Advertisements
Feeds:
Posts
Comments

It looks like we are making headlines again. Few days ago, the Chief Secretary of the Government publicly announced that housemen are the highest number of civil servants being terminated. As for me, it did not come as a surprise.  This is something that is well-known to the medical profession. Many housemen just go missing without any notice. I had said this before that it is better for them to give a resignation letter than just go missing in action. The government’s procedure is as such that it will take almost a year to terminate someone from civil service. During this time, no one else can occupy your post. This is one of the reason I support giving housemanship under contract. It will be much easier to terminate someone who goes missing. It will also keep everyone on their toes.

Today, NST published several reports on these issues as below. I had said it many times since I started this blog that you should know what you are getting yourself into when you decide to do medicine. That is the reason why I started this blog in 2010. Unfortunately, many still refuse to believe what is written and in denial. Parents on the other hand do not even bother to ask their child what they want to do in their life. They pressurize their child in doing medicine by promising a good life and money.

Medicine is a stressful job. It is not about sitting in an office and having a chat with a patient and pocketing RM 50-70. IT is much more than that. The time taken to be competent and the amount of responsibility taken is huge. With increasing literacy rate and demand of patients, it further adds to the stress level. Some times I get amused when the person who makes the most fuss in a clinic or a hospital actually sends his own child to be a doctor! I know another parent who do not believe in western medicine and takes only complementary medicine but sent his son to do medicine overseas! Is this called hypocrisy or they simply believe that medicine brings easy money for their children?

As a response to the issue, our Health Minister says that all future housemen would be given counselling! Sometimes I simply don’t understand the logic behind some of the answers coming out of our politician’s mouth! Why do counselling after they graduate? Why don’t we start counselling before they even enter a medical school? Or even conduct some form of standardised entrance exam and interview? Tell them and their parents the reality out there. Unfortunately this will not happen as it will affect the enrolment into our 35 medical schools. Then the medical schools will start making noise as they will be loosing money! The very moment our policy makers decided to commercialised medical education and put quantity ahead of quality, we know where we are heading!

For those who intend to do medicine, please read this blog or buy my books! I had many comments which said that I am discouraging many budding doctors by being very negative. I had explained many times that what I write over here are the REALITY out there which you should know before putting your foot into medicine. If you only going to realise it after you graduate, then it is simply too late…… Trust me : Life in Medicine never gets easier…….

My Books are still available and can be purchased directly from me by following the instructions over HERE. Each and every budding medical students should read this book before deciding to do medicine. Softcopy is available at Google Play Store.

HARD TRUTHS AI BLUE - New Blue

 

HARD TRUTHS AI BK2- New Red

 

Doctor dilemma: Why are Malaysia’s housemen buckling under pressure?

