When I wrote the first part of this topic few days ago, I received good and bad feedbacks. There was one unknown guy who called me “bodoh” and also called himself “bodoh”. If this is the type of young generation that we have than our country is doomed. I have always said in this blog that if you want to argue about something, do it intelligently with facts rather than emotionally.
Many people are still living in dream land and think that being a doctor is glamorous, will have a glorified life and rich with a lot of money a.k.a good life, good future and good money. BUT the reality is the opposite. I have written enough information about the life of a doctor and the general misconception of being a doctor. No one can deny these facts. It is the younger generations who are unaware of all these issues before they decide to do medicine. There is a blogger (who quit medicine during housemanship) who decided to post my article in his blog http://chroniclesofaloner.com/2012/06/20/an-overrated-job/. Just look at the questions that were asked to him when he decided to quit medicine. That is exactly what the public thinks about medicine which obviously is not the reality. All doctors are rich?? Gosh, have they seen a doctor driving Kancil? I have! I also know of many doctors who buy big cars just to keep up with the social status but have huge amount of debts! Even their own parents force them to buy big cars to show that their son/daughter is a doctor. I still drive a Honda Accord with a RM 90 000 loan from the bank! Every now and then I get disturbed by Insurance agents and Banks to take up some investment plans. And guess what the amount they want you to invest? At least RM 100 000 – 200 000, one-off payment!! Even they think that we are being “paid” a huge salary. When I tell them that I am not employed by the hospital, they get a shock.
In many developed countries, doctors have a very stressful life with a lot of litigations going around. Some quit practising medicine when they get sued once or twice. The society will eventually get very demanding and would not hesitate to take any action against any doctors for the slightest mistake that you make. Everyone wants to make money and the lawyers are ever willing to sue you. The indemnity insurance is increasing by almost RM 200-300 every year. MPS (Medical Protection Society) http://www.medicalprotection.org/malaysia/membership/subscription which is the most well-known indemnity scheme in the world publishes case reports of some of the cases which they have to settle by paying quite a big sum of money. You can view these cases over here: http://www.medicalprotection.org/malaysia/casereports. As I have said before, the “forgive and forget” generation is slowly disappearing. Even in Malaysia, as I wrote in my first part, the litigation rate is going up on a daily basis especially in big towns like KL etc.
I was informed that under the recently amended Medical Act 2012, it is mandatory for every doctor to purchase indemnity insurance including government servants. Previously, government servants need not take insurance as the government will cover you but the situation will change soon when the Act is gazetted. This is because the government could not cope anymore with the rate the litigation is going up. So, eventually the government will also disavow your existence if you get sued.
Malaysian Medical Council is also receiving all sorts of complains from the public. As long as a complain reaches MMC, an investigation has to be conducted. You can view some of the cases over here http://mmc.gov.my/v1/index.php?option=com_content&task=view&id=90&Itemid=134 in each of their bulletin. Of course, most of these cases may finally turn out to be “no case” BUT the hassle that you have go through will only add more stress to your working life. FYI: once MMC calls you for an enquiry, it will be held in Putrajaya and you need to take few trips between your hometown and Putrajaya. Finally, not only your insurance have to pay the compensation but MMC will also suspend you from practising, if they find any form of negligence or professional misconduct. These are the problems that a doctor has to put up with when you start to work.
