I read the news below in today’s Star and I began to wonder whether this will be the fate of our doctors in the future. I was informed that MOH has already started to give contracts for housemanship. This basically means that after 2 years of housemanship, there is no guarantee that the contract will be renewed for MO. This puts you equivalent to a temporary teacher under contract and the same problems will occur. Most likely, the contract will only be renewed on you accepting where you are going to be posted, as the number of post is going to be very much limited. E.g: if MOH asked you to go to Limbang, Sarawak as a MO and you refuse, MOH will not renew your contract which basically means you are jobless! You also need to apply for a job in government sector after housemanship.Of course, government sponsored students will be given priority.
As David Quek mentioned in his speech (http://myhealth-matters.blogspot.com/2011/11/standards-of-medical-education-in.html), SPA is asking MMC to remove the compulsory service so that the government do not need to provide a job to you after housemanship. There are a lot of implications if all these comes true. Firstly, an inexperienced doctor is not going to be a good GP. With litigations rate going up everywhere, these doctors will not survive with the public demand. They will be sued all the time. Secondly, if you do not get a job in civil service, you can forget about postgraduate training and applying for Master’s. At this point of time, only training in government hospitals is recognised. Even if you get a contract job, it does not mean you will be posted where you want to. Your training can still be compromised. The way I see it, there is going to be a lot of chronic medical officers in near future with little post-graduate opportunities. This is when your basic medical degree recognition is going to be very important in finding a job/postgraduate training somewhere else in this world.
Even Academy of Medicine Malaysia is very much worried about postgraduate opportunities in near future. Residency style training is being considered to shorten the training programme and produce specialist faster but this need to be carefully deliberated. It’s implication to our healthcare system also need to be considered as not all our hospitals are equipped with all speciality.
Soon, the title of the news will be “Temporary doctors protest unfavourable terms in contract!…………………..”
Temporary teachers protest unfavourable terms in contract
By KANG SOON CHEN
educate@thestar.com.my
KAJANG: A group of temporary teachers protested outside the Hulu Langat education district office over new terms in their service contracts.
They claimed they were at a disadvantage with the new terms.
Under the new contract, their salaries will be reduced from RM2,500 to RM2,300 and they will not receive allowances or EPF contributions from the government as of next year.
The terms, effective Oct 15 this year, also pointed out that the teachers had to return the allowances and EPF paid to them for October and November.
They were also disgruntled that they would not get paid for the December school holidays.
“It is unfair,” said the group’s spokesman.
“The terms of the new contract overwrite the earlier one that we signed this year and that was supposed to be effective until the end of the year,” she said, adding that they would lose their jobs if they failed to comply.
“There was also no guarantee that we will be absorbed into permanent positions.”
In March, Education director-general Datuk Seri Abdul Ghafar Mahmud announced that 6,000 of the 13,000 temporary teachers were ready to be absorbed as permanent teachers.
Deputy Education Minister Datuk Dr Wee Ka Siong said the ministry was working on a solution to end their predicament.
Earlier, he had said the government’s decision to absorb temporary teachers into permanent posts had resulted in insufficient funds to pay their salaries.
Pagalavan's Avatar 
I dont think residency training style is suitable in Malaysia as it will likely lead exactly to same situation to over-production of doctors. If that were to happen then Malaysia will have up coming specialist that has low qualification
how la malaysia!!
im mara student..we dont have complsary service like jpa student..nooo!!..how i want to become doctor after grad!!help me dr paga..huhu..
Well, nothing special of becoming doctor soon. It is just like any other job, go and look for a job
or end of as direct sales
This is our deepest fear in the future and it is very likely to happen in 5-10 years time. We may end up like pilots in Malaysia where only 5 out of hundred able to secure a job after graduation. If unable to work as medical officers, these junior doctors will end up becoming drug representatives, insurance agents etc (I am not joking), since they won’t be able to survive competitive GP practice. Sooner or later, doctor will lose the respect of the society and there is the demise of this once noble profession in Malaysia…
Well, it has happened in other countries like India, Phillipnes, Vietnam etc. Why not Malaysia?
