Whenever the salary scheme changes, issues like this will appear. The letter below appeared in the Sun yesterday http://www.thesundaily.my/news/257153. It will always benefit the juniors and the seniors will always lose out and forced to leave. When SSM was introduced in 2003, I was one of the casualty. I was gazetted 2 weeks after SSM was introduced and just because of that I did not get my promotion to U48. People who were gazetted just 2 weeks before me were given promotion. It took me another 4 years after much discussion between SCHOMOS, MOH and JPA for me to get my U48 promotion. By this time, even my juniors who were just gazetted in 2006 were also given U48!! So, in terms of salary, I was sitting at the same salary as my juniors of 4 years. That was one of the reason I quit civil service and joint Monash University then.
As I had written before https://pagalavan.com/politics/government-doctors-promotion/, when the time based promotion was introduced in 2010, the same situation happened. The senior consultants were given U54 at the same time with junior specialist. Basically a consultant who has been in service for almost 15 years was sitting at the same salary as a junior specialist of 9 years of service. A consultant and his subspeciality trainee was at the same salary. Again, this chased away a lot of senior specialist from civil service.
Now, with the introduction of the new salary scheme for civil servants (SBPA), the same issue is happening again. The seniors who were in U54 will be at the same salary with junior specialist of U54. Everyone will be getting the same salary except for those who are in JUSA scale. There is a huge bottleneck at U54 that not many are going to be promoted to JUSA in near future. IT is really demoralising to be in their situation and I felt the same when I was stuck at U41 grade for almost 4 years after gazettement.
These are the many frustration that you will face in civil service. It only chases away all the good hardworking senior consultants, leaving behind the “world travellers” and apple polishers. Unfortunately, the private sector is also getting saturated with lower incomes. So, if you can’t beat them, join them lah…………
Senior medical specialist in distress
Posted on 4 January 2012 – 07:40pm
Last updated on 4 January 2012 – 08:19pm
I AM a senior specialist practising in one of the busiest hospitals in the country. I’m in my 10th year of service as a specialist and 19th year of service as a doctor.
The introduction of “Sistem Saraan Baru Perkhidmatan Awam” or SBPA has been unfair to me and other senior specialists and consultants who are stuck at maximum salary scale in the UD54 post.
First, based on the SBPA salary adjustment formula, I and many other senior specialists will see an increment of 3.9% from our previous scale of P1T8 (Sistem Saraan Malaysia) to UD1-6 T1 scale (SBPA scale).
However, a different formula is used for salary adjustment of junior specialists that does not make any sense.
Ironically, these junior specialists were automatically promoted in 2010 through a “time-based” promotion exercise. Junior specialists who are holding the UD54 post will be paid the same salary as senior specialists and consultants in SBPA.
Some of these junior specialists were my former house officers and medical officers when I was a specialist. As an example, a junior specialist who holds a UD54 post in my department draws a salary of RM5,465.42 (P1T2). After SBPA is implemented on Jan 1, his or her salary is increased by 30.1% to a scale of UD1-6 T1.
According to media reports and PSD, civil servants were supposed to enjoy an increase of 7-13% in pay rise but how do you explain the big jump for junior specialists? Isn’t this unfair to senior specialists and consultants? I understand that those in JUSA post will also enjoy a big increase in pay rise and thus, making us a breed that is easily dismissed, expendable and easily forgotten.
Today, with the introduction of SBPA, we will all be lumped together and thus, senior ones like me will lose our years of service. I do not know if anyone realises that we are the ones who perform the bulk of specialist work, train the junior specialists, train the medical officers, Masters candidates and house officers, involved in various ISO and accreditation activities and come up with ideas that benefit the department and hospitals in general.
We also perform activities that fulfil Key Performance Indexes (KPI) and make sure our services satisfy our customers. With the implementation of SBPA, it makes us feel as if, all our services are unappreciated.
I also noted that there has been no promotion exercise at all for us clinicians in 2011. Most senior specialists and consultants can’t imagine what is in store for them after looking at such unfair practices in salary adjustment. I believe that the lack of proper career development paths that we see in SBPA will compel more senior specialists to leave government service.
As a senior specialist, I have sacrificed my precious time to gain knowledge and skills and have continued to serve the Health Ministry diligently. I hope the higher authorities including the ministry will look into our plight and save whatever little dignity that is left of us.
Doctor
Shah Alam
Pagalavan's Avatar 
Why complain about money?
Realize back the purpose of becoming a doctor
For money?prestige?secured job?to be praised?to show off?to get better pay?
