Over the last 2 weeks, I have been receiving numerous emails and blog queries about which university he/she should choose to do medicine. It is rather surprising to see that each student seem to be have received at least 3 university/college offers to do medicine ! This is what happens when you have close to 36 medical schools with almost 45 medical programs. It is surely an Air Asia theme like scenario “Now, everyone can become a doctor…….” This does not include those who go to various other countries to do medicine. Shockingly, after writing so much about medicine in this blog, I still get questions that I find rather irritating at times. There are many students out there ( some are already 4th/5th year medical student) who still do not understand about degree recognition issue and post-graduate educations. They still think they can go to another country and easily get a job! They still think that postgraduate education is as simple as reading books and sitting for exams. Gosh, what do our schools teach the current generation of students ! They really fulfil the criteria of “katak bawah tempurung” .
As I have been saying many times over the last 3 years, just imagine the glut of doctors that we are going to face in 3-4 years time. When the market is saturated, the income of all doctors will decline. Even now, I see new clinics being open just few doors away from another clinic. That is how competitive it has become. In fact, I was just informed that some insurance companies have started to reduce their consultation fees for doctors by at least half ! If you don’t agree, they will go to another doctor who will ! The newer GPs will obviously agree, to get some income, rather than nothing. To add salt to the wound, our Health Ministry is planning to open another 40-50 1Malaysia clinics throughout the country as mentioned here and below. The 1Care system is still being kept under the carpet till further announcement.
In January 2012, I wrote an article on how doctors in US are going broke. Well, the situation has not changed much. The latest news from US says that many private practices are being closed/sold due to poor income (insurance companies have started to slash the payment), increasing litigation rate and high maintenance cost. Thus, many of the specialist are running back to hospital based practices with a fixed income. The situation is the same in many other countries as well. Even in Malaysia, some of the private hospitals have started to employ doctors compared to “self-employed version” which use to be the norm for a long time. This clearly shows that we are now at the mercy of the private hospitals and they can now demand what they want. A fixed income means that your income will be generally lower with higher tax, since you can’t play around with your tax. Furthermore, your income will not be much of a difference from what a government consultant earns.
The declining income has increased the amount of unethical practices. Whatever said , a private practice is a business to earn income for a living. Once you are used to a specific amount of income, you will try to achieve it no mater what. Thus, unethical practices will surface. That’s why I alway tell people that,never let money to buy over you. Keep your commitment low and earn a decent living. Medical business is a “one man” show. If anything happens to you, your income is ZERO!
Doctors bail out on their practices
By Parija Kavilanz @CNNMoney July 16, 2013: 9:18 AM E
Dr. Patrick Cobb sold his private oncology practice in December 2012. “It just wasn’t feasible for us to stay in practice,” he said.
Doctors who own private practices are looking for a way out. Fed up with their rising business expenses and shrinking payouts from insurers, many are selling their practices to hospitals.
It’s happening nationwide and has picked up pace, said Tony Stajduhar, president at Jackson & Coker, a physician recruitment firm.
Experts say the number of physicians unloading their practices to hospitals is up 30% to 40% in the last five years. Doctors who sell typically become employees of the hospital, as do the people who work for them.
The reasons for the trend vary. Doctors are tired of the hassle of filing insurance claims and collecting payments from patients and want to only focus on medicine again, Stajduhar said.
Obamacare has also created more fear of the unknown. Doctors are worried that new regulations will add to their administrative work and require them to pour more money into their businesses, Stajduhar said.
Related Story: One doctor gave up on health care in America
Dr. Patrick Cobb, an oncologist in Montana, sold his 30-year group practice Frontier Cancer Center to a hospital in December. His practice was struggling for years even before health reform passed.
Changes in chemotherapy drug reimbursements badly hurt the business, he said. In cancer treatment, patients don’t buy the drugs themselves. Oncologists buy the drugs and then bill insurers for the cost. Medicare significantly reduced reimbursements in 2003 for chemotherapy drugs.
That was a turning point, said Cobb. “We spent millions on drugs that we bought directly from distributors. When reimbursements fell, our costs went up,” he said. Cobb and four other oncologists at the practice took pay cuts to offset declining revenues, but it wasn’t enough. In 2008, the practice closed one of its four locations.