If they were to implement housemanship on a contract basis, wouldn’t they need to scrap the 2 year service following? I think that the government would have a tough time scrapping the 2 year compulsory service. If they did, could there be an acute shortage in government hospitals when the MOs leave en masse? Anyway, save Singapore and a few other countries, most aren’t picky about medical schools – just as long as they’re listed in the WHO directory. They have their individual medical licensing exams anyway to filter out the bad apples. And even countries like Singapore still accept a “higher” medical qualification, say MRCP.
Removing the compulsory will definitely come, and no, it will NOT cause any problem with government hospital, since the posts are (or will be) all filled. Except for those with good quality, marketable qualifications, the bulk of graduates (that will include the russian, egypt and indonesian, most of the indian, and most of the local private and gov graduates) will get stuck, and find themselves out of a job.
As for sitting and passing licensing exams, if you think you can sail through them, you are mistaken.
as for other countries ‘not picky about med schools’, can you give an example of one where msians may want to go work in? how many russian/egpytian/indonesian grades actually want to stay back in russia/egypt/indonesia to work? (even if they can, which they cannot).
JK you may be wrong!. What will happen is: incompetent doctors will quit practise and look for job in some other sectors like insurance company, drug company, business etc simply because incompetence will make life very difficult for them. It will be very painful and embarrassing to face fellow doctors who are competent and worst still to face educated patients – they may go into depression!!!!
Why should they quit when they get paid at the end of the month? These incompetent doctors will NOT quit but will enjoy all the benefits they get in gov sector. It is already happening.
I don’t think so. Where are these MOs are going to go? The private sector is not lucrative as you think. Many who open GP clinic over the last few years are not doing that well. So, majority will stay on in government service as you will still get paid at the end of the month whether you work or not. The reason why they will scrap the compulsory service: so that they don’t have to give a job to every doctor!They can just say: find your own job after housemanship. The job availability in civil service will be on availability of post. The input will be greater than output!
WHO directory is of no value. It just says that such a medical school exist in such a country. Sitting for qualification exams are not easy. IT is also very costly. Even if you pass the exam after spending a lot of money, there is no guarantee that you will get a job. If I were to spebd RM 500K sending my child to a medical school, I will definately look for a well recognised uni.
First of all, I think we’re mixing up all the categories of doctors into a large conglomerate. After graduation, there are competent doctors, and the incompetent. As for the incompetent ones, frankly speaking, no one really cares for them anyway. They might even give up medicine all together to set up a business when going gets tough in the sector. If the government decides to “chase away” all the incompetent, are there really so many competent ones left?
By the way, how is the government going to decide who are they going to “keep” after HO? By default it’s the scholars plus the public uni grads, but there’s really not enough of them in the first place isn’t it? That’s why the government started this whole learn medicine craze – because what we HAD weren’t enough. So maybe there would be a qualifying exam after all – after housemanship that is.
And Doc Paga, if a university is not listed in WHO, a graduate from there can’t work anywhere ELSE. If you do a check on other countries’ requirements for the eligibility to sit for their licensing exam, you’ll find that they don’t really care where you read medicine. Just as long as your school is in the WHO list, you can sit for it. Reason being, talents can come out of anywhere. Oh and when you mean “recognised uni”, you do mean it as it concerns Malaysia right? Because this term does not exist almost anywhere else – like I mentioned, “recognised” means being on the WHO list. Besides that, it really isn’t 500k anymore. More like 1 – 1.5 million now, as compared to 250k all expense included in Russia, Ukraine, Egypt, Indon… etc.
I think you don’t understand how our civil service work. There is no way an incompetent doctor can be removed from service. No matter how incompetent they are , they will remain in service unless they resign by themselves, which would not happen most of the time. So, the government cannot “chase away” the incompetent ones untill they retire at the age of 60! In civil service, the more incompetent you are, the less work you will get but the same pay.You will understand what I am saying once you start to work.
When the government started this craze, there were only 3 public universities with medical degree. Now, we have 12 public unis, each producing about 200 students annually, totalling atleast 2400 graduates. There are about 1000 JPA scholars and almost 2000 MARA scholars all over the world and locally. Annually, the resignation rate for MOs is less then 1000. Lately the numbers are even smaller as many are comfortable in gov sector and being a GP is not lucrative anymore.Also remember that 50% of 36 medical schools in the country are yet to produce graduates! So, if even now there are already not enough post to sustain, what more in 3 years time? WE are running at positive balance and it will not change. Soon, government scholars and public uni grads are enough to fill up the gap of resigning doctors. YES, I do agree that they may introduce an exit exam after housemanship to decide who are going to be choosen like the PTD officers exams.
