It’s been a while since I updated my blog. It has been a hectic year-end for me with so many stuffs to settle including registration for GST etc. Interestingly, along the way I received a lot of information regarding issues surrounding the field of medicine. After my last post, I received a lot of comments in this blog, some questioning the bullying and long working hours etc. As I have said many times before, doctors cannot run away from working long hours. The recent floods in many of the states in Peninsular tells you how doctors had to work when situation demands. Hospitals in Kelantan were flooded and many critically ill patients had to be transferred to other hospitals including to Klang Valley hospitals. Doctors in these hospitals who worked tirelessly trying to save lives never even considered how many hours they had worked! When the situation demands, as it always does, doctors work. That’s the reality. So, for junior doctors who thought that doctor’s life is just sitting in a cozy room and seeing patients as they walk into your clinic, please change your perception. If you can’t handle it, it is better to change your profession or do something that is not clinically related. As for bullying, I had said enough. Unless the system changes, nothing will change.
Since almost 8 years ago, I have been constantly writing about possible future unemployment of doctors. Despite producing all the facts in this blog over the last 5 years, many refuse to believe and accused me of trying to take care of my rice bowl. Some even said that there is no such thing as unemployed doctors! The reality is now right in front of our eyes. In fact, it is happening 2 years earlier than I predicted (2016). Please remember that 50% of the medical schools in Malaysia just started to produce their graduates since 2014 onwards and these medical schools have not reached their maximum production capacity yet.
MMA had a meeting with the Minister of Health last month and the Minister finally admits (he refuted the allegation last year during a dinner meeting with MMA) that we are facing shortage of post for doctors. I attach the snapshot of the interview below. He said that the waiting period stands at 6 months now and will get longer. He also said that they might raise the min requirement to 5As in SPM. However, he declined any possible pre-employment exams, likely due to political pressure. As I had said many times before, I disagree that SPM being used as sole criteria. A better method would be to limit the type of Pre-U courses that can be accepted for medical schools. Foundation studies, which are NOT standardized, should NOT be used. Established standardized Pre-U courses like STPM, A-Level, IB, AUSMAT etc should be the sole entry qualifications. I also support a common entry exam as practiced in many other countries but of course it is a politically unwise move as many MARA, Majlis Agama and JPA scholars may have a problem if they do not pass the exam.
There are still many out there who do not understand the field of medicine. Just last week I was talking to a Marketing executive regarding the 6 months waiting period for housemen and possible limitation of employment for doctors. His immediate respond was: why not do Masters while waiting for employment!! Their perception is that Masters in medicine is equivalent to any other Masters program as for other fields. In any other field, you can directly go for Masters after graduating without any employment. BUT in medicine, post-graduate training is a FULL TIME WORKING AND PART TIME STUDYING. You can’t get into a Master’s program without completing your housemanship ( aka full MMC registration) and at least a year of MOship. It is the same anywhere in this world.
Recently I received an email from a doctor in Bahrain. He allowed me to share his predicament in my blog, as below:
“I discovered your blog website some time back, and I have to say your words and experiences are a strong confirmation about what I have been feeling about Medicine even before I graduated as a doctor in 2004. My parents are old school folks from Karachi, settled in Bahrain since 1979. I was educated in Bahrain, and was sent to Pakistan to study Medicine.
During my time as a medical student in Pakistan, I had to suffer a dysfunctional and rotten state education system, and students willing to do anything unethical to cut corners to jump ahead. Following the crowd and herd thinking has always been something I hated.
I always had a strong suspicion in medical school that conditions were going to be worse, and the western nations would close their doors and opportunities for everyone taking the USMLE/PLAB path. I really wanted to get myself away from all those problems and study healthcare management in the UK.
Business and politics has interested me more than clinical practice. I don’t necessarily hate Medicine, I just hate the lack of opportunities and deep problems that await you even before graduation from Medicine.
I told my parents before my graduation that I would change my career after gaining the MBBS degree, but was forced to continue after my housemanship.
I passed MRCS part 1, PLAB 1 and PLAB 2 after a lot of investment of time while not working in Bahrain. I really wanted to train as a surgeon in the UK, because I seemed to have been mentally competing against my professor of surgery. But during my time in the UK after gaining full GMC registration, I realised that the market and training job/post for which I had struggled for was non existent.
After making no headway in the UK, I returned to Bahrain, cleared the licensing examination and subsequently joined a private medical centre as a General Practitioner. I am grateful to Almighty God for allowing me to earn and save money while living with my father. My saved income has made me feel confident, and allowed me to think about what to do in the following 5 and 10 years ahead.
