First of all, I would like to wish everyone a very Happy New Year 2011. It has been a while since I last posted anything on my “For Future Doctors “series, the last being on “Housemanship Glut”. I have been observing all the comments and enquiries that were posted in my blog regarding my articles. I had many interesting questions by medical students as well as houseofficers regarding their future prospect in medicine. I thought of answering some of these queries’ in this posting.
What if I quit Housemanship?
I had a couple of housemen who asked me what will happen to them if they quit housemanship and what the other options are. According to Medical Act 1971, a medical graduate has to complete 1 year housemanship in order for them to receive their full registration under the Malaysian Medical Council. This has been increased to 2 years since 2008 (officially). I am not sure whether it is legally binding as the Medical Act 1971 has yet to be amended.
What will happen if you quit housemanship? The answer: You will NEVER be able to practise as a doctor anymore. If you quit housemanship, you will not get your full registration which means you will never be able to practise legally. Thus, whatever you have studied over the last 5-6 years is just a waste. It would have been better if you had decided much earlier that medicine is not your field and switch course during your undergraduate period. There are 2 parties to blame here, yourself and your parents.
Basically, you need to find another job or undergo another undergraduate training in another course. One of the person who wanted to quit housemanship asked me whether she can do Master’s programme in preclinical studies such as Physiology (Master’s in Medical Sciences) or Anatomy and subsequently become a lecturer. The answer is yes and no. Of course you can but in order for you to get a place for Master’s programme in Malaysia, you must be in service. You must have undergone at least 3 years of service with full registration and need recommendations from Head of Department as well as good SKT marks before being able to apply for the programme. As such when you quit housemanship, this is NOT possible especially when our Master’s availability is very much limited with high demand. Probably you can try overseas universities but however, the degree offered must be recognised in Malaysia as a postgraduate degree.
Can I join Pharmaceutical companies? Again it is a possibility. In fact, with oversupply of doctors in Malaysia in a few years’ time, we might be seeing a lot of medical graduates joining pharma companies to get a job. Sometimes, pharma companies also need you to have full MMC registration in order to join them.
Can I become a Lecturer by just holding a MBBS? The answer is NO. As I have said before, medicine a very peculiar field. If you are an engineering graduate, can’t find a job, you can be made as a lecturer if the university wants to. Of course an engineering graduate without field work is going to be a useless teacher but who cares in this Bolehland. I have seen so many engineering graduates who have become lecturers the day after they passed out! No wonder we have so many buildings collapsing. I also have seen many engineering graduates becoming school teachers. But for medicine this is not possible. Only doctors with postgraduate degrees are allowed to become lecturers, internationally and of course you will never be accepted as school teachers. But, who knows………………… in Bolehland anything can happen.!
Usually, my general advice to whoever decides not to continue as a doctor is to at least complete your housemanship, whether you like it or not!
What if doctors become jobless in the next 5 years?
To me, this is a distant reality. There were some comments which said that doctors will never become jobless but will become lowly paid. Remember, in Malaysia doctors has to join civil service in order to do your housemanship. Under the Medical Act 1971, housemanship can only be done in government hospitals.
It is a 2 parallel system. After you graduate you need to apply for a post in civil service which is done by the Public Service Commission (SPA). Only when SPA accepts you into the civil service, the Ministry of Health will decide on your posting and place of training. This is where it gets a little bit tricky. If you read my article in MMA written in July 2006: “Future of Government Doctors: Die Another Day!” (https://pagalavan.com/my-mma-articles/july-2006future-of-government-doctors-die-another-day/), there is a limit to the number of post that is available. The number of post in the government sector is NOT limitless.
We are already suffering from an over bloated civil service. We have one of the highest numbers of civil servants in the world, compared to our population. Housemen start at UD41 grade in civil service. Due to recent promotional prospect, all medical officers have been pushed to UD44 grade and thus creating more vacancy in UD41 grade for houseofficers. But this vacancy has a limit and the government is not going to keep increasing the number of post as they need to consider the financial implications.