Again, I would say that being in WHO registry is no big deal. Any medical school can be listed as long as they apply for it. Yes, I know that only when you are listed, you will be able to sit for the entrance exams in respective countries. When I said RM 500K, I am talking about some local medical schools which charges such a high fee when it is not even recognised elsewhere. IF they are only producing graduates for Malaysia, then the fee should be much lower!
P.S by the way, Perdana, Cyberjaya, NUmed and other newer ones are not listed on the WHO list.
They are not listed because they DID NOT apply!
Sparks, I think what Dr P means is that being on the WHO / Avicenna list is no big deal. A medical just needs to submit their application and they are in. The criteria is not hard to meet, and can be found here:
http://avicenna.ku.dk/uploads/policy_medicine.pdf/
Being on the list allows one to sit the USMLE, PLAB exams etc.Why some of the schools you mentioned aren’t on the list? Someone should ask their admin.
That exactly proves my point, Nav. I am trying to say that there really isn’t an issue about “recognised” or “not recognised” or “reputable” or “not reputable”. In the end of the day, it is all whether you can pass the exam or not. Other countries in the world know that if you can pass their exams, it means you’re up to the mark. If a graduate from Cambridge failed to pass USMLE, he can’t work in the US.
This whole thing about how reputable is a university is an ingrained Malaysian mindset, who tries so hard to push himself up by pushing others down. I’m still a student but I was disappointed when they ditched the MQE idea. Having it would have separated med grads into only 2 categories – competent and incompetent.
I see your point Sparks and agree with you. Most rational-minded people support the concept of the MQE, if you could guarantee fair and transparent implementation (I wouldn’t trust one run by one of the public uni medical faculties).
The utility of having a medical degree that is ‘recognised’, is that it makes it a lot easier to do postgrad overseas, in a time where training opportunities in Malaysia are severely limited.
I think you don’t get Dr. Letchumanan’s point. Medicine is a very competitive field. Everyone with a medical degree can apply and sit for a board exam, but whether or not you get a job, it depends on your qualification (and your uni’s reputation can have quite an impact), i.e., training experience, publication, references, performance during job interviews etc. Plus, even if the uni is listed on WHO, if a country does not recognise medical degrees from a particular university, you can sit for all the board exams in the world, and you will still not be eligible to apply for a job.
I think only MOH sponsored doctors are affected.
MARA and UiTM doctors can always return to Uni to be lecturers.Not that worrying.
These days even non Bumi also applying into UiTM as trainee lecturers…..
So…can u say it is NOT 1Malaysia?
Would UiTM accept non-Bumi students? If NO, what 1Malaysia are you talking about? They accept trainee lecturers because they are short of lectuerers!Soon UiTm will also get saturated if all MARA sponsored students get into UiTM. How many doctors can the Uni support?
Who funds MARA? Ultimately, the tax-payer. And 90% of personal income tax is payed by non-Bumis. Yet, we have a publicly-funded university that restricts intake to one race only. They had similar universities in apartheid-era South Africa. So no, this isn’t 1 Malaysia.
Nav, they don’t disclose the percentage of tax payers base on race. See http://teresakok.com/2007/08/14/pertanyaan-atas-hasil-pembayaran-cukai-individu-mengikut-pecahan-kaum/.
So 90% is not accurate.
Ed, I was quoting Dr M from a few years ago. Am guessing he had the right info 😉
I dont think doctors will protest as what the teachers did! Teachers are much more united and have trade union unlike doctors which somehow no political power and ill-informed and the mindset is “follow the flow” as they are too busy with work.
U know the result of the protest that almost half of them is absorbed as permanent civil servants…
No offense doctors, but it’s indeed a reality. Just last week I read an article from poor doctor in the Star saying no one is representing doctors’ welfare.
MMA did but the doctos themselves were not interested. Now, they are deregistered!
“These days even non Bumi also applying into UiTM as trainee lecturers…..
So…can u say it is NOT 1Malaysia?”
pedigree and eloquence, at its very best.