I hope you will work for free. Every one works to earn a living. Medicine is no exception. The article above is just not about income but also about seniority and dignity.
who is going to keep doctors alive if they dont pay us enough? doctors get paid probably as much as salesman if we average out the work load and work hours, not having to compare job responsibility and effort spent to become one.
I am sure there are doctors that just want to earn $$$. However, I believe most of us are doctors because we want to help, and what we are asking is just enough income to support our family and give them a better life and educations in return of our service.
ya right ,doctors are slaves ,they cant complained about money!
wellsaid and written…Pagal
JUSA,
Doctor’s, like everybody else, have mouths to feed and bills to pay.
Hey, you wanna save lives for peanuts, be my guess. But at the end of the day, tell me how you’re gonna feed your wife and 3 kids at home. Who’s gonna pay for the utility bills, house/car loans, school fee’s, textbooks, uniforms, and tuition’s.
Think with your noggin’ and not your behind.
By the way, couldnt you have come up with a more creative nickname other than JUSA…you’re so obviously not a JUSA. meh…
PAT,
Doctors nowadays are paid…if they want more money…do bussiness..
Why?Do you think the money being paid currently is not enough for doctors to live or its just because they want more?Be grateful..improve standard then talk about money..Most people wont satisfied no matter how much they earn..they always want more
By the way,PAT is not a creative name..be more creative
JUSA,
I am starting to wonder if you have a family. Do you even know how much would it take to support a family?
I agree that there are people that will never be satisfied no matter how much they earn, but again I even believe more that most of us aren’t that way. 5-6k per month to support 1 family with 2 kids will be barely enough unless both parent work. Even so, what about the children?their future education?Are you going to send your kids to local university with questionable quality?(I would have send my kids to UKM tho 30 years ago)?
As far as I know with the new system whether you have standard or not, or whether how much you work – you will be promoted as long as you stay and dont get fired. Is that really a fair system?
and I know my name is not creative at all
probably his children will be sponsored by the government!
The Top 10 Reasons Why You Should Not Go To Medical School… And The Single Reason You Should
By Ali Binazir MD
Why you should not go to medical school – a gleefully biased rant.
In the few years since I’ve graduated from medical school, there has been enough time to go back to medical practice in some form, but I haven’t and don’t intend to, so quit yer askin’, dammit. But of course, people keep on asking. Their comments range from the curious — “Why don’t you practice?” — to the idealistic — “But medicine is such a wonderful profession!” — to the almost hostile — “Don’t you like helping people, you heartless ogre you?”
Since it’s certain that folks will continue to pose me this question for the rest of my natural existence, I figured that instead of launching into my 15-minute polemic on the State of Medicine each time, interrupting the flow of Hefeweizen on a fine Friday eve, I could just write it up and give them the URL. So that’s what I did.
Now, unfettered by my prior obligations as an unbiased pre-med advisor, here are the myriad reasons why you should not enter the medical profession and the one (count ‘em — one) reason you should. I have assiduously gone through these arguments and expunged any hint of evenhandedness, saving time for all of you who are hunting for balance. And here are the reasons:
1) You will lose all the friends you had before medicine.
You think I’m kidding here. No, I’m not: I mean it in the most literal sense possible. I have a friend in UCLA Med School who lives 12min away, and I’ve seen her once — in three years. I saw her more often when she lived in Boston and I was in LA, no foolin’.
Here’s the deal: you’ll be so caught up with taking classes, studying for exams, doing ward rotations, taking care of too many patients as a resident, trying to squeeze in a meal or an extra hour of sleep, that your entire life pre-medicine will be relegated to some nether, dust-gathering corner of your mind. Docs and med students don’t make it to their college reunions because who can take a whole weekend off? Unthinkable.
And so those old friends will simply drift away because of said temporal and physical restrictions and be replaced by your medical compadres, whom you have no choice but to see every day. Which brings us to…
2) You will have difficulty sustaining a relationship and will probably break up with or divorce your current significant other during training.
For the same reasons enumerated above, you just won’t have time for quality time, kid. Any time you do have will be spent catching up on that microbiology lecture, cramming for the Boards, getting some sleep after overnight call and just doing the basic housekeeping of keeping a Homo medicus upright and functioning. When it’s a choice between having a meal or getting some sleep after being up for 36 hrs vs. spending quality time with your sig-o, which one wins, buddy? I know he/she’s great and all, but a relationship is a luxury that your pared-down, elemental, bottom-of-the-Maslow-pyramid existence won’t be able to afford. Unless you’ve found some total saint who’s willing to care for your burned-out carapace every day for 6-8 years without complaint or expectation of immediate reward (and yes, these people do exist, and yes, they will feel massively entitled after the 8 years because of the enormous sacrifice they’ve put in, etc etc).