My advice to everyone around me is to avoid medical school at all costs and try achieving more at less financial and mental investment. That is in line with Sun Tzu’s principles in the Art of War. A senior UK registrar from the UK agreed with me when I said studying Medicine does not make any business sense in this day and age.
Hope to meet you one day soon to talk about the abysmal state of affairs of doctors worldwide.
Regards & Best Wishes “
He also said the following, which I had already mentioned long time ago:
“Most, if not all of the children wishing to become doctors have had no real exposure to hard economic facts of life and the job market. It’s very easy to say one wishes to serve mankind, but once you graduate and your family can no longer support you, and you have utility bills, rent etc to pay every month, then feelings of charity gradually fades away. The world and society have no patience with anyone who can’t pay their way or find a job, why should medical graduates be treated or regarded any different from everyone else?”
As mentioned by him, when you ask anyone who wants to do medicine, the standard answer will always be “ I want to help people”. Of course at that young age, many do not know anything about medicine or just get carried away with what is shown on TV. Furthermore, they are living with their parent’s money with no commitments. I have had many medical students who wanted to help people in war-torn countries and work with WHO etc but ended up going nowhere. I know some students who said that they want to set up charity clinics and even start a foundation to help the poor etc. Do you see any doctors doing as such? Life starts after you graduate, when you start collecting debts (if not already), get married, have children and your parent’s financial help gets cut off (unless your parents are millionaires). This is where you will realize that no matter what your earlier intention was, reality bites. You will realize that being a doctor is just another job to earn a living. All the noble intention will disappear into thin air. Very few will endeavor.
Here I attach another email from a lawyer who reads my blog, which is self-explanatory:
“I think one of the main reasons for the deteriorating quality of HOs is because they don’t understand the profession before leaping into it. This is a “fast-food generation” where people seek instant gratification and get all disappointed when things do not immediately live up to their expectations. A lot of parents are still under the delusion that doctors immediately earn a lot of money and live a comfortable life with guaranteed jobs, so they keep encouraging their children to do Medicine for all those wrong reasons. It makes me very sad – more people should read your blog in order to quell these misconceptions.”
Doing medicine is not a good idea if you intend to migrate. However, I use to say that if you intend to migrate, please do medicine in the country where you intend to migrate. Unfortunately, even that may change soon. Just last month, there was a suggestion in UK that all foreign students graduating from UK must leave the country before applying for a job. This will have a great impact to medical graduates as they are usually given internship post under student visa. Graduates from outside UK are almost impossible to get an internship post in UK despite passing PLAB due to their immigration laws. The situation in Australia is also the same as I had written over HERE as well as what was written HERE. The reason why I keep saying this is because due to the current political climate of this country, almost 80% of non-bumis that I talk to are planning to migrate, atleast for their children.
Some may argue that we are still short of doctors as you can see hospitals being overcrowded with doctors running around. While I agree that we are short of specialist, I disagree that we are short of general doctors. What we are facing is actually MALDISTRIBUTION of doctors, between urban and rural, between public and private, between hospitals, between departments and between East and West Malaysia. Klang Valley has a doctor: population ratio of 1: 400 but why are we seeing the public hospitals overcrowded with patients? That’s because, public hospitals and clinics are catering for 80% of the population. If you add up all the beds in Klang Valley (private and public), we have enough number of beds to cater for the population. Same goes for the number of doctors but many of these doctors are either running their own clinics (GP clinics), in private hospitals or doing administrative work. The only way this “presumed” shortage of doctors would be solved is when we integrate the private and public health sector into a single entity paid by a National Health Financing Scheme. The supposedly 1CARE scheme is still in limbo for time being. The private healthcare is almost 80-90% supported by insurance. If insurance companies collapses, the private healthcare will collapse! Specialist can also become jobless.
The government on the other hand would not be able to sustain the ballooning healthcare cost by building more hospitals or creating more post. We are one of the very few countries in the world, which is still surviving with a system created by the British almost 50 years ago. It is not sustainable. Thus, as long as housemanship is under civil service, there will come a time where the government will not be able to give employment to everyone as what is happening to the nurses. The filtering has begun with the re-introduction of compulsory SPM BM paper for all, including foreign spouses and non-availability of post for PRs as mentioned in my earlier post.