Whatever dr pagal has mentioned before is already affecting senior doctors including new batch specialist. Starting from this month for new specialist who just passed master final exams from local uni (exam november) needs to do gazzettement for 18 mths instead of 6 mths. Im not sure about mrcp or mrcog but this is the latest new i’ve just heard today. Im not sure whats their agenda but my speculation is that government want to delay the promotion of mo from u48/52 straight to 54 as they want the for election!
I heard it is still 6 months but you need another 1 year of service before being able to apply for subspeciality. For MRCP etc, it will be 18 months gazettement and another 1 year, meaning 2 and a half years. Correct me if I am wrong. Basically, the government just wants you to serve longer so that they can utilise you in district hospitals etc before you go for your subspeciality. The number of post for subspeciality is also very limited as theere are not many trainers available in MOH.
Dr. Paga,
Are you referring to similar FATE for doctors, your heading
mentioning faith is misleading.
Thank you very much! Did not realise it! Too many things in my head when I wrote this piece.
You are most welcome. I enjoy reading your posts, very informative and
the feedback interesting. Thank you very much for taking time off from
your busy schedule to keep us all informed.
TO related person,why dont you trust the MQE run by one of the local governmant public medical university?Whts wrong with the MQE conducted?
Of course Bumiputera need to be given priority no matter whether 1MALAYSIA or not..Thats the privilege for the Bumiputera,amendment in the constitution..Other races should not question that,learn history,understand and take lesson from it
What is so important about recognized degree internationally for somebody who dont even plan to work oversea?Almost all royal college membership can be done in the country..Once somebody has it,go on to work anywhere or oversea if that person still have the thought that everything from the WEST is the best which is undeniably wrong ok
Why did the cabinet shot down the idea of MQE for all medical graduates then? What are they afraid of?
I think you are the one who should read history, I mean the true history and NOT UMNO’s version of history!
You are wrong. NOT all membership exams can be sat here. For all surgical field, Master’s is the only option! So, if you don’t get a post for Master’s then you can forget of becoming a surgeon in whatever field. With globalisation, being a jaguh kampung is of no use!
How come everytime there is a talk about quality control for anything, the phrase “Bumiputera rights have to be protected” comes up. I really don’t get it. A doctor’s competence has nothing to do with his bumiputera status whatsoever. Would my Bumiputera friends go to a substandard bumiputera doctor for advice, just so “Bumiputera rights can be protected”?
My distrust of local public uni medical faculties stems from stories told to me by colleagues who went thru UPM, UM, UKM about 10-15 years ago. Essentially, before an exam, their Muslim classmates would get called to the surau for ‘doa’ the night before the exam and get given the exam questions or answers. Some of my friends were sharing rooms with them and saw the handouts themselves. If this sort of hanky panky was taking place so blatantly, there’s no telling what else could be going on. Admittedly, this was 10 years ago and I have no idea about the situation now.
The Malaysian govt sponsors many students who should not be doing medicine, based on their academic acheivement (or lack thereof). A (fairly-implemented) MQE for everyone will inevitably result in some of these sponsored students not making the grade so the govt basically shot down ex-DG Tan Sri Ismail Merican’s request for the MQE.
Yes, what you said happened when I was in UM. Mostly during preclinical years.
What do you mean by jaguh kampung only?You are here in this country..to treat people in this country,so what’s the point..does someone with fellowship ( FR something ) too different with those specialist without FR something?In fact,those with Master postgraduate training can still sit for fellowship recognition if its too important to be recognised for the sake of name,proud and popular
Does having fellowship (FR) too significant?Is it for fame and proud?
Most doctors should purify their soul to face the reality of becoming a doctor.Those doctor who are working in the government,they face a lot of challenges compared to doctors in private sector..
From the nation’s history,its the fact that Bumiputera party fought for independence..wht is so different?How many version of history this country have?People should learn,understand and take lesson from history
You are talking with emotions rather then your brain! Is there anywhere in this blog did I say that Master’s is inferior than a foreign postgraduate degree? It is more about opening global opportunities when you don’t get a post over here. In 3 years time when doctors become jobless, will you say the same thing or will you start looking for other alternatives? Ask yourself!
Again, please read the real history about independence and not UMNO’s version. What do you mean by fought for independance? The British would have given independence anyway as they were going bankrupt! Pls read proper history! If the British were not here to fight the communist, the country would be a communist country! UMNO could not have done anything! You got a lot to learn! BTW, who were the agents that sacrificed their life to beat the communist? The chinese community!
