The Great Transformation: Revenge of the Fallen to the Dark of the Moon
It has been 8 months since I last wrote an article in this magazine. Many changes occurred during the last 1 year in the field of medicine in this beloved country of ours. Thus, I borrowed the above topic “The Great Transformation” from a book written by the world-renowned religious historian, Karen Armstrong.
The year 2010 started off with the rise of the Fallen. The Fallen was finally trying to take revenge to the ever-increasing power of the dark side. Multiple goodies were introduced for the government doctors to keep them happy and quiet. Time based promotion was introduced to prevent the doctors from leaving the civil service. Although it is an interesting development, several problems will arise from this “time-based” promotional scheme. One of the main problems in the civil service is the fact that promotion is never based on merit! This is the phenomenon that is screwing up the system. Furthermore, no action can be taken against these civil servants even though they are hardly doing any job. The commonest action will be “transfers”. They will be transferred from one place to another, making his/her job easier from place to place but receiving the same salary and annual increments. Finally the very same person will be promoted with the rest of the people!
Now, this sickness may be coming into the Fallen’s territory soon. With the time based promotion introduced into the system, will an MO be interested in doing speciality? Wouldn’t it be easy if he just stays as a MO and at the end of 12 years, he will be given U54? The only difference will be the “Specialist Allowance” which is about RM 2800 for U54. The MO can easily earn this by doing locums either in MOH or outside. They can just park themselves in some rural/semi-rural clinics and continue to enjoy the same salary as with a specialist with less commitments etc. Of course, the good ones will strive to become a specialist but what do they get?
The specialist in the other hand will be at U54 after 9 years of service whether they have subspeciality or not! This is another form of discouragement for specialist. Why must they bother doing subspeciality when there are not going to be any added advantage in civil service. You would have reached U54 by then. In fact, currently there is a lot of dissatisfaction among the senior specialist as they are sitting at the same salary scale with their junior specialists who are 3-5 years junior! We have senior consultants who will be at the same salary with their junior trainees. So why bother doing subspeciality!! Those who are really interested will still do it but would they remain in civil service since there is no added appreciation?
These steps will definitely retain more doctors in the civil service temporarily. Soon after, frustration will grow again for the senior specialist as they will continue to sit on U54 forever and nothing to hope for anymore. JUSA C posts are limited and not everyone will be promoted to JUSA C and thus a bottle neck will appear at U54. Remember your annual increment in U54 is only about RM 180. It will take about 20 years for the basic starting salary of RM 5000+ to reach RM 7 000+.
This new “time based” promotion definitely benefits the MOs more than anyone else. Thus, the government may be retaining more MOs than specialist in long run, unless they come up with a separate salary scheme for specialists. At the same time, the Fallen is also slowly and surely taking its revenge to all the doctors who have been demanding all sorts of benefits. A checkmate is in process. As Dr Milton Lum rightfully said in his article in the Star about a month ago, the number of medical schools in Malaysia is increasing day by day and will produce large number of doctors in the near future. As of my last calculation, we have a total of 29 medical schools in the country (the highest per capita population in the world) with Perdana University, SEGI College and Premier University Of Perak joining the bandwagon. Unless the government is willing to produce an additional 7000-8000 new post annually after 2015, jobless doctors will become a reality. So, stop demanding and get ready to take a pay cut!
At this moment, this type of promotion may look good as there are many vacant posts but within the next 3-5 years all these posts will be filled and another new problem will arise. No Post No Promotion! Remember, doctors will also lose their critical allowance when all posts are filled. Medicine will not be considered a critical post anymore. That means a RM 750 pay cut! By 2015, the Fallen will finally take its revenge on the ever demanding doctors. Remember my article which I wrote in June 2006, Future of Government doctors: Die another Day? (You can read it again in my blog). Remember my last sentence: “There will come a time when we will be told that “if you don’t like the system, you may leave”. Since the “World Is Not Enough” we will be asked to go all over the country for promotions since the posts available will to be limited. We can “Never Say Never Again”. The administrators are NOT going to be “The Spy Who Loved Us” but rather they would become “Goldfingers” and “Thunderballs”. In near future (not long, just another 5-7 years!), we are going to become “Dr. No”- body and since “You Only Live Once” and not twice, we will “Die Another Day”……………or we may just end up playing the“Casino Royale”…………..” Maybe, SCHOMOS may need to find another job! The Fallen is also encouraging doctors to join the civil service and a new pathway of higher grade intake has been implemented. This means that returning specialist can now be absorbed into service directly to U54 etc.
The Fallen has also spread its hands to the private sector by introducing 1Malaysia clinics and many more polyclinics, thus killing off the lives of the General Practitioners. Even the lives of private specialists are not spared. Well, the Fallen may finally get its wish but I feel that the Fallen’s empire is getting darker by the day. Many under qualified doctors are being produced and being undertrained due to lack of academics and trainers in our grandiose medical schools and hospitals. It is a money-making business for the medical schools. The medical schools are capitalizing on our society’s obsession of being a doctor with guaranteed job and good money. This obsession need to change as being a jobless doctor is the worst scenario a person can be caught in. I have written numerous articles for future doctors in my blog http://pagalavan.com which has received tremendous amount of viewers, some reaching almost 2000 views a day. I have written about “ General Misconception of being a doctor”, “Housemanship, District postings and Postgraduate training”, “ Housemanship Glut”, “ What if …………….” and many more articles which should be read by everyone who aspires to become a doctor, including parents. Before and after writing these articles, I realize that many do not know what they are stepping into when they choose medicine!! Some still believe that they can become Neurosurgeons and Plastic surgeons instantly after finishing their MBBS and some still believe that private hospitals pay a “salary” of RM 50K for specialist!! What a misconception! The comments that I get for my blog postings really frighten me as to the standards of students who are doing medicine!
The Dark of the Moon is be falling the Fallen and despite the present rise and revenge, it will finally fall again and will be swept away by pure incompetency of its fellow members…………………… just keep watching…………………