This is the reason why many doctors DO NOT encourage their children to do medicine. Worldwide, most surveys have shown that more than 50% of doctors do not want their children to become a doctor. I found this article written by DR Greg Hood very interesting indeed http://boards.medscape.com/forums?14@@.2a31ed0c!comment=1 (see below). The article is spot on and he also talks about the debt that a medical graduate accumulates the moment he steps out of the university and the time taken to settle this when in most other profession, you can settle it within a few years. This comment by a surgeon also interested me:
“I am a surgeon and my wife is a family Medicine specialist , we pray together as muslims do everyday and in my prayers i ask for the normal things such as long life , good health but since 2 years back we always end our prayers with ” please Allah , do not let our children look at us and choose to become doctors, let them live their lives and have time for both themselves and their own families, let them have a fair chance of being happy”
I believe in Malaysia it is truly the wrong profession to be in —at the current moment”
I also had a very interesting comment on the “saving” life issue:
“During interview, most of the interviewers will start with this question, “why you want to become a doctor?”. When i am a first year medical student, my answer will be saving life. When i graduated, the answer is different. Doctor cannot save life, instead doctor can only help and comfort patient. Saving is the job of God.
i have a friend who did a great job. He saves earth. He owns a recycle factory. Guess what, he is a PMR leaver. Currently owned a semi detached double storey house, a few lorries and vans. His income is 5 digits. He is doing greater job than doctor. Better quality of life.
Another friend of mine who is an accountant who own an ACCA, currently married and owned a happy family, blessing with 1 kid. Income, amost 5 digit. She is doing her job in helping people as well.
In fact, we are helping each other. If want to save most people, then become government will be a better choice.
For sure, I will never encourage my children to become a doctor. So far, they do not have any intention as well. May God show them the way.
You Advised Your Child to not go into Medicine, How’d it go?
Greg Hood, MD, Internal Medicine, 09:08AM May 26, 2012
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A common refrain when doctors get together is that they would not/have not recommended a career in medicine to their children. A frequent refrain is heard, as one comment on a recent blog of mine opined, “This is but one additional reason why I directed my children into careers other than medicine.” Lending credence to the frequency of this advice, a 2007 survey by Merritt, Hawkins indicated that 57% of 1,175 physicians would not recommend the field to their children. Subsequently, this year The Doctors Company released the results of a 5,000+ physician survey. It revealed that, a mere five years later, the percentage of physicians who would not recommend medicine as a profession has increased to 90%. Such warnings are eye-catching and potentially dire for the profession, but for those who have actually rendered such advice, how has it panned out for your children? Today, many college graduates have well publicized difficulty gaining employment. Spontaneously, one of my children recently remarked that, with two physicians as parents, she finds it difficult to imagine what going into a field other than medicine would possibly be like. Many professional fields thrive on such multi-generational ties. Indeed, not only are such connections a major advantage to children seeking employment in certain fields, these connections represent vital lifelines in medicine through which decades of experience are passed along. In 2012, some career fields are reported to have demands for graduates that match or exceed the available supply of graduates. For example, actuaries, who are employed to estimate future risks and costs for companies, are looking at bright futures themselves. Astrophysicists are similarly able to look to a future where the sky is the limit. The shortage of geophysicists in some ways mirrors the shortage of primary care physicians. Schools are not graduating enough grads to meet demand. As a result, significant numbers of foreign trained geophysicists are being brought in on visas to fill open slots.
Several reasons are given for why physicians may not advice their progeny. Frustrations were recently outlined on Medscape here where almost 50% of physicians said they would not choose medicine for themselves again. Being a doctor is seen by many as a career on the wane. Education and training goes on for ever, and ever. The hours are getting longer, and the freedom with which to help patients has become progressively constrained. One major concern students have entering medical school is indebtedness. Medical students commonly graduate now with over $120,000 in debt. To illustrate, payment on a debt of $150,000 at the end of residency at an interest rate of a mere 2.8% is $1,761, every month. Few have been able to repeat the feat of Joe Mihalic, who paid off $90,000 in student loan debt from Harvard business school in just seven months, as noted here. Physician incomes have not kept pace with the growth of education expense. Medical liability insurance and risk, office overhead, and new costs, such as for servers and electronic health records, have whittled away at the bottom line. Take home pay has waned, along with the autonomy and respect that were once synonymous with being a physician.