Cobb and his partners looked for a buyer in 2012 and found one in Billings, Mont.-based St. Vincent Healthcare. The hospital system hired Cobb and the rest of the practice’s staff. “It just wasn’t feasible for us to stay in practice,” said Cobb.
Related Story: Doctors driven to bankruptcy
The cycle of hospitals buying private practices has happened before. In the early 1990s, hospitals went on a buying spree as a way to get access to more patients, said Thomas Anthony, an attorney with Frost Brown Todd in Cincinnati. At the time, it was a sellers’ market and the deals were financially rewarding for doctors.
This time, the market dynamics are different. Doctors are eager to sell and might not be able to make as much as they did in the first wave of acquisitions, said Anthony.
But, for sure, hospitals are buying.
As more of Obamacare is put in place, hospitals are rushing to increase their market share in anticipation of millions more Americans getting access to health care. Buying practices is a quick way to do that, Anthony said. And more private practice doctors want to enjoy steady salaries and hours again as hospital employees.
Dr. Dwayne Smith, a bariatric surgeon, sold his group practice to a hospital two years ago. His practice was profitable but costs were creeping higher in recent years because of shrinking reimbursements.
Related Story: Why doctors can’t stay afloat
One big cost coming down the pike was tied to electronic medical records. Federal law gives physicians until 2015 to implement digital records technology or face a 1% reduction in Medicare payments.
“This would have been a very difficult investment for us,” said Smith.
Smith’s practice approached Cincinnati-based St. Elizabeth Healthcare in 2011 with an offer to sell. The hospital bought the practice and Smith became a hospital employee. He’s happy with the decision even though he has had to adjust to the loss of autonomy.
“My hours are better. I’m not spending hours on administrative work or worrying about my business,” said Smith.
The private practice model is very expensive to operate, said John Dubis, CEO of St. Elizabeth Healthcare. “That’s why it’s diminishing,” he said. Most of the 300 physicians employed by the hospital’s specialty physicians group have come from private practices.
Said Cobb, the oncologist: “We have a joke that there are two kinds of private practices left in America. Those that sold to hospitals and those that are about to be sold.” 
40 To 50 More 1Malaysia Clinics To Be Set Up From Next Year
Health Minister Datuk Seri Dr S. Subramaniam said the clinics would be concentrated in areas with many residents from the low-income group.
“Despite grumblings from the operators of private clinics when K1M was set up, K1M still receive encouraging response from the people because of the low charge imposed.
“It is a successful 1Malaysia product and can benefit the people by ensuring a good level of healthcare,” he told reporters after attending a gathering, here, Thursday night.
There are now more than 200 K1M nationwide serving about 1.5 million people with the minimum charge of RM1 for citizens and RM15 for non-citizens.
K1M is one of the initiatives under the 1Malaysia concept mooted by Prime Minister Datuk Seri Najib Tun Razak.
— BERNAMA
Pagalavan's Avatar 
act..what is the prob regarding with the opening of the KK1M? seriously i dun get ur point..
If I open a clinic which charge 1 ringgit beside your clinic for basic medicine, will there be any problem? FYI, 1malaysia clinic is run by medical assistance and not by doctor. Imagine you have an account firm which employ charted accountant and I open a similar firm next door and employ CLERK (with SPM qualification) and charge less which does similar job. may i ask, will it affect your practice?
Soon, with the glut, KK1M will be taken over by government MOs, which is way more professional than being manned by MAs. Then, these KK1M will probably offer more services just like the normal KKs.
Yes, it has already started in NS, Selangor and Malacca. They are also planning to have antenatal checkups and vaccination services soon
Is a open secret 1 Malaysia clinic will be fill up by MO. When that happen 1 care will come into picture. I estimate it will fill up in the next 5 years. Why? Bacause in few years time gov MO post will all be fill up and it will spill into these clinics.
All 1Malaysia clinics will soon have doctors. It has already started in NS, Selangor and Melacca.
There is NO problem of opening 1Malaysia clinics. Soon this clinics will also be occupied by a doctor when the glut gets worst. I am talking from GPs(private doctors) point of view. I am talking about their declining income etc. Instead of opening these 1Malaysia clinic, the government should integrate the private and public sector
thank Q..
many private clinics, where K1M clinic opens, wil go bust and close for good.