We also know that government is financially hard pressed now. The fall of the oil and commodity prices, the rise of US dollars etc is putting a lot of burden to our financial coffers. Our ruling regime has wasted enough money. The 47% who voted for them were deceived by the false promises from the ruling government. When the opposition said that we are heading for bankruptcy before the election, many supporters of the ruling government refuse to believe. We have a bloated civil service (one of the highest per capita population in the world), which is also not sustainable in long run. Almost 50% of our budget is allocated as operational budget, meaning paying civil servants (25% of the budget) and to maintain and run the civil service. As much as I don’t like Dr M for his social engineering and the reason for racial polarization in this country, I must agree to some of his long-term policies such as Dasar Pensyarikatan and Dasar Penswastaan. The whole idea is to reduce the number of civil servants to about 500K to reduce the financial burden of the country. Unfortunately, the number has bloated to almost 1.5million in just less than 10 years after he left! No job is going to be guaranteed in the future.
My advice for students is to do what you are interested in after doing some research and not based on which field can make more money and which field has more prospect etc. If money is your intention, than there are many ways you can make money. Most millionaires do not even have a degree! If migrating is your intention, never do medicine. Jobs that are most needed nowadays are not professional jobs but technical jobs like interior designing, any form of designing, architecture, software engineers, accountancy, technicians etc. Professional jobs limits you in many ways. Do it only if you have real passion for it.
Happy New Year to everyone……………… May 2015 be a better year for Malaysians……….
Pagalavan's Avatar 
Regarding UK, there has been some development:
http://bma.org.uk/practical-support-at-work/immigration/guide-to-uk-immigration/visas-and-your-training/tier-2-sponsorship-in-england
The current pressing (election year) issue as highlighted by first UKIP’s Nigel Farage, and today, Tory’s Boris Johnson, is the inability of many NHS workers to speak proper English.
Which is why the medical profession itself is very keen to keep the international students graduates from British universities, who are familiar with the NHS and competent in English. If the EU will allow. They get around silly EU rules by putting FY under student visa, and now placing trainees under a single employer.
Hi.If i am someone who not good in biology and english but i have some interesting in medical ,so did i recommended become a doctor?And become a doctor need very good in memories?
Oh my English!
my suggestion : do business admin
Business admin? With that level of English… ?
I got No idea what you are talking about
Sorry that i dont know how to say ….
All the more reason to stop this fantasy of wanting to be a doctor. Communication skill is MORE important than knowledge in medicine.
ouch, thats harsh! language skills can be worked on. ought to not discourage him for that reason alone. why have we become so cynical?
It should be :
Hi. I’m interested in medical field, yet my biology and English aren’t proficient, but am I eligible for it? Furthermore, do all medical students have powerful memory?
Nope and not quite.
English is affirmative at times and quite sadly the pivotal medium, since the books and journals are all in english. Biology is the bedrock of medicine, enough said.
Medicine was never about memorizing, its about understanding.
Thank you for helping me to explain my meaning and your suggestion .
You need Chemistry the most AND a good command of English.
I don’t understand why don’t the government raise the SPM minimum requirement immediately. It had been discussed for quite a long time. To be completely honest, 5As in SPM is still considered very low for entering medical school. So now, think again, what would you say about SPM 5Bs for medicine?
They cannot increase the minimum requirements, as it will kill off many of the IPTS med schools. Remember, this is not an academic meritocracy, the system is now based on having money to pay for the course. When the Nursing Board increased the minimum for nursing course from 2 to 5 Credits at SPM, enrolment in some colleges dropped up to 80%.
As it is now, some colleges are already having difficulty filling all their places, even well known (but expensive) ones.
Some one told me that B in SPM now stands for Bodoh! When thousands can get 8As, what more 5Bs!
A in SPM is considered AVERAGE unless it’s an A+. There’re about 12K students scored straight As in SPM 2013.
Hi Dr Pagalavan,
It was really great to read your blog.
I was a doctor working for MOH and just completed my hoship. I too “suffered” through the bullying and long working hours. But all these made me grew stronger and learned more about medicine.
I did medicine out of parental expectation. Medical school wasn’t hard for me because I was just a spoon fed exam machine. However, reality only hits when I started my hoship. I was lost and depressed (not because of bullying or long working hours). I found no passion and interest at all. It was an agony to wake up everyday and go to hospital. I completed my hoship smoothly(at one point I wanted to quit halfway), thanks to my wonderful colleague and bosses who helped me and gave me encouragement.
After my hoship and much struggles, I decided to resign frm MOH. I am going overseas to further study in public health (something non clinical). People around me are disappointed.They are expecting me to become a specialist and sit comfortably inside the clinic and earn big bucks. And they think I’ve ruined my future by making such decision (to give up on a high salary job). Their disappointments and expectations made me even depressed and lost.
Lucky day today. I read your blog and I found some encouragement and hope. Thank you Dr P.
Good insight, and right decision.