The brass tacks question is; however, is the grass really greener in other professional pastures? To be sure, those who enter other fields, such as in business and in law are able to produce at a younger age. They are able to take greater advantage of compounding interest with their savings. They may have a lower degree of indebtedness to offset after completing their training. This may be conducive to a better balance of family work-life balance. Their quality of life may differ, because they are not making life and death decisions. However, what happens to them should they question the relative importance of what they are contributing to society? That is one question few physicians have to ask themselves. Additional potential downsides to other professions may include a lack of job security. The potential of having to relocate for work can be a frequent worry. |
Pagalavan's Avatar 
Many HOs had e-mailed me regarding other possible careers for a mbbs graduate.
I have some points to add in my previous post :
1. If you are into money, never join medicine
I had the opportunity to meet with graduates from other fields in my job in the financial industry.
Do you know how much an Investment Banker with a Chartered Financial Analyst (CFA) qualification earns? (highly reputable qualification from the CFA institute of Malaysia)
For a starter the pay is around RM 6k per month, with at least 6-8 months bonus per annum. Those who really performs or experience can even earn a bonus of 2 years, with a basic easily of 20-30k.
Of course, the job is stressful, since you are managing and multiplying the banks money. But you get the option of retiring early.
One with ACCA, there are plenty of job opportunities out there with high income and good prospects.
Actuarist – high in demand in insurance companies.
The money is not in Medicine.
2. Once you’ve joined medicine – life long commitment
Honestly, it’s not easy to chance your career, unlike those in engineering fields (they understand the risk of big construction projects financing – an expertise required by banks), lawyers – there are plenty of companies they can join, ranging from banks, insurance companies, real estate and property, as most companies requires a legal advisor.
Unfortunately, options are not in favour of medical graduates.
It’s well reflected by the number of interviews I had to go through.
3. If you quit medicine, people always question you…
This is a real problem when it comes to job interview. The questions I’ve mentioned above are some common question of the interviewers.
Some may even think that you had a major misconduct in the hospital and you have been dismissed from the hospital since in their perception, being a doctor is such a lucrative and respectable job.
Guys and girls – please choose your career wisely. There’re plenty of careers with great prospects out there, please do not limit your options. Take a career aplitude test, ask around for opinions, do your own research and choose wisely.
And as mentioned by Dr Paga above, if your intention is to help others – there are many ways of doing it. What matters is whether you are able to make a difference…
Lastly, only those doctors with true passion to serve the patients will survive.
Sorry for a long post, Dr Paga.
Sorry, CFA qualification is from the US.
Typo error.
Well said.
Not all taking accountancy, banking investment, actuarial science and etc will pass their professional exams (same as not all MO will pass their MRCP, MRCS, etc) becaue these exams are not easy too. Most of them also just end up as chronic basic degree holders of these courses and landed on jobs not related to their trainings with lousy pay and no job statisfaction, grumbling the rest of their life like the chronic MOs do. I have met many of them.
Not all CFA holders earn good pay as it all depend on whether they have clients with high investments. Not all ACCA earn high income because of the stiff job competition among themselve.
Of course they are some very successful ones, same as they are also some very successful specialists earning a lot of money in private hospitals. In any profession, you always see more “losers” but less “winners”.
Karen
I agree
Unfortunately, in this world, it’s all about survival of the fittest. Those who aren’t smart (academically or in real practical world) will not do well in medicine or in other professional course.
I believe all we want to do is to let those young secondary school graduates understand that a career in medicine does not guarantee high earning.
So it is also not advisable to encourage any student (wants to make a lot of money) to take up other courses like accountancy, actuarial science, engineering, law, etc and giving them false hope that they will earn big money in the future. For examples, the professional exams for actuarial science and ACCA are tough and a series of them too. Besides that, many are not qualified to sit for the exams due to lack of work experience or exposure, etc .. . So they most probably may end up as chronic basic degree holders with lousy pay too.
