This is an email from a concerned citizen that was sent to me few days ago. Most of the issues that he mentioned had already been discussed in my blog over the last few months. Unqualified students doing medicine by going through Foundation courses organised by many dubious private colleges for both local and overseas medical schools. There is no standardisation and quality control by the authorities, the usual Malaysia boleh syndrome!
Most of the brain drain that this country is facing is because of the issues mentioned in the first paragraph of the email. Even though the situation has changed to a better after the 2008 election where UMNO/BN realised the importance of non-Malay votes, it is still not satisfactory. IN 1980s and up to mid 1990s, JPA scholarship to do medicine overseas is only reserved for Bumiputeras. Me and my good friend who got 9As in SPM were told openly that we will not be given scholarship to do medicine but we can choose engineering or any other field. We took the courage to do STPM and did well to get a place in UM. The situation gradually improved towards 2000 when MCA started to make some noise. Since 2008 election, about 40-45% of the JPA scholarships are now being given to non-Bumis for various field of studies. That’s roughly about 900 slots for various field.
Najib has promised that from this year onwards, all top scorers will be given scholarship but it is yet to be seen.From my ground survey, I do see more non-Bumis receiving scholarships but the numbers are still small. Remember, only top scorers are given this scholarship but the same rule do not apply for the Bumiputeras. I have seen and heard of so many Bumis who got only 2As – 5As in SPM receiving scholarship to do various courses overseas. One thing the government never reveal is the number of MARA scholars overseas. But GOD has shown us the figure when Egypt was in turmoil last month. Almost 5000 medical students in Egypt alone, that’s almost 1000/year! I can assure you , almost 90% of those are MARA scholars. MARA also sends medical students to Ireland/UK/Australia/Poland/India/Indonesia, Russia etc as well as local public and private medical schools!! So, what is 900 slots compared to thousands given by both MARA and JPA to the Bumis? To say that all of them are poor is also not true as I have seen sons/daughters of Tan Sri/Datos and wealthy businessman receiving the same aid! Where is the logic!
Well, coming back to the email below, as the writer has said, the country is heading for doom if the situation of unqualified doctors are not addressed in an urgent manner!
Unqualified Doctors who are already in the medical practice
It is very sad to understand the declining of quality of medical doctors in Malaysia. 20 years ago one cannot hear so many doctors passing out as our system of education was class 1 English medium. Now scholarships are granted for all bumiputras. Their parents do not have to toil and labour for the money. The Chinese and Indians have to find their own fundings. The government is to be blamed for this. The 1 Malaysia concepts is not applicable to the other 2 races when it comes to funding for the straight A students who are Indian and Chinese.
I have been following what is going on in the hospitals. The housemen are unable to carry out on a patient professionally as he/she lacks experience. They are unable to diagnose the diseases. Tan Sri Dr Ismail Merican did not address the sub-standard quality of these housemen. It is a devastating issue where the present to be doctors cannot understand and identify the disease or symptoms of the complaints.
He commented that the doctors are overworked and are mentally stressed. i would say these housemen to be doctors are mentally disturbed as they did not excel in the medical exams set in their universities.
Many have gone abroad without the NOCs and many medical students somehow got their NOC’s illegally as their SPM and Foundations are not up to mark. They manage to do their foundations in the institutes around town and are able to leave for their medical studies within 4 or 5 months time. The agents arrange this with the principles of the colleges in our country. I would say on commission basis.
The private institutions of higher learning like Nirwana, Lincoln and others come out with instant certificates for these students to go and do medicine abroad.
The students who did not score in Science subjects who only got 7 and 8 are able to do medicine.
70% of these students are passing out these years.
MMC does not look into their poor SPM results but acknowledges the Degrees. First of all they should not allow students with such poor results to do medicine. If they were a gateway not to allow these students to do medicine our country will not look this akward about the Malaysian doctors. Parents would not then pressure their loved ones to do medicine as MMC would counsel such parents to avoid the glitches of unqualified doctors in our country. The team to be blamed is the Ministry of Health, MMA that knows what is going on and MMC.
Agents have made billions in this booming business of sending unqualified students to do medicine. How did the Ministry of Education give out the NO OBJECTION CERTIFICATES TO THESE AGENTS?
Many who did not excel in SPM have become doctors.
Why is it that the entrance exam is going to be implemented for those taking up medicinein future and not for those who are already in the medical universities. The lousy stock of unqualified medical graduates are soon passing out to practice in the hospitals. The problem is not going to be tackled in a proper manner.
Kursk and Ukraine or those universities that has caused it all. A CATASTROPHE. Why are the agents corrupting the government. They are able to talk through and been gaining in wealth and are filthy billionaires. The concerned educational departments have been convinced by these money making agents. I have seen advertisements by these agents which is full of misleading information. They are not professionally experienced to figure out who can sturdy for medicine.
I hope the Cabinet will implement the exams for all from this year that would start the ball rolling.
Pagalavan's Avatar 
I have a non-bumi Malaysian who scored 5As in SPM and managed to become a doctor (self-sponsored). Makes two of us.
Dear Siti,
I did not say anything about 5As SPM students doing medicine! I am talking about the number of scholarship given out by MARA for VARIOUS courses locally as well as overseas. If you read carefully, no where did I say that 5A student should not do medicine. I am just saying that a 5A SPM Bumi student can easily get scholarship from MARA/JPA but the same cannot be said for a non-Bumi. That was the point that I am trying to make.
A poorly written e mail by the concerned citizen. Wonder why it caught your attention, Dr.
This email was written by a lay person, a non medical person. Most of the facts written are the truth at the ground level. We should be as worried as him. In fact most of the issue that he has mentioned, I had already written in my blog.
“To say that all of them are poor is also not true as I have seen sons/daughters of Tan Sri/Datos and wealthy businessman receiving the same aid! Where is the logic!”
Can you please be more specific when your are making this statement by at least mentioning along the rough figures as well. Do you realize how much such simple statements can be very misleading given the current poor critical judgement of many Malaysians.
Like I can say that I have seen sons/daughters of Chinese and Indian receiving the same aid (MARA scholarship, in case this is the aid that you are mentioning about).
And I really hope that you do realize that MARA’s requirement for those doing medicine is just the same as JPA. meaning on paper, these students are just as qualified as JPA scholars (academically). Many are even among top scorers in school/state/ even country.
How do I know these? Cause I’m Indian and on MARA scholarship as well.
Social injustice is undoubtedly happening in many scenes in our country. However it is disheartening that in many cases, people exaggerate it to a much worse extent that results in poor presentation of the actual system or even our country.
Interesting! As far as i know, MARA scholarships and loans are only for bumiputeras. I am not sure when they started giving scholarship to non-bumis. Please enlighten me.
Secondly, I DID NOT say that MARA send unqualified students to do medicine. I am only talking about the number of scholarships given by MARA for VARIOUS courses overseas and locally despite many of these students only achieving lower grades. The same do not happen to the non-Bumis!
Yes, of course I do know that all MARA scholars have to do Pre-U courses before being sent to do medicine and where you will be sent depends on your performance. Again, please read my article where I did not mention anything about MARA sending unqualified students to do medicine.
About Tan Sris and Dato’s getting scholarship, I hope you will open your eyes and see for yourself. I worked in a private universitie before and I saw enough number of wealthy children doing medicine under MARA. In fact they were driving bigger cars than me including Pajero, Volvo and Merc, all bought for them by their parents!! In fact the area where I am staying right now, has many well to do Malays(staying in Banglos and Semi D houses with big cars) but yet their children are all sponsored by MARA or JPA. The same cannot be said for the non-Bumis!
BTW , are you an Indian Muslim?
Here I attach one of the comments from a MARA scholar which appeared quite some time ago in my blog:
Currently I’m a MARA scholar studying medicine in the UK (only a first year though). As accurately as you described, my dad is indeed a Dato. In the beginning I was quite reluctant to take the scholarship. It felt as though I was going against what I believed, equality and transparency. To cut the long story short, together with many long and heated arguments, my parents eventually forced me to take the scholarship.
I often tell myself that I don’t deserve it. The fact that I got this scholarship just because what I am sickens my stomach. But am I really expected to put the equality of the’ rakyat’ first in the stead of my family’s sacrifices? And no, I do not know the answer to that.
In all honestly, I know my parents are good people. Perhaps they are a little racist but it probably came with the instillation of siege mentality back in their time.
My dad keeps on telling me how the chinese only look out for their own kind and he tells my sister to not work for a chinese boss.
But sometimes life is funny, because my dad is half-chinese.
Oh the irony.
10% of MARA places/scholarships etc are meant to go to non-Bumis now. UiTM is still only for bumis I believe.