BY FAREZZA HANUM RASHID AND VEENA BABULAL – 15 FEBRUARY 2017 @ 2:03

 MANY housemen find it difficult to cope with the pressure when they cannot adapt to the rigorous training regimen in hospitals. Deputy Health Minister Datuk Seri Dr Hilmi Yahaya said this had led to many housemen not completing their training, especially those who studied abroad, as the systems were different. “In some countries, interns are not even allowed to touch patients, and they do not even know how to get a patient’s history. “There is also the language barrier. If they studied in Indonesia, the common language is Bahasa Indonesia, but in Malaysia, we use English,” he said, adding that this had increased the pressure on housemen. Dr Hilmi said there were about 10,000 housemen from various backgrounds in Malaysia, including graduates from local, overseas and unrecognised universities. He said of the number, at least 20 per cent had difficulties with training and were asked to extend their internships up to six to eight months. “Last year, 1.2 per cent of housemen were either terminated or had quit because they could not take the heat. “Many went to other countries to complete their internship, while those who did not show up for many months were sacked.” On why it took so long to identify absent housemen, Dr Hilmi said there were so many housemen that sometimes their superiors did not notice that they had gone missing. “That is why some have gone missing for up to 400 days,” he said after launching World Leprosy Day at the Gombak Orang Asli Hospital in Selangor yesterday. He was responding to Chief Secretary to the Government Tan Sri Dr Ali Hamsa, who had said trainee doctors made up the highest number of civil servants who were given termination notices. Health Minister Datuk Seri Dr S. Subramaniam said about 20 to 30 per cent of about 5,000 housemen who joined the service every year opted to extend their housemanship. He said there were cases of housemen leaving the profession or were removed after they disappeared after finding out that they could not meet the expected requirements of working as a doctor. “I’ve seen some who resigned within 24 hours. “Many don’t resign, but they are not in the system because they don’t go to work. “Later, when we identify them, but can’t trace them, we have to take disciplinary action,” said Dr Subramaniam at a seminar on workplace health here yesterday. He said stress was the main reason housemen dropped out, were absent or extended their housemanship. “People who take up medicine and don’t know what it is all about (often find that) they can’t fit in the system.” However, he said, the number of such incident s had dropped as the ministry had taken steps to intervene by counselling the housemen. He said the respective sections had been instructed to counsel and train housemen before they began their programme and to offer them transfers to other facilities to help them adjust. Dr Subramaniam said universities should consider using an aptitude test. He said to address the problem, the ministry’s main job was to ensure that working conditions were conducive. He said universities might need to regulate interviews to ensure the screening system was compatible with the ministry’s requirements. He said imposing such requirements on private institutions was a tall order as a strict vetting process would reduce the number of students who passed,thus leading them to collect less fees. He said housemen who dropped out and wanted to rejoin the service would not be given a second chance. “Once they drop out, it is the end of their medical career. “The Malaysian Medical Council will not recognise them as practising doctors. “The ones with major disciplinary issues will not have a certification of good standard and they will find it difficult to find jobs in other countries.” Ali Hamsa had said some housemen were laid off because they went missing for up to 400 days. He said some of them had studied abroad on government scholarships. It was reported that sponsoring a medical student overseas could cost as much as RM1 million or more, while the cost in local universities was far lower, but still hefty. Ali Hamsa attributed the policy of permitting hospital interns to follow their spouses overseas for study purposes as another possible reason many went missing from work, and called for a policy review.

Read More : http://www.nst.com.my/news/2017/02/212611/doctor-dilemma-why-are-malaysias-housemen-buckling-under-pressure?d=1

Planning to become a doctor? Get set for burnouts, depression

BY FAREZZA HANUM RASHID AND VEENA BABULAL – 15 FEBRUARY 2017 @ 2:00 PM

While many consider being a doctor a dream profession, a growing number of those working in the field find it miserable. Numerous reports can be found on how a growing number of physicians and trainees are going through dark periods of turmoil due to stress. Dr Elaine Cox, in an article on health.usnews.com, said statistics on the number of doctors-in-training and those practising medicine who faced stress was alarming, with about one-third of physicians reporting experiencing burnout at any given point. “As a matter of fact, doctors are 15 times more likely to burn out than professionals in any other line of work, and 45 per cent of primary care physicians report that they would quit if they could afford to do so. “Physicians have a 10 to 20 per cent higher divorce rate than the general population and, sadly, there are 300 to 400 physician suicide deaths each year.” She said the lack of control over schedules and time could contribute to high-stress situations for physicians. “This can result in poor sleep patterns, interference with family activities and events, and poor self-care. “Because there is a patient in need at the end of every phone call and every office or hospital interaction, setting limits is beyond difficult. “The result can be physical and emotional exhaustion, leading to cynicism and burnout. Add to that the increasingly litigious society in which we live, and there is a recipe for quite a few failures.” Dr Cox said in a study published recently, medical students reported a rate of depression that was 15 to 30 per cent higher than the general population. “This can lead to poorer performance, such as 6.2 times more medication errors, exactly the opposite of what we are striving for through the education process.” She said many physicians did not recognise and seek help when they experienced early signs of burnout, primarily because of fear. “Frequently, privileges and licences could be denied if physicians are under treatment for substance abuse or depression. Without those certifications, the source of livelihood, not to mention identity and many years spent in training, is lost.” She said many feared that the struggles they faced would be noticed by the doctor they were getting the treatment from, and, as a result, many self-medicate, which was not a good strategy. Alexandra Sifferlin, writing for Time.com, said research showed that almost 40 per cent of doctors in the United States experienced emotional, physical and psychological burnout from their jobs. “The more doctors feel stressed about their jobs, the more they feel burned out and defeated by the healthcare system, leading to less motivation to improve conditions, both for themselves and for patients,” she said. 2106 reads NST Infographic

