I received the following “prescription” from a friend of mine! It is definitely a prescription from a government hospital as you can clearly see. I can also say that it is likely from a medical department looking at the types of medication being prescribed ! In my last blog post, I was talking about how some pharmacist are treating patients like doctors and giving dual sulphanlyureas. Unfortunately, the situation among doctors is also getting bad to worst.
For those who do not realise, please look at the last medication that was prescribed: “GlaxoSmithKline 250mg bd” !! This is NOT a name of a medication. It is the name of a pharmaceutical company aka GSK. I still can’t figure out what it should have been. I hope some of this blog readers can give me an idea or make a guess.
I was informed that in many of the new medical schools locally and overseas, pharmacology is not being thought as it use to be. They expect the student to learn along the way. It could also be due to the fact that a pharmacist always follows and plays an active role in the management of patients in other countries. Unfortunately, we have a long way to go, even though many general hospitals have started to do so.
In this case mentioned, I am sure the pharmacist would have picked up the mistake. As for the doctor, even though it would not have caused any serious problem to the patient (since the drug does not exist), prescription errors does cause serious harm ! Thus, it is important for any doctor to check their prescription properly before giving it to the patient.
Laughter is the BEST medicine………………
Pagalavan's Avatar 
Zinnat maybe? Govt still uses the original I think! Haha this made my day btw, doctors write the darndest things!
Hmmmm, you may be right !!. I never knew KKM still uses original Zinnat.
BTW, did you realise that the Metronidazole and “Zinnat” is being prescribed for 3 months? I got no idea what is the indication
Hi doctor, are you aware of any (private) practitioners in KL providing 24 hour ambulatory blood pressure monitoring? As far as I know, I don’t think government clinics or even government hospitals providing this monitoring. I check the websites of some private hospital in KL and they do not seem to provide this service.
Only basic pharmacology is thought in medical schools. Such problem is due to the poor housemanship. However the senior is not entirely to be blamed as the number of HOs are so many and it is impossible now to give individual supervision. Such prescription is likely give by HOs by continue the previous prescription as he had no idea of what he was writing let alone spell out that ‘mistake’.
Interesting. I wonder how the poor patient would be hobbling after eating 3 months of metronidazole….
Poor patient. Tsk…tsk…
I would like to call upon fellow medical doctors to see this: the outcome of our successors. It pains me to see the ultimate price of corruption to our fraternity. If DG is seeing this, I hope he keeps his word.
http://quittinghousemanship.blogspot.com/2012/12/just-to-clear-few-things-up.html?showComment=1373539268971&m=1#c7655396540699606737
well, it is a capitalist world. Everyone wants to make money , by cheating people.It is the public we need to educate as our enforcement is weak!
I agree with you Dr. Pagalavan. it is the public we need to educate. and as doctors, it is one of our perogatives to provide evidence based information as accurately as possible. if all of us do our part, hopefully the exploit of the gullible will be minimised.
This should be posted to the DG’s facebook since he is quite active on facebook, so that he is aware of what is going on.
3 months of metronidazole! perhaps it is just a glib from the busy houseman? i would like to think he/she knows better. i mean we all make silly mistakes when we are busy and in a hurry, and especially when we are just housemen. I have been reprimanded before by my registrar for writing up prophylactic dalteparin for a patient awaiting gastroscopy with ?UGI bleed. I learn from my mistakes. And hopefully someone will point this out to the houseman so that he can learn from his mistakes too. and be safer in the future!
That is the biggest problem over here. There are just too many housemen with too few supervisors. Thus, mistakes like this goes unnoticed. However, I am sure for this incident, the pharmacist would have noticed it. If not, it would not have appeared in this blog, haha.
Pretty sure the pharmacist would have called up the dr when prescribing metronidazole and GSK for 3 months. Hardly any room for mistakes when there is counterchecking, though mistakes still do happen. A 5 years old kid was prescribed Sy Penicillin 270mg qid but was given Sy Erythromycin 800mg qid instead. Fortunately(or rather unfortunately) the kid developed severe abdominal cramps after the 1st dose. No other harmful effects was done, but it caused a furore over the parents’ side and the attending Pediatrician had to monitor the case.
In response to Poor Doctor’s comment regarding poor housemanship, I would like to comment that it is not always the problem with housemanship. I work as a consultant in a large government tertiary hospital and I am involved in HO training. The quality of some of the HOs leave me horrified on occasions. Some don’t know how to take BP, some don’t even know where the spleen is located and can’t even name simple antibiotics! (name 2 examples of aminoglycoside antibiotics :gentamycin and erythromycin!). We can only do so much in our 4 months the HOs are posted to us. We assume that the medical schools have equipped them with the basic knowledge in medicine but sadly some leave their medical schools without even the basics. We cannot re-educate them again when the medical schools have failed to do their job. Some medical schools have such low entry requirements that they enrol students who neither have the interest nor aptitude for the job. We used to have 20 or so HOs previously but now have over 50! There’s no way that there can be adequate supervision for all of them. So we try and identify the weaker ones and concentrate our efforts on them. We try to ensure that they are safe, if not exactly fully competent. We are being overwhelmed by a tidal wave of mediocrity which is extremely sad for the country and for the patients.
But according to some politicians and officials, you ARE supposed to re-educate these housemans to competency. If you don’t/can’t, you are no good.
Yes, it is like compressing 5/6 years of medical school into 4 months.
Don’t we think that we can claim a new Guinness World Records? It is truly Malaysia BOLEH.
Hi sir…. I just graduated from Matriculation and I got accepted into USM. I am a bursary student too and so I am guaranteed a JPA scholarship. I hope I can have some opinion from sir about the schorlarship. Since there will be a surplus of doctors in the future, does this scholarship give us priority in housemenship and job opportunity?But there is one thing i worry about. If I take this scholarship, MOH will have right to decide my job allocation and i heard rumours that they will arrange jpa scholars to remote places since they are bound by contract. I am able to afford the course with or without the scholarship… So does sir think that I should take it?