If I am not mistaken, the 10 percent is only for places in MARA college and not for scholarships.
Dunno the exact number then, but I’ve also personally met non-bumi MARA scholars doing degrees overseas, though they are very hard to come by!
This is an interesting info I got from a website http://faizalfredley.com/2011/01/03/senarai-biasiswa-di-malaysia/
1. Jabatan Perkhidmatan Awam (JPA)
Biasiswa JPA ini boleh dimohon dalam masa 7 hari selepas result SPM diumumkan. Untuk JPA dan MARA, anda hanya boleh mohon salah satu sahaja dalam website eSILA. Biasiswa JPA 60% untuk bumiputera dan 40% untuk bukan bumiputera. Masa zaman saya dulu, interview JPA menggunakan dwibahasa.
Anda akan dapat 1 tajuk untuk dibincangkan dalam kumpulan selama 30 minit. Bahasa Melayu (15 minit) dan bahasa Inggeris (15 minit). Mungkin formatnya berubah, tapi saya pun tak berapa pasti. JPA menawarkan 1800++ tempat setiap tahun.
Untuk tips-tips temuduga JPA, sila klik di sini.
2. Majlis Amanah Rakyat (MARA)
Nak mohon biasiswa MARA pun guna website yang sama untuk mohon JPA. MARA hanya untuk pelajar-pelajar Melayu dan Bumiputera sahaja. Interview MARA tak sama macam JPA. JPA interview secara berkumpulan manakala MARA interview secara individu, face to face dengan 2 orang penemuduga.
Ada course tertentu hanya ditawarkan oleh JPA seperti Farmasi. Tapi jangan bimbang, course-course lain seperti Medicine, Biotechnology, Engineering, Accounting dan sebagainya ditawarkan oleh JPA dan MARA. Cuma kadang-kadang konfius juga sama ada nak JPA atau MARA.
Katakanlah anda dapat 6A1 4A2 atau 7A1 3A2 tapi anda nak apply course Medicine. Saya syorkan anda pilih MARA sebab dengan result yang anda dapat, susah untuk dapat JPA melainkan result anda 9A1 1A2 atau 10A1. Sama juga untuk course-course lain.
JPA dan MARA dua-dua ada kelebihan.
Peluang nak dapat MARA lagi tinggi berbanding JPA kerana JPA kena compete dengan semua orang tak kira Melayu, Cina atau India. Kalau anda dapat JPA, anda memang dapat biasiswa walaupun keputusan tak cemerlang mana pun time degree. Kalau MARA, ada portion yang anda kena bayar kalau result tak cemerlang. Ini dinamakan biasiswa boleh ubah.
JPA anda terikat beberapa tahun dalam sektor kerajaan. Biasanya 6 tahun kecuali doktor terikat selama 10 tahun. MARA, anda bebas untuk bekerja di mana-mana sahaja even di luar negara sekalipun.
Jika anda memohon course Medicine, JPA biasanya menawarkan program twinning iaitu 3 tahun di Malaysia dan 3 tahun di luar negara. Kalau MARA pula, 5 atau 6 tahun di luar negara.
Kalau saya, saya akan mohon MARA.
I just received this email which might be of interest to you, adding to what I had replied before:
im sorry i send u 2 emails
just want 2 say that i was from a boarding school in kl
when i was in f4, i was shocked to know that many of my seniors are filthy rich
some of them r ank dato’s
theres a lot of businessmans children there
i thought sbp’s r only 4 those who r poor or come from a moderate-income family
the same goes to mrsm
i have a fren who has a fren that has ferrari, of course with a driver!
that makes me sad
4 ur information my father’s a teacher n my mother’s a housewife
thnk u doc
I absolutely agree. There is a place for affirmative action when scholarships etc are awarded to the poor or medium-income, reaching a certain academic threshold. In its current form, it is being misused and serves to make the UMNO-connected rich richer.
good evening doc,
all i was thinking that practical knowledge much important that theoretical knowledge as one dealing with patient physically .
of course, good and proper basics in medicine will make one to not to misdiagnose.
being a student, im always make sure myself getting adequate information regarding what im studying now.
regarding the spm and stpm, yes i do agree that more and more students whose results are not qualified to do medicine , can do medicine .
everyone wants to become doctors and for them being doctor is a prestige . but for me , studying medicine is a passion. im not excel much in my spm or stpm.
But i do have a honors degree in biomedicine and now doing medicine.
due to financial insufficiency , i ended up in an unrecognized institution but i do updating now and then whats happening in malaysia’s health care system.
i do see much more students who are in public and private local med school and surviving with ‘at least passing” status. we fails to address their ineffectiveness in practicing medicine. why it is so?
i wish the government will implement the qualifying exam for all so , the good and deserved one will do medicine and enhance better health care system to the community .
Dr Paga, everytime i read your posts, I feel terrible about my future. Currently i am a second year medical student at a local U. I am going extra miles to improve my clinical skills by going to a district hospital every saturday to practise history taking and PE skills and learn from MOs.
I am really afraid i’ll end up being a useless doctor. =(
Thanks for posting all this up. They motivate me to do better.
dear alck,its good to hear sum1 like u having a good attitude and the initiative to learn. wv these qualities, shud b no fear for u when started working as medical officer as u ar going to face the all the challenges well if u maintain this kind of good attitude. the problem wv the current HO is not only they ar lack of knowledge but also the pride and lack of initiative to learn more
gud luck !
Dr. Pagalavan- this is not the first time you have posted such kind of articles that under mind Russian graduates. I obtained 9A1 and 1B3(Bahasa Malaysia) in my SPM and 3A’s and 2B’s in my STPM- and yes I am studying in Kursk, Russia.
I do agree we do lack in practical skills but I am very sure I will learn it during my 1st week of Housemanship ( even though I am sure there will be a few specialist like yourself who will give me hell through out the process just because I am a Russian graduate ). I also agree that the structure of our Case History is also very different from those in Malaysia- again i am confident that I will be able to master the proper art of “clerking” in a weeks time.
Saying that we do not know how to diagnose patients at all… now dont you not find that just going over the line. Everyday for the past 3 years ( clinical years ), we have been learning the exact same thing. Yes I do not know all the signs and symptoms for all the diseases in the world, but believe me when I say we would be able to diagnose patients based on their complains.
Dr. Pagalavan – what are you trying to advocate- that all Russian graduates are bad? All the students studying here should not be able to practice medicine in Malaysia? As doctor is this what you are trying to preach? Tell us how we can improve- eg how to fill up a case history, and protocols and so on. You are just bashing us just because we could not afford to pursue our higher education in the UK or USA?
Many Russian graduates go on to continue to work in Australia , US and also UK by obtaining good scores the entrance exams of these countries. I will be finishing my degree this summer and am looking forward to work in the medical field in Malaysia. I do really hope that I get a specialist and MO who is willing to teach and not be biased.
All I can say is that – Russian graduates, with determination and hard work , we can over come any mountain. Never give up because of some email that some one wrote.
I think you should read back all my postings. NO where did I point fingers at any particular country or university regarding quality. Most of the articles which mentioned the names of universities and countries are NOT mine. I just cut and paste the article in my blog like the email above. I practise freedom of press and as such I do not censor any articles including all the comments that appear in my blog, whether it is for or against me.
Of course you are right. I have also seen and worked with good students from Russia and Indonesia and at the same time bad students from local universities. It all depends on your interest in medicine and passion! The only issue that I keep pointing is the entrance qualifications for medical school which should be monitored closely.
‘M writing in response to the report “Mediocre students becoming doctors” (New Sunday Times, Feb 20).
Nineteen years ago, when I did my housemanship at Ipoh Hospital, I had the opportunity to work with people who graduated from various medical colleges all over the world.
At that time, there were not as many house officers as today. The majority of us graduated from India (both from recognised as well as unrecognised medical colleges), from the three medical faculties in Malaysia (including my wife and I), Pakistan, Indonesia, the United Kingdom, Australia, New Zealand, Iraq and Belgium (who brought reference books in Flemish).
Initially, I could sense “favouritism” among the medical officers, clinical specialists and consultants towards house officers who graduated from certain universities.
As my wife and I graduated from the youngest local medical faculty from among the three, word went around that we were not as good as graduates from the other two faculties.
However, our attitude, dedication, commitment, accountability and passion during our housemanship earned us their respect.
I have had a colleague, who graduated from a prestigious medical college in the UK, asking me how to take blood from a patient because in the UK, she never had to do that (it was done by a phlebotomist).
She learnt and became an expert.
