Some times, I wonder whether our DG knows what he is talking about http://www.thesundaily.my/news/209582. Does he know what is happening on the ground? Firstly, we do not have enough specialist to supervise all these housemen. Secondly, many of the HODs are not interested to extend the training of the housemen. They do not want the headache of doing more paper work. Thus the saying is ” get him out of my department, no point extending as it won’t make any difference etc etc” I must say that these HODs are selfish and one day these same doctors will land up in your department! This is one of the reason why you see almost 95% of the HOs passing out, on paper! HODs are not just bothered as long as the HO is out of their department and not their headache anymore. Only very few HODs conduct exit viva and proper assessment of housemen. Many of the HODs who use to extend housemen are not in MOH anymore, either retired or left to private sector.
I really don’t know what our DG means by training ! There are just too many housemen with too few specialist to supervise. The shift system only makes the situation worst by even less supervision as mentioned in the letter below.
I think the DG should go down to the ground and find out what actually is happening, rather than listening to the politicians. A common entry exam or an exit exam after housemanship may need to be implemented.
Continuous efforts to improve housemanship training
Posted on 16 November 2011 – 05:07am
I REFER to “Sub-standard housemen” (Nov 8). The Health Ministry appreciates input provided on housemanship training. Continuous efforts are being made to further improve the training programme of our housemen which is conducted in 41 accredited government hospitals.
Among the objectives of the programme are to further improve their knowledge, clinical experience, attitude and ability to carry out treatment procedures in a safe and competent manner. They are trained for a minimum period of two years in six major disciplines – internal medicine, paediatrics, general surgery, orthopaedics, obstetrics and gynaecology, and emergency medicine or anaesthesia, with a minimum four months in each discipline. The majority of our houseman are competent as more than 95% completed their posting within the stipulated time and a good officer will be able to complete training in two years.
On the other hand, to ensure the quality of medical graduates, the Malaysian Medical Council has set the standard in recognition of universities offering medical programmes locally and overseas, while the Malaysian Qualifying Agency and the Higher Education Ministry ensure these universities conform with standards set by the governement.
Datuk Seri Dr Hasan Abdul Rahman
Director-general of Health Malaysia
Shift system ill-defined
MUCH has been said about the standard of House officers in Malaysia lately. Most of the write-ups have been rather negative.
As a doctor practising here, I have a few points to share. A patient who came to my outpatient clinic, asked: “Dr, I hear your trainee doctors from (this and that country) are not performing. Are they qualified to treat patients?” I just smiled. A colleague recently said: “I wouldn’t send my family members to doctors with MBBS/MD from (this and that country).”
Many more are extremely concerned about the performance of housemen in this country, as are parents who spend hard-earned money to put their children through medical school.
Media write-ups are gradually tarnishing the image and future of these young doctors. I agree there is much to be done to improve the training system, including filtering “sub-standard” medical schools, improving the lecturer to student ratio in universities etc. We should now at least concentrate on improving the knowledge and performance of trainee doctors.
We are seeing a trend among patients to select doctors based on which country and medical school they graduate from. There is a worrying trend of patients losing confidence in doctors trained during this period of time. This in future will have a psychological impact on the doctors themselves, causing them to lose confidence in medical practice. Remember, they spent five to six years in medical schools recognised by their own country.
Having been through the houseman system here, I should know – it was very hard indeed. The ministry’s policy of running houseman-ship training on a shift system now (fewer working hours) aimed at improving performance, might be a popular approach, but to me, is ill-defined. We can’t expect results when you compromise on the number of encounters with patients, doing fewer procedures, following fewer ward rounds with specialists and attending less CME (Continuous Medical Education). On the shift system, house officers have time, in fact, plenty of time. We should offer them re-training, re-introduce the MQE (Medical Qualifying Examination), and most importantly, early specialty training. Incentives should be given to those taking the initiative to study and obtain a post-graduate degree in a specialty. This will encourage self-improvement or at least, improve basic medical knowledge. Incentives of RM600 might be popular, but we don’t expect results.