Read More : http://www.nst.com.my/news/2017/02/212607/planning-become-doctor-get-set-burnouts-depression?d=1

Advertisements

So, finally it has made the headlines. After many years of me talking about it, finally the reality was reported by mainstream newspapers few days ago. When many of us in the medical line brought up the issue of too many medical schools and too little training position, we were condemned. This is partly because the government itself, till 2014 denied that such a thing will happen. For those who know our government very well, surely know that not all said are trustable. Despite overwhelming evidence, people refuse to believe. As I had always said, people would only want to listen to good stuffs. When I tell them the truth and reality, I am accused of discouraging, very negative etc. No job is going to be guaranteed….. The only difference is , you will be spending RM 300-600K for a medical degree locally!

On 19/01/2017, The Star as well as Malay mail published an extensive report regarding contract HO post and no guarantee of a civil service post thereafter. Since I wrote about the contract HO post in November 2016, a Malay mail reporter was trying to get in touch with me to get my views on the issues. However, I did not respond to her since I was overseas till mid December 2016. She contacted me again few days before the articles were published and I gave my views. She was more interested about the JPA scholars. She wanted a copy of the contract which I refused, as the doctor’s name is written on the contract.

As usual, all these happened because there is no such thing as “planning” by our ministries. Each ministry works on its own without proper consultation with other ministries. For Ministry of Education(MOE), their goal is to make Malaysia an education hub, quality aside. It is a money-making business. My stand has always been that education should never be commercialised! License to start medical schools were given like peanuts. Only in Malaysia, colleges in a shop-lot can be given license to run a medical program. Accreditation works on minimum criteria and not based on an expected standard. As long as the college achieve a minimum standard, they will get the green light to continue. It’s like saying, 20% is enough to pass. You don’t need 70% to prove you are good and excellent. MOE treated medicine just like any other educational program!

Medicine is not like any other course. The 5 years undergraduate program is just the beginning. It is a life long learning. You learn by apprenticeship. You are dealing with life and death mater. A simple prescription error can cause a death! Training can only be done in accredited training centres. Many parents live in a delusional world thinking that jobs for doctors are guaranteed. The fact is, not anymore. Even in countries like US, UK, Australia etc, doctors work on contract basis. However, most of these countries have enough internship post for their graduates, due to proper planning strategy. Apart from internship, there is no guarantee that you will get a permanent job. Some survive by doing locum. Malaysia is now entering the same situation. And don’t forget that if your degree is not recognised elsewhere, you can’t work in another country without first sitting and clearing their qualification exam, with no guarantee of a job. This will cost you more money!

From the newspaper report, it is also obvious that all HO post will be given under contract basis from now onwards, even for JPA scholars. Permanent post is only eligible after you complete your housemanship and there is no guarantee that JPA scholars will be given a permanent post. As I mentioned earlier, this is good to kick out the poor performers and retain the best  in civil service. However, the selection process must be transparent. If not, many accusation will be floating around in the next few years. Please be informed that if you do get a permanent post after housemanship, you have to go where the post is vacant! You cannot choose or appeal. If you don’t want to go, someone else would be willing. You can’t choose where you want to work. You are also not eligible for car or house loan from the government if you are not holding a permanent post. Even bank loans can be a problem is you don’t have a permanent job.

With 32 medical schools and close to 38 medical programs, oversupply of doctors is inevitable. As of 31/12/2015, based on MOH statistics, the doctor : population ratio is already 1: 656, not including doctors from non-MOH public hospitals. So, we are already 2 years ahead. Chasing after numbers do not make any difference. Quantity does not equate to quality!

Well, I had spoken enough about these issues many times before, including in my books that was published last year. So, I will not repeat it all over again.