3) You will spend the best years of your life as a sleep-deprived, underpaid slave.
I will state here without proof that the years between 22 and 35, being a time of good health, taut skin, generally idealistic worldview, firm buttocks, trim physique, ability to legally acquire intoxicating substances, having the income to acquire such substances, high liver capacity for processing said substances, and optimal sexual function, are the Best Years of Your Life. And if you enter the medical profession during this golden interval, you will run around like a headless chicken trying to appease various superiors in the guise of professor, intern, resident, chief resident, attending and department head, depending on your phase of devolution; all the while skipping sleep every fourth day or so and getting paid about minimum wage ($35k-$45k/yr for 80-100 hrs/wk of work) or paying through the nose (med school costing about $40-80k/yr). Granted, any job these days involves hierarchy and superiors, but none of them keep you in such penury for so long. Speaking of penury…
4) You will get yourself a job of dubious remuneration.
For the amount of training you put in and the amount of blood, sweat and tears medicine extracts from you (I’m not being metaphorical here), you should be getting paid an absurd amount of money as soon as you finish residency. And by ‘absurd’, I mean ‘at least a third of what a soulless investment banker makes, who saves no lives, produces nothing of social worth, and is basically a federally-subsidized gambler’ (but that’s a whole different rant, ahem).
I mean, you’re in your mid-thirties. You put in 4 years of med school, and at least 4 years of residency (up to 8 if you’re a surgeon). You even did a fellowship and got paid a pittance while doing that. And for all the good you’re doing humanity — you are healing people, for godssakes — you should get paid more than some spreadsheet jockey shifting around numbers, some lawyer defending tobacco companies or some consultant maximizing a client’s shareholder value, whatever the hell that means.
Right? Wrong. For the same time spent out of college, your I-banking, lawyering and consulting buddies are making 2-5 times as much as you are. At my tenth college reunion, friends who had gone into finance were near retirement and talking about their 10-acre parcel in Aspen, while 80% of my doctor classmates were still in residency, with an average debt of $100,000 and a salary of $40,000.
5) You will have a job of exceptionally high liability exposure.
But wait, it gets better. Who amongst these professionals has to insure himself against the potential wrath of his own clients? The investment banker’s not playing with his own money. And even if he screws up to the tune of, oh, hundreds of billions of dollars, Uncle Sam’s there to bail him out (see: World History, 2008-2009).
The lawyers? They’re doing the suing, not being sued. But the doctors? Ah. Average annual liability premiums these days are around $30,000. That goes up to $80,000 for an obstetrician-gynecologist (who remains liable for any baby s/he delivers until said infant turns 18) and into the six-digit realm for neurosurgeons. Atul Gawande wrote a dynamite article about docs’ compensation in the 4 May 2005 issue of The New Yorker entitled Piecework — check it out.
6) You will endanger your health and long-term well-being.
The medical profession is bad for you. Just ask any current doctor or med student. You will eat irregularly, eat poorly when you do get the irregular meal (and so much for the now-outlawed drug-company sponsored meals — god bless their generous hearts and bottomless pockets), have way too much cortisol circulating in your system from all the stress you experience, have a compromised immune system because of all the cortisol in your blood, get sick more often because of the compromised immune system (and the perpetual exposure to disease – it’s a hospital where everybody’s sick, duh), and be perennially sleep-deprived. If your residency is four years long, on average you will spend one of those years without any sleep. A whole year of no sleep. Do you get that? This is as bad for you as it is for patients — you’ve heard of Libby’s Law, right? Groggy doctors can kill patients when they don’t mean to.
Groggy docs can also hurt themselves. One friend stuck herself with a needle as she was drawing blood from an HIV patient. She’s fine now, but that was a good 9 months of panic (PS: she has since quit clinical medicine). My good friend and college classmate James — a serious contender for the title of Nicest Guy on Earth – had a severe car accident one morning on the way to the hospital because he fell asleep behind the wheel. Luckily, his airbag deployed and he didn’t suffer long-term injuries. Everyone seems to know already that medical care can kill patients (haven’t read The House of God by Samuel Shem yet? Go get it now – brilliant and the second funniest book I’ve ever read, after Catch -22), but it’s usually news that it can kill the docs, too.
7) You will not have time to care for patients as well as you want to.