In a competitive office or corporate environment , there are also many dirty ‘office politics’ victimise or ‘kill’ you too just like the dirty ‘ward/department politics’ faced by some MOs/Hos.
One difference between other professions and medicine is the fact that when become a private doctor( to make money), it is a 1 man show. Where as in other professions, when you open your own business, it can still run without you being around. In medicine, you earn nothing when you are not physically there. Of course you can hire locum but patients may not be interested!
A Doctor is just like a movie star, either he/she is very famous making a lot of money or just ‘cari makan’. They (the patients) go to the clinic because their trustworthy doctor is on duty there. Just like movie star, they (the movie fans) go to a particular movie because their favourite actor/actress is acting in the film.
can i have your email?
Medicine, is a science to look out for progress, just as computers have evolved, so has medical science. With a narrow outlook of merely earning money to drive a big car, to show your fellow being that you are better materially is never lasting. This is the very principle of doing medicine.
3 days ago, in the remote Village of Pagar, Betul a small village in India, a group of doctors, 5 from the batch of 1982, CMC Vellore, India, came together exactly 30 yrs of graduation to work to seperate this conjoined twin…not in a well equipped centre but from a small remote village and basic borrowed equipment, without fees or money involved, this 12 hours surgery was done with prayers, hardwork and faith… I am indeed proud to hear about this… Here we are talking about doing medicine, driving special large cars to please or show off to another person… There are lots more in this world who need help and care….There is always a role in being a doctor…You are chosen few to cure sick…Healing is not your job….but if there is so much of self centredness involved..the very essence is lost…This is what I am finding today in Malaysia….
The following are the articles in which the village hospital separated twins to create Medical history….
http://ibnlive.in.com/news/mps-conjoined-twins-separated-after-12hr-surgery/267191-3.html
http://www.indianexpress.com/news/in-a-village-hospital-doctors-separate-twins-to-script-medical-history/966058/0
I know young MOs driving cars worth more than RM100K, paying the monthly installements through their nose, to upkeep the status. I don’t drive a flashy car, so am free of debts can use my money for so many things even do some charity. I am happy :).
good for you..most people would probably succumb to peer and social pressure. it’s funny when people are trying so hard to live up to the high expectation of the society instead of focusing on what really matters in their life.
“I still drive a Honda Accord with a RM 90 000 loan from the bank! ” I think you are trying to joke here.We are all fully aware that the least a Consultant Physician & Rheumatologist could make a month is rm35k.You are either having the fifth car or buying your niece a car.Feel free to correct me if i’m wrong.
Nope, I am not joking!! I have this car and my wife got another car with a bank loan of RM100K! I know a doctor who drives a BMW but pays RM3000 permonth for bank loan! I don’t think you are getting the point. It is about debt.
Of course, you can buy big cars with big debt but being a private doctor means it Is a 1 man show. If anything happens to you( like accident, cancer etc), your income will be zero. So how are you going to pay when you also have 3 kids to feed & educate?
I know of a cardiologist in private who was doing well and his wife resigned as a teacher and became housewife. 4 years later, he was diagnosed to have brain tumour, inoperable! The entire income of the family became zero with huge debt!
So, I am NOT joking!
Dr.Paga
Does the insurance companies in Malaysia offer disability insurance? That is the way we protect our income in the event of any accident causing disability in North America. And there is life insurance that one can buy so that their family will benefit from it if the breadwinner pass away.
There are but how long can this insurance support you? At the most 2 years!
Dr paga, maybe insurance in Canada gives better deal. The disability insurance will pay monthly until age 65 to 70yo. And you can buy large pay out critical care insurance to protect ourselves if we unfortunately get cancer, MI, meningitis, etc. Otherwise with standard life insurance, one can ensure that their family get the large amount money if one dies.
WE don’t have disability insurance as mentioned by yourself. We do have critical care insurance but the premium is high for large amount.
Well said Dr.Paga.
