Last year in October 2011, the government reduced pharmacist compulsory service from 4 years to 2 years https://pagalavan.com/2011/10/06/i-told-you-so/. It was reported that almost 90% of the post in government sector has been filled. Subsequently, MOH has also allowed pharmacist to do their internship training in private sector. I was also informed that the 2 years compulsory service for pharmacist are now given on contract basis. The only good thing for pharmacist will be that their opportunity in private sector is still open especially when the government introduces the 1Care system which will need a lot of community pharmacies.
Today, MOH has announced that compulsory service for dentist will be reduced from 3 years to 2 years! This sentence really surprised me as well “For those who have served their compulsory two years, they may wish to join the private sector,” she said before launching the Colgate Oral Health Month 2012 in Bandar Utama yesterday.She said that last year, 415 graduates had registered with the Malaysian Dental Council. This represents an almost 400% increase from 2002 to 2011 (112 in 2002 to 415 in 2011),” she said.
Even though the increase is almost 400% in 10 years, the total number is still small (415 last year). Compare this with medicine, where the total number was 7000 last year, from just about 2000-3000 in 2008!! An increase of 4000- 5000 in just 4 years with 50% of the 36 local medical schools yet to produce any graduates!
I know for sure that MMC is being pressurised to reduce the compulsory service to just 2 years of housemanship. Once this is implemented, you need to apply for a job after housemanship ( which will be given on contract basis) in government service or wherever else! There are also some plans by private hospitals to offer themselves for post-graduate training!! God save us all!
So, when will be the doctors turn? 2013? 2014?……………….keep guessing but for sure it is coming.
Shorter stint in govt hospital for dental grads
By WONG PEK MEI pekmei@thestar.com.my
PETALING JAYA: Dental graduates will only have to serve the Health Ministry for two years instead of three, Deputy Health Minister Datuk Rosnah Abdul Rashid Shirlin said.
She said the Malaysian Dental Council had approved the shorter national service on Feb 29.
“Due to the tremendous increase in the number of graduates, it is timely that the compulsory national service be shortened. This will ensure that new graduates will continue to serve in the ministry.
“For those who have served their compulsory two years, they may wish to join the private sector,” she said before launching the Colgate Oral Health Month 2012 in Bandar Utama yesterday.
She said that last year, 415 graduates had registered with the Malaysian Dental Council.
“This represents an almost 400% increase from 2002 to 2011 (112 in 2002 to 415 in 2011),” she said.
Rosnah said with the setting up of new facilities and upgrading of existing facilities at the primary care level, the ministry would continue to require the services of dental graduates.
She said there were 4,289 active dental practitioners, with 58% of them serving in the public sector as at Dec 31.
Malaysian Dental Assocation president Dr Mohamad Muzafar Hamirudin said he was shocked to find that 90% of adults had cavities, according to a survey by the ministry.
He said that since oral diseases might be linked with a higher incidence of life-threatening diseases, it was important to educate Malaysians about regular dental check-ups.
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Heard a news that Alliance medical school (Penang) offered scholarship to new med students with 10year Job contract to their graduates at their Very own Hospital. Looks like a private university hospital.
Are you sure? Firstly I did not hear any news of them building a hospital. As far as I know, Housemanship cannot be done in private hospital.
I know they are giving scholarship under their DANA but no bonding was required. As far as I am concerned, no medical school guarantees a job!
Dear Dr,
I want to get your opinion on homeopathy medicine, is it reliable? evidence based ?
Homeopathy = Water.
There have been NO randomized controlled trial that has shown any therapeutic benefit for so called “homeopathic” remedies.
Ie. It’s a sham/scam dont fall for it.
The BBC (with a donation from a philanthropist) actually offerred ONE MILLION DOLLARS to anyone who can show in a properly controlled RCT that a homeopathic treatment works.
Modern medicine does not necessarily need to know how a medicine works (how paracetamol/panadol works was not known for decades!) but trials have to show that they actually work.
Homeopathy has been repeatedly shown to have no added benefit compared to a sugar pill.