On the contrary, I also had a colleague who graduated from a well-known medical college in Australia who could not cope with the workload. It came to a stage where, during ward rounds, the consultant would prefer to ask the nurse about the patients’ progress because the consultant did not trust the doctor’s judgement.
On the second day after reporting for duty, a colleague took me aside. She was my senior in that department and had graduated from a recognised medical college in India.
She told me that she was assigned to teach me how to do an insertion into a central venous line.
She mentioned that she had performed many such procedures during her college days as well as during her posting at the department.
But I found that she was not doing it right. She, however, insisted that her method was correct.
In the end, the patient ended up with no central venous line but surgical emphysema and bilateral pneumothorax. The medical officer had to intervene and the patient had to have bilateral chest tubes inserted.
What I’m trying to say is that we should not prejudge our medical graduates based on where they graduated from. As graduates, they would have attained similar basic knowledge where medicine is concerned. What is lacking in some of them are the skills they should have acquired during their housemanship.
To those who have graduated from so-called low-ranking medical colleges, please do not feel disheartened. I challenge you to prove the critics wrong.
With the right attitude, dedication, commitment, accountability and passion to learn, you are not far from the quest to become a good doctor.
To the rest of you who have graduated from recognised medical colleges, discard the arrogance and be humble because without the right attitude, dedication, commitment, accountability and passion to learn, you are nowhere near to being a good doctor.
Read more: Mediocre doctors: Prove yourselves worthy http://www.nst.com.my/nst/articles/24mms/Article/index_html#ixzz1GrKzRIkO
post this kinda articles and support students..
As I have said again and again, I am not bothered from which university that you graduate from, local, recognised or unrecognised. What is important are the following :
1) Good entry qualifications and strict monitoring of the PreU standards . If I am not mistaken, the article that was published in NST before was talking about entrance qualification and not whether the university is recognised or not.
2) You must have passion and interest in doing medicine. If you are doing medicine because your parents say so or for glory and money, then no matter which university you come from, you will be mediocre.
3) Strict monitoring of quality by MMC
4) Entrance exams for everyone!
http://pagalavan.com
Sent from my BlackBerry® wireless device via Vodafone-Celcom Mobile.
I am constantly in awe of the amount of ego a person can develop in medical school. For the proud Kursk university student, I would hold my tongue at least until I enter the working world. I have seen many patients harmed and some even die from getting treated by your seniors. Not all.. but majority of doctors from your university cannot function in my hospital. This is not prejudice but rather my experience. I am sorry if it upsets you.
Quote: “Everyday for the past 3 years ( clinical years ), we have been learning the exact same thing.. …believe me when I say we would be able to diagnose patients based on their complains.”
It is due to overconfidence and egoism that many patients receive wrong and sometimes fatal treatment. Even after years of service, I would never be stupidly proud enough to be So sure of myself. I find it is the same with many of your seniors. Overconfident and unwilling to ask if they are not sure. As a result, patients die of stupid reasons like being given lytic cocktail for hypokalemia. Imagine if it was your family members being treated in the hospital. I think a lil less ego will go a long way.
You may be proud now, but even the gold medalist from your university handed in her resignation within one month of working as she could not cope.
You ask how to improve yourself?.. Some humility would be a great start.
Good day 🙂
What should these unexcel in SPM and went through Foundation courses organised by many dubious private colleges students who currently half way of doing medicine?
Thanks.
if implement the exams for all from THIS year, it would be unfair especially for those going to graduate soon.
i believe the learning system especially practical are slightly different between Malaysia and foreign countries.
they need internship/HO-ship to gain more local experiences.
“medical students will be free to study in any institution of their choice” -apply to NEW medical students.
so for those fresh medical students can choose medical school that equalvalent to Malaysian standard. in other word, it’s “in your own risk” 🙂
Hmm there’s no fair and unfair in this world, if all the graduates have the true quality, they shouldn’t have any problem on the exam… I’m sure that the exam test only the basic knowledge
I find it disheartening that some of our young doctors (and some medical students) have already developed EGOS on the ability to diagnose, treat, fly, dodge a bullet, develop laser vision, etc wayyyy before they have started working. That supposed to happen after you have sub-specialized 🙂
There are always two perspectives to the coin. Two ways of thinking about this….
1. It doesnt matter how hardworking, dedicated, people-centric you are. You need a baseline intelligence, without which, you cant be a good doctor.
2. It doesnt matter how stupid you are. As long as you work hard enough and dedicated enough, you can be a good doctor.
And most of us operate from either of this logic, and we reject the other.
I hope we can rise above this, and understand the crux of the issue. Poor governance and regulation by the authorities. The last time someone criticized me for not providing solutions. So this is my idea..follow the french system.
1. Practice transparent meritocracy – eliminate racial quotas (BUT SERIOUSLY, this can never be done)
2. We have enough medical schools now. Improve the quality of each school, and distribute our academics evenly, while giving good incentives to train new ones. again, eliminate racial quotas here.
3. Treat doctors like gold-assets. Sweeten up the deal so that they dont leave the country (again, not going to happen because who needs quality gov doctors? The naive ppl who’s votes are bought in buy elections? ooo )
4. Stop sending doctors overseas. Send lecturers overseas instead to adopt the best other countries can offer, and develop a good local teaching system.
Medicine, you cant use british/irish/russian/australian systems to treat Malaysian doctors. Maybe a good start will be to integrate UM/UKM/USM with IMU/PMC/Manipal in a fair and equitable manner.
dear chillax,
i like the way u point out the prob the suggest appropriate ways to improve it. so our current tound drs lack the 1st and 2nd – basic intelligence and knowledge and hardworking and motivation as well.as for ”treat drs like assets’, its right that its not going to happen if our policy maker who never try to address the issue of drs wv gud qualities but only quantities. in my workplc, we owez joke among ourselves by calling ourselves as’dogtors’ rather than drs :p.(just a joke).
Well, if our policy-makers are really genuine in their agenda of improving the country, we should import lectures and experts from internationally recognized-institution to teach our medical graduates here.We should have a national medical academy under the ministry of health the governs the country medical training of future doctors akin to the current KKM nursing college, instead of having 30 medical schools both private and public. By having just one academy, we can carefully predict how many doctors are being trained to serve the country’s demand as well as ensuring quality and standards. Also, by focusing on just one academy, resources, R&D can be channeled and done properly.
This ideal medical academy would train all the top scorers students etc in the country (instead of wasting time and effort sending them overseas where a number of them don’t return). Impose a strict entrance exams and interview for wannabe docs who want to enter this medical academy. Have all the best professors that we can afford to teach them in the pre-clinical stages and send them all over the country general hospitals during the clinical phase and do a centralized exit exams.
Those who can’t make it as doctors ..there’s always option for them to become medical assistants. remember doctors are not technicians, we already have MAs who can do venupuncture,thoracentesis, echo scans etc, all the procedural skills u can name and they even run clinics. I still remember my consultants referring to GMC: The future role of doctors, there’s always a strong economic argument to replace doctors with nurses or MAs.
Doctors are supposed to be leaders therefore we should carefully select and train our future leaders if not our medical fraternity would be just a stupid and corrupt as our political system.
Mr. pagalavan, i respect you as a consultant who has worked many years in medical field, treating ill patients and teaching junior doctors with dedication. But this layman’s article that you brought up really tainted your blog and your charisma as a consultant. Yes, it’s just someone else’s opinion, but the fact that you’re putting it as a reference somehow shows that you do agree with this layman.
1. I have been following what is going on in the hospitals. The housemen are unable to carry out on a patient professionally as he/she lacks experience.
Come on, a houseman should have 15 years of medical experience is it? All houseman starts fresh. In the hospital where I work, first poster houseman always struggle compared to a 5th and 6th poster, regardless of where they graduate from.
2. Kursk and Ukraine or those universities that has caused it all. A CATASTROPHE.
Again blaming ukrainian/russian graduates. Come on la, this year only in HKL, almost 50% of houseman are russian/ukrainian/indonesian graduates or these so called lesser known universities. Now that we are MANY, you consultants have to know la these universities… Wake up and lets not dwell in those good old days where the excellent ones come from local graduates or UK/AUS/US universities. Times have changed now.
To keep being ignorant about these russian/ukrainian/indonesian grads are just so annoying. Some of them still thinks that the famous 5 russian universities (Moscow Kursk, Nizhniy Novgorod and Volgograd) are still not recognized. Specialists/consultants nowadays are that ignorant isit?
And yes, for first posters they do struggle a lot. But they can catch up after few postings. And I have had experienced working with locals and ukrainian/russian grads. It’s not a generalization, but i have seen russian graduates clerk more cases and takes care of more patients while the local graduates abscond for 4 hours, refuse to clerk cases, and have this superego that they’re very very intelligent.