This is how the math works: Many patients, few of you — usually one, unless your name is Tara with florid multiple-personality disorder (no, it ain’t the same as schizophrenia). So you have to take care of many patients. And if they’re in the hospital, that means they’re really sick, otherwise they’d still be at home.
So you are scurrying around trying to take care of all of them at once, which means that each individual patient can only get a little bit of your time. Which means that you won’t have a chance to sit at the bedside of that sweet old vet and hear his stories of Iwo Jima. Or get to the bottom of why that LOL (little old lady — medical slang’s been around way longer than internet slang, buddy) can’t get her daughter to come visit. Or to do any of that idealistic stuff that you cooked up in your adolescent brain about really connecting with patients.
Get a grip! This is about action, about taking care of business, about getting shit done, about making that note look sharp because the attending is coming to round in an hour and he’s a hardass, and that’s the difference your passing and getting recommended for honors, so get on it already and quit yakking with the gomer (which is an older patient with so many problems you should have never let him/her get admitted in the first place — stands for get out of my ER, and I didn’t make it up the acronym, so direct your righteously indignant wrath elsewhere, thank you very much). It’s about CYA — cover your ass. For better or for worse, you just start to treat patients as problems and illness-bearing entities for the sake of mental efficiency (“55yo WM s/p rad prostatectomy c hx CHF & COPD”), which does not do much for your empathetic abilities. Which brings us to…
8) You will start to dislike patients — and by extension, people in general.
OK, so now you’re overworked, underpaid, underfed, and sleep-deprived. Whose fault is that? Well, it’s not really the hospital’s fault — it’s just drawn that way. And it’s not your boss’s fault, because somebody has to take care of patients, and he can’t do it because he’s the boss, duh.
So whom to blame? Ah yes — patients. It’s the patients’ fault! They’re the ones creating all the work! The ones who get in the way of your nap, your catching your favorite TV show, having an uninterrupted meal, getting together with your sig-o for some therapeutic nookie. How dare the gomer in 345E have an MI while you’re watching CSI? Does she have any consideration, letting her blood pressure tank to 40 over palp at 3.30am, while you’re making out with Elle MacPherson on the shores of Bora Bora (assuming you’re lucky enough to be actually asleep)? The logic may be twisted — patients, on the whole, don’t get sick voluntarily just to spite you – but it is deeply ingrained in medical culture. Heck, there’s even a slang term for it: a hit. As in, “We got four hits on our admitting shift at the ER today.” Hit — the same way you would be struck by a mortar, or a shell, or a bomb. Getting hit is a Bad Thing.
Patients aren’t people, you see — they are potentially lethal disasters that can explode all over the place and ruin your whole day. “We got hit again” — one more patient to take care of, says the resident.
But really, is that resident blameless? Or how about Dr Hardass the attending and his intransigent ways? Hell, they’re at fault, too!
Soon the circle of blame expands to the outer reaches of the cosmos, and every potentially accountable organism from amoeba to blue whale will be personally responsible for your misery. But lest you think we’ve forgotten you, patients, remember — it’s all still your fault.
9) People who do not even know you will start to dislike you.
Once upon a day, in a time somewhere between the Cretaceous and Triassic eras, physicians were held in awe and respect by the general public. Their seeming omniscience was revered, and TV shows like Marcus Welby MD glorified their empathetic sangfroid and cool grace. Heck, they were even considered sexy or something.
I only noticed in recent years that this ain’t the case no more, and doctors rank on the contempt scale somewhere above meter maids and at or just below divorce lawyers (but still much higher than I-bankers and other invertebrates). The average Joe and Janet are tired of the ever-rising cost of medical care, tired of all the stories of malpractice, tired of the perceived greed of the pharmaceutical firms, tired of the heartless profit-focussed practices of insurance companies.
But where do they pin their frustration? To whom can they direct their ire? Insurance and drug companies are nameless, faceless entities, as are hospitals. We need a person to blame, like a nurse or a doc. Nurses are overworked and massively underpaid, so it doesn’t really make sense to get mad at them. But doctors — those darn Mercedes-driving, Armani-wearing, private-school using, golf-playing arriviste docs! By being the most visible symbol of the medical profession, the doctor will have the dubious distinction of being the scapegoat for all its maladies. Fair? Hell no — we already told you docs are overworked, underpaid, and often railing at the same injustices Joe and Janet are. Most of them don’t even play golf! (They don’t have time. Except for dermatologists). But such it is. Just letting you know which direction the rotten tomatoes are flying so you can consciously choose to stand at the ‘toss’ or ‘splat’ end of the trajectory.