It is time for medical graduates to look for other jobs. GP market will be flooded in few years time and as I had mentioned in my last article, unethical practices will become a norm in the name of survival……..

Gong Xi Fa Chai everyone…………..

Contract doctors judged on merit, not government scholarship, MOH says

BY BOO SU-LYN

Published: January 19, 2017 08:50 AM GMT+8

Dr Noor Hisham confirmed that permanent positions for graduating house officers were not guaranteed. ― Malay Mail pic

KUALA LUMPUR, Jan 19 — Permanent positions will be offered to contract house officers depending on their performance rather than any government scholarship they may or may not have received, the Health Ministry said today.

Health director-general Datuk Dr Noor Hisham Abdullah confirmed that the government started the first intake of contract housemanship last December 5, with Public Service Department (PSD) scholars among the graduate doctors on contract as no permanent positions were offered at all.

“Based on merits, not based on scholarships,” Dr Noor Hisham told Malay Mail Online, when asked if PSD scholars will be prioritised for permanent positions given that they are bonded to the government.

“Bond still the same and when they are absorbed to permanent post, their service from Dec 5 will be taken into permanent service too,” he added.

Dr Noor Hisham also confirmed that permanent positions for graduating house officers were not guaranteed.

“If you are competent and good, then no worries. Those non-performers and MIA [missing in action] should be worried as it’s based on merits. For this, anywhere you go it’s the same — public or private.

“Who wants to employ incompetent and missing in action doctors?” the Health DG said.

Dr Pagalavan Letchumanan, a consultant physician and rheumatologist, said he was made to understand that 1,300 contract housemanship placements were given out, including for PSD scholars, after the last Public Services Commission of Malaysia interview in October 2016.

“There is no guarantee that you will be continued to be employed just because you are a PSD scholar! This comes as a surprise even to me as the scholarship contract specifically says that you will be bonded with the government for 10 years,” Dr Pagalavan posted on his bloglast November.

“What happens if the scholar is not able to get a permanent job with the government? Does he need to pay his bond? An interesting question,” he added.

Dr Pagalavan told Malay Mail Online that a PSD scholar had told him that he was given a contract post and was informed that the government bond was between the scholar and PSD, and had nothing to do with the Health Ministry.

Among the criteria listed on the house officer’s contract for the offer of a permanent position, “depending on the availability of positions”, were completion of one’s housemanship, a good track record and a recommendation from the head of department.

The copy of the contract that Dr Pagalavan posted on his blog also stated that the government could terminate the contract at any time if the house officer’s performance was not satisfactory and that a 30-day notice, or one month’s basic salary, would be given.

“Somehow, I feel this will remove all the dead wood graduates from the system. However, I am also worried about lack of transparency in making such [a] selection,” Dr Pagalavan said, adding that a committee should be formed to ensure that such decisions were fair.

Malaysian Medical Association president Dr John Chew claimed that before the implementation of the contract housemanship system, 20 per cent of doctors holding such posts were not performing.

“So the new system will be better,” Dr Chew told Malay Mail Online.

“For most of us, employment and work are more important. Most people are happy that they have started work”.

Health Minister Datuk Seri Dr S. Subramaniam reportedly said last October that offering contract housemanship would help about 2,600 graduate doctors on the waiting list every year, saying that they could wait for up to a year because there were not enough permanent positions.

– See more at: http://m.themalaymailonline.com/malaysia/article/contract-doctors-judged-on-merit-not-government-scholarship-moh-says#sthash.2nwRcPoG.dpuf

Medicos no longer guaranteed civil service employment

BY LOH FOON FONG

‘Permanent appointments will be based on their merit during housemanship training and recommendation by the Health director-general.’ – Datuk Seri Dr Chen Chaw Min

EXCLUSIVE: PETALING JAYA: Permanent employment for doctors, pharmacists and dentists in the civil service is no longer guaranteed.

The Government has started issuing jobs on a contract basis for them since last month as announced in Budget 2017.

According to the Health Ministry, if doctors successfully completed their housemanship within the three years of contract, they would have another two-year contract for compulsory service as a medical officer.