Come on la, wake up. We are already in this system. Work with it. If wanna complain, talk to the policymakers, do not blame the houseman for their abundance in numbers or poor competency.
I respect freedom of speech and since the author wants me to publish this in my blog, I got no objection. I do not agree with all that he has said but I will always agree with one thing: there must be good and proper quality control for medical school entry qualifications and post graduation! To me, this is the main issue that the author is trying to say but of course in a layman’s way. As I have said earlier, I don’t care where you graduate from, what matters is entrance qualifications, attitude and whether you really had interest and passion for medicine. As long as you don;t have those qualities , you will never become a good doctor!
If you don’t simply agree with what the author had to say, there’s always a disclaimer. You’re a doctor and you shouldn’t have missed that so easily.
To Annoyed ex-Houseman
There are mix of good or bad lemons out there irregardless where they are trained. But it is hard to imagine those with poor SPM grades and without any pre-u qualifications are now practicing doctors in our system and they are likely to come from these ex-ussr states or some dubious unrecognized medical schools. the reason why these medical schools in ex-ussr colonies are recognized in the first place is because JPA/MARA officers are stupid enough to send students there. Look at those who graduated from China, they have to sit for MQEs unlike their ukraine/russian counterparts. Is this fair? Just because JPA/MARA don’t send students there to study medicine they have to work extra hard for MQE. Do you know the passing rates of MQE?
I’ve came across a lot of doctors who are trained from the ex-ussr states. Here is my summary
The good ones
Some of them are very good and if you pry them further you will realize that they are just unfortunate bunch with good grades and pre-u qualification but didnt make the cut (financially or disadvantaged etnically or maybe relatively mediocre grades ) to study at our local prestigious medical school or in UK/OZ (read:higher entry qualification and interview required). These bunch have the right attitude even though their core knowledge maybe poor simply because they are not exposed during their clinical training. If you train them well, they will become excellent clinicians.
The bad ones
This group of graduates are likely to come from financially able family but did not make the grades at all. They become doctors because of parental pressure or maybe they had inspirations from some medical dramas. These are the dangerous bunch. Because of the way university are runs in these vodka drinking countries, they can afford to cheat their way through medical school (you can pay to pass exams, questions are recycled, cheating is common practice) . And now they are doctors earning 3.5K from our tax payers money and think they are the exclusive bunch. A lot of em are nicompoops and sadly many of em are becoming MOs. We all know the logbook is just pure bullshit and the preferential treatment and loopholes in the viva assessment. I have seen a number in my department who dont know jackshit about the core knowledge in the posting and simply passed the viva by polishing the bosses apples and copying the logbook, not counting all the MIAs.
As I said earlier, if you look at MOH job description for medical officer you will realize that there’s a lot of leadership role too. Imagine those with poor spm results, didn’t have any college education, pay their way through in medical school, smart enough to cheat the local houseman system are now running the district hospitals and KKs. I applaud them for being smarter than all of us who studied really hard to get our grades and scholarship, go to prestigious and internationally recognized medical school and have to maintain good grades for the being expelled and now had to return to the country being subordinates under these new MOs.
If the famous russians medical school are so great why don’t Singapore or OZ list them in their recognized medical schools?
Don’t start on the EU recognition bullshit we all know that is just due to the labor law. So are the consultants/specialist ignorant? Maybe our annoyed ex-houseman is just an ignorant arrogant. You should be thankful that Malaysia accepts and willing to train you when nobody does.
An exit exam would be fitting for all houseofficers who are finishing soon and newly registered MOs. Maybe we can kick some of the from the system so that we don’t have to work with them anymore.
I was just too lazy to write a long reply like this. I think I had mentioned about this so many times in my blog but some people still don’t seem to understand! Anyway, thanks for the reply
to MN,
is there anywhere that I mention russian graduates are great? read in between lines please, don’t assume.
Please dont generalize that all russian grads are cheaters or bribers. Just because some few did that, doesnt mean all the russian graduates are like that. As I know, Mr Pagalavan also doesnt like generalization..
There’s a loophole in every system, and I had to agree there’s a big loophole in russian system. There’s also a freaking big loophole in malaysian system as you mentioned “We all know the logbook is just pure bullshit and the preferential treatment and loopholes in the viva assessment.”
Would you say Malaysian system is any better?
Exit exam? With all the so-called preferential treatment you mentioned? Do you think thats any better?
And I assume you are an MO as well but I pity you for not knowing the system pretty well. Yes, there’s no recognition of russian med schools from singaporean government. As for Aus/UK/US, they have entrance exam irregardless of where one is from, as long as the med school is listed in their system.
As for Malaysia and Singapore, I dont know why they still have this recognition list as if it’s the sacred list from the ancestors. Every country should do entrance and exit exams, no matter which med school they’re from.
If they pass, then they should be given a license to practice. If not, they’re not fit to practice and should part ways with medicine.
Yes, I agree that sadly some Mos lack quality leadership, always MIA, not knowing jackshit about all these core knowledges yada yada, but they are not only the russian grads. Some of them are local grads too. Your observation is rather biased MN, you only observed the russian grads. So you concluded some of them are good and some of them are pretty bad and you elaborated on that bad part so detailed everybody who reads your statement knows where your position is.
Why dont you make the same observation to local graduates or these graduates from prestigious universities? I would say WOW if you say local grads never cheat in medschool.
My statement doesn’t mean to ridicule specialists/consultants. But who isnt annoyed if they keep harping about poor quality houseman from russia/ukraine when some of them have proved otherwise? Please observe your local graduates closely too because once they feel they’re off the radar (as the specialists are busy condemning those russian graduates houseman), they’ll go MIA without anybody noticing.
Dear Annoyed Ex-Houseman,
There are a few holes in your argument here.
“As for Aus/UK/US, they have entrance exam irregardless of where one is from, as long as the med school is listed in their system.”
This is not true. Everyone in the US has to sit for the USMLE, even their own local students. The UK only stopped recognising Aus/NZ/Singapore in 2003 because of the EU labour laws, and started recognising all the EU degrees instead (and my British friends think this is one of the biggest mistakes they’ve made, due to the ‘quality’ of grads from Eastern Europe). Aus and NZ both recognise degrees from other countries (e.g. UK, Ireland, etc), only those from Malaysia, Indian, Russia, etc have to sit exams.
“I would say WOW if you say local grads never cheat in medschool.”
This statement implies that you think it’s ok to cheat in med school. I hope I’m wrong.
I do agree that Malaysians in general like to condemn and criticise, without necessarily telling people how to solve things. The problem here is, the issue is way beyond solving. A whole crop of substandard doctors (whichever uni you may be from – Russia, Ukraine, Indonesia, local, etc) has been and continue to be injected into our workforce. How are these seniors going to teach basics to 60% of the HO cohort? The problem needs to be nipped at the bud but the govt is taking the easy way out with the MQE. Now people who study in UK/Aus/NZ will never come back, but at the same time those who would’ve gone to Russia. Ukraine, Indonesia might opt for local private unis – which is what the politicians want cos all their kaki run these private unis. A small minority who can only afford the cheaper overseas options may still go and try their luck, hoping for the best with the MQE.
I’m a second year medical student, sorry to tell you that we couldn’t cheat in our exam and I’m sure 99 percent of us never thought of it. And you revealed the fact that you guys are allow to cheat @.@ oh my goodness, you cheated yourself in the end.
dear obviously annoyed houseman,
i’m suggesting the exit exam because of the stupid logbooks and viva assessments. clearly you haven’t sat for any entrance exams before. if you are familiar with USMLEs, AMC and NZREX you will realize how a transparent examination can be done. for your information australia still have a recognized list because they audit the recognized medical schools every 3 years and number of medical student per medical school is limited not like in russia/ukraine/indonesia/egypt where graduates are mass-produced.
the americans dont have a list due to their law of access to education. do you know that you can homeschool your children to become a doctor and coach them to pass the USMLEs and voila by law they are qualified doctors. that is how confident they are with the exams.
i assume you are from GHKL and a new mo.do correct me if am wrong. by the way i’ve rotated in various hospitals since the houseman tsunami starts. ive seen my fair share of housemans.
i’m not biased towards russian/ukraine graduates but the reason why we are currently having houseman tsunami and having this discussion is because of russian/ukraine. why are consultants and specialists making noise all over the country voicing out the same problems?
there is an old saying in malay “kalau tiada angin masakan pokok bergoyang”. in my book the prestigious local med schools are um, ukm n usm n imu perhaps uia. not the newly formed local med school.
the crux of the matter is we have too many housemans. because there are too many russian/ukraine graduates, their weaknesses seem more obvious. and having a foreign degree with an easy entrance requirement definitely would not help to remove the bias.
don’t let me start on indonesian and egyptian grads ( whom the governement have sent way before russia/ukraine) they already have given me headaches.