So you will not be a doctor for the needy in “remote places” then?
oh i am sorry… I am not meaning that… it is just that in my early years of being a doctor, I hope to be exposed to the latest equipment to learn and gain experience first…
Equipment does not give you any experience. Medicine is not about equipment. Trust me, the more rural you work, the more experienced you will become!
Yes, being a JPA scholar guarantees you a civil service job. Where you will be posted depends on availability of post. It does not matter whether you are a JPA scholar or self paid, as long as you are a government servant, you can get posted anywhere in this country.
so i guess it is better to take the scholarship right? thanks a lot for your information.
yes
Dear Dr Paga, i just got accepted into UM to read medicine. Applied for dentistry but got a medicine offer. Should i try appealing or settle for medicine? Will they withdraw my offer if my appeal to switch fail?
do what you are interested in. Sometimes, I really don’t understand how our university system works! It has never changed. Most of the time, the UPU decides instead of letting the students to choose their subject of interest.
If I am not mistaken, you can appeal but you don’t loose what you have already got till your appeal is accepted.
How come you get medicine if you dont put it as some of your first choices?
What courses you applied based on priority?
Welcome to boleh land
Dr Pagalavan,
Do you think our local university should introduce interviews for prospective medical students in order to shortlist them?
Not every top student has the necessary qualities of a doctor.
This will open up a whole new topic of discussion! Entry requirements into private medical schools in the country is already a “conundrum”, for lack of a better word.
Yes, most countries do that but not in Malaysia. Even if they introduce it, it should be centralized and not given to the respective universities.
i m curious why you said it should be centralised? In the UK, the universities conduct their own interviews and decisions are made by the respective universities. And it has worked very well so far. With a league table, each university will want to choose the best students to stay competitive.
Also, it will help stop the demands from top students that they should get a place as now there is an interview requirement to select not only top achievers but those with the necessary qualities of a doctor.
I think you forgot that you are talking about Malaysia!
There is NO transparency in Malaysia. Even if the interviews were to be conducted by the universities (public), they will do it indoor with no outsiders. How transparent would that be? When I was with Monash Malaysia, I was trained to become a interviewer in Australia. The interview panel will consist of 1 rep from the faculty, 1 from the uni and 1 a general public representative. The decision is made there and then itself and made know to all the panel members.
As for the large number of private universities, only money matters ! the interview will be an eyewash only same as the so-called foundation studies.
You need to “familiarise” yourself with how things work in the country, JL. Education is highly politicised, and it’s uncool to question issues which are deemed “sensitive”.
The interview is useful to ascertain that the right student gets selected, amongst the best applicants. That is the purpose.
There is NO point doing interviews in Malaysia, since the priority is NOT to choose the best students, but to get enough students with money to fill the places. When enrollment is below the medical school’s capacity, the priority is to encourage students meeting MMC’s minimum requirements to enroll to fill all available places. It matters not, whether they are suitable, after all, many will be just be with the minimum BBB grade. It’s the RM250-450K per student that matters.
Personally the interview process i underwent many years ago as a student was one of the best experiences in my life. I was away when the Cardiff interviewers came to Malaysia but they even re-arranged a tele-conferencing for me in the RTM station. The preparation process, the excitement, the anxiety and the reassurances by the interviewers when you know that you have done well make the application process so memorable. I receive offers from universities from England, Wales and Scotland but I chose Wales in the end as the positive experience from the interview affected me greatly.
does anyone here know about rig doctor ( doctor working on oil rig)? I heard the oil company usually use intermediary agent to look for doctor, but I hardly can find the job opportunity in the web.I don’t mind the working environment/ condition-( stay offshore for months, continuous oncall when offshore, far from family- oh i’m still single)
usually you need diploma/masters in Occupational medicine. You need to contact the oil companies directly. Sometimes they subcon this service to other companies. Try Exxon Mobile/shell
occupational medicine – is it Dip OSHA, the one that u have to do at Bangi?
one of my friend – MA, said that usually they only hire paramedic (his takehome pay around RM 18k,currently working with Aramco). nevermind, I’ll try my luck
Thanks Dr Paga. They told me appeals are not applicable for medicine and dentistry. Parents considering private unis since dentistry is what i really want to do.
as I said, our university should start treating people like adults and let students to choose their course of interest.
Not sure if it has been dealt with this way ever since then or it just started this year. Was told to leave the offer to make life easier for them with a tinge of racist remark when i went to appeal for a switch of course. Anyways, will be heading to imu for dentistry. Dr Paga, what do you think about imu for dentistry?
Would you like to share what was said? 😉
Welcome to Bolehland! IMU dentistry is fine.
Jaz, dont think its appropriate to pen it down here as it serves as a platform for future healthcare professionals to seek clarifications and advise. Haha. Dr Paga has helped me too and i believe it will continue to be an eye-opener for many aspiring Drs out there.
Thankyou Dr Paga.
Meihan,
I used to have a friend who applied for JPA to study pharmacy. instead she got an offer to study medicine in UK and Ireland. while studying her A levels in Taylor’s college (also under JPA) she applied for a change to pharmacy but the appeal was rejected. Hence, she continued with her course and got into Nottingham University for medicine. After graduation, she returned to Malaysia. Today she is a doctor, though her initial dream was to be a pharmacist.
Hey Jeff, i prefer something more hands on hence i chose dentistry. Plus severe lack of empathy and ability to comfort compared to some of them whom i met during the UM interview will make me a bad physician. Thanks for your kind advise. 🙂