Dr Paga, you have all the patience in the world to answer repetitive questions which answers can be easily found in your blog/comments. The attitude of these GENERATION Y (or Z or whatever one calls them nowadays) is really appalling as they are supposed to be more learned in gathering information in this day and age. It only boils down to the point that this is indeed a ‘spoon-feeding’ generation.
I would blame the education system
Sometimes I think the education system in Malaysia has prepared me well for future aspirations. I recall when I was studying cambridge A levels in Taylor’s college, Subang, I find the level of difficulty not too far from SPM papers. I find that the Maths paper is one subject that is almost guaranteed an A without much studying. Of course the transition from Malay to English in science subjects is a challenge but you get the hang of it after a few months. And because I was educated in the Malay language throughout my secondary school days, I find it bemusing that most parents make a pandemonium out of the issue of teaching Science and Maths in English. At the end of the day, it all boils down to one’s aspiration and perspiration, I believe.
I think GP and Dr Paga meant “the culture” of the education system in
Malaysia, not the academic preparation, per se.
Dear Jeffrey,
As you rightly mention, there are some good elements in the Bolehland education system. For example, I never met top level Malaysian medical students who did not have the ability to bolt their rear ends to their chairs and put in the hours of bookwork required to memorise their textbooks.
But therein lies the problem. After years of rote learning culture, they struggle when the answers require more than just opening a chapter in a textbook.
So they excel with questions like:
“What are the causes of atrial fibrillation?”.
But struggle with questions like
“You have a half million budget. How would you use it to improve diabetic services for your clinic patients?”
In this day of information technology, we should be prioritising information gathering, creativity and innovation in our schools. But no, at all levels (including the training of teachers), the Bolehand education system is still stuck with rote learning and spoonfeeding.
And so, Dr Pagal has to constantly face the same tired questions in this blog from those who would rather get a quick, easy answer than to do their own reading and research.
Jaz, I agree with you especially with the example questions you posed. When I was in Uni here, most of my local friends gave lots of ideas when it comes to open questions. But I also realised one thing – they have been taught to be bold and expressed their opinions. Not so with the Malaysian system with didactic teaching and rote learning. A lot of times, the british locals can talk and express themselves even when they have no idea what they are talking about. Haha! But yet, it is true, generally they are more open minded and think out of the box. That is what I have learnt and still learning in my many years here.
Another thing I remember from my secondary school days is the introduction of KBKK – Kemahiran Berfikir secara Kreatif dan Kritikal. I actually find it very useful and helpful in moulding my thinking skills. KBKK was introduced for science subjects – chemistry, biology and physics. Some of the questions require alot of creative thinking in order to solve the problems and I relished those questions! But alas, I believe KBKK was stopped a few years after my SPM, possibly because the questions in SPM examination were too difficult.
Thanks Jon J for your input as well. I glanced through your name and thought it was just Jaz who replied to me.
Doc,
Am just wondering if it is possible to increase the comments in the “Recent Comments” section? Thanks!
Thank you, Doc!
You’re full of rubbish when you say there’s a glut. Im here, a miserable HO, working from 5.30-8pm each day (NOT because I cannot manage my time) but I have to handle whole cubicles by myself and help out with clinic work on top of that. WHERE ARE THE DAMN HOs I FAIL TO SEE IN MY CUBICLE? haha. Glut glut glut. nonsense. and stop blaming us for being spoonfed. who the freaking hell spoonfeeds us? PEOPLE FROM YOUR GENERATION will never teach us a damn thing anyway. Generations after generations they just know how to bully juniors, scream at them, be mean to them and never to guide them. Pots calling the kettles black! and you wonder why Malaysia is so backward? MISMANAGAMENT AND LACK OF MANNERS – THESE 2 THINGS WONT GET YOU ANYWHERE. and stop blaming, open up your damn eyes and see how you CAN MAKE USE OF THE SITUATION BY EXPANDING THE HEALTHCARE SYSTEM AS A WHOLE. rural areas still lack our services. big city hospitals are overrun by patients. USE YOUR BRAINS and see that more and more patients are coming to our goverment hospitals UNLIKE YOUR TIME where people would just stay at home with Stage 4 Ca. Backward clowns, all of you. I am ashamed that you are the so called senior generation. Look at the Japanese, everything is a silver lining. for us, everything is a freaking CURSE. a backward nation will always be in status quo with clowns like you and the so called ‘amazing seniors’ whose favorite pasttime is to bash the young ones without realising we are working our asses off too. SHAME ON YOU!.