Finally, I strongly think we should take a better approach to discussing the quality of houseman in this country.
Doctor with recognised degree (hopefully respected)
Kajang
Pagalavan's Avatar 
Got question to ask….medical graduates from which country have poor performance during housemanship?Is it from public universities in Malaysia,USA,Canada,Ireland,UK,Australia,New Zealand,Egypt,Russia,Indonesia?Which one?
Does the performance really really correlates with the universities?
How about performance of medical officers,specialists and consultants in this country?Are they really good?
It does not matter which university you are from but the most important thing is:
1) good Pre-U entry qualification and not some dubious foundation studies etc etc
2) a genuine interest in doing medicine for what it is and not for glamour and money
3) reputable university which obviously take only good students with good results as in (1) above.
Generally, a poor performing student in SPM or pre-u will become poor performing housemen. That is what I gather from years of my personel observation. Those good students who do not perform are those who do not have interest in medicine.
Soory to say but most of the good consultants get frustrated and leave to private sector.
They have really messed things up for the next decade or so.
Decades…………. You mean!
Actually all got bad ones.
Why pick a certain ones only?
Isit discrimination cos we didnt get As in STPM/Pre U?
Or some of us from Arts Stream?
Hey we are still a doctor even if we come from (this and that country) !
Please treat us with Respect also regardless where we from.
It is not discrimination if you did not get As in pre-U. It is a reflection that you may not be academically up to the mark to become a doctor, which is why you have ended up in Ukraine because no reputable medical school would have accepted you.
Not everyone who goes to Ukraine/Indonesia/Russia are academically incapable. Some are there purely because they cannot afford to go anywhere else even with good marks. Those students will tend to do better but it is still difficult to make up for 5-6 years of poor university teaching.
If you come from the arts stream, you can still do medicine but it is more difficult because you have to learn basic chemistry and sometimes physics again. Unless of course you were in the arts stream because you were not good enough to get into the science stream – then what I wrote in the 1st paragraph applies to you too.
I will treat you with respect once you earn it. Just because you are a doctor, whether you have graduated from UK, US, UM, Ukraine or elsewhere, does not mean that you automatically deserve respect.
A “doctor” on paper not necessarily a doctor . You need to earn that ! Noawadays, you can even buy a cert!
I know of 2 unis in India that offer that service=P
With more than 200 med schools in the country, this definitely could happen. I have heard of ppl paying off for their compulsory internship service, just to get time to prepare for the PG entrance or USMLE, and I have to say that this is not uncommon at all. Bribery and corruption is so severe here to the point that the previous MCI (Medical Council of India) committee were dissolved and the president was arrested for accepting bribe.
My college itself was derecognized by Singapore Medical Council because of the MCI issue. (The chancellor refused to pay MCI to maintain the recognition and brought the case to the court).
KW to be truthful and honest, can you be certain that the training in your medical school is carried out properly and so called foreign students (like yourself) are subjected to vigorous training as per their own russian students?
I have heard on double standard when coming to teaching and training of medical students in russia, where often the foreign students are neglected. I can’t confirmed it, but this is what has been told to me by medical students from russia who are attached with me for their electives.
RESPECT?? just because you are a doctor you want to be RESPECTED??
WHY? Are you a Doctor to serve or TO BE SERVED??
A clear reflection of your mentality. Instead of ASKING for respect, go and earn it.
Reflect, how have you improved.
I failed my 1st year in Med School despite getting an A my entire life. But that failure was necessary for me to reflect on myself. Today, I am a 3rd year medical student. My knowledge is far more than the HO in the hospital I learn.
However, I never want to be respected. I just do my job, my service, my obligations and perform better each and everyday. Medicine is my life. I go on DAYS in the wards. I hunger for knowledge. DO you do that?
RESPECT isnt what we are here for as doctors. OUR MAIN GOAL is our PATIENT. Even if u cant treat always, u can definitely CARE.
I’ve seen, HO in Seremban who shout at patients. Not surprised where they graduate from. (ukraine/russia/indonesia) Some of these nut jobs even pass on to become MO. To me, even if your medical knowledge is poor, there is NO REASON to have a poor empathy to your patient.