Dr Paga, don’t la. You might end up in jail. We need you to continue informing the Rakyat about the realities of healthcare in Malaysia.
In any case you, I don’t mind running the blog for you haha..
you are welcome.
lol Chillax has his/her point. Dr Paga remember you are in Malaysia.
I cant comment much on Royal’s comment because it is really hard for me to understand what he is trying to say.
Probably he is a priest in Malaysia that doesn’t speak good English *purify my soul*
To those of you who are having problems, what my good friend ‘Royal’ is trying to say is
” Is someone with a fellowship (FR something) so very different from those specialist without FR something?”
” Is having a fellowship (FR) very significant? “
Yeah i kinda get what he is trying to say, but thanks for clarifying=P
But I am confused – how can you be specialist if you do not have “FR something”? Or do they go through the “master” pathway? I heard its mostly research and no hands on for those who went through master. I could likely be wrong with this info as I have no idea how Malaysia system allow doctor to be specialist without fellowship. Doesn’t that sound similar to physician assistant trying to be doctor?
Frankly speaking Master’s was a very good postgraduate programme when it started. The failure rate were almost 50% in 1980s and 1990s. Then again, politicians began to get involved and wanted the universities to produce more specialist and pass everyone who enrolls. So, the quality started to go down the drain. The selection process is bias and the results are manipulated. Even if you fail, the senate can pass you at the end of the day. Most senior professors are no more. Some local unis can give A/Professor to a person who had just published 5 papers, even conference publication is accepted!! Now, we have surgeons who can’t operate even on simple hernias!
The Masters system is an absolutely valid way of becoming a specialist. As someone with a background in medical education, I can tell you it is superior in many ways to an external postgraduate programme like the MRCP, FRCS, etc.
The problem with the Malaysian masters is that their selection process is not transparent, the qualified lecturers are no longer there (any joker can beome an A/Prof) which means teaching is not as good as it should be. Some specialties are still ‘strong’ because they have retained staff while some have gone down the drain. The duration (4 years) is ok if they are exposed to whatever they need to be during that time.
The Masters system is favoured because certain public unis have a monopoly on it and the govt controls the universities. A postgraduate college would be an independent body, out of govt control (which is why parliament passed legislation in the 1970’s to allow only unis to deliver post teaching despite the fact that some colleges in Malaysia had already set up training programmes ready to be implemented).
Fellowship = Recognition by a group of specialists. It’s like them saying, “hey, you’re one of us now because your skills are up to standard”.
If your mother were sick, would you want her to be seen by a fellow of a reputable collage (association) of specialists from the appropriate field? Who’s knowledge and skills have been certified by other specialists?
So now ask yourself. Is a fellowship significant? Would you rather your mother be seen by a specialist with a masters if you knew that the selection process was non-transparent (ie. people getting in by pulling strings/nepotism/corruption/politics)? What if the teaching standard is not very high because politicians decided to up the numbers? That’s what the whole fuss is about. Fellowship exams have very low pass rates… could that be said about the masters?
The fact remains that one is internationally recognized while the other is not.
Everyone fought for independence. Independence was over TWO GENERATIONS AGO. So stop glorifying your grandparents and look to the here and now. What they did was great but it has NO IMPACT ON THE ISSUE BEING DISCUSSED.
Personally i find the term jaguh kampung a bit racist, but Dr Paga was pointing out a valid point. There is a real good reason for having international recognition of your skills in any field, especially if you are going into a subspecialty somewhere down the line.
Hahaha.. the comment thread is hijacked by Pro-Bumiputeras. Hidup BN!
kepada royal.
mula datang cerita MARA…pastu cerita bumiputra..plak. apa menda la komen ni.
orang tengah bincang pasal health system dekat msia la bangang. asal ko nk rasa offended plak…memang jaguh kampung since 2000s. tanya ar dato2 datin2 HOD yg dh buat fellowship overseas. tanya derang.
memang bnyk kelemahan dlm negara ni sbb affirmative action gone wrong. policy bagus ..implementation tarak….ko tgk civil service nye blueprint whitepaper n stuff …semua bagus top notch. dtng kat politician..buang dlm tong sampaj..jahanam .