Pharmacists will be hired as provisionally registered pharmacists (PRP) for one year, with a maximum contract offered for two years and for the compulsory service thereafter, one year, with a maximum contract offered for one year.

There is no compulsory internship for dentists and compulsory service for them is one year, with a maximum contract offered for three years.

Health Ministry secretary-general Datuk Seri Dr Chen Chaw Min said from last month, 1,219 candidates had been offered jobs on a contract basis by the Public Service Commission.

“Permanent appointments will be based on their merit during housemanship training and recommendation by the Health director-general,” he said in an e-mail to The Star.

The move, he said, is expected to reduce waiting time for housemanship training and compulsory service.

Dr Chen said competent staff who fulfilled specific requirements will get permanent posts but they may not immediately get the posts until there are vacancies.

Their salaries will be backdated to the date of appointment once the posts are available, he said.

He said for government scholars who have not been offered permanent posts in the ministry upon completion of their compulsory service, they could seek jobs in the university and military hospitals and the private sector.

He also said that for this year, the ministry planned to take in 9,300 candidates – six batches of intakes which will involve 5,425 candidates for house officers (housemen), three batches (1,921) for dental officers and four batches (1,954) for pharmacists.

He added that housemen will enjoy the same benefits received by permanent house officers as stipulated in a 2008 circular on contract of service with additional advantages.

Those under this “modified contract” will have full-pay medical leave up to 90 days, and the extension of medical treatment for parents in government hospitals and clinics, he said.

But only those who are appointed as permanent medical officers and have obtained their confirmation in service are eligible to apply for government housing loans, he said.

The monthly basic pay of a houseman is the same as the grade category UD41 of the permanent service which is RM2,947, while a dentist (grade UG41) gets RM2,844 and a pharmacist (UF41) RM2,740. With allowances, they could get RM4,000.

On the criteria for a permanent medical officer post, Dr Chen said doctors must fulfil the service requirements, including attaining a good level of competency and performance of at least 85% in the yearly performance review during their house­man­­­ship training or compulsory service.

The permanent posts would also be given to the best talents who have the potential for specialty training and are willing to serve at any place in the ministry’s facilities during their tenure, he added.

PSD confirms no permanent spot in public hospitals for scholars

Published: January 20, 2017 03:00 PM GMT+8      

Health director-general Datuk Dr Noor Hisham Abdullah confirmed that the government started the first intake of contract housemanship last December 5, with PSD scholars among the graduate doctors on contract as no permanent positions were offered at all. — File pic

KUALA LUMPUR, Jan 20 — The Public Services Department (PSD) has confirmed reports that only performing scholars will be offered permanent contracts at public hospitals.

In an email response to a query by Malay Mail Online, the agency said that the government is currently looking at alternatives on how to absorb scholars who failed to secure permanent jobs despite being offered housemanship contracts by its hospitals.

“Students who qualify for our scholarships are excellent students. With that we hope that they can continue to display similar performance as they do with their studies, and show high commitment when executing their duties under their housemanship contracts so that they can be offered permanent jobs,” the agency said.

“Nevertheless, the government is currently looking at several alternatives should PSD medical scholars already offered housemanship contracts fail to secure permanent jobs once their contract ends,” it added.

Yesterday Malay Mail Online reported that public hospitals will only offer permanent contracts to  house officers based on their performance, and not to any government scholarship students.

Health director-general Datuk Dr Noor Hisham Abdullah confirmed that the government started the first intake of contract housemanship last December 5, with PSD scholars among the graduate doctors on contract as no permanent positions were offered at all.

“Based on merits, not based on scholarships,” Dr Noor Hisham told Malay Mail Online, when asked if PSD scholars will be prioritised for permanent positions given that they are bonded to the government.

“Bond still the same and when they are absorbed to permanent post, their service from Dec 5 will be taken into permanent service too,” he added.

Dr Noor Hisham also confirmed that permanent positions for graduating house officers were not guaranteed.

Health Minister Datuk Seri Dr S. Subramaniam reportedly said last October that offering contract housemanship would help about 2,600 graduate doctors on the waiting list every year, saying that they could wait for up to a year because there were not enough permanent positions.