Thus, there will come a time where medical graduates will become jobless in Malaysia if the current trend continues. Despite a stop in new medical schools, the existing medical schools (total of 32) will continue to increase the number of graduates as it is a money-making business. Doctors will become like lawyers in another few years’ time.
If you don’t believe me, just take a look at nurses. About 10 years ago, the shortage of nurses made headlines in newspapers. The government began to approve private nursing colleges. Now, we have almost 100 over nursing colleges in the country so much so, you can get a place with just 1 credit in your SPM. At the same time, you are also seeing many nurses with no quality at all, can’t speak/write English and totally unemployable. There are so many unemployed nurses in the country at the moment, some even working in petrol stations! These nurses were guaranteed a job in government sector by the private colleges. However, only nurses trained in KKM nursing colleges are given priority to be absorbed into government sector. The rest has to queue up to get a job in civil service. The private sector is also full. The big private hospitals such as KPJ and Pantai have their own nursing colleges and they will absorb their trainees.
So what happen to the rest? Jobless lah………………………..
Next in line: will be medical graduates……………….!
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Nice article Dr. Paga. I have always looked forward to your gloomy, oh-we-all-are-so-doomed articles. Keep up the good job.
Ha ha, well all my prediction since the last 5-6 years has become a reality. Many argued with me then that I am over exaggerating but reality has hit them now!
Dear Dr Pagalavan,
Your predictions over the last few years are slowly coming true of late. I wonder when will the health care system in Malaysia hit rock bottom and finally take its toll on the Malaysian people?
Speaking of which, you might be interested in the latest controversy surrounding one of our private medical colleges, Cyberjaya University College of Medical Sciences. If you happen to have any CUCMS students on your contacts list, you might have noticed that 236 and CUCMS seem to be all the rage on facebook now. Apparently, the institution has recruited more students, 86 to be specific, than what is allowed by the Malaysian Medical Council (150-seat quota). CUCMS is now asking the 86 unfortunate students (a few of which are jpa and mara sponsored students) to ‘voluntarily’ withdraw or risk losing recognition from the MMC.
I’d love to hear your take on this issue.
I have not heard of anything yet. If you know someone pls let me know. However, it is not entirely unexpected! All private colleges are here to make money, period!
And they want to make as much money as possible before the market get saurated with doctors. Almost all medical colleges in Malaysia do not have enough lecturers even to take 100 students! They use the existing doctors in the government hospitals (where they are attched to) as well as fractional tutors to make up the numbers on paper. So, on paper, the number of lecturers look big but not in reality. I left one of the so called international branch campus of a foreign university and I know what is happening down there! All this MSQH/LAN accreditation is total crap! these guys, who are not medical people just come over for a day or two for auditing and then accreditates the university based on what is available on paper. Malaysia Boleh mah……………………
Dr Pagalavan, I have read an article sometime ago, about a medical specialist who, on talking to a plumber who was doing plumbing work in his house, wanted to know how much the plumber earned.
And he was really surprised when the latter gave him the answer which showed that the plumber earned much more than him.
Thereupon, the doctor immediately signed up for a plumber’s course and became one himself!
Doctor,
I understand that FRCP from the UK is no longer recognised in this country.
That’s one of the best medical qualifications in the world!
What’s the reason, if any, for it?
You mean FRCS? FRCS is still recognised in Malaysia but none of our hospitals are recognised as a training centre in Malaysia. Thus after you pass MRCS, you would not be able to do FRCS anywhere in Malaysia, unless you go to Singapore or UK.
Winston, actually the joke went like this:
Doc: $400 for one hour of work!! I don’t even make half that.
Plumber: Neither did I when I was a doctor.
Dear Dr Paga,
By any chance, do u think dat all of these problems are actually applied to the field of dentistry too? because from what i’ve heard and read through, it seems that dentistry is much a better prospect and endurance than medicine itself in terms of working hours and so forth.
at the moment , dentistry is a much better option if you like it.
Dr,
What is your view in terms of the demand for various subspecialties cardiology, hematology, respi, rheumato, nephro, gastro, hepato? I mean in terms of demand, the current standing number of each subspeciality, future outlook, etc
There is definitely a lot of demand for subspeciality especially haemato, rheumato, respi, nephro and haemato. Cardio is rather saturated but demand in gov sector is still there. Unfortunately the main problem now is lack of training centres and post!