well said anakmalaysia
to anakmalaysia
What a crap stupid “bangang” words have you spoken in this blog!!!!Use suitable words to comment.Use your brain rater than blank emotions.It shows a bad dubious attitude
To chillax,its not ” wells said “, its a bad said
Use your brain rather than blank emotions
Nothing “bangang” about his words. He types using colloqiual Malay txt-speech. Easily understood. And I agree with what he’s trying to say. Of course, ATTITUDE (or anyone else) is free to disagree.
seriously whats with the ‘tude? I don’t get you. What were you offended with? The ‘content’ or the ‘presentation’ ? In any case if you are not happy about the ‘presentation’, i thought it was spot-on. If you’re not happy with the ‘content’, then you’re damn lame. seriously, how much do you all get paid to ‘defend the cause’ ? 1 dollar per blog post?
Im sick and tired of all this cybertrooper rubbish. The thread was doing well until jokers like Royal, Attitude, etc have to come up with some respect and emotion-related issue. You all sound like little whiners.
This is the bloody health system we are discussing. Put YOUR emotions aside and think about it. Someday, you’re going to have a son or daughter, gasping for air because of an asthma attack at 2 a.m, and I swear to God you won’t give a damn about anything but your childs health. Guess what? Lets hope the medical officer in the ETD does not decide that nitrous oxide and ventolin are interchangeable.
guys im not saying u cant disagree with Dr P, u can disagree but do take care of ur manners…do give constructive critisims where it can help all of us and not the other way round. we still need experienced people like Dr P to let us knw the reality of msian medical healthcare out there..for sure things are going to change in the next few years
Thanks for your comment. People don’t like to accept reality nowadays. They want to live in their own world when the rest are moving fast.Almost 2 years ago in this blog when I said doctors will become jobless, many people cursed me. Now, it has become a reality.
Dr Paga,
I am a semi-retired layman and enjoy very much read your blog.
I do agree that the standard diagnosis and treatment in the government hospitals has a lot of room for improvement, more so today as compared to yesteryear. I have experienced doctors in Orthopedic clinic who could not identify radius and ulna correctly. My close friend died because MO failed to diagnosed ESRF despite being warded for almost 5 days. These are basics and I expect our modern docs to know them like the back of their hands. A doctor who cannot master basic O level physiology has no business treating patients. These are theoretical knowledge that can be gained anywhere, even at home, so absolute no excuse will be entertained.
We could all strive to make a better Malaysia but if the government keeps creating entries through the back door for some selected group based on some out-dated untenable doctrine and affirmative policy, the standards will keep on sliding.
There are some noble people who has infinite patience in guiding the many not-so-skilled HOs, but this is the exception rather than the rule. How many people can swim against the tide and win in this real world?
The medical profession is not only a numbers game. Quality if of paramount importance but this is not a priority for this current crop of leaders. Making $ is. How else can we explained the fact that we will soon produce more fresh medical doctors than Britain?
It is dereliction of duty on the part of the MOH and other relevant authorities to allow so many potential half-past six medical graduates to be produced and sadly as you pointed out, once being a penjawat kerajaan, the iron rice bowl stays no matter what.
Keep on writing Dr Paga. I am sure many have benefited tremendously from your writings. We might not agree on everything. We are human after all, but we MUST agree on the main issues. Only the trivial ones can be safely left “un-agreed”
Thanks for your comment. My duty is to make people realise the issues that we are facing. Medicine has become a comodity for businessman to make money. Society is to be blamed for this. The government just want to see the numbers. Probably 1 family 1 doctor philosophy!
I am lost for words …1 Malaysia or not… the whole education system in this country needs a revamp
The education dept need to see
are we educating the future of the country correctly
are the students chosen to do medicine fit to continue and do medicine or any other course for that matter
I am foturnate I belong to the old generation of
i remember some of my teacher who have become examples for me to follow
Dedicated doctors who wanted to work hard. Not merely take but give to society
I am not sure what is it now???
want to make a difference, we need at least 8-10 good medical bloggers to group up, and make a change. Fearless in criticizing the present state of affairs.
I dare say the biggest cause of political change in our country over the last ten years can be attributed to four websites – Malaysiakini, Malaysia-Today, Malaysian Insider and Free Malaysia Today.