Many other there have the same impression of doctors: sitting in a room and earning “easy” money! What they do not see is the amount of work and years of training involved to become a specialist, the ward work, calls, risk taken and litigation rate.
I might do the same thing after finishing my medical degree. Research and public health nutrition are really exciting for me.
U made a wise decision. Its ur life and u hold d steering wheel.nothing wrong or inferior about studying public health, or going out of clinical at all. Whats d use if u take up clinical specialty, passed post grad exams (bcos ur good in memorizing, n exam techniques, for some) but ur passion isnt there,become a specialists who rather not b at work, escape work for better remuneration outside, moody at work etc.. I wish u all d best in ur future endeavour, dont worry much about what other thnks, they r not living ur life..
Didn’t think it is just the medical field that is this way. Other profession too. Instead of looking at the money, look at what the kids can really do and want to do by showing them the real situation that is not made up. Schools and Universities have been built for economical situation whereby advertisement created something like a hype where parents or younger generation just fell into it. All profession can earn money but just have to make sure you can really do the job and not being dumbstruck by the real nature of the job totally different from expectation. Attract the right crowd for every profession is important for individuals and their country.
Exactly
Dear Dr Paga, I regularly read your blog but this is the 1st time i m actually commenting on your blog. Let me share you my life experience. I m Medical Registrar who resigned recently from the government sector because i was FED UP with the system. A rather bleak system that is Biased in every sense imaginable. I was one of the youngest to complete my MRCP( UK) by 28. My superiors refused/delayed to fully gazette me because they feel i m too young. Can you imagine the type of biased system we are living in? I have completed the log book, even did a few case series and presentation and heck i was always looked down. This started even when i was in SPM, despite me getting 11 1As i was rejected by JPA. I have to thank my parents for sponsoring my studies thru a partner medical school abroad. I didn’t disappoint them and returned with so much hope. However the seniors were constantly mocking me. But that didn’t stop me from pursuing my dreams. I worked so hard to achieve my goals. But in Malaysia, there’s always this barrier that Just doesn’t appreciate talent. I m a register in Singapore now. Although i m not a specialist i feel Singapore is an excellent place to horn your skills because they appreciate talent unlike Malaysia. There is no BIASNESS. Malaysia is certainly going towards a downward spiral ever since Russians and Ukraine Grads took over. Have you examined their results? Some don’t even have a C5 in Biology.
Firstly, being in Malaysia, you can’t run away from “non-merit” based system as what you saw when you got 11A1s. MOH do have a rule that you must have atleast 4 years of medical training before you can be considered for gazettement. So, even if you pass your MRCP early, you need to complete atleast 4 years of medical training, which is usually decided by your HOD and subsequently MOH.
Malaysia never appreciates talent! As for grads from russia: I am sure you read this article of mine!
Yes Dr Paga. I m fully aware of that. But why so much biasness? Even when there s procedure like OGDS in ICU)-, i have heard them saying- He can wait, he’s still a baby. You see when someone is eager to learn, The so called Bosses try to shut them down. That is Malaysia. The same boss once bragged about Russian Unis coz his daughter was studying there. Double standard much? So i telling you guys- if you are GOOD, leave this goddamn place. Go somewhere like Singapore . BTW, is there a papers saying if you pass your MRCP earlier you are subpar? MMed is longer due the rotations the do. There is gazzezzment period of 18 months. That’s another 1.5 yrs post MRCP.
Yup, it is a Malaysian culture where they do not want to see another person better than them. I have seen enough along the way!When you do something new, they will shoot you down. It is the civil service culture. Where as in Singapore, if you want to do something new, they will encourage you to do it.
How good you become after MRCP depends on your own initiative. It is your own initiative to undergo all the rotation.
The culture of “do not want to see another person better than them” makes me wanna leave this country! Like what for i work so hard, right?
If you have UK training experience, you will know that MRCP is an *entry* qualification to specialty training in the UK and not a specialist qualification itself. Specialty training after MRCP is five or more years. No one in the UK gets on the specialist register at the age of 28. It is not an age bias. It is simply a reflection of the properly structured training system which requires a stipulated number of training years and the final certification of specialist accreditation is competency assessed.
Only in Malaysia do people have some warped perception that having MRCP automatically means that the doctor is/can be deemed a specialist. Do you think a 28 year old with MRCP on the physician training pathway in the UK would even imply he/she is a specialist? Even the most talented trainees wouldn’t suggest that for fear of being soundly (and rightly) ridiculed.
Neither is it possible to be a gazetted physician specialist in Singapore at the age of 28. It’s not about merit. 10,000hrs to become expert at something, so on and so forth!