The whole statement of yours above just proves who “LACK OF MANNERS” !! It’s 4 fingers pointing at yourself!
Anyone who knows how to count will tell you that the glut is coming. If not, how the hell the shift system can even be introduced?
The problem is MALDISTRIBUTION!! The maldistribution is not just between rural and urban, general and district hospitals but also among departments. FYI, most public and private medical schools graduate in August/September nowadays and thus the major influx comes in September.
BTW, how do you know that I never thought anything to the younger generations? Do you know me personally ? If not, it is better to keep your mouth shut before saying that we don’t teach anything.
FYI, even from those times, government hospitals were loaded with patients. They don’t sit at home with Stage 4 Ca!! I hope you get your facts right before talking. The load in government hospitals is still the same but it is the demand of patients that has changed.
Overall, you just made a fool out of yourself with the statement above and shows what type of doctor you are going to become.
Hi Dr Pagalavan. For old times sake I decided to read your reply on my rude outburst written above a few years ago. I was a stressed housman back then. but i still stand by my points. Im currently working as a doctor overseas, i just want to thank you for being one of the many factors that encouraged me to leave instead of serving a hopeless and ungrateful generation of senior Malaysian bosses such as yourself. I would not have learnt much anyway. I would in fact have wasted my time each day thinking of new ways to suck up to bosses to go up the ladder. I have no time for that. I have all the passion in the world, but I feel working in kkm would either make me more stupid or make me mentally unsound. I thank you for your pessimistic views, your holier than thou attitude and your very “accurate” opinions and “facts” about a lot of things. I thank you for your wonderful work “ethics” as a doctor with you constant bashing of other doctors and writing about the incompetencies of other doctors in your blog. however, you are not the voice of the majority of us. You are an empty can living in a 3rd world country. If you were employed in a developed country, expect to be sued for divulging details of mismanagement of other doctors in your blog.
Hahaha, a person who runs away from taking the challenge to change the system is a coward to say the least! At least I am still here trying to change the perception and improving the quality of medical system. If you don’t know me you won’t know what I had done over the last 20 years. So, please refrain yourself from saying something that you do not know. As for divulging details ? what details? Was there anywhere I mentioned patients name, hospital’s name or even the doctors name? FYI, GMC can even take action against doctors who refuse to complain to GMC despite knowing their colleague is incompetent and harmful to patients! As a doctor, our outmost priority is patient safety and not to protect incompetent doctors! That is what you call ethical practise. It is you who is being unethical by sweeping under the carpet. AND finally, everything that I predicted in this blog over the last 5 years had become a reality.
I’m really unsure what your contributions are aside from this blog and your amateur predictions. it doesnt take a genius to figure out the overwhelming number of incompetent drs and the glut. Everyone knows that. Ive been an avid reader of your blog for quite some time now. I know your style and statistics. But I’ve yet to see you dig deeper into the psychosocial aspects of the situation. I wont elaborate further, cant teach an old horse new tricks. I didnt “flee” because im a coward. I was more inclined to provide patients more consultation time to benefit them. Our system does not allow that. I was sick of the racism. sick of certain ethnic groups ganging up and mistreating doctors not of the same color. I was sick of a lot of things. kkm is definitely a negative place to be. Pagalavan, I agreed with most of your articles. The reason why I dont have much respect for you is that you are a very negative person. you are biased in your judgement. And you bad mouth colleagues. I dont care what GMC does, profiteering bullshit hospital. My standard and code of conduct is simple. just ask your uk/aust/irish grads what they learnt in ethics. Never badmouth a colleague even in your judgement you think he made a mistake. You think Im a dangerous doctor? I dont know what’s worse – a seasoned specialist who cant adhere to codes of conduct or a reg like me who knows doctors are not above human error. ruminate that will you?