 

– See more at: http://m.themalaymailonline.com/malaysia/article/psd-confirms-no-permanent-spot-in-public-hospitals-for-scholars#sthash.UYFxAzZA.dpuf

It’s been one and a half month since I last updated my blog. As I wrote in my last post, I was going for a long holiday after an hectic year dealing with IRB. Coming back from a long holiday is the worst nightmare. Clinic was packed to the brim, multiple medical reports to write and multiple reply letters to type. Then came Christmas, New Year and finally my hospitals MSQH audit which just ended today! Phew………

Unfortunately, doctors were in the limelight for the wrong reasons towards the end of last year and the beginning of this year. A daring expose by Al-Jazeera regarding baby selling syndicate in Malaysia on 24/11/2016 was a disaster for doctors. The faces of many doctors involved were clearly shown. Unfortunately this is nothing new. Many years ago, a similar syndicate was exposed and caught in Johor. The police acted swiftly and did manage to arrest few of the members of the syndicate that was exposed by Al Jazeera.

Just when we thought it was already damaging enough, came another exclusive expose from NST. Doctors venturing into unethical practices of cosmetic products. Frankly, this is nothing new as well. I have seen enough doctors practising what was exposed by the report. Injecting IV Vit C for whitening/anti ageing and many more so called aesthetic practices are common nowadays.  In 2012, MOH (tr-vitamin-c-injection) had already issued statement that there is NO evidence that IV Vit C has any benefit. In fact, ViT C is NOT approved by MOH for intravenous injections for cosmetic reasons. Anyone found doing it can be charged for unethical practice. Ozone therapy is another major complimentary medicine practise that doctors are widely involved. Way back in 2011, MMC had already issued a statement that ozone therapy do not provide any health benefit and any doctors found guilty of providing ozone therapy by claiming that it can cure diseases, can be charged for unethical practices. Unfortunately it did not prevent many doctors from doing it. In fact I even know nurses who are openly promoting such centres on Facebook and showing many VIPs who are taking their ozone treatment. Again, on 3/01/2017, our DG issued another press statement regarding ozone therapy. The press statement came after NST reported that many celebrities who were openly promoting ozone therapy for advertisement purposes expressed their regrets. I have heard of reports of people dying during the procedure and even developing cardiac and renal failure. It is not a procedure without complications.

The question is, why are doctors venturing into such practices? The answer is simple : money and survival! Since I started blogging in 2010, I had written several times regarding these issues. In fact in 2012, I wrote on how desperate have doctors become. That is the reality out there. No matter what passion that you talk about before going into medicine, at the end of the day, it all boils down to money and survival. There is no such thing as easy money or easy life in medicine. Many doctors especially GPs are struggling to survive. Thus, to keep their income and their clinic running, they venture into these unethical businesses.

I get a lot of query regarding aesthetic medicine etc. My reply has always been to ask yourself why you became a doctor! Is it to treat and cure people with sickness or to become a glorified beautician! Yes, there is a lot of money in aesthetic medicine. There are huge financial backup from big suppliers all over the world. Cosmetic and aesthetic suppliers are one of the largest companies in the world. The companies need doctors as doctors are the only people licensed to inject substance into a person! At the end, no doctor will do it if not paid well!

The situation will only get worst. My last article talked about the introduction of contract HO post with no guarantee of a permanent post. I had mentioned that those who do not get a permanent post will end up flooding the GP market. Imagine what will happen then. Issues mentioned above will only get worst day by day, in the name of survival. WE have to blame ourselves for loosing the respect and trust once given by the public. Worst still, many of these young doctors would have huge amount of debts to pay! As I had always said, never take huge loans to do medicine!

Well, it did not end there. Just when 2016 was coming to an end, 2 cases of botched circumcision were reported. Interestingly, the first clinic was reported as not having a  license to run! Interesting indeed if the report was true.