100% placebo effect
One question, Why does it exist until today ??? And I found many association regarding homeopathy.
Thank you for your reply by the way.
It exists because the placebo effect is very much real.
Why does it can produce therapeutic effect since it is just water ??? Because patients believe it works???
Dear Sicked,
I will try to simplify it for you.
Homeopathy CANNOT work because it has no active ingredient. It is diluted so many times over, that the concentration is equivalent to 1 molecule in the entire world’s ocean. I am not kidding.
It SEEMS to work in some patients because of the placebo effect.
Taking a placebo is not the same as doing nothing.
When you take a pill that you think will work, you feel better. Why do you feel better? Because your body releases endorphins that bind to your opioid receptors. These are the same receptors that pain-killers like morphine bind to.
Practitioners of complementary medicine also spend 45-60 min with each patient, talking to them, showing empathy, acknowledging their problem, etc. All of this also makes the patient feel better and releases the previously mentioned endorphins. Unfortunately, practioners of science-based real medicine don’t do this often enough, probably because we are swamped with patients.
It is reasons like this why complementary medicine seems to works in vague ill-defined ailments like back pain, or knee aches or whatever. It is also difficult to measure the severity of these sorts of conditions as they are all very subjective. Hence why homeopathy SEEMS to show some benefit in patients with these sorts of conditions.
This is also why you don’t see much research on complementary medicine for treating bone fractures or cancer (even though they claim they can) – because the outcome of these conditions are easily measurable.
Even then, the research done by practitioners of complementary medicine is of such poor quality and hardly ever subjected to peer review. This is mainly because they are charlatans out to fleece your money.
Recently, there was a big news story about acupuncture (instead of a general anaesthetic) being used to perform surgeries. Even the BBC was fooled and reported it. Turns out the patients always gets massive amounts of sedation and local anaesthetic (under which you can perform almost any surgery, I assure you).
Practitioners of complementary medicine will defend their trade to the hilt, despite the volume of evidence showing that its all a scam. This is because they will lose their source of income otherwise.
Homeopathy is complimentary medicine. So far, no concrete evidence it works but used widely as a compliment to western medicine. I know a friend who worked in a homeopathy factory. He told me that they do add steroids into their “herbal” medicine! Same like most of the chinese medicines. That could be the reason why some disease gets better with these sort of treatments.
In keeping with good practice like any modern surgeon, I am a strong believer of having a sound evidence base for any intervention.
The only time I would endorse trying an unproven remedy is if it fulfills all four “Browning Principles” (named after internationally reknowned ENT surgeon Prof G Browning with whom I had the great privilege of serving time):
1) Cheap
2) Does no harm
3) Gives the impression of activity
4) *Might* even work! (ie: plausible)
He wrote this in context of nasal balloon (Otovent) therapy for glue ear, but the four principles are generally applicable. The problem with most alternative therapy practitioners is that their interventions typically fail at the first hurdle – most of them don’t come cheap!
While on this subject, I’ve never quite understood the way Malaysians are happy to pay good money to be duped by all sorts of alternative therapies. Herbal pills/lotions/potions, needless vitamin supplements, ionisers (wah! like standing next to waterfall!), energised water (ha! ha!), magnetic bracelets (how do you spell Trion:Z?), biofield modulation, sympathetic resonance (ni Q-link manyak bagus kua), etc etc.
One can hardly walk through a shopping mall in Bolehland these days without some promotion of the latest and greatest in alternative therapy being thrust in one’s face.
Fact is, the trouble with modern society is that they want things quick and easy. Have their cake and eat (a lot of) it. Cheapest way to good long term health is a healthy lifestyle – eat the right food, exercise, don’t get fat, don’t get lazy, don’t smoke, moderation of alcohol and vices… that sort of thing.
But most people don’t want to hear that. They just hope to pop some magic pills and live a good life (“Aiyo, if I have to give up my delicious food, I rather die-lah!). In fact, death is the easy end. Long term chronic ill health with suffering and pain never appears to be a concern until it happens to the individual. By then, it’s rather too sad and too late.