We should not disregard annoyed ex houseman’s perspective.. I think there is a growing number of quality doctors who are unfortunately subjected to unnecessary vilification instead of being shown appreciation for diving into the medical industry.
Let’s face it. We have a fragmented system. Instead of controlled optimized hand built crafting (think Bentleys), we have a rather crude version reminiscent of early IBM clone computers (parts from china, chips from USA, put together by some college kids in a basement, etc).
Some computers can be over-clocked to supreme speeds, while others will get killed by virus’ and poor craftsmanship.
American, British and Australian doctors are like Apple computers, we would like to think. Polished, works, and desirable.
Yet, from the doldrums of piracy, Taiwan, comes the best competitor Apple has faced yet. HTC. What they did? They took the processes they had (they were manufacturers for 02, a former british phone company), threw in a lot of ‘compassion’, ‘respect’ and ‘hard-work’, some very very intelligent design, and quietly yet brilliantly produce some of the best phones in the world, and hardly looking like Apple phones.
Generalization help consultants/specialists simply because the system prevents them from knowing the junior doctors personally. It is easy to say ” oh… you are from X university? you should be ok”.. then you see that X grad going back at 2pm while a patient collapses.
We need a SYSTEM, where specialists can get to know their junior doctors much better, so that he does not need to generalize on the quality of the doctor based on his uni of graduation.
All problems are a smart system away from solution.
I have been following what is going on in the hospitals. The housemen are unable to carry out on a patient professionally as he/she lacks experience. They are unable to diagnose the diseases. Tan Sri Dr Ismail Merican did not address the sub-standard quality of these housemen. It is a devastating issue where the present to be doctors cannot understand and identify the disease or symptoms of the complaints. – End of quote
Given the circumstances, patients, especially those who go to public hospitals will most probably end up worse than BEFORE their consultation!!!!
Only way to change this whole stupidity is to give the opposition a chance to rule.
I think the entire public healthcare system need to be changed!! It is long overdue when most other countries has already changed their system. Whether it is BN or opposition, may not make any difference. We need intelligent people to run this country.
Just to share some real stories of our housemen, unfortunately all of them from Russian or Ukrain.
Story 1:
– We wanted to teach a houseman to perform peritoneal tapping, only to found out that he didn’t know what “right iliac fossa” means!! (he pointed at his right thigh when we asked him to locate it)
Story 2:
– A medical officer asked his houseman to remove a subclavian central line. The houseman confidently said he know how to do it but the patient ended up to be referred to cardio ! He removed the central line by cutting it with a scissors and the patient had extensive bleeding.
Story 3:
– A patient with severe pleural effusion was admitted with respiratory distress. A medical officer asked a houseman whether he know how to perform a (pleural) tapping or not? Unsurprisingly, the houseman answered yes confidently. The MO then went to attend other cases. Half an hour later, he came back and saw the houseman repeatedly “tapping” the patient’s back with his hand!
Hopefully those graduates from Ukraine and Russian won’t blame us for being biased, these kind of stories frightens us. That’s why we all are extra careful when handling those graduates from these universities. But I must say quite a number of them become competent and earn respect after adequate teaching.
I don’t know whether to laugh or cry when I hear these sorts of stories (and there are many more that I have heard!)
I laughed at the beginning but feel frightened and sad later on. Yes, there are even more stories spreading around but I can’t be certain whether they are fictional. I used to enjoy teaching very much, but recently I find I may not be the suitable candidate to teach them. Sometimes I just lost my patience to start with anatomy…
dear dr.
just to let you know, recipients of scholarship are just for excellent students. most of them got 8A’s and above. my friends who got below than that didn’t ever get a chance to be interviewed, yet being sponsored the scholarship. you should take your time to read the requirements of JPA and MARA scholarship. don’t simply accuse! -.-
Of course I know the requirments of scholarship but I think you should open your eyes and see for yourself. I am not talking about doing medicine alone but for all other courses. Please feel free to ask MARA about the number of students that they have sponsored all over the world/local for various courses and you will know what I am talking about!!
Please also read this:
This is an interesting info I got from a website http://faizalfredley.com/2011/01/03/senarai-biasiswa-di-malaysia/
1. Jabatan Perkhidmatan Awam (JPA)
Biasiswa JPA ini boleh dimohon dalam masa 7 hari selepas result SPM diumumkan. Untuk JPA dan MARA, anda hanya boleh mohon salah satu sahaja dalam website eSILA. Biasiswa JPA 60% untuk bumiputera dan 40% untuk bukan bumiputera. Masa zaman saya dulu, interview JPA menggunakan dwibahasa.
Anda akan dapat 1 tajuk untuk dibincangkan dalam kumpulan selama 30 minit. Bahasa Melayu (15 minit) dan bahasa Inggeris (15 minit). Mungkin formatnya berubah, tapi saya pun tak berapa pasti. JPA menawarkan 1800++ tempat setiap tahun.
Untuk tips-tips temuduga JPA, sila klik di sini.
2. Majlis Amanah Rakyat (MARA)
Nak mohon biasiswa MARA pun guna website yang sama untuk mohon JPA. MARA hanya untuk pelajar-pelajar Melayu dan Bumiputera sahaja. Interview MARA tak sama macam JPA. JPA interview secara berkumpulan manakala MARA interview secara individu, face to face dengan 2 orang penemuduga.
Ada course tertentu hanya ditawarkan oleh JPA seperti Farmasi. Tapi jangan bimbang, course-course lain seperti Medicine, Biotechnology, Engineering, Accounting dan sebagainya ditawarkan oleh JPA dan MARA. Cuma kadang-kadang konfius juga sama ada nak JPA atau MARA.
Katakanlah anda dapat 6A1 4A2 atau 7A1 3A2 tapi anda nak apply course Medicine. Saya syorkan anda pilih MARA sebab dengan result yang anda dapat, susah untuk dapat JPA melainkan result anda 9A1 1A2 atau 10A1. Sama juga untuk course-course lain.
JPA dan MARA dua-dua ada kelebihan.
Peluang nak dapat MARA lagi tinggi berbanding JPA kerana JPA kena compete dengan semua orang tak kira Melayu, Cina atau India. Kalau anda dapat JPA, anda memang dapat biasiswa walaupun keputusan tak cemerlang mana pun time degree. Kalau MARA, ada portion yang anda kena bayar kalau result tak cemerlang. Ini dinamakan biasiswa boleh ubah.
JPA anda terikat beberapa tahun dalam sektor kerajaan. Biasanya 6 tahun kecuali doktor terikat selama 10 tahun. MARA, anda bebas untuk bekerja di mana-mana sahaja even di luar negara sekalipun.
Jika anda memohon course Medicine, JPA biasanya menawarkan program twinning iaitu 3 tahun di Malaysia dan 3 tahun di luar negara. Kalau MARA pula, 5 atau 6 tahun di luar negara.
Kalau saya, saya akan mohon MARA.
thanks for your reply. but i still don’t understand what are you saying. are you saying that even low-standard-academic-qualification students (esp malays) are still being offered scholarships from mara & jpa?
yes! Just look at Egypt recently when the turmoil happened. There were so many students studying various courses in Egypt, a total number of almost 11 000, out of which there were 5000 medical students alone. So basically, 1000 medical students for each year of medical studies. I can assure you almost 95% are sponsored students , predominantly by MARA. How many straight A students are there every year? Remember, this is only for Egypt, what about the students sponsored in many other countries, including within this country? Does it correlate with the number of students scoring 8-9As?
dear dr paga..
i’m a med student from egypt currently in my 5th year.
yes, i got scholarship from mara.(staight A’s for spm)
as u stated ..90%+ of med student in egypt are sponsored by government..let me assure you that is wrong.
there are lots of private students(malays) here which may or may not have qualification to do medicine
but i’m begging you and senior doctors..please do not generalized us.
thank you.
No one is generalising but the fact remains, majority of the students in Egypt are government sponsored via MARA, JPA., JAKIM and even Majlis Agama. Yes, there are private funded students with questionable qualifications. I also know that some of the Egyptian colleges take post SPM students without the need for Pre-U courses. Again, who to blame?
how could you be too sure that they are sponsored by mara? as nowadays only excellent & high demanding quality students are selected and being sponsored. who knows they’re from private agencies that keep mushrooming day by day?
As I said, please ask MARA to provide their stats. I worked in a private university before and I know what is happening. The drop out rate for medical students sponsored by MARA is almost 30% worldwide!!