First of all, car prices in Malaysia are ridiculous!! Why even think of buying a BMW? The tax here is astronomical,public is taken for a ride. You can get a brand new BMW 5 series for just 30 thousand punds in the UK, and the car is like RM350K here… study MBBS for 5 years but don’t know how to not get cheated!!!Memang Bodohlah!Moreover you buy the car, you won’t make a cent of profit selling it as a car is always a liability.Trust me, he/she who has ready money in the bank is the rich one in today’s world, and not those paying so much of loan…!!!
Direct comparisons between Malaysian vs European car prices is actually pretty pointless. UK income tax bands are 20%, 40% and 50%. The upper rate of income tax in Bolehland is a relatively paltry 26% (and basic at 1%!).
In addition, UK also has VAT (a type of govt sales tax) at 20% on just about every retail item. In Bolehland, this is 6%.
Governments will tax the people one way or another. If you pay less income tax, expect to be taxed in other areas (eg: cars, tolls etc). Tolls are almost non-existent on the UK motorway network.
Well said Dr.Paga. I’m a frustrated 5th year med student, soon to graduate from an unrecognized Chinese medical university in July 2012. I was thrilled to hear the MQE, thinking to myself that MMC finally did something RIGHT. But the process of going through the MQE application was very demoralizing. The formalities can definitely kill the passion for medicine. Why can’t the MMC model an exam out of USMLE. USMLE is such a convenient tool for both the medical authorities and med students. I have big passion for medicine. The wonder of medicine awes me frequently. But the thought of combing through the curves and bends of getting myself a license to practice in Malaysia throws me back sometimes. It’s a game of love and hate.
may I ask you whether you learn in English or chinese?
Bilingual. The school hired lecturers who studied abroad to mentor us. We communicate in English mostly. When we were interns in the hospital, we converse with patients in Chinese. It was tough at first, but we get hold of things after some time. Most of my classmates were preparing for USMLE. The overseas student population is made up of Indians, Nepali and some minorities such as Malaysian, Ghanian, Indonesians.
Medicine is beautiful. It is the bureaucracies behind it that tainted it.
Medicine is an art and a science, but it is not a miracle. Many people see Doctors riding in on a horse saving people, but the reality is that there is only so many conditions that can be cured.
In this day and age the art of medicine in slowly being killed, it is being killed by litigation. Many a good doctor will second guess themselve or unnecessary test just to prevent litigation. It is not so uncommon when someone gets sued that the hospital will leave you high and dry for the lawyers. Even the very people we seek to help will sue us at any chance they get. Getting medical indemnity is just the smart thing to do, so when we make mistakes we don’t have to pay for it at a price to costly.
Medicine is likely any other field people work in, not everyone gets into speciality training. But that does not mean to say that medicine does not pay well. I agreed with Dr. Pagalavan that in medicine you will never drive the latest or best car, but you will never be without a job or without a roof over your head(even if it means sleeping in the hospital between shifts).
Many traditional asian families still want their children to do medicine, because for them it is one of the big careers in society. But they don’t know the stress and pressures people have once they do enter the medical word.
If asked whether I would make my children do medicine?, I think that is their own decision. I can only show them what the world of medicine is like and if they want to do it its up to them.
Yup, agreed. However, guaranteed job may not be true anymore in the future. You may still be able to get job but not as a doctor!
Dr.Paga,
This is a bit out of the topic, I have friends who are doctors, they are actually my childhood friends. They are so pompous with having the DR. title in their names, and tend to make a big deal out of it. I am not a doctor and I feel very left out. I feel like they are in their own worlds and don’t really have the same bonding towards me like before, does medicine change people to this extent?
It is actually very disheartening……
These are people who do medicine for glamour and prestige. Real doctors are people who are humble and treat everyone with respect, same as how they are suppose to treat their patients.
However, sometimes a lot of people assume that their doctor friends are bossy just because the doctor did not entertain them. This could be due to their busy schedule and tiredness.
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