Dear Ignorant Mint Berry Crunch, alopathy treatment is just one type of treatment method. There are many other alternative methods to treat various illness. Moreover, alopathy medication doesn’t guarantee 100% cure, it is just a platform of its own.
Show me one well conducted (read: properly blinded) randomized controlled trial that shows homeopathy is significantly more effective than a placebo and I will eat my words and forever hold my tongue.
Otherwise, you are the ignorant one.
PS: We are talking about homeopathy
Allopathy is the opposite of homeopathy.
ಠ_ಠ
*double facepalm*
For clarification: I am not opposed to homeopathy as a concept, but for all intents and purposes, homeopathy in the modern context refers to “medicines” produced via serial dilution. This is what I am referring to when I say homeopathy does not work any more than a placebo.
If you are referring to homeopathy that does not involve serial dilution, then I’d say the jury is out – and I am open to the findings of any well blinded RCT.
Do you consider this homeopathic medicine?i just search for the fun of it
http://www.ncbi.nlm.nih.gov/pubmed?term=Homeopathic%20ear%20drops%20as%20an%20adjunct%20to%20standard%20therapy%20in%20children%20with%20acute%20otitis%20media.
anyway i am not oppose to homeopathic medicine either but its interesting to actually see that there are more and more RCT ran with homeopathy.
sorry i mean this
http://www.ncbi.nlm.nih.gov/pubmed?term=The%20effect%20of%20Neuragen%20PN%20on%20neuropathic%20pain%3A%20A%20randomized%2C%20double%20blind%2C%20placebo%20controlled%20clinical%20trial.
and
http://www.ncbi.nlm.nih.gov/pubmed?term=A%20randomized%2C%20double-blind%2C%20parallel%20trial%20comparing%20capsaicin%20nasal%20spray%20with%20placebo%20in%20subjects%20with%20a%20significant%20component%20of%20nonallergic%20rhinitis%20
They are not large studies but they are double blinded RCT. =P
I have nothing against homeopathic medicine unless they claim something that is ridiculously impossible =)
Yes, there is evidence that Neuragen works better than a placebo =)
There is nothing wrong with Naturopathic remedies. They contain active ingredients. In the case of Neuragen:
Pelargonium spp. (geranium oil), Lavendula angustifolia (lavender oil), Citrus bergamia (bergamot oil), Eucalyptus globulus (eucalyptus oil), Melaleuca alternifolia (tea tree oil).
If it works it works. There is no dire need to know the mechanism of action.
With capsaisin, there have been a number of studies that show it has a moderate benefit for pain by modulating the release of Substance P found at pain receptors.
However, homeopathy is a totally different kettle of fish. We’re talking about water without any active ingredients in it!
Of course the real issue with the homeopathy vs allopathy debate is “what is therapeutic” ?
Different people have different interpretations of Therapy. If therapy has to be clearly observed by well defined parameters that are reproducible repeatedly, then yes homeopathy is 99% of the time not therapeutic.
But many patients who have highly subjective symptoms that are considered “grey” even by modern medicine standards tend to feel better with certain homeopathic Therapy.
Having said that, as allopathic doctors, it is highly unethical to promote or encourage patients to try homeopathic medicine before all RCT-proven therapies are exhausted.
Something doesn’t quite add up! They say that there are too many new medical graduates. They say that housemen are like ants in a ward. Then others say that the workload is too much. Some say that they do not even get a proper off day, or had no time for lunch or dinner.
Logically speaking, too many doctors = more time to shake legs. Too little doctors = heavier work load. Now its too many doctors but still there are complains about being put into slave labor.
So which is it? Or is the whole issue just a matter of improper distribution?
Firstly maldistribution is a problem. Secondly, the idea of shift duty is to reduce the number of housemen per shift and thus your workload will increase. I heard the shift duty has actually reduced the rest time as well in some hospital!!
you could think of internship as a graduate entry program (in the finance world).
You need to get rotated to different areas for experience.
And there is only so many places available in each of these areas.