WHY ARE U A DOCTOR is an important question you ask from the first day of your medical life. If you graduate from these so called ‘useless’ medical schools, YOU SHOULD BE GRATEFUL because you have soooooo much to PROVE to others. YOU have sooooo MUCH to work and improve yourself.
Do not condem your fellow colleagues from ukraine and russia but show them the right way.
I wish you all the best in your medical education. just remember, once you start studying medicine there is no end to it.
regards.
Dr David Quek’s speech on similar issues. Interesting to read his perspective on how MMC accreditation occurs.
http://myhealth-matters.blogspot.com/2011/11/standards-of-medical-education-in.html
I am surprised that Dr David Quek’s statement that
“In June this year, house officers are no longer employed as permanent service civil servants, but instead as contract workers. Thus, their forward service as automatic medical officers would no longer be guaranteed. ”
and
“Already, recently, the Health Ministry and Public Services Commission have asked the MMC to seriously reconsider the necessity for compulsory service for our medical officers”
IF the compulsory service is scrapped off. Then I think when these group of young doctor come to public sector (can’t stay in government), because of lack of experience, most employers (private hospital / chain clinic / private clinic) won’t hire them.
IF they open up their own clinic, it won’t survive well because they have not enough experience (to manage and detect the emergencies (medical/surgical)) and competition as well. And when mistake happened, you may get lawyer letter and suit will follow.
Still complaining of long working hours where this is the time you get and learn experience?
Still complaining that government job is no good? Or you rather jobless than working in the government?
I think the storm is hitting as soon as you expect. By the time you are realized, it is too late and you are already jobless.
the mind of a ‘complex’ house officer.
enjoy.
http://afizaazmee.wordpress.com/
its more like he’s confused….
She?
There’s a difference between being “confused”, expressing opinion, or just simply not being from an english speaking background.
Chillax why do you allege the blogger is “complex” and by that are you trying to be sarcastic? I’ve had a look at the link and found nothing out of the ordinary… it’s not like she’s delving into epistemology or things like that. She’s blogging about day to day life. What’s wrong with that?
Read past the grammatical inaccuracies and you will realize that she is actually raising some valid points.
From what i read on the blog, sounds like she’s an australian graduate (likely government sponsored) who had returned to malaysia to do her internship.
Not everyone is from an english speaking background. To look down on others based on their level of proficiency in language is unbecoming of any member of civil society.
Which medical schools in this country are considered as having high standard of medical graduates?
This is very subjective as there is no real measure to compare graduates except thru anecdotal evidence.
There are some better medical schools but I would find it hard to say that there is any medical school in Malaysia that has a “high standard of medical graduates”.
In my OPINION, these are UM, UKM, USM and IMU (I include IMU because they are extremely strict on their entrance criteria – you need AAA or AAB in A-levels to get in these days). Other people might think otherwise. Many will also think that the medical school they went to is the best, rightly or not.
IMU has very strict entrance requirement. Their clinical training is so strict and vigorous. I even heard IMU clinical students are better than some MO’s in Seremban Hospital!!!.
Is it true that the IMU requirement is that high? I have heard of a student who got BBC in A levels was offered a place in IMU and now she is doing the clinical phase in UK. In fact almost everyone in my class of A Levels has got a seat in IMU, some left to join Monash after getting the admission. I myself rejected the offer of local program as I thought the degree wont be recognized anywhere else.
IMU use to have strict entry qualifications. That’s the reason IMU graduates in early 2000 were good. However, due to stiff competition from other medical schools now, I heard they have also lowered their intake criteria.
IMU has strict requirement?maybe that’s something new,…
Entirely plausible that IMU’s entry requirements have gone down since there is increased competition now. BBC was the minimum in the late 90’s, then AAB about 4-5 years ago. Website now says BBB.
