What is happening here? After this report http://thestar.com.my/news/story.asp?file=/2012/4/12/nation/11090364&sec=nation appeared in the newspaper today, I received few emails and even friends asking me about this incident. I have always said that doctor’s life is stressful but before jumping into any conclusion, just review the article below critically. Did the police say that it is a suicide?
I was made to understand that bullying is rampant in this hospital. Something that I do not tolerate but our civil service is rotting anyway. Most of the HODs nowadays are good for nothing. Sorry to say this but it is the reality on the ground. How many of them do teaching rounds, grand rounds, supervise housemen and Master’s students? I am sure most of you will know that the universities do pay a fee to the HODs for every Master’s student that is posted to his department. It use to be RM 1000-2000/month! Do you also know that every medical school attached to the hospital have to pay RM 600-1000/month to the HODs? All these money suppose to be used to facilitate the teaching of Master’s student and medical students. BUT I am sure you know what happens on the ground.
Now, coming back to the story below. The police said that it is an overdose and never said that it is a suicide! I have seen doctors who were pethidine addicts before who stole pethidines from OT. Furthermore, he was found in the hospital’s toilet and not at home or in his room. If at all he wants to commit suicide, I am sure he will do it at home or in his room. If it is true that he worked 5 days in a row then the HOD should be taken to task!! No one can work 5 days in a row. Even in those days when I was a housemen, the longest I have worked is 56 hours ( 2 consecutive calls) but it was a passive call. Generally, we work 32-36 hours the longest. Could the system have made him to become an addict to stay awake and energize himself?
I am also surprised to see that this doctor graduated from Uruguay? There is no university from Uruguay recognised in Malaysia. So, if it is true then he must have sat and pass the MQE exams, thus explaining his age of 29.
I am not sure what exactly happened to this guy. We need more info before we can conclude that it is due to work stress. Whatever it is, I hope MOH will conduct a detailed investigation into this matter. I also hope that the housemen in this hospital will contact the state SCHOMOS rep or MOH if indeed it is true that bullying is rampant in this hospital to the extent that extension etc has become a norm!
Trainee doctor found dead after suspected overdose
By M. KUMAR kumar@thestar.com.my
KUALA LUMPUR: A trainee doctor was found dead in a restroom at Kajang Hospital.
Police believe he had overdosed on an unidentified drug.
Lee Chang Tat, 29, was found dead in the men’s room of the paediatric ward at 7am yesterday by hospital staff who went looking for him after they noticed that he was missing.
He was found with a used syringe beside him, which police believe he had used to inject himself with a drug to fight off fatigue.
It is learnt that Lee, who had been working at the hospital for the past three years, had been working on call for five consecutive days.
Selangor health director Datuk Dr Azman Abu Bakar said hospital staff, who found Lee, tried to resuscitate him but were unsuccessful.
“He was rushed to the emergency room but it was too late,” he said.
Lee, he stressed, had no previous medical problems.
A security guard at the hospital said they found him when someone tried calling Lee on his handphone and heard the ringing tone coming from the restroom.
“We broke into the toilet cubicle and found him lying there with the needle,” he said.
Kajang OCPD Asst Comm Abdul Rashid Abdul Wahab said Lee, who studied medicine in Uruguay, had been complaining to his family about the hectic working hours.
“His family said he had also been planning to go on a holiday to Cambodia soon with friends,” he said.
ACP Abdul Rashid confirmed that an initial post-mortem indicated that Lee had died of an overdose, adding that the case was being investigated as sudden death.
This is not a comment about the tragic incident which definitely requires further investigation. There are too many inconsistencies in the report to make any conclusions now.
However I would like to comment about your statement ‘ … that extension etc has become a norm!’. I am involved in HO training in my hospital. The quality of HOs in general have taken a nosedive over the last 2 years. Though there are still HOs who are a credit to the profession, they are now clearly in the minority. If previous standards were to be enforced, extension SHOULD be the norm. So do not presume the worst of a dept if it often extends HOs, because many do deserve to be extended.