As a person intimately associated with training HOs on the ground, I can tell you why the increased number has not resulted in better results. Many of the current HOs take an inordinately long time to complete any given task, and that poorly. Clerk 1 medical inpatient – 1H, doesn’t include sending off the investigations. Writing a discharge summary – 30minutes, then need to redo because the quality was unacceptable. In other words, many HOs are of poor quality in terms of aptitude, therefore they suffer from low efficiency. Add poor attitude to the above, you have a disaster. Almost forgot, they are so pampered, most work is considered ‘slave labour’.
Well, the answer is simply
More housemans = more effort = not necesarilly more productivity
How do you measure productivity? Anyone can walk around with a branula dangling from his fingers, ‘acting’ really busy…. How do you know his cannulation success rate?
You cant incentivize what you cant measure.
but come on, no one who was walking around all day with a brannula stuck between his fingers can seriously say “we were so busy at the ward today we worked from 5am to 12am in the morning, even though our shift ended at 5pm – we couldn’t even take turns to go for lunch because we had new patients at that time!”
I mean like, seriously? If there were so many houseman, we would all have a field day being organised and taking breaks by turn.
It all depends on how the housemen work together! WHen I did my HO I had a good team of colleagues. Even though we were short that time, we managed very well.
http://www.mmail.com.my/story/doctor-found-dead-hospital-ward
Houseman found dead in the ward
Don’t speculate. From the info I got, it was definitely not a suicide case.
Wah, if not suicide then murder?
I used to work as govt dentist..this recent news is quite a shock to me as well..as far as i know, from my colleagues in the govt sector, govt dentist can never cover the whole population in malaysia..there are not enough manpower..thats why, at times they still have to go relieve some other clinics whose dental officer in charge went for courses, on maternity leave etc etc..it still happens nowadays..that also would answer why the public hav to wait longer time for seeing a dentist in the govt clinic, coz normally there is only one dental officer in charge at one time if its in the periphery clinic, and 2 dentists in main clinic..latest registration number for registered dentist under mda that i know is around 5000++..and how would that number can help to cover the whole population in malaysia???
That’s why I thought as well but I think the government is probably not interested to create more post due to financial constraints. 1Malaysia clinic is more important!!
i’m spm’s leaver 2011.. i want apply the mara convertable loan as it’s has started open today.. but i’m very confused whether to further in medicine or dentistry.. i’m interested in both of field but my friends told me that dentistry don’t have guaranteed job.. n my parents want me to become a medical doctor.. i don’t know which one is better for me because i interested in both.. can Dr give your opinions..
First ask yourself, why do you want to become a doctor? Is this because you want to fulfill your parents dream? Is this because the perceived glamour and financial status of a doctor? Or most importantly do you have the passion for the job? If you do not have passion for this job, you will find the job, boring, tiring and not motivated to excel!
Why only dentistry got no job? Doctors will also be jobless in 5 years time. Don’t listen to what your parents want you to be. Ask yourself what is your interest. read all my post under “For future doctors” page and decide.
thank for giving the respons.. ect it’s true that the demand for dentist is high ? ya, all my classmates want to continue their study in medicine and i’m the only one who interested in dentistry.. so which one is more needed ? it’s true that all the HO will face the difficult to do their postgraduate as the amount of HO has increased larger nowadays..
yes, pls read all my blog postings
Dear nurlina..currently there r only 5000++ dentists registered in malaysia..only 80-100 graduates produced from dental school each year..so, what do u think??do some research from here on..
I’ve gotten an offer from USM for dentistry and a JPA offer for medicine in NuMed? I’m quite interested in both, but I’m afraid one day I’ll get bored of practising dentistry..
Any comment? What do you think?
Thank you
Everyone will get bored one day no matter what they do.
Wouldn’t a doctor see cases in a more varied way? I’ve thought of becoming an oncologist 🙂
Compared to dentistry, yes but after some time you will end up seeing same type of cases 80% of the time.
Hi options options. Can I know what pre-university course did you do before applying for USM? And how and when do you apply? Thank you in advance 🙂
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