On the other end, MMC has now started their own qualification exam for those from unrecognised universities. It is now known as EPR (Exam for Provisional Registration). Is this a prelude for a common entry exam? Only time will tell……….  As the years pass by, almost everything I predicted is becoming a reality. God save this country……

So, finally the first batch of HOs under contract has been given. I was made to understand that 1300 contract posts were given out after the last SPA interview conducted in October 2016. These were graduates who were waiting since early this year. Interestingly, I was told that none received permanent post. Even JPA scholars were only given contract post and it seems, the agreement that you have with JPA has nothing to do with MOH. There is no guarantee that you will be continued to be employed just because you are a JPA scholar! This comes as a surprise even to me as the scholarship contract specifically says that you will be bonded with the government for 10 years. Only from this year, the scholarship contract was redefined as convertible loan. What happens if the scholar is not able to get a permanent job with the government? Does he need to pay his bond? An interesting question.

The good news is, those who received these contract post were able to get their posting in December 2016(in just 2 months after interview), as long as they are not choosy in picking their hospital on e-housemen portal. But they still waited for close to 7 months to even be called for interview.

There were many questions on the pros and cons of being under contract. Frankly, as long as you are under contract, the salary and leave benefits will be the same. However, you do not get to enjoy other benefits such as house or car loan. Applying for a bank loan may also be difficult as you do not have a permanent job. The government can also terminate you immediately if they find you are incompetent, missing in action or have poor track record. These will definitely keep the HOs on their toes. Below I attach snapshot of some of the “Syarat-syarat pelantikan secara kontrak

Part 1

Part 3

 

 

Part 4

 

Number 13, 14 and 15 might be on interest for some who intend to pursue post graduate education. Number 13 and 14 clearly says that the government can terminate you anytime by giving a 30 days notice or immediately by giving 1 month salary. Number 15 is another interesting statement about application to be absorbed into permanent post. The first and foremost criteria is “availability of post“! This is were I am worried as the number of permanent post available may not be the same as the number of HO’s graduating. They have also listed the criteria that may be used to decide on who will get the permanent post. Basically, you need to complete your housemanship as per requirement (which means within 3 years), have good track record and gets good recommendation from HOD. …………

Somehow, I feel this will remove all the dead wood graduates from the system. However, I am also worried about lack of transparency in making such selection. Those who are hard working and got no issues in completing housemanship should not have any problems. I feel there should be some sort of committee to make such decisions to be fair. Contract post also means that HOs can stop demanding this and that. The motto will be ” you tak suka, you boleh keluar“, the most favourite statement from our politicians. Your contract can be terminated.

The contract also clearly says that government is not obliged to provide permanent jobs to everyone:

Part 6

So, what happens to those who do not get permanent post after 4 years contract? Firstly, you need to find a job: either open a clinic, join as emergency department MO in private hospitals or find another non-medically related job. Secondly, all your ambition to become a specialist will have to disappear unless probably FRACGP organised by Academy of Family Physician of Malaysia, join as a private Master’s candidate at local university(you pay full fee and very limited seats) or probably do some non-clinical, part time courses.

Whatever it is, the government will not be able to absorb everyone. They are not obliged to provide every graduate a job. Many may end up with a license to kill…………. Medicolegal cases are going to increase by leaps and bounds………

 

Finally after settling my tax issues with IRB, I am off again for a long holiday of 3 weeks……… Sayonara to everyone…..

 

I have been very quiet over the last 2 months. I am sure those who are in the private sector(specialist) would know the reason. All of us are undergoing a huge heartache due to a change in the policy of LHDN/IRB to disregard any income declared under our own company (Sdn Bhd). For those who do not know, private specialist are independent contractors in a private hospital. We are not paid a salary by the hospital, thus we are not employed by the hospital. Basically, our income is the fee paid by the patient as what we charge, based on PHFSA act minus 10-15% administrative fee by the hospital. Our fees are limited by the government BUT not the hospital charges. Thus, to manage our tax better, we form our own company where the income is channelled. This practice has been going on for close to 30 years since private hospitals started in this country. Unfortunately, as the government tries to get more income from taxes, the rule has suddenly been changed. Effective mid of this year, a letter from IRB has declared that all income generated by a specialist in a private hospital MUST be subjected under personal income tax! AND it does not end there, we are being asked to redeclare our income tax from 2013 and pay the penalty for the difference not paid! AND we have to do that by 15/12/2016 to receive a reduced penalty rate of 15-20% under the amnesty period introduced by PM from March 2016. Now you know why I was very quiet over the last 2-3 months! The penalty and tax arrears can cost hundreds of thousands of our hard-earned money, working day and night.