Its time we have http://www.malaysianhealthsystemkini.com or something
I’d say viral facebook campaign, with true stories (de-identified of course) posted by reputable people.
The important thing that everybody here should remember is that if you like to criticize others,be ready to be criticized.
Everything that we say and do comes with responsibility
No body here said that they are not willing to be criticized! this is what you call intelligent argument to find a solution. If you don’t know the problem, how are you going to find a solution?
An eye for an eye makes the whole world blind…Mahatma Gandhi. We can have disagreements but lets do it through dialogue, not confrontation. This is a blog about medical issues, so let’s keep it that way.
I am truly worried about getting treatment from government hospitals and it has nothing to do with Dr Paga’s blog. It is from my own experience. In my younger days, all my family get treatment from government hospitals and we never doubt the competency of the doctors. Of course there are always bad ones but they are few and far in between.
As I am getting older, it seems the front liners in OPD and A&E are not competent anymore. There was even a case where a Nephrologist removed a patient(a rather problematic pt who had problems controlling his fluid intake) from dialysis and almost condemned him to death. He had to go begging etc and but finally readmitted to the dialysis clinic. A few days ago, I was told the A&E was not manned because the docs has gone off for prayers. Well, one can argue that it is only 10 – 15mins and there are HA and nurses around.
This sorry state of the excess fresh doctors must be rectified soon. Let’s help Dr Paga in this mission. Totally agree with Chillax that more medical bloggers are sorely needed. POTS is one of them.
I can understand your worry. But normally OPD & A&E got most of the complaint like this because they see most of the patient in the community. The problematic doctors are seen everywhere.
I don’t think that the A&E was not manned as you mentioned because you were ‘told’ of it. You were not in the situation. So you should not ‘amplify’ the ‘rumor’. I will suggest you go and work in OPD & A&E for 6 months before you make your comment.
A&E and OPD turn around rate is high, so indirectly it is hard to control their MO quality. Because of the rumor and certain amplification of the rumor among doctor, A&E and OPD do have not so good reputation and young doctor are reluctant to go there.
Indirect reason is A&E and OPD has not ‘market’ value because private hospital do not offer such vacancies.
In fact, their are the backbone and important front liner of the health system. My experience told me during ‘SARS’ time, the ward doctors are required to be manned in the A&E and because of this order, some MO resigned in 24 hours.
I’m saying this is assumption that doctor do make mistake (whether big or small) on every 5% of what he/she is seen.
A&E will see around 200-300/day (average) – 5% mistake = 10-15 pts
Ward doctor (e.g. medical maybe 20-30 pts/day – new cases) – 5 % mistake = 1 to 2 pts. But patient in the ward will be seen by few doctors as well, so mistake can be covered.
That is why we see less complaint for the ward doctor but if the complaint arise, it will be a more serious complaint.
The same go with the specialist level as well as consultant. By the time reached consultant level, the patient has been seen by various level of doctors so the chances of mistake escaped is pretty low.
Do you ever resuscitate 5 patients in a row from night till the other morning?
Do you ever seen at least 50-60pt in a days?
Do you ever scolded by the patient and bad one is the VIP relative (because often they misuse the system) and many others?
Everybody make mistake even up to consultant level as well as private specialist. We seldom see because the issue are quickly covered.
hi dr,
i’d like to ask you, actually, doing housemanship for 2 years is one of the studying medical course or not? if im not mistaken, so we gotta learn all the theories for 2,3 years only? and all together is about 5 years. or i am wrong ?
Wrong. Housemamship is after you complete 5 years of undergraduate medical education. So total 7 years.
housemanship is like an apprenticeship. You are a PAID, sort-of-qualified, doctor. Expect to make mistakes. Expect to be told off. Expect to LEARN. The reason is that medicine is a lot like mid-level management, and there are lots of things you just need to know how to manage… and coming off medschool you may know theories but have no idea what to do when a patient is sitting in front of you.,.. and let’s not get started about the paperwork/beurocracy of discharging patients etc.
I can fully understand mistakes and doctors are human too. What is hard to comprehend is incompetence and bad attitude.
Nothing to do with amplifying rumors. There is nothing to be gained by doing so. Just stating facts without adding salt or flavors. I feel the pain and hope the system can get better.
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