As I said, if you don’t know me personally and do not know what I have done , please refrain yourself from issuing statements. FYI, I have done more to the medical profession in this country than you know. I don’t have to brag about it over here. Ask those who had worked under me. You know me only through this blog which is talking about the reality out there. The very fact you are judging someone without knowing the person shows your ethics! I will say this again, our utmost priority is PATIENT SAFETY! In every country as mentioned by yourgoodself, doctors who commit serious mistakes are thrown out, period! A person who do not report an incompetent dangerous doctor is as guilty as the doctor himself!
Go to any medical council website and see what is their motto. It is always ‘protect the patient’. Patient safety etc. And which medical ethics say protect the doctor by sweeping under the carpet?
GMC stands for the General Medical Council of UK, and not some “medical centre”.
I have now read your biography and some of your published papers. i will not deny the fact that i was impressed. To be honest, I dont think many people can reach your status in medicine. I understand your frustrations with the current younger doctors. but im advising the use of proper channels to take actions. What happened to the incompetent doctors u mentioned in ur blog? Were they ever reported? if they were, good. If not, what is the point
Dr Pagalavan. I feel an apology is due on my behalf. I was immature to judge you as my perception of you was a self centred individual who enjoys labelling the young doctors without knowing how hard most of us work. Encouragement can do wonders. Step in our shoes for a day. avoid blanket statements.
This is your blog and as a reader i should respect your views though i do not subscribe to all of it. Thank you for your patience and time in entertaining my views.
FYI, everyone one of us has gone through the same situation as most of you “junior” doctors. Do you think we reached our current status by short cut?
So, your statement “step in our shoes for a day” does not make any sense.
Yes, some of the cases that I published has been officially reported and actions has been taken. Unfortunately, the action in civil service is either transfer or do desk job.
Dear Pissed Houseman,
Your outburst reflects poorly on you though I would definitely support your rights to put forward your views. I think you will turn out to be a dangerous health care provider unless you change for the better.
Pissed Houseman,
Where are you working? Its obvious that you are probably on the verge of a nervous breakdown. But you got to think that you are probably doing more procedures and seeing more cases as compared to your friends in other hospitals.So, when you are probably posted to a district hospital after finishing HOship, you would fare better and you probably would thank you ‘hands on training’ while you are slogging as a HO.
Dr Paga,
The word is that there’s nearly 8000 housemen joining the service annually. Soon, there would be ratio of 1 HO to 2-4 patients country wide.
You should be happy of your condition as it provide ample opportunities for you to learn. During my houseman time, I managed 45 patients alone in the surgical wards for 3 months before posted to an ‘easy’ ward where only 12 patients. Had dinner at 12am. Did all the follow up, tracing blood investigations, even had hypoglycemia in OT & others. Out from all postings, I learned most from there. I worked from 6am to 8pm everyday and with 14 calls/months. Relax….enjoy the training.
MMI just revised the rate for the medical indemnity insurance. High risk specialist rate go up 300%. For example O&G specialist coverage RM 1million, rate is RM15k (5k last year and 3.2k 2 years ago)> For coverage of 5 million, the premium is RM39k. http://www.mma.org.my/LinkClick.aspx?fileticket=aepHauLzsjo%3d&tabid=36&mid=373 Time to revise my fee, my patient got to pay this!
Yes, I heard about it and it only shows that the litigation and payout rate is increasing exponentially.
Is it compulsory NOW for government doctors ie MOs onwards to have indemnity cover?
Not sure yet. I was told that under the amended medical act 2012, every doctor must have indemnity insurance cover to get an APC but MMC has not made any announcement yet.
Definitely glut + maldistribution…. Tawau GH, where is was based previously has 8 medical MOs with 60 medical beds (medical dept). Alor Gajah Hospital, 24 MO for 26 beds…. Of course, we had to cover nunukan/tarakan/sg nyamuk which is part of kalimantan and numerous illegals…
Is it true that Master of Community Health/Public Health is not as easy as we thought? It has been reported many failed in the top local universities as the university requires publication in international journals before allowing candidates to be called for final exam cum viva.
It is a real shock to me. Some are considering that as a choice upon failing to get into medical/surgical Master. Looks like it is not so simple after all though
this field is commonly linked with paper works and meetings.