Coming to our Budget 2017. In August 2016, I wrote about the soon to be introduced contract HO post to reduce waiting period for housemanship. Well, it has been confirmed in this budget. 2600 contract post will be created by December 2016 to cater for the shortage. He also mentioned that contract post will also be created for dentist and pharmacist but that is nothing new as it has been done. Unfortunately, the budget is silent on what happens to these contract post after they complete housemanship. Will this shorten the waiting period? Personally I don’t think so but it may shorten by 1-2 months for a short period of time. Always remember that starting from this year (2016), ALL medical schools in this country will be producing graduates and those who started to produce graduates about 4 years ago will be producing maximum number of graduates from this year. Another question is how they will select candidates for permanent and contract post? My prediction: probably government sponsored and public university graduates may be given preference and those who do well in the interview might be given priority as well. What happens after you complete housemanship? MO post are also FULL!

Another interesting development is the introduction of a new grade for specialist known as Grade U56. As we all know, since the time based promotion  was introduced in 2010, there is a bottle neck at U54 as all specialist of 9 years of service will be automatically promote to U54. Unfortunately, no JUSA C promotion has been coming since the last 2 years as there are not enough post or money to do that. Thus, the creation of U56 is to relieve the anxiety among all these specialist and to encourage them to stay. I know many U54 and even JUSA C specialist resigning from government sector but with the recent IRB ruling as above, private sector may not be as lucrative as what you expect it to be. You will end up paying 26-28% of your hard-earned money to the government. You will be working 3 months in a year for the government. Now you will know why the mood among all the private specialist is down over the last 2-3 months. For me, the introduction of U56 is just to say that you are not going to get JUSA C anytime soon or even forever!

Budget HO

 

 

The government is also planning to expand their Full Paying Patient scheme to more hospitals as another form of encouragement for specialist to stay in the government sector. I still remember almost 11 years ago, I was one of the SCHOMOS committee member involved in this discussion to introduce FFP.

FPP

 

Interestingly, there is also a suggestion in the budget to build “non-profit charitable” private hospital under government initiative. RM 20 Million loan is nothing as far as building a hospital is concerned.I wonder how long will that last unless the government comes up with a National Health Financing scheme…… How a private hospital is going to survive with government hospital rates? Isn’t that what the government is doing with government hospitals? Sometimes I don’t understand all this populist ideas which most of the time never happens.

Budget 2017 Hospital Non profit

Anyway, government servants will receive RM 500 bonus and no income tax reduction as promised. He did promise few years ago of a gradual personal income tax reduction when GST is in full force. AND what happened to “janji” of reduction in car prices? Janji dicapatikan,  I guess.

Finally, today’s BUDGET speech in Parliament felt like a election public rally! Why do we need all the “public” icons to be made present and introduced? First time in the history of Malaysian Parliment!

I give up some times!

 

Just to update for those who wanted to buy my books when it comes to the bookstores, my books are available at the following bookstores for the moment:

  1. Kinokuniya (Suria KLCC)
  2. MPH (Subang Parade)
  3. MPH (Mid Valley)
  4. MPH (One Utama Megastore)
  5. MPH (NU SENTRAL MALL) (NS)
  6. MPH (Vivacity Megamall) – Kuching
  7. Smart Book Shop (Kuching)

As informed earlier, my Ebooks are available at Google Play Store and soon Amazon Kindle. For those who don’t wish to buy directly from me as stated HERE, you can also buy it online at Kinokuniya Online and MPH Online.

Thank you for all the support so far and you are welcomed to write reviews at any of their sites.

 

I have had many queries regarding e-book version for my books. I am proud to announce that the E-Books are now available at Google Play Store.

Please visit Google Play Store or HERE.

The price is determined by Google and Publisher. I got no control over it. If you want to purchase Hard Cover books, please visit over HERE.