I do agree with u that cardio seems saturated, but with ever increasing patient loads, do u think it will sort of balance off?
Popular subspecialty such as cardio and gastro seems saturated due to interests shown, right? The less common ones eg hemato n rheumato will seems to have better prospects, do u agree? But would it be fair for me to say that statement is limited to govt service but not private. Reason for tat is bcos treatment of say all or myeloma or even novel treatment for RA, will be too much to bear for pt unless insurance policies is in place. Am I right to say that ?
But if the one healtcare insurance were ever to take place, do u see a reversal of situation that I protrayed in the statement above?
Yes, you are right. The private sector seem to be saturated with cardiologist and gastro mainly because these are interventional fields that produce money in pricate sector. That’s the reason people showed a lot of interest in these fields. Same can’t be said about Haemato where no private hospitals will take you because patients generally can’t afford the treatment. Furthermore, insurance do not cover all the cost for treatments of cancer/complicated RA etc. Insurance only covers for inpatient admission costs and not long term treatment. Infact private hospitals are now looking for speciality like respi and nephro currently.
Yes, if the government introduces National Healthcare finance, the demand in private sector may go up but same can’t be said about the earning capacities. As more hospitals appear, the income of each doctor will reduce. This is already happening in Klang Valley where specialists seem to be jumping from one hospital to another hoping to earn more. It is becoming more and more competitive in private sector. The demand in gov sector will be there atleast for another 10-15 years but you will be pushed deeper and deeper into the districts etc.
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[…] year ago, I wrote this article : https://pagalavan.com/2011/01/02/for-future-doctors-what-if/. It is about what happens if you quit housemanship. Recently I came across a blog of a houseman who […]
Dear Dr.Pagalavan,
When you say one NEVER will be able to practise medicine anymore ( If he quits/does not complete his HO) , do you mean in Malaysia or anywhere outside of Malaysia?
if you are going outside, you will have to do housemanship over there, meaning: start from sratch again. However, whenever you apply to another country, you will need Certificate of Good Standing from MMC. This is where problems will arise. If you quit housemanship halfway, the report may not be favourable.
Dear Dr. Pagavalan,
You mentioned that “Usually, my general advice to whoever decides not to continue as a doctor is to at least complete your housemanship, whether you like it or not!”
I was wondering what’s the advantage in doing this? I mean, once you finished your housemanship, you would be awarded with a license to practice. But, the license need to be renewed yearly, right?
What if after that one decides not to be a Dr anymore? What happens to the licence? Can one still renew it the next year even if he or she is not a Dr anymore?
Thanks!
It just gives you a better oppurtunity to get into other jobs in the market. You can read this guy’s write up which is interesting http://chroniclesofaloner.com/2012/01/22/life-after-medicine/
At the moment, you can renew your license even if you are not practising but from next year onwards, you need a minimum CME point for you to renew your APC.
Dear Dr. Pagavalan,
You mentioned that \”Usually, my general advice to whoever decides not to continue as a doctor is to at least complete your housemanship, whether you like it or not!\”
I was wondering what\’s the advantage in doing this? I mean, once you finished your housemanship, you would be awarded with a license to practice. But, the license need to be renewed yearly, right?
What if after that one decides not to be a Dr anymore? What happens to the licence? Can one still renew it the next year even if he or she is not a Dr anymore?
Thanks!
Good Day and Happy New Year Doctor,
I came across your website as I was searching for some advise for my brother whom gave up working with the government as a doctor. He has already completed his houseman service and have another 4 months to go to complete being an MO. However due to the treatments in the hospital, he just could not bring himself to go on. Could you please give me some advise or point me in some direction, for he does love being a doctor and said that he needs a particular cert to be able to be attached to a clinic or private hospital.
he needs APC ( annual practising certificate). In order to get this, you need to complete the compulsory service of 4 years ( including 2 years housemanship). If not, you need to write in to MMC.