I don’t know if there are any private students sent there, but the vast majority of the 1,000 medical students sent annually to Egypt are MARA-sponsored. MARA even owns buildings in Egypt to support these students.
As for “nowadays only excellent & high demanding quality students are selected and being sponsored” – I do not think that’s true, but I can only speak for the sponsored medical students I’ve seen overseas. I do think however that the standard has improved from 10 years ago. Having said that, I think I see the very best that get sent overseas, the not-so-good ones probably get sent to Indonesia, Egypt, etc. It wouldn’t make sense to send the brilliant students to countries like UK/Aus/NZ – they wouldn’t make it past 2nd year or they repeat 2-3 years. I’ve seen both happen.
CORRECTION: It wouldn’t make sense to send the mediocre students to countries like UK/Aus/NZ …..
MARA usually has 3 level of students that will be sponsored. The first level will be the best students which will be sent to UK/Ireland/Aust and NZ. The second and 3rd layer is sent to Egypt, Indon, India, Poland, Russia as well as local Unis!! Furthermore they have 2 type of sponsorship: scholarship and loan. However, the student need to pay only 1% of the loan if they complete the study!!
MARA and JPA sent off some of their best students to Indon, Russia, Poland and so on. It depends on your luck and how much you know about what’s going on.
The system is not transparent. Even for me who qualified to go to Dublin after my Pre-U, I was initially offered to go to India after I dropped one point short to go to Otago University. Still, my points were more than enough for Dublin becoz the entry requirement for Otago was much higher than that of Dublin. I fought back becoz I knew at that time some students who didn’t even qualify to fly overseas in the 1st place were offered to go to Dublin. By doing that, I managed to piss off some of the placement officers in MARA but in the end, I got to Dublin.
And pls don’t generalize that those people in Russia, Indons and etc are second class students. I personally know three of my friends in Pre-U whose points were enough to get them to Edinburgh or Melbourne but were sent to India + Indonesia instead while some who didn’t even score the minimum requirement managed to get to UK and Eire. And yeah, 6 years on I still blame the ignorance of some of those MARA officers in placing their students overseas becoz I had to go through administrative and academic hell to get to where I am now due to their doings. One of those 3 people I mentioned earlier was my classmate and I still remember that when I was given the offer to Dublin, I invited her 1st to take another vacant place available but she couldn’t make it becoz she was living far away in Kedah to settle the administrative process. Last I heard she’s already married with one kid and doing well in India.
Nonetheless, I am still grateful for being given the chance to study and I will repay back my scholarship. When I looked back at what happened I realized everything that has happened up to now, happened for a reason but still I cannot help but feel some people should take responsibility for what has happened.
I think the main reason why MARA seem to be sending more students to Indon, Russia and Egypt is to cut cost. They can send higher number of students to these countries with the same cost.
I m a school teacher pensioning in 5 yrs time.so u can imagine the number of students that i hv come across.do u know that i hv malay students with 8A1 n 2A2 that were rejected by both MARA n JPA to study medicine in 2005.Following that many malay students who got less than 9As dare not try their luck in medicine.So please dont simply accuse the govt n mara for the low qualities of the medical graduates.do some homework before firing.My daughter with 11A1 n many of her JPA mates with same or better results are sent to Indonesia n i bet they will be super doctors one day irregardless of where they graduated from.The incompetent housemen are those sponsored by their parents n not JPA or MARA.Blame the system but dont underestimate the prowess of JPA n MARA sponsored students
Dear Teacher,
I think you are just looking at your school students. Please also check MARA, boarding schools and agama schools as well before you make your coments. Furthermore, please go back and read what I had written, I was referring to the number of scholarship that are given for VARIOUS courses overseas by MARA and not just medicine. AND i never said that the low qualities of medical graduates is due to MARA!! The email that I attached was not written by me. Also don’t forget the number of MARA sponsored students locally and UiTM. Please check the figures than you will know what I am talking about. I have said this countless number of time: it does not matter where you graduate from, what matters is the standards of entrance qualification/pre-U to do medical courses. I am also sure you know that the standard of “A” in SPM nowadays are also questionable.
Dear doc, my son got 8A+.1A and 1A- in SPM 2010.
He went for a JPA interview to do medicine in overseas. When there was an announcement that all 8A+ will get a JPA scholarship we were overjoyed. By then he already got a place to do matriculation locally. Then the offer came from JPA stating that my son gets a scholarship to do any dgree programme locally after completing his matriculation progrramme. That also depends if only he gets a place in local university. I feel funny and confused, because i’m sure that my son is capabele of securing a place in a local university and still will be eligible for JPA scholarship then. Why JPA wanted to give now something that we are going get for sure later. in the name of all top scorer getting a JPA scholarship. When we went for an appeal, officers at JPA telling us that our goverment wants some smart students like my son to study in local IPTA. But some students with only got 4A+ (definitely not a non bumi) are sent to do medicine overseas by JPA. What a logic. I’m really confuced.
It is the reality of life in Malaysia. You just have to accept it. However, with so many medical schools in Malaysia now, it is better for the top students to stay within the country and do the degree locally. Only then our university standards will improve. If you ask me, JPA and MARA should stop sending students overseas. About “bumi – nonbumi”, I am sure you know the answer! Furthermore, there is no guarantee that your son will even get a job as a doctor after he graduates in 2017/2018!
Better a local uni than sent to Russia, Indonesia, Czech Republic, Ukraine, etc. Unless your son was denied a sure place in Aus/NZ/UK, I wouldn’t be too worried abt it.
Don’t let your straight As SPM results get to your head too quickly… you’re bound to regret it later.
Let me tell you a little bit about a MARA scholar at my university(Go8 in Aus). She failed first year and sat for a supplementary exam and failed that too.( MARA apparently wasn’t too happy and decided to haul her back to Malaysia…and guess what they put her into CUCMS. Says a lot about the quality of medical schools in Malaysia.
But my point is, don’t think your SPM results are the be all and end all…studying in an overseas medical school esp in Aus/NZ/UK is a whole different ball game, you’ll be competing some of the brightest local students as well as other international students from Singapore, Hong Kong etc
And to confused mum,
Don’t worry, those with 4A+ probably won’t make it to a reputable overseas institution anyways, or they would just end up like the MARA scholar mentioned above.
By the way, it costs roughly 200K ringgit to fund a medical student in Australia per year, so I guess that’s 200K of our taxes down the drain…
hurm…interesting comments…russian/ukraine really get a no-no from most comments I’ve read so far..even in Recom Forum!!… I have 2 friends going to further their studies in Kursk State Medical University,KSMU, Russia this sept 2011. They both have diploma in Science from UiTM with cGPA of 3<cGPA<3.5…regardless of their low cGPAs, they both have passion and dedication to serve people (as future Drs). However, it is sad and frightening at the same time about all the stuff that was said about the U. Even the students who are currently doing their MD there are saying negative things about the place..but as I agree with some of the comments, I too think that not all the graduates from the U are bad Drs as many of my seniors who are sponsored by JPA there are 10As-11As students. A senior of mine who is currently taking her first year of MD in KSMU confess that there are some students who bribe the lecturers for academics purposes…BUT not ALL!! However, it all depends on whether the future graduates from Russian/Ukraine will be able to perform well or not after that. Of course, I believe that those who graduate with sheer hardwork/dedication will have better adaptation to the local Malaysian hospital compared to those who graduate by cheating their ways through it..I just hope that both my friends and seniors won't get involve in corruption..hee…I hope they all can prove themselves worthy of being a Doctor when they graduate and not be look down to just because they're from Russia Medical U.. I wonder how things will be 5/6 years from now (which is apprx the time they will graduate from KSMU)…hurm…
Luxor, your comments are insightful. The vast majority of students who score 9 A’s or more will do well wherever they end up. However, if one has graduated from an institution that allows its students to bribe their way through the course, the integrity of that qualification is flushed down the drain. Even if Ahmad, Ah Beng and Arumugam say they didn’t bribe anyone, who’s to say that the lecturers and clinicians at that med school are not equally incompetent and reckless in other aspects of standard-setting? I have also heard stories of bribery at the Eastern European medical schools. But our govt agencies are still sending students there so there is no chance of MMC derecognising these unis. A sad state of affairs, really.
here is some interesting stories,,doctor who is consulting my dad (having stroke now) was previously my dad’s student in secondary school,,he dont want to become a doctor,,in fact he didnt know he wanted to be..he told me how he messed up himself during interview (im not going to tell bcoz its personal),,how poor he was during med school,,how he was so blurrrr during HOs,,
guess what,,now,,he is one of neurosurgeons in Malaysia. 🙂
consultant/specialist/PG saying MOs are no goods,,and everyone’s saying HOs are no goods,,tht showed da true colour of mentality of ‘living in the past’..that we’re still living in period of ‘seniority’..