Yes, of course. If the housemen is incompetent, you must extend him and not allowed to practise. However, I have also heard of some department extending HOs without a proper reason, just because he did 1 mistake etc.
To extend HO is not an easy task as it involves many admin steps. Extension of HO is usually a last resort. The consultant in charge got a lot of reports to write on why such HO need to be extended and pengarah will usually put pressure on the consultant unless you got absolute reason to extend him. The approval of extension needs to go through various committee before it can be implemented. So extension of HO is usually a last resort to discipline the HO. Usually most people will take the easy way out by sending out the HO to next rotation ASAP.
poor doctor: those specialists/consultants who send off incompetent HOs to the next rotation for the sake of convenience are, to my mind, negligent to the highest order. They must be at least partly responsible any catastrophe committed by the substandard Dr in the future.
It is not that difficult to extend a HO. Yes, there must be paperwork to justify the charge of poor knowledge, technique or attitude. There must also be documentary evidence that the individual had been counselled several times on his weaknesses and the need to improve. Preferably most if not all the specialists in the dept should agree that an extension is required. Pengarah should support the HOs direct superiors. I have yet to come across one who is willing to overrule a HOD.
don’t believe everything u read in the papers..he’s a friend of mine..yes he has been doing ho for 3 years but was never extended…he took 1 year leave for personal reasons…worked with him in 3 rotations..and he was my ho when i last served in paeds as mo..he was a good ho..someone i can rely on…no he was not doing 5 days straight on calls or tagging…he only has about 1 month left in paeds…just thought i should clear that up..little things i can do for a friend who’s gone..may he rest in peace..
sir this what. my senior who working in kajang hospital replied me
Tagging was my “personal theory” which I suppose I must now retract. FYI their fifth day is an off day, so I’m now equally baffled as to why he was working five day shifts (as poor doctor said below). But of course, he could easily have taken on an extra shift for some simple reason! Your senior says he is good and reliable, so we must consider how a good and reliable houseman came to an unfortunate end as such. Why was he so fatigued that he could either miscalculate or felt that the deliberate risk was necessary? It is an unfortunate event that I hope will be throughoutly investigated.
If you looked at our MMC Medical Registry (which is available online for public use), you will notice that the above had graduated from Crimeria not Uruguay.
Speculation will not help us. Let’s wait for the full police report.
It’s a sad day cos a life is lost.
http://www.kosmo.com.my/kosmo/content.asp?y=2012&dt=0412&pub=Kosmo&sec=Negara&pg=ne_05.htm
if you read the malay article in that link: it seems like the trainee worked 5 night shifts and not 5 consecutive calls? Too much
You SL?
typo : “delete” too much.
Ya indeed don’t believe what was reported in various newspaper. I knew the consultants who work in the hospital. The cause of death is certainly NOT related to work and definitely NOT due to bullying. He worked 5 consecutive shifts NOT 5 overnight calls. If you check the MMC registry, he was from Crimea U, Ukraine NOT Uruguay. The paper don’t even care to verify this fact and just show how bad is our journalism.
Also I think it is not fair for you to say bullying is rampant in this hospital. I worked in this place for many years and I can say for certain that bullying NEVER happen here at least for last 10 years.
As I said “I was told”. I never said it happens but investigations need to be carried out before any conclusion is made.
Stealing pethidine from OT is an almost impossible task especially for HO. First, he was in pediatric posting. Secondly, pethidine is a DDA drug and is LOCKED in the cupboard. The key is usually with the nurse who will never give the key to anyone. If he were to steal drug from OT, he was alomost certain stole the wrong drug.
Yup but it has happened before!
Prolly gave himself Suxamethonium
IF he gave himself a dose of relaxant and I wondered how come he didn’t look at the medicine before self injection. It is a common sense that you double check the name and dosage before giving any med to the patient despite this time he gave the medicine to HIMSELF.
may his soul rest in peace.imagine his parents sorrow ?! MOH should be held responsible and act responsibly….. OUR DOCTORS NEED MORE CARE AND ATTENTION . They are not as tough as we were in the 70s .