4-5 years ago they were getting 500 applicants with minimum BBC (or BBB) for 200 places so realistically only students with minimum AAB were getting in.
yea Nav you are right. the minimum requirement was about BBC 5 years back. And i can still remember the first question during the interview was “we have about 500 applicants this time, what is special in you that would make us giving you a place?” But since everyone was applying with the forecast result(which is apparently better), I have heard of only one student got rejected, and she was offered the place again before the start of the semester, as a lot of students had turned down the offer, many used it as a backup while waiting for admission into better med schools.
Yes, 5 years ago the number of medical schools were 50% less then what we have now!
As an IMU student I would say, they have VERY high standards.
I was always the top student right from standard one till pre-uni.
I failed my first year in IMU. However, that was required for me to mold my medical life.
Today I understand what is my purpose here. To SERVE at my BEST. Principles I follow.
1. Medicine is more of emotions and art rather than science.
2. Medicine is EVER GROWING. So keep abreast of the latest news.
3. Medicine is a team effort, from studying to learning to practicing.
4. Having knowledge which is important to promote, prevent, treat and care any disease is a must.
To all those, medical students who think being a Doctor is glamorous, ask yourself these simple question:
– Will you sacrifice your time for your patient?
– Will you care without prejudice?
– Will you except criticism and IMPROVE on your weakness?
– Will you admit that you are NOT PERFECT?
– Will you treat a patient with LOVE AND CARE?
If you cant do all these, then its best to find another profession.
Regards,
3rd year medical student, IMU.
Use to be UM/ukm/usm but I heard even their standards are dropping.
Based on what criteria have made IMU as having HIGH STANDARD?Isnt all private medical schools are interested more in money?Look at the application fee and the course fee…Any opinion?
what about Monash and NuMed? their school fees are so expensive..
You are paying for their degree. Going to Monash Malaysia or NuMed does not equal doing your training in Monash Melbourne or Newcastle upon Tyne. Their home/parent unis have very high standards. I am not saying their Malaysian branches don’t have high standards – I’m just saying I highly doubt they are the same (again, only my opinion).
Monash is expensive because they have Australian Medical Council accreditation. Out of 60+ students who graduated this year, only 9 are going to work in Malaysia. The rest have got a post in Australia and most likely will not come back.
NUMed is new and can’t comment much about their quality. However having GMC recognition is of no value as no other countries have accreditated and recognised NuMed.
Whetever said, their standards is no where near the main campus in their respective countries.
to Nav,are u in your postgraduate specialty training?
Just finished my specialty training. Doing a fellowship now, specialist post starting in 6 weeks.
are u in surgical field or others?
Others
Nav, you have my respect sir!!
Based on what criteria have made IMU as having HIGH STANDARD?Isnt all private medical schools are interested more in money?Look at the application fee and the course fee…Any opinion?
I think it is base from the performance of the graduates they produced. Even though not all of them are excellent. Their system of teaching may produce 75% average and above doctors (This info was from the talk given by their lecturers). The teaching system was first developed by USM and was brought into IMU by Prof Mustafa Embong if I’m not mistaken.
Seldom I heard from my friends they complained about IMU graduate.
Letter wirtten by an MO about the attitude problems of current housemen:
http://thestar.com.my/news/story.asp?file=%2F2011%2F11%2F27%2Ffocus%2F9978991&sec=focus
KBU claming that they are having a collaboration with IMU. By studying foundation in Science in KBU you can get into IMU’s medicine course. I don’t know how true is this but I know that IMU usually don’t accept student from those fancy foundation course.deteriorating standards??? I think so…
I would always suggest a more well recognised Pre-U course if you want to be more secured. Pls do not do some dubious foundation course which is not recognised elsewhere.
Usually IMU is quite strict on their entry qualification.
I totally agree with you that DG should go to the ground to do the field work rather than just listening to the politicians.
The previous scandalous DG was so into his Hepatology….and setting up so many opp for GI teams. Current DG is not so outspoken…but a hard working fellow. However, I hope the Dato Hassan, LTL and Rosnah understand that Public Health is MORE than just the Dengue Fever….There are so many issues to tackle in Public Health which need the commitment of all stakeholders…..