i’ve talked with senior doctors,,n some of them brave enough ,put their ego aside,,admit tht theyre also ‘not that good’ during their early career,,its experience that make them evolved..so why slating the new budding doctors with very little experience n less exposure,,sound like they’re so useless n didnt deserve to be a doctor? like they’re never gonna be good/better doctors
im calling all of senior doctors to stop living in the past,,
if im comparing myself to my younger brother because he’s using mobile phone as early as primary school,,thts not right,,bcause it just meant to be like that.
its like an old man saying to you that the new generations are bunch of lazy bcause they’re using cars to travel instead of cycling n walking,,use machine to doing works instead of barehands…is it fair to say like that?
so doc,,while i enjoying reading ur blog n respecting ur level of knowledge,,i would like to challenge you to make a blogpost about yourself during ur HO in ‘most honest way’,,by meant the true story about ur HO life..
of course this is ur blog,,so its up to you to accept it or not..
take it or leave it..
you take it,,you gain no cent but you’re going to awe many eyes who read ur blog
but if you decide to leave it,,you loss no cents,, but hm,,i thought u’re not that good either indeed 😉
I think you got no clue of what I am trying to say in my blog. Of course, everyone learns from experinece but what experience are you going to get when there are 100 housemen in each ward!! Secondly, housemanship is not for you to learn how to take history, do physical examination and coming to a diagnosis. These are things that you should have learned in medical school. Housemanship is for you to sharpen these skills and learn how to manage these patients. As one consultant mentioned in a meeting : we are not here to teach you medicine! Thirdly, in the name of experience , how many patients are you going to kill? when you don’t even know how to read ECGs and interprate CXR? or don’t even know what to do in acute pulmonary edema or hyperkalaemia?
As for the example that you gave above about the neurosurgeon, first of all, what was his entry qualification? Doing poorly in medical school could be because he was not interested in medicine but he could have been an intelligent person to start with. Later he had no choice but to do something in medical field in order to survive since he is already a doctor.
Lastly , since you insist that I must write something about my housemanship, here we go! I do not want to write about it because people will say that I am boasting but since you insist. My first posting was medicine in Ipoh Hospital. My consultant : Dr Padmini who is a Haematologist (BTW she can still remember me). For 3 months I was kept in the same ward by her and she refuse to let me change the ward. I was single handedly taking care of all her chemo patients on top of the medical patients. Remember, those days there were only 3-4 HOs in each ward of 40 patients. I had to beg her to allow me to change to another ward for the last 1 month. During calls, I rarely call the MO and if I call, the MO knows that something is not right. I learned my first CVP line insertion at 4am in the morning! I use to do Bone Marrow aspiration almost on a weekly basis.
My second posting: Surgery. I use to do on calls 2 days in a row at times. Consultant : Dato Kandasamy ( in IMU now) and Mr Sarkunathass ( Ipoh specialist now ). No problems and I never had any problems diagnosing anything and the consultants also had no problem with me eventhough they know I don’t like surgery.
My 3rd posting: O&G under Dato Sivalingam (in IMU now) and Dr Rajesh ( in UNIMAS). Did extremely well. Dr Siva challenged me to do a study on maternal weight gain. I completed the study on the last day of my posting titled ” Average maternal weight gain among the 3 different races in Ipoh Hospital”, after 3 months of data collection while I was still doing housemanship call etc etc. The paper was supposed to be presented at the Perak scientific meeting but I was transferred out to Johor by then. Dato Siva was impressed that I actually did the study. However, O&G was not my field.
Transferred to Pontian hospital for MO. Use to read blood film slides myself to diagnose leukaemia because if I send it to JB, will take atleast 1 month to come back. I remember a lab tech told me that I was the first doctor to do that! I even do CVP lines, Chest tubes, excision of lumps and bumps etc etc in the district hospital. Got my MRCP Part1, sent to JB hospital under Dato Velloo. I was put incharge of Dato Velloo’s ward. He trusted my management so much that he hardly comes to ward for rounds unless I call him! Did rotation in nephro, chest, neuro etc etc. Each department wants to make me their trainee but I declined and chose rheumatology.
You see, I can go on and on telling my life story but still I will tell you that the quality of graduates has gone down the drain ++++++. If you can’t even take a proper history than what kind of doctor are you? I have given all my consultant’s name, you can counter check if you want.
b_o_d,
Your assessment of the current situation using analogies of mobile phones and grumpy old men is very far off the mark.
I remember clearly when I was new doctor, and I’m sure most of the people who read this blog remember their experiences. Sure, there were lots of times when I did not know the answers to things (I was a pretty average student at med school) and I always had a competent senior person (registrar or specialist) I could call to guide me if needed. BUT:
1. I could read an ECG – or least identify dangerous rhythms/changes
2. I could handle the initial management of medical emergencies – i.e. important things to do before seeking help and advice
3. I could recognise the unwell medical and surgical patient
4. I was diligent in performing my duties
5. I was not lacking in the basic understanding of the postings I went through
6. I could perform basic skills (e.g. IV line insertion, ABG collection, history taking, examination, urinary catheter insertion, etc)
In short, my medical school provided me with an adequate education that enabled me to perform at the required level. Not super high performing, but enough to function without causing harm. Now, you have medical schools accepting poorly-performing students, then tolerates them bribing their way through some assessments. Of course you’re going to end up with doctors who don’t know things! And the education of other students there are also compromised by the activities of staff like that (they might be irresponsible in other teaching activities).
Some of the stories I’ve read in this blog about incompetent doctors are absolutely shocking – people like that should not be practicing medicine. I myself have seen an MO in Ipoh during an elective a few years ago do a lumbar puncture on someone without any skin prep or gloves on – even as a medical student I could recognise that this was wrong.
I absolutely agree with you, that experience makes you a better doctor. What it does is reinforce what medical school has tried to teach you (no one remembers everything from med school). Since you were so fond of analogies, I’ve got one of my own:
Let’s talk about commercial pilot training. Experienced pilots are better than those with less experience, no doubt about that. When they were less experienced, they may have made some mistakes but usually irrelevant or easily correctable ones because before they’re even allowed in the cockpit, they would have had teaching in the classroom and/or the simulator about physics, aircraft mechanics and aeronautics. If they don’t get these basics right, they will be DANGEROUS when allowed into the cockpit. Some of our doctors in Malaysia are now dangerous because of their medical school education. And to make things worse, they can’t even get the experience and teaching needed from senior staff because of the glut of new doctors.
great blog!
b_o_d,
With your clear conscious, would you allow your family members to receive the treatment by those poorly-trained graduate when your family members have some life-threatenig conditions?
If yes, I am concerned that you may have a bad relationship with your family members?
If no, is it ethical to let the other patients to become guinea pig? Don’t forget our ethic on equity and do-no-harm.
Nobody would like to talk bad things about those housemen unless something goes very wrong. If the problem is not rectified, public will soon lose trust on our profession.
Dissatisfaction …. express it !! I’m the best ….. just show it !! I know everything … it’s true? I can say anything …. but i can’t do it :(( Defensive ….. blaming others…. ummmmppp, something not right !!!
Keep it up !!!
U know what,,u hv a job.. Just live wif it.. And u should be grateful..cz ur a malaysian..( I dont want to be racist) but in India,,i dont think tht d govt is kind enough to give subsidies, scholarships, free textbooks,1malaysian concept..and other privileges etc. Pfft,, ur so funny,, bumis privileges are stated in perlembagaan.
What does race have to do with this? Comparing India to Malaysia just because Dr P’s ancestors were from India is like comparing Indonesia to Malaysia when addressing any greviances a Malay might have (80% of Malays can trace their ancestry to Sumatra, and some to Java).
Bumiputra priveleges are written in Art 153, you are right. It says that there are privileges with scholarships, training, business licences. It does not say that rich bumis shold get 5% discounts when buying million-ringgit properties or that bumis should be promoted purely on race (especially if there is a more competent person for the job). In fact, there is a specific provision in the constitution that says civil servants must be treated equally regardless of race, which obviously is not happening.
Apartheid South Africa also had racist policies written in their constitution. Did that make it right?
I think you really don’t know what you are talking about and you do not understand what I am trying to say. Go back and read carefully! AND who says that India do not give subsidies, scholarship? Pls go to each country and see what their citizens are getting. 1 Malaysia concept?? what 1Malaysia?