If our doctors are not though physically and mentally, what hope do our patient have? A quote by American physician Martin Henry Fischer BEFORE taking up medicine, “A doctor must work 18 hours a day and seven days a week. If you cannot console yourself to this, get out of the profession.”
Typo error, I meant tough not though.
It just shows that not everybody who has the right academic qualification can become a doctor. Could it be perhaps the parents are not fault here, “forcing” their son/daughter to take up medicine when their result was just ok? or their son / daughter does not have the right apptitude to become a medical doctor? This is similar to someone who does not have the gift of the garb wishing to be become a lawyer!!
Perhaps the MMC should revise their guidelines on the recognition of all medical degrees (both local and foreign) which should include an apptitudde test and an interview prior to medical school admission!
PS. I am a O&G Consultant, trained in the UK and thus involved in training of medical students / juniors.
This is common scenario in Malaysia. Also sorry to say that MMC is not in control in Malaysia in approving medical schools. The one who is actually responsible are the ministry of higher education and those businessman and Politicians who set up those medical schools. MMC’s role is to rubber stamp these medicals schools and MOH is suppose to accept all these graduates.
sorry, typo mistake….”Could it be perhaps the parents are AT fault here, “forcing” their son/daughter to ….”
In Malaysia, the government only wants to see the numbers !! quality who cares?
It sounded more like a drug misuse case leading to an accidental death. Why on earth is this chap killing himself where the resusc facilities are abundant? quirky! By the way take a look at this, both cases hv pretty much resemblance, involving doctors who died in the toilet after taking drugs intravenously
http://www.dailypost.co.uk/news/local-north-wales-news/bridgend-news/2012/03/01/doctor-died-after-injecting-himself-55578-30434689/
Chirpy
Again, obviously, this shows this man may not be suitable to become a doctor. He was only 31; thus would not have become a specialist yet. He was most probably trained in Egypt; and he was definitely not the only medical person in the family. Perhaps pressurised into the profession.?? He went to the UK, thinking life / training is all rosy there, but instead a working / training condition which is totally alien. The Bridgend Hospital is not that busy, but life pretty boring there…(been there, I know!)…everything shut down (except pub!) after 5 – 6 pm. Thus very depressing. Way out ? Started to abuse medications…..
Further more, being a foreign trainee in the UK is tough!! One is not given the same chance of recognised training to become a specialist here, as competition for a recognised position is extremely stiff, even after passing the necessary exams. First obstacle is one’s attitude / apptitude which is tested at interview; secondly, immigration status (which is not a big problem if they wanted you). I am qualified to say this, as I am Malaysian trained, went over to UK for my preparation on MRCOG Part 2, got accepted into the UK training position, completed the CCT- UK (O&G) training, and is now in the GMC Specialist / Consultant Register.
extending HO is difficult task?? let me brief you what is practising in my hosp. in my hosp, there will be 2 extension meeting per month. This meeting will be held just to extend the HO. The director is really pleased if any HOD want to extend the HO.
To extend the HO, is very simple task. Fill up the form and send it to Pengarah before the extension meeting. Then, u will be called to the meeting and they will give you and opportunity to talk and defend for yourself. Oh yah, before i forgot, the extension comitte comprise all the HOD. Nobody else involved.
Is the opportunity to talk and defend is really valuable to you?? No!!
They will just laugh at you and if you defend yourself, they will simply shout at you. So, what you can do is just shut your mouth and nodding your head.
Basically they call you for a formality.
So, how about the paper work?? Dont be so naive. Each HOD is provided PA (personal assistant), so the PA will do all the paper work. In fact, all PA’s already has the template of paper work. So, it’s simple thing to do. The Bos only need to sign.
so, that’s why my hosp is currently is an award winning hosp in term of highest extension rate. they also can simply extend final posting ho which is really done by any hosp. one of my friend was extended for non specific reason. she fight back as she could. But in the end, no point you’re fighting the battle that you can’t win. In the end, she resigned. She was a good and competent HO. Extended because HOD didn’t like her. So sad..