10) You’re not helping people nearly as much as you think.
So by now I may have managed to inspire your righteous indignation with some of the things I’ve said about the medical profession. But maybe in the back of your head, you were still thinking, “Well, even though it sounds like a bunch of black bitter bile, he does kinda sorta have a point.” In which case, I’ve almost certainly lost you on this one: “Whaddya mean you’re not helping people? Isn’t that what medicine is all about?”
Well, actually, yes and no. Sure, there is the immediate gratification of delivering a baby, fixing someone’s eyesight with LASIK, catching a melanoma before it causes trouble, or prescribing some thermonuclear antibiotics to kick a nasty bronchitis before it becomes lethal pneumonia.
But, depending on the field you choose, most of the time you’re not doing that. You’re treating chronic conditions that are self-inflicted: emphysema, obesity, cardiovascular disease, diabetes. Moreover, patients tend to be non-compliant — they basically don’t do what you tell ‘em to do (NB: mea culpa). In fact, you too are probably one of those non-compliant patients who doesn’t exercise more, eat healthier, and take pills as they’re prescribed. Anecdotally, 50%+ of prescribed medications are taken incorrectly or never.
So there you are, like Cuchulain the legendary Celtic warrior, wading into the ocean and, in your rage, trying to fight the invulnerable tide and improve the health of your patients. You pour all your earnestness, good intentions and expertise into it, and — not a whole lot happens. Your efforts bear no fruit. So you suck it down and move on, sustained by the occasional kid who does get better, that eyesight that does improve, that bronchitis that doesn’t turn into pneumonia. Win some, lose many more.
And now, the only reason why you should go into medicine:
You have only ever envisioned yourself as a doctor and can only derive professional fulfillment in life by taking care of sick people.
There’s really no other reason, and lord knows the world needs docs. Prestige, money, job security, making mom happy, proving something, can’t think of anything else to do, better than being a lawyer, etc are all incredibly bad reasons for becoming a doc.
You should become a doc because you always wanted to work for Médecins Sans Frontières and your life will be half-lived without that. You should become a doc because you want to be the psychiatrist who makes a breakthrough in schizophrenia treatment. You should become a doc because you love making sick kids feel better and being the one to reassure the parents that it’ll all be OK, and nothing else in the world measures up to that. Or as my general surgery resident put it, you should become a doc because “my dad was an ass surgeon, my big brother’s an ass surgeon, and by god I’m going to become an ass surgeon.”
But woe betide you if there’s anything else, anything at all, that would also give you that fulfillment. Because pursuit of medicine would preclude chasing down that other dream and a whole lot more – a dream that could be much bigger, much more spectacular, much more enriching for yourself and humanity than being a physician. Just ask John Keats, Walker Percy, Sir Arthur Conan Doyle, Giorgio Armani, or Michael Crichton (some of these guys being more alive than others these days). Or you can just ask me a few years down the road, by which time I should have a blog entry for that question, too.
About: Dr. Ali Binazir has an A.B. magna cum laude from Harvard College, M.D. from the University of California San Diego School of Medicine, M.Phil. from Cambridge University and is a Certified Clinical Hypnotherapist and NLP Master Practitioner. has written books that include the #1 rated dating book on Amazon, The Tao of Dating as well as for the Huffington Post. He blogs at Ali Binazir
Dear JUSA,
You are obviously an immature person. You have not read the article & understood it. Its not about money alone. Its much more than that.
You talking about improving standards? Do you know that in order to gain knowledge and skills, doctors have to keep up with latest journals, books and attend courses. None of this is paid by Ministry and we have to fork out $ from our own pockets. Otherwise, we won’t be at the level that we are today.
Don’t blame us for poor facilities in government hospitals and incompetent junior staff. We are not administrators and we don’t run universities or medical schools that train this people.
If I wanted more money (or rather tons of it, as you may think), I would have left for greener pastures long long time ago.
I hope you get the point.
The only other reasons, I am still not with the private is to help my patients. Pay wise, I waited 26 years before getting my Jusa. I have recently retired and still hope to serve….getting my contract.. The pray of my patients will be enough to pay for my next life
Government has decided to review SBPA. Professional bodies are giving their input. The professional body responsible to look into the welfare of Medical Professionals should raise their greviences on salary and give their input urgently! Please dont miss this golden opportunity!
Dear All,
MMA and SCHOMOS are aware of this and have put forward their suggestions on the review of SBPA. Hopefully the outcome will be favourable to all of us civil servants.