Discrimination is not going to get you anyhere? Is there anywhere in the Quran that legitimises discrimination and special privilage? Remember, GOD is watching!
1Malaysia??
Oh my… muahahahahahaaaa….oh stop it… hahahaha…gawd, I think I burst my spleen laughing!! Help!!
Dear Dr Pagal,
I graduated from a medical university in Bandung Indonesia in 2008. Just so u know, i did all the things that u were boasting about during ur HOship, during my clinical years in Bandung! I even managed to conduct deliveries, perform vacuum extraction and forcep assisted deliveries, just as an intern. Please do not underestimate Indonesian graduates.
FYI, pls go back and read my blog and see where did I say anything about any graduates from any particular countries being incompetent!! The letter above was NOT written by me. I have said many times that I DO NOT care where you graduate from as long as you have genuine interest in medicine, have good entry qualification and willing to work hard!
I am sure you are aware that there are many universities in Indonesia. There are good ones and bad ones same like anywhere else including Malaysia! BTW I just heard of a graduate from Bandung who is on the verge of quitting as he is unable to cope!!
you have written tonnes and tonnes of articles regarding the surplus of doctors, unqualified doctors, yet no advice is given in regards of how such a doctor should cope. i wouldnt be surprised if a doctor who happens to be in this predicament might just decide to kill himself after reading ur blog. u should be supportive too u know.
p/s: i just heard last month of a UM med student who threatened to jump of a building cause he was unable to cope with the pressure of exams..
cheers!
Again, if you do read all the comments in each of my blog entry, I had given enough advise to junior doctors. You need to know the problem before finding a solution, right? That is what all the info in this blog is about. When you realise the problem, you can find the solution yourself. There is a lot of solution given in my blog entries if you care to read in between the lines.
You don’t know me personally and thus I don’t think you know anything about how many junior doctors that I have helped before! A lot of the info I enter in this blog is based on my experience dealing and helping the junior doctors!
Yes, in every well renowned universities, there will be students who develop psychiatric problems! It happened even during my time in UM.
BTW, what have you done to change the situation? I was active with MMA and had helped to improve the working condition of the doctors even when I was a MO!!. Do you know that the current promotion the doctors are enjoying was single handedly written by me in 2006 and submitted to Minister on behalf of SCHOMOS??
Humble, it must be one of the most unfair comments toward Dr.Paga. If the young doc-to-be does not have insight regarding his/her own ability and cannot cope or handle the pressure during medical school/housemanship, the young doc-to-be ain’t going to be fit to be a doctor. That’s reality.
Dr.Paga would be wrong if he chooses to support those incompetent doctors to continue on their journey because these doctors are going to run into bigger and more serious trouble later on in their career and worst of all, endangering many patients’ lives.
To cope with the surplus of doctors is to be the best among the best. The famous quote “Survival of the fittest” is very much applicable to this scenario. Hence, if one does not have the intelligence and passion to be a doctor, he/she is better off pursuing a career in something else.
Humble intoned: i wouldnt be surprised if a doctor who happens to be in this predicament might just decide to kill himself after reading ur blog. u should be supportive too u know. i just heard last month of a UM med student who threatened to jump of a building cause he was unable to cope with the pressure of exams..
Just as well that student discovered his inability to cope with the stress of examinations early on. At least now he knows that medicine is not for him and an early change of career is indicated.
If an undergrad cannot cope with the stress of exams, then it does not bode well for a future career in medicine. Postgrad exams are much sterner tests, have much higher failure rates and require substantially more in-depth knowledge. And one has to get through these whilst working a full time job that is both physically and emotionally taxing.
Dear Dr Pagal,,I am a student who is about to go to Egypt, my SPM result was good but apparently not good enough to get a scholarship for MARA or JPA to study overseas in medicine and so I decided to use an Agent and go do my pre-U in Alexandria Uni. What are your thoughts on my actions ?? Because I’ve heard many say that better study medicine locally than go to Egypt and so forth.
If your SPM results are good, why don’t you do Matriculation, STPM or even A-levels? Why do preU in Egypt? I know that Egypt can accept you into medical schools with just SPM results but I don’t think it is the best way to enter medical schools. Have you got your NOC yet? You must understand that by the time you graduate, there will definitely be surplus of doctors. Self sponsored students will likely have to compete for post.
As a medical specialist, with doctors under me, I find most Russian and Ukraine graduates are really efficient. Many are better than many locally trained doctors. Cheap medical fees to study medicine does not mean that there is no quality education. It’s even cheaper to study medicine in China. And I have worked with many Chinese medical graduates. They are exceptionally efficient. There shouldn’t be any prejudice here. Right attitude, experience, hard work and willing to explore and learn make a good doctor. Not from which institutions they has graduated from.
Dr Shamsul
As I said, it all depends on the type of students who go there to do medicine. There are good students and bad students.
Dear Dr Pagal,
I was very fortunate to have the opportunity to study, gain employment, and sub specialize in a western economically well off country.
many procedures eg chest drain, central line etc are carried out at specialist level in this country. for example a central line will be put in by an anaesthetist, a chest drain by a respiratory physician, and a temporary pacing wire by a cardiologist. These procedures may be done by an Ane doctor in the extremely acute setting, but that too usually a very senior doctor ie senior registrar and above.
Housemans job is paper work. Mo’s job is clerking patients and informing senior team if worried. Senior team generally accept it as fact that one is to be called and it is unacceptable not to see patients when junior team is worried.
All this done in the interest of best patient care.
I have not worked in malaysia but get the impression from blogs that the houseman are very much left on their own to learn and carry out, if not done properly, possibly life threatening procedures.
Certainly if there is concern that underqualified stuff are roaming the ward, focus should be on identifying loop holes in our horsemanship training programs. Mentorship programs should be done with view of very close ( perhaps even 1:1 supervision for long periods of time. Underqualified docs should be given a chance to be thought the malaysian way to achieve expected standards, however upon completion of these mentors hip programs and a trainee is deemed unfit to practice the Mentor should reserve every right to recommend the trainee not fit for further practice. This however should only be done if the trainee has been thought properly.
Perhaps there are two sides to the coin. Are the people who are supposed to be teaching younger doctors not doing enough?
I humbly come back again after 3 years to see how are matters going on in Malaysia regarding poor recruitment for medical studies. How is this going to be solved? Why is MMC, MMA, Kementerian Kesihatan allowing such weaklings to study medicine? We demand for good doctors. Not for doctors who study medicine with weak SPM grades and INSTANT NO OBJECTION CERTIFICATES. They did not work hard in secondary schools. They failed in all exams. And yet they become housemen prowling around the hospital with their stethoscope coiled on their necks. The MMC has given them green light to masuk into the Giovernment hospitals. So they stroll around for few years. They stuck in the hospitals for donkeys years because they cannot complete their horsemanship due to lack of practical knowledge. The parents ego of having a few doctors in the family is a trend. They have the money to pay out lavishly to crook agents to make their son or daughter gain a medical seat in recognised universities in any part of the world. It is better for MMC not to allow those who do not excel in the science subjects to approve them to gain a place in the government hospital. Firstly they are not qualified to do medicine. How the Hell they become doctors. the Malaysian public should call them Quack Doctor. There is no reason to feel pity for these unqualified to come in with degrees. Let them be male and femaile staff nurses at least. They will excel in it and guide their experienced doctors. Lives will be easier for the real persons who are deemed fit in this profession. MMC should strart digging out from the Minsitry of Education to review the SPM results of these unprofession doctors who pass out with false NOC. This is mimicry to the profession. How can MMC allow such methods. Say NO to those who did not make it in the science subjects. Let them become nurses in the hospitals they can do better then to be a doctor and get suffocated and call it mental strain. These unqualified doctors should suffer mental strain because they are not qualified to be in the hospitals. A lay person can feel it why not MMC get the message through. WOW parents pay the agents to get a medical seat. Look at the advertisements. Public get carried away. I surveyed the educational booths. Its Time Kementerian Kesihatan, MMC, MMA pull themselves up and realise that this noble profession is taken over by hapazard unqualifed cheat
doctors who did not excel in science subjects at all. ……………………………….
Annoyed citizen
In Malaysia, money talks. Politicians are only interested in making money. Try looking into all the medical schools locally and see who are the directors etc
Nice and informative post.
Hi Dr Paga.
Have been following your blog for quite some time.
But I think sometimes to certain extend some of your comments are rather too racist with political motivated.
Can’t you be more constructive in building a harmonious relationship among all.
Thank you.
If you do not know the diagnosis, how do you treat? Making a diagnosis is what you call constructive critism! Unfortunately in Malaysia, when a diagnosis is made, people say it is politically motivated, racist and even foreign country interference !