Am I wrong to say that?
Kindly share some insider news.
I wrote about this in June 2011 over here
TQ for the link. Looks like it is only UM is facing the issue of publication in order to graduate. Other local Unis have not yet come out with these criteria for publication in ISI Journals. UiTM had few lecturers trained in UM.
From discussion published in July 2011, I guess the one who does not seem to like OH in fact is the then DDG NOT the DG as reported. Perhaps, that was among other reasons he was caught and being promoted as “advisor” in disguise. In short, the hazard of OH in Malaysia has been eliminated.
Future could be bright…at least on paper.
While i do not entirely approve of pissed housemen’s tone (and thereof lack of manners), i can see where he is coming from. In a nutshell, your blog is nothing but a pessimist’s take of the world. With all due respect, this is how you sound to alot of us:’The medical world is about to end, and everyone is going to drown…oh wait…not everyone…i can still escape to singapore’ declares the self proclaimed keyboard messiah in each of his blog post.
I have seen both sides of the divide in my 23 years of medical practice; good housemens/bad housemens, good consultants/bad consultants, and these individuals come from different educational backgrounds. Some come from reputable universities, others not. But to my surprise, the quality of these doctors do not coincide with the reputation of their varsities. A colleague of mine would often jest ‘diaorang (houseman) datang dari ireland ke, mesir ke, longkang ke, semua sama standard. Cuma yang datang dari ireland lagi pandai cakap’. Id like to go a step further than he did by saying, that while not everyone can become a good doctor, a good doctor can come from anywhere. These children that you are discouraging may be better off doing something else, i grant you that. But who’s to say that the secret of eradicating cancer or the like may not be hidden in these fellows you discourage?
That being said, i generally agree that there are flaws in the malaysian healthcare system (as there are in any healthcare system, as im sure you are aware of), but my main disagreement with the whole concept is the attitude of Malaysian doctors in general. When i read pissed houseman’s comment, i had to say to myself, that the kid has some valid points. Sure, we can lament the doctors of generation y as incompetent, but what about us generation W and X ? I have seen colleagues of mine chide both their housemens and patients alike with harsh words and punish these people for no other reason than sheer spite. Some simply because wished to impart the full extent of the torment that we had to endure during our days. Worst still, when proven wrong by juniors, there are consultants whom target these individuals simply because their pride was hurt. When i spent sometime in UK several years ago i was surprised to find a junior HO’s challenging a senior consultant’s management of a patient. I was even more perplexed when the said consultant thanked his junior for his opinion and took the time to explain the reasons behind his management. These are things you NEVER see in Malaysia. Here seniority comes first, pride comes second, insults come in between and arrogance always. In the united kingdom, they treat each other professionally regardless of seniority. This is the culture we should emulate to and impart to our juniors.
In summary, i believe
1. Good doctors are not born, they are made. Help make these new doctors with empathy, respect and patience that you think you yourself deserve.
2. Consultants should be the change they want to see. So change with the times
3. Hate the game not the players; the problem is with the malaysian politics, not these children. Change the politics if you can, if you cant, at least try to avoid chiding the victims of such politics from behind the comforts of a keyboard.
4. A little optimism might go a long way, although this may be too much to ask
5. A word to the wise; Nothing is ever as good as it seems nor nothing is ever as bad as it seems.
with all due respect, whatever you have said above had been written by me many times in this blog over the last 3 years. Attitude of consultants, work culture and work environment in Malaysia has been mentioned by me many times before. Unfortunately, it is NOT going to change anytime soon. We will never reach the culture of the western country anytime in the near future. As I have said many times in this blog, I write what is happening on the ground that many of this budding doctors do not know or understand. A person who has the passion for medicine and do not care about money/glamour would still do medicine. BUT they must know what the job is all about before putting their foot into it. I had seen many housemen and even MOs who regretted doing medicine and the reasons mentioned by them is what I write in this blog. I am not discouraging anyone but they should know what they are getting into. You are right when you said that it does not matter which university they graduate from. I had said that many times. What matters, is their genuine interest in medicine and willingness to learn. Unfortunately, majority of those who are doing medicine now are not from this category. The second factor is the entry qualification which plays an important role. That’s the reason in most developed countries, only the top students do medicine. Unfortunately, in this country, anyone can do medicine. I just got an email that a student with 9F in SPM is doing medicine in Russia !
