The statement “Housemen need to practise their specialties at district level as there is a lack of specialists in district hospitals,” he said after witnessing the signing of three Memoranda of Agreement between the ministry and Universiti Tunku Abdul Rahman (Utar) here, yesterday.” really made my day!!
If what the reporter has written is the truth, then I am speechless, in thinking what type of Health Minister this country has! Since when housemen became specialist and can provide specialist services in district hospitals? We already have some below par medical officers mismanaging patients in these hospitals without supervision and now we are going to let Housemen to manage this patients? As I said earlier, our current DG is just a puppet to the politicians. Our previous DG had better guts to say NO but was thrown out! I will let the email below to say the rest:
Hi Doc,
The muppets at MOH have done it again! (see linked article above) How do they solve the glut of HOs? Simply create more HO jobs! MOH have just accredited 22 district hospitals to complement the 41 hospitals where housemanship can already be done. The problem is, these 22 district hospitals do not have enough specialists! Where are they going to get them from? You can hire 500 from Pakistan/Bangladesh/Egypt but there are no facilities at these hospitals for specialist services (e.g. theatres, beds, radiological equipment, etc).
Liow Tiong Lai justifies it like this: “Housemen need to practise (sic) their specialties at district level as there is a lack of specialists in district hospitals”. IS HE MAD? How can they ‘practice their specialties’ when there are no specialists to supervise these house officers? Are the MOs going to supervise them? It will be a case of the blind leading the blind.
I am seriously at a loss for words. There is no doubt that many district hospitals in Malaysia should be upgraded to allow specialists to practice there. But this cannot practically happen overnight. Bed spaces and operating theatres do not magically manifest themselves. It takes months to years to plan service upgrades. Once all that is in place, especially the specialists themselves, then HOs can work there. Problem is, the govt has already shot themselves in the foot by allowing all these med schools to mushroom and also sponsoring hundreds of students to med schools overseas (1,000 to Egypt alone each year).
One more thing: LTL mentioned that the current capacity is 6500 housemen, increasing to nearly 10,000 with these district hospitals. Personally, I don’t believe that number because it probably includes departments with 60-100 house officers when there should be only 20-30. Even if we accept his figure, the number of house officers per year is conservatively projected to be 6,000-7,000 by 2014, which means we will need 12,000-14,000 houseman places. Good luck.
p.s. Feel free to post my rant on your blog
63 hospitals to train housemen
By QISHIN TARIQ
qishin.tariq@thestar.com.my
KAJANG: A total of 63 hospitals are now available to universities as a training ground for medical students, said Health Minister Datuk Seri Liow Tiong Lai.
The ministry has added 22 district government hospitals to complement the 41 hospitals currently hosting housemen undergoing practical training.
Liow said the 63 hospitals would be able to host nearly 10,000 housemen, up from the current capacity of 6,500 housemen.
“The chosen hospitals will be able to give better service with the addition of more staff and in return provide facilities to train medical students.
Good practice: Utar nursing lecturer Liew Siew Fun giving a briefing to Liow along with others during his visit in Kajang yesterday.“Housemen need to practise their specialties at district level as there is a lack of specialists in district hospitals,” he said after witnessing the signing of three Memoranda of Agreement between the ministry and Universiti Tunku Abdul Rahman (Utar) here, yesterday.
The agreements would allow Utar degree students in nursing, physiotherapy, biomedical science, biochemistry and microbiology to be placed at one of 13 government hospitals or eight health clinics.
Meanwhile, Liow said the Traditional and Complementary Medicine (TCM) Bill would not be postponed any further as all the relevant parties, including TCM associations and practitioners, had been consulted.
He said once the bill was passed, the industry would be registered under a council and regulated, just like doctors.
“Practitioners can be held liable if they do not give proper treatment to their patients,” said Liow, adding that the Act would also cut down on fly-by-night TCM practitioners.
Ayurvedic, homeopathic and traditional Malay medicine practitioners would also be regulated under the Act.
Liow said the Act would not only regulate and enforce the industry but also allow the ministry to officially fund research for evidence-based TCM treatment.
Pagalavan's Avatar 
i believe not so long ago, in a consultant conference of an esteemed field of medicine, almost all of the head of departments in hospital around the Malaysia had stood up unanimously and agreed that the number of house officers is over the top and they should all stand up and allow only a fixed manageable number.
Yet, almost a year from that day, none of them actually stood up for their frustration for the system and the vision for a better medical fraternity. Reason behind such timid inaction is really still everybody’s guess, but my best bet on the fear of jeopardizing their salary hike or the promotion or the JUSA their aiming for in the near future.
now, instead of researching into the feasibility of making the house officers training into shift system, which can help expose them more clinically while at the same time, save the government from the bloated house officers’ on call claim (2-3 times more), the ministry attempts to put house officers into district hospitals, because of lack of specialists. In other words, the medical officers will have to act as the acting specialists, and the house officers the medical officers. Anyway, no matter how one puts it, it doesn’t make sense.
with the mock moratorium together with this HO in the district hospitals fiasco, i hope the seniors of the fraternity can really stand up and make something solid out of it.
Our future generation depends on it.
Do it now…. better late than never…
Are you surprised? How often you see the politicians getting treatment in government hospital…unless emergency.
Most if not all…seek treatment in overseas. I recall a former CM in the northern state went all the way to south-Singapore to get treatment.
Ironically, the doctors who treated him are from Malaysia.
