recognised. is that means that one can apply for job after DNB in those counteries. plz reply
What is DNB?
are you talking about postgarduate training from India? I am not sure about recognition outside India as each country have their own specialist recognition. You need to contact each medical council for further info.
Now im in my 5th posting HOusemanship,and it getting harder and harder to go to work everyday,i feel that i not suit working in clinical field..i want to ask,if working as pegawai perubatan pentadbiran is a better choice?what they do? And how to be one?
Pegawai Perubatan Pentadbir are people working in the health department ( Jabatan Kesihatan), Pengarah hospitals, District Health officers and HOD of Klinik kesihatans. They usually do admin work with minimal or hardly any clinical work. However, the posts are limited and not necessary you will get a post if you apply.
Dear doctor,
I am a medical graduate and finished one year internship training in my country.I recently finding job in MALAYSIA. i want to apply job in UNIVERSITI MALAYSIA SABAH. Plz guide me how to get it and requirement. Also give me ways to get doctor job in Malaysia.Thank you..
University malaysia Sabah do not employ medical officers as far as I know. You can try applying directly to Uni sabah and wait for their reply. If they do offer you a job, then you must apply for MMC registration. Your degree must be recognised by MMC
hello sir, i’m considering to apply housemanship in sabah. But unsure of the procedures involved as in the accomodation and transport to sabah. Will all of those be provided before actually departing there, or do we have to arrange the ticketing and accomodation ourselves beforehand?
You need to pay and claim later once you have reported to duty.
Dear sir, i wish to ask whether it is possible to do medicine with grade abb in as level? I haven’t sat for my a2 yet but i am already planning to apply to universities. By the way, is it possibe to do housemanship in uk by doing a twinning program ? Do they have very limited place or they just don’t take in overseas students? Some say it’s very difficult due to current british policy n some say non- citizens cannot do housemanship there at all. Can u work there then?
please visit MMC website for further info on minimal qualifications http://mmc.gov.my/v1/docs/MY%20Entry%20criteria%2020120911%20Adopted.pdf
If the twinning program is a university in UK and you do the clinical years in UK, you can do your housemanship in UK. However, after housemanship, your chances of getting a job there is almost NIL. Under the immigration law, non UK and Non-EU citizens are the last to be considered, meaning the chances are almost NIL.
To be fair, you can get a job in the UK after your housemanship there, as it stands now. It is getting a training job that is the problem, though still not impossible. Having said that, things might change in 2, 3 or 5 years time and it will probably get harder not easier.
Oh, so even if we can do housemanship we have to come back to msia then? What are the chances to do housemanship there? I read somewhere that out of 10 000 overseas students only 1000 or so got to do housemanship there. Yes, the twinning university is imu and the clinical year i have to do in uk but when i asked about housemanship they said it’s very difficult to do housemanship there and british policy changes every year and now it’s very strict or sumthing like that. Many say in a few years it will become worse and that after a non-citizen obtains a degree from uk (i mean through back door way), u have to go back to home country. Is it true?
Wow,………… the number of foreign ( Non-EU ) medical students in UK are 10 thousand. Where do you get this number ?
I’m not sure. I read in some forum. Haha. But this forum is dated 2006 so i can’t really say for the present. What i mean to ask is from so many students back then they get to choose only 1000 it should be more strict now ryte?
According to http://www.ukcisa.org.uk/about/statistics_he.php#table6
international medical student were 10 thousand but intenational means non-EU and EU at undergraduate ( over 5 years ), postgraduate, and PhD.
if all 10,000 international medical students were Non-EU undergraduates, so it was around 2000 newly graduated medics must obtain internship in UK. Spread evenly the 10 000 medical student for 5 years — 2000
I don’t know where you got the figure of 10 000 foreign medical students graduating in UK!! As far as I know, the total number of graduates in UK is about 7-8000/year. Foreign students are about 10% of the total.
YES, the situation in UK and Australia is of no difference. Both these countries are producing more than the number of post available. Thus, the logical thing to do is to provide their citizen and PRs the first choice to get a job. The rest just have to go back to their home country.
Malaysia will also face the same problem. NOT all is going to get a job by 2016/17
Good day Dr,
I’m a final year student. I’m interested in anatomy & physiology subjects. I’m considering to skip housemanship & want to apply to be a lecturer. I’m currently studying in Egypt. The problem is I’m unsure of the procedures involved. How and where to apply & what are the requirements needed. I need your advice on this matter.
Thank you for your time.
As far as I know, you can’t become a anatomy/physiogy lecturer with just MBBS. You need to do Masters in Basic Medicine. Please contact some of the local universities for further info.
Thank you Dr.
Dear Dr,
Many thanks for the info you’d provided in this article. My husband has just received a news from the MOH that he needs to accept his job (UD43) in Sabah or Sarawak. He finished his housemanship in UK last year and when filling in the form to work with the MOH, there was no option of which states he can choose to work in. He was quite frustrated as we have never been to Sabah/ Sarawak and have absolutely no idea of how life would be there, being far from our families and where he will be posted. He has to serve the government for 2 years before he can work in private sector. Do you have any personal experience or preference as in which state will be better for him to work as a medical officer? Many thanks for your reply and have a good day.
Ms A
Surely, you are aware that your husband is not the first person to be posted to Sabah or Sarawak!
Waiting with bated breath for responses from Dr Paga, jk, and Poor Doctor.
You will love sarawak or sabah! Also work in private sector after 2 years? Has he specailized?
Lolz, as the poster said, the husband just finished FY in UK.
And indeed as stated, go with an open mind, and an open heart to serve, and you will enjoy the Borneo states.
And finally, I think very few people nowadays quit promptly after completing the 2 years compulsory service. At that point, one does not have the skills necessary for anything except a GP practice. And unlike the old days, GP practices are getting more difficult to start and to survive in.
THis is what I was saying in my blog. The time has come for the government to decide where you are going to be posted as you got no choice anymore. You either take it or leave it. The post in peninsular Malaysia is almost FULL. However, I must say that working in Sabah and sarawak do give you a good and excellent experience. Many would not want to come back to Peninsular again!
Dear Dr. Pagavalan, I’m going to PTM (Program Transformasi Minda) in KT and will know which hospital I would get. I’m from West Malaysia, I put down all 3 choices for Sarawak, first choice is SIbu,second choice is Kuching and third choice is Miri. Would you know how’s hospital Sibu in term of housemanship? Would they give me my first choice/ anyone of the choices? Thank you.
Dear Dr. Pagavalan, I’m going to PTM ( Program Transformasi Minda) in KT. I’m a West Malaysian. I’ve put Sarawak hospitals for all my 3 choices. First choice is Sibu, then Kuching and Miri. Would you know how’s housemanship in Sibu and would I get my first choice/ any of my choices. I picked Sibu because my girlfriend is studying in Sibu. By the way, I’m grateful to see so much effort by doctor to give out good and solid information to help us in the medical line as well as the ones in dilemma.
What is this PTM? another brainwashing session?
Sibu is OK bit it is a cowboy town
Program Transformasi Minda is the induction for future government servants. Yes, lol.