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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.

 

ON this auspicious 59th Merdeka day celebration, I would like to announce that my books “Hard Truths of Being a Doctor Part 1 & 2″ are both available at Kinokuniya Bookstore in Kuala Lumpur.

If you would like to buy it online from them, please visit the following website .

You can still visit my blog post HERE if you would like to purchase directly from me.

 

whatsapp-image-2016-09-03-at-14-00-11

In my first post with the above topic , I mentioned about the government’s intention to introduce contract HO post. Sometimes I do not know whether to laugh or cry. Few years ago when I predicted that the time will come for graduates to wait in a “Q” and jobs will not be guaranteed for doctors, I was scolded, laughed at, humiliated and given numerous sarcastic remarks. Few years down the line, when what I predicted happened, the situation has changed. Now, these very people claim that I am boasting and self-glorifying. I don’t know what these people really want. When you tell them something , they don’t listen and when it happens, they throw back their tantrum to the very same people who predicted it will happen. What precaution did you take ?

There was a meeting between MOH officials with HODs of a big hospital in Malaysia recently. In this meeting, the current situation of doctor’s post was discussed. Please be informed that MO post is currently 16% oversubscribed! Interestingly, some of the HO post are being converted to MO post to cater for this oversupply. This happens because , all those who are appointed into civil service are on a permanent post currently. Thus, the government is now in the process of trying to get contract HO post to fill up the gap and to shorten the waiting period . However, this new situation will only reduce the waiting period from about 8 months to about 6 months. With the increasing number of graduates from this year onwards (all 32 medical schools will be producing graduates from 2016 with increasing numbers), the waiting time will only shorten for a short period of time before climbing back to about 1 year or even longer.

It is expected that the contract HO post will start from this October if approved by cabinet. The question is “what happens after HO?”. It seems that the government is not obliged to provide jobs to everyone, which is a fact. Thus, if you do not get a permanent post after HOship, your contract may be renewed for another 2 years to complete your compulsory service. After the 4 years compulsory service, you can do what you want! The GP market is going to be severely affected by this as those who can’t get a job in MOH will open their clinics in every corner of the town. The struggling GP market will continue to struggle.

As I said in my previous post, this will affect post-graduate education. At the moment post-graduate education can only be done in public hospitals. I also heard rumours that those with MRCP, MRCS Part 1 etc will have a better chance to get into a permanent post. Another good news is the fact that some of the public universities are building their own teaching hospitals which can probably employ some of these MOs. UPM, UiTM, University Sarawak and Sabah etc are all in the process of building their own teaching hospitals. However, these will take another 3-5 years to materialise.

It is also informed that no more contract extension will be given to those who had retired from civil service. This “post retirement contract” is something which I had always felt is not appropriate. Those who had retired should not be reemployed to the same post under contract unless it is a very much-needed service with no replacement found. In many instances, HODs who had retired continued to become HOD under contract. That is not right as far as I am concerned.

I still get questions from foreigners who are interested to do internship/HO/MO in Malaysia. Let me tell you once and for all, Malaysia DO NOT provide housemanship to foreigners. Foreign Spouses of Malaysians were given internship post till 2014 under contract but stopped since then. In February 2016, MOH came up with the following circular to confirm the fact that foreigners will not be given housemanship post till further notice. It also mentioned on those who has quit housemansip or terminated.

Screen Shot 2016-08-21 at 10.54.02 AM

With the introduction of HO contract post, it will become very much easier for MOH to terminate any HOs who go missing or have poor performance.

And for those who think that being a doctor guarantees you a job anywhere in this world, don’t live in a delusional world. Doing medicine for migration is the worst thing to do. It is the most controlled profession in the world and most difficult to migrate. Just recently, there were suggestion that Australia should stop recruiting foreign trained doctors.  Please check how much easier it is for people of other profession to apply for “Skilled Migration” Visa to Australia compared to medicine. With the new PM in UK who supports anti-migration policy, the situation may not be any better. Singapore has also stopped conducting qualification exams for foreigners with unrecognised basic degree. Unless you want to migrate to an African or 3rd world country, doing medicine is the last thing you should do.

The world of medicine is not the same anymore. Majority of those who I talk to are intending to retire early. For those who intend to do medicine, PLEASE read my books. You can buy it online as mentioned HERE. It should be available in Kinokuniya bookstores very soon. Popular will be next………..

Almost 3-4 years ago I predicted that there will come a time where HO post will be given under contract. In August last year, I again predicted and heard rumours that HO post may be give under contract, after which you need to apply for a permanent MO post. There were even a suggestion than that en exit exam is being considered after housemanship. Well, looks like once again my prediction may become a reality soon.

TheStar reported today that MOH is waiting for green light from the cabinet for creation of temporary HO post. This basically means the HO post will be given under contract. What happens after housemanship? It basically means that you will need to reapply for a permanent post as a MO. There are pros and cons in this system. Firstly, how do SPA or MOH decide on who will receive permanent post and who will receive contract post? I presume JPA scholars/government scholars might be given preference for permanent post as the contract guarantees a bond with the government. Secondly, how do you assess who will get permanent MO post after the contract expires? This is where the said exit exam may come into force. BTW, 300 contract post were created this year for dental graduates as reported by DG and written by me in March 2016.

On the other hand, it will keep all HOs on their toes. If you don’t complete your housemanship in 2 years (usual duration of any contract post), you may not be able to continue the contract. It is also easier to terminate HOs who are missing in action. If you perform badly during housemanship, you are likely to have a lesser chance of getting a permanent MO post. Be also aware that if you do not get a MO post in government, you have almost zero chance of pursuing post-graduate education.

As i had always said, there is no such thing as job security in medicine anymore. It is considered as just like another job but medicine is far more complicated than any other jobs out there. Without housemanship, no full registration. Without full registration, you can’t practise as a doctor etc etc.

What’s next ? A reduction in compulsory service from 4 years to 2 years ? Open clinic after housemanship? Another of my prediction which may come into reality. Then we may have a lot of doctors with apparent ” license to kill”……………

Temporary posts can reduce waiting time for medical grads

KUALA LUMPUR: There is good news for medical students who will be graduating soon as they may not have to wait too long before being offered a job.

The Health Ministry is in the final stages of implementing a plan to introduce temporary posts for medical graduates who face a long wait to do housemanship.

Its deputy director-general (medical) Datuk Dr Jeyaindran Sinnadurai said the rigidity of the current system did not allow the ministry to offer permanent positions to more people as they serve their housemanship.

The plan for temporary posts, he said, needed the Cabinet approval before it could be introduced as “we have to ensure that it is fair to all and no one is marginalised”.

On whether the ministry can justify the number, he said “yes” as it had developed many new services.

“The workload has increased, so we need those numbers to deliver care to the public.

“Presently, we take in about 4,500 house officers annually on permanent posts and upon completing their housemanship, they become permanent medical officers,” he told The Star after chairing a lecture at Hospital Kuala Lumpur on Thursday.