Another prominent ex-politician went more south to stay…Australia. Perhaps, he still need to pay some $$ for treatment…he chose to come back during a festive season in order to get FREE treatment in Malaysia. Eventually, he was requested by MACC for further Inx.
Another ex-minister went to Australia for hair implant…also by Malaysian.
The Doctor in the House went to Australia for an event hosted by Malaysian students but ended up getting treatment for lung infection there. Upon discharge, he received visiting nurse to his place to monitor his progress. Guess what?? Our friend said…this system is good. Should be implemented in Malaysia. WTH…After more than 2decades, he didnt know tht until this MERAWAT sambil Belajar trip.
Anyway, his visit was quite fruitful compared to Kill Toyo’s Disneyland trip.
So..tell me…does it matter to them if HO play specialist role in district?
The district hospitals in Sabah and Sarawak are white elephants.
Many hospitals are being managed by less than 10 doctors during my time.
I call upon those YB to really serve the nation..rather than keep serving their own cronies.
GOD BLESS THIS COUNTRY~!!!
i cant foresee what type of dr i will be in future………….
Muahahahahaha! As ever, Malaysia (apa-apa pun) boleh!!
DG LTL shows his inaptitude yet again! So the solution to a lack of specialists in district hospitals is to have HO’s practice their specialties there?? WTH?
It used to be said in medicine, “See one, do one, teach one”.
So is this now going to become “See one, do one, teach 150”?
Or maybe “See none, do one, teach 150”?
I’m glad I’m not ill…
There is no easy short term solution to the problem of excessive numbers of medical students (and HO’s). And no effective long term solutions appear forthcoming given the amount of self-serving political meddling going on higher up the food chain.
The effective solution is to cull the herd and ensure quality by limiting the number of HO places to only as many that can be trained effectively. Competition is a hard but effective way to get the best candidates. No one ever promised that a medical degree guarantees a career in medicine. And with the number of graduates coming through, there will certainly be increasing numbers of medical degree holders who will have to choose careers outside of medicine in future.
No matter how many doctors are produced by any system, there will never be an excess of good doctors. There is even less chance of producing good doctors if training is inferior.
There is a very simple solution, but none of our politicians will be willing to enforce it. Make all fresh grads sit for a single qualifying exam, maintain the maximum number of HO posts that the system can accommodate for good training and only let the best of them take the HO posts. The rest of the cohort either take the exam next year or forget about medicine and find another job.
One of my friends recently told me that a certain fresh grad from an eastern european country was exempted from HOship because his parents were sufficiently well connected. that is to say he had the license to start as MO as a fresh grad. Is that even true or possible ? If that is indeed true, what next ? Fresh grad be appointed consultants if parents are sufficiently connected ?
WTF?!! Able to skip HOship due to cables and connections? Mind sharing some more? I thought you need the signatures of specialists from all 6 rotations and a review by MMC to pass HO and the person is from Eastern Europe whose quality is questionable. I bet not even a Cambridge/Princeton/Harvard grad dare to go around as an MO right after graduation. Nobody does. Such an irresponsible act will no doubt put a lot of patients in danger as long as the person is still practising.
Malaysia boleh mah……………..
I would agree that a single uniform qualifying exam for fresh grads is a good idea. And no exceptions no matter which medical school you graduate from (otherwise, more political wrangling will go on to get a particular medical school exept).
Also, I cannot see why government hospital appointments in Boleh-land need forever remain under total control by MoH (more self-serving political control yet again).
In the UK, government (ie: National Health Service) hospitals are responsible for their own appointments. It is up to the human resources team of each hospital to make the job attractive. And all jobs have to be advertised nationally and appointed by means of an open competitive interview.
So if no one wants to come work at your crummy district hospital (or your poorly managed, holier-than-thou central teaching hospital for that matter), then it is up to the management of that hospital to implement changes so that the top candidates will apply to work there.
Open competitive models are harsh, but they do bring out the best in those who really want to succeed.
Regarding the graduate who got exempted from HO, I would find that hard to believe (though in M’sia, anything is possible given enough political ties). Even if this was offered, I think said grad would have sh*t him/herself over the prospect of going straight to MO! You can only cheat the system so far before your own inaptitude is found out. Funny how this doesn’t apply in Malaysia politics… but that would be going off-topic.
The time will come for a common exam as the government will not be able to sustain the cost of employing everyone. OR they will just coperatise all hospitals and HO have to apply for a job in these hospitals.
AS for the VIP case, I don’t think so unless the graduate has done housemanship somewhere else before coming to Malaysia. If it is true, then I am speechless again…………….
The future might be worse than we think. Traditional assumptions about a career in Medicine are:
1) job security
2) reasonable financial returns
3) training and career progression is assured
There are no guarantees for these; never have and never will. Even if past history might suggest otherwise.
When there are too many medical graduates and not enough jobs, then the law of supply and demand means that employers (in this case MoH) will be able to dictate terms to their advantage.
There is nothing to prevent MoH creating a whole load of dead-end service oriented jobs designed to staff hospitals without the need to provide good training and a progressive career pathway.
So say hello to jobs such as a 6-8hr rotating shift with a 5-day working week pattern designed entirely for service delivery on a lowly paid salary scale. “Not interested? Never mind-lah. Outside the door got another 1500 applicants. NEXT!!”
Jobs like this exist in various healthcare systems all over the world. (eg: “staff grade” or “associate specialist” posts in the UK).
Yes, the time will come.
LTL needs to get treatment for his “mad”ness. Full stop period.