Don’t be surprised that, the main cause of extension in my hosp is because HOD doens’t like her/him..
typing error ” rarely done by any hosp”
That sounds uncomfortably like a case of schoolyard bullying – a crowd of bullies encircling a poor defenseless child, ostracized just for being different or simply because, as you say, the director is happy when any HOD wants to extend HOs. It is unfortunate that this is happening in some of our hospitals. The effects of unwarranted extensions only cause broken spirits and affect their performance. There is also the limited time they have to contend with!
people is just so vulnerable, especially the high educated ones. a doctor is working too much, receiving too little in malaysia. it is an unbalance.
news telling us that, working in such environment, it is unpleasant to everybody.
before taking up medicine, i guess, in every children’s mind, doctors are angel, smiling, kind. who knows behind the scenes, at the same time, they are slaves, devils, satans?
i really question, what patients should expect from doctors?
what society should expect from doctors?
what senior doctors should expect from junior doctors?
Well, let’s just say, the system has been corrupted from bottoms up. HO -> MO -> Specialists. Not all of them though, but judging from ratio of safe doctors to patients, it is far less than the projected figure. At most maybe 10%.
couldn’t agree more with JMO! well said. being a doctor in malaysia aint that noble afterall. sad but that is the fact. nothing much can be done. “you kiss more butts-you win,” … treating patients is just a job for most specialist/MOs. it aint a passion anymore. when the going gets tough – the HOs are the ones being bullied, tortured, insulted, & even assaulted resulting in them turning on each other – start pointing finger, ass licking, & some even fulfilling their MOs sexual needs in order to get through. & when these HOs become MOs the cycle continues. for the record, a respi patient collapsed & died – a wont be bothered consultant on call stated pneumonia as the COD. who the fcuk dies from pneumonia dammit-! well i wouldnt know where else to send a sick family member/relatives nowadays – maybbe i should try my verybest to treat them myself. as far as i know, your life shortens by 50% aint because you smoke a cigarette, it is once you step into a government hospital !!!!!! beware =.=
As I have said before, many of the good consultants/specialist have left the gov service leaving behind the “apple polishers and world travellers”. The junior specialist are not getting adequate supervised training.. That is why things like this are happening in civil service. BTW, patients can die of pneumonia! I got no idea what you are trying to say.
couldnt agree more with JMO! well said. being a doctor in malaysia aint that noble afterall. sad but that’s the fact. there’s nothing much that can be done – “you kiss more butts, you da winner”..treating patients is just a job for most specialist/MOs. it aint a passion anymore. as a houseman, i never saw my HOD throughout my whole posting. was she too busy?@!@?# when the going gets tough – the HOs are the ones being bullied, tortured, insulted, & even assaulted. well then come the MOs – but they more or else have an immunity – at the end of the day they would just quit the job, apply for a private hospital, or just do locum….the HOs are the ones vulnerable resulting in them turning on each other just to find a way out – ..start pointing fingers, blaming collegues, more gluteus maximus licking, psychotic neurotic breakdown, drug abbuse, & sad yet true some resulted in fulfilling their MOs sexual needs …(yes the truth needs to be revealed)..& when these HOs become MOs the cycle continues. For the record, a respi patient collapsed and died – a couldnt be bothered consultant on-call simply stated pneumonia as the COD at the same time yawning****who the fcuk diesfrom pneumonia dammit!!! well i am clueless as where to send a sick family member/relative nowadays – or maybe i would just try my very best to treat them myself….as my experiences tell me, your life shortens by 50% aint because you smoke cigarettes, it is once you set your foot into a GOVERNMENT HOSPITAL for treatment….sooooo kudos MOH Malaysia.