9F in SPM doing medicine in Russia? I wonder how did the student got the NOC then?
NOC? what NOC? I know many students got NOC without minimum qualifications. The agents will do it for you!
I find that the argument of on HO treatment very interesting. Seem that there are lots of people from both side trying to reason out how HO should be treated. No offense, if you are a HO happen to read my comment : may I ask If you were to work in multinational company would you complaint if your boss asked you to work extra hours during weekend ? Mind you some company do not even pay you OT. So what would you do? If you are the employer of a multinational company, and your employer kept on screwing up his/her work, will you keep them? Will you explained again and again to them? May be some of you may argue I should not compare medicine with other work on the market but are we living in a illusion world of medicine such as the famous ER movie drama? Unfortunately we are living in a real world. If your were scolded by your boss in a multinational company will you complaint to your mom/dad? Will your mom/dad come to the company the next day to reason with your boss? If your were the boss, will u entertain your employee’s parents? Or rather u asked them to pack their bag? The question is, are the senior suppose to baby sit the junior? Why are we degrade to such a mentality? Perhaps some of you can share your thought.
PS: I am not trying to offense anyone one. Just for discussion, please do not use ‘capital letters’ if you want to share your opinion.
Hi Dr. I know this seems out of the topic but I have a question. Can you describe about a career in academic medicine; on the pathway to be one, requirements etc.
Thank you.
I presume you mean working as a lecturer in a university. Firstly, to become a lecturer in medical field you need to have a postgraduate degree. You can’t become a lecturer with just MBBS even though some universities may appoint you as assistant lecturers. IF you want to teach pre-clinical courses, you need to do masters in basic sciences. For clinical, you need to become a specialist.
ok I understand. Thank you dr.
Haizzz future doctors or so called Generation Y will suffer in the future badly, I hope I could survive by working as a doctor in the future, hope one day I’ll be seeing Dr. Paga when I’m studying pre-med. Will Dr. Paga let me visit u?? Maybe you could be my mentor for doctorate thingy hehe
Of course, no problem. What doctorate are you talking about? No such thing in medicine. Post graduate in medicine is not about siting and studying. It is FULL TIME working, part time studying.
[…] hospital in each district. The insurance companies now dictate everything, as I had written over here. Similar situation will happen over here […]
Dear Dr,
Thank you very much for opening up my naive “Generation Y” eyes. My head just came crashing down from the clouds. I’m continuing my clinical phase in ANU, and plan on coming back to Malaysia to work and train to become a specialist. Many of your blogposts have described the future of Malaysian medical practitioners to be bleak. So I post these questions to you, in hopes you will reply me without bashing me..
In your professional opinion, what would you say is needed to right the wrong?
In this sea of chaos, what would be the best course for all the average-joe doctors, with closed, uncreative minds born from this new system, such as myself? (I won’t pretend that I’m in love with this field and my entire soul has called out for this field long before I was born. But I like what we do, alot.)
So what should we do when passion alone isn’t enough anymore?
LOL @ sarky undertones.
ask yourself, why you decided to do medicine. If you had chosen for wrong reasons that you will never be happy on what you are doing. Remember, being a student is different that being a doctor. I know many of my classmates who enjoyed being a medical student but resigned when they started their working life. That’s the reason why I keep saying that you need real passion and not just superficial passion.
I have been reading Dr. Pagalavan’s blog with great interest. He gives great insight on what is the gritty reality of working in healthcare. Unfortunately I came across Pissed/No Longer Pissed House man’s rants. I believe that Dr. Pagalavan is entitled to his own blog posts whether negative or positive as it’s his blog. You can choose whether you want to be affected by it or not. In any workplace whether in government or private, it’s always the same s**t every day. Its how you react & adapt yourself. Racism? Grow a thicker skin! Adapt! Where ever country you go it’s the same. Please don’t compare the Asian working culture with the British or Aussies or Europeans way of doing things. There is no bridging the gap, merely the fact that if you want to survive, again, adapt. If you cannot change others, change yourself.