I feel sorry for what you have gone through. Well, whether you are in the gomen service or in the corporate world, you have to stay and wait for the right moment to seize any opportunity or opening. Life is tough in the corporate world and there is always accusations of biasness and favouritsm and luck also plays an important part. You should also know that networking and social interaction plays a very important part in career advancement.
Don’t get carried away. Life is such; it can be with you at times and it can desert you when you need it most. And remember, please don’t challenge the system. You can never win.
Dear NeuroAspirant,
With your qualifications, logbook, experience & intelligence, the Singaporean should have gazetted you by now.
How come you are still a registrar over there?
Is there a problem with the Singaporean system as well? 😜
OMG NeuroAspirant get over yourself. You really sound like a: http://youtu.be/EuULjB8xKdY?t=6s I hope the future crop of ‘specialists’ wont have this attitude. The situation in OZ is no different from the UK. Yup, you’ll be about 5 years off from being a specialist too.
No idea why you are mean when people are just sharing their life experiences. In PACES we have Station 5 that tests ethics. You would have gloriously failed. Oz ( FRACP)and UK ( NHS) designed the system because they have surplus of physicians. The ratio of Physicians to patients is like 1: 800. It is not the same like in Malaysia where we are lagging by leaps and bounds, yet biasness is rampant. I did my training in Aust so i know how the system works. After some time as a RMO you can apply for Basic Physician training and then complete for FRACP Part 1 then the final part. Overall it is a NOT biased system that appreciates talent. Please do some extensive research and try not to sound like a M*ron. Don’t comment for the sake of commenting. Cheers
@NeuroAspirant, why did you not continue in Australia, since you trained there?
Dear Jaz1,
First of all, there is a surpluss of physicians in Australia.
The same happens in OZ & UK.
Keeping the facts in mind & as pointed out by Jon J, there are in no hurry to gazette NeuroAspirant.
Furthermore, NeuroAspirant probably can’t get a job there.😢
Malaysia has achived a doctor:patient ratio of 1:400 🙊
This means Malaysia is much much better than Australia (ratio of 1:800 only).
Malaysia BOLEH👍👍👍
So Malaysia is also not in a hurry to gazette NeuroAspirant.
Singapore has a ratio of 1:600. I think he will not get gazetted there anytime soon either.
“Journay of a thousand miles begins with a single step”
So enjoy your registrar post 🎉🎊🎉
Dear Jimmy Lee,
I understand “training” as FY/internship/housemanship. Oops.
There’s no surplus of physicians in the UK, from what I’ve read. There’s also shortages of doctors (specialists) in Australia, but there’s also shortages of internship posts!
Let me TL;DR it further for you: You dont become a specialist that quickly in developed countries either!
@jaz1 haha. The lack of doctors is only partially true in certain areas like Wales. NHS is having a huge financial crisis at the moment. As for oz those were the days when the group 8 used to churn out MBBS grads. Now aust has nearly 16 med schools. Most med school are done with their MBBS prog and have opted the MD prog akin to the US. Jobs are really difficult for IMG@ Jimmy lee . Wow. Typical. You are trying to sound satirical. Bro here is an advice. Enough of your mockery la. I m happy with my job now. It is always better to work in an encouraging environment then here, man. Cheers
@NeuroAspirant, so you didn’t manage to get a job in Australia then?
Dear Dr Pagalavan
Any suggestions where supposed to let my daughter pursuing her medicine course ? Currently she’s pursuing A Level .After read your blog,should I ask her to change her course? If study local as I am not a rich parents which medical school will you recommend?
Highly appreciated with your reply..
Let her decide what she wants to do after reading this blog. Do not push her to do what you want.
Most of them do not know what medicine is all about before stepping into it.
The best local medical schools are still the UM, UKM and USM. Private IMU,PMC,Monash,
Dear Dr. Pagalavan,
PMC, you are referring to Penang Medical College? What is current and previously is totally different. Nowadays, you see about 70/80% of graduates coming from one community.
Yup
Dr.P, how about Perdana University?
No graduates yet
Dr P is still living in the 90’s. Nowadays JPA and MARA have sent all top student overseas. The leftover are all placed into local public universities. Furthermore, top non-bumi student too have either gone overseas or study in local private universities at their own expense. This is a fact but I knew you would argue otherwise.
Of course, who said NO?? The top 50 students were given scholarship last year to go to overseas universities. However this number is very much less than the 1990s
I’d say JPA has sent less top students overseas nowadays than 90’s. Besides the National Top 50 Scholarship which is automatically given to all top 50 SPM students, many other students with 9A+ in SPM are also sponsored for overseas study under KPM Bursary Program but the numbers of 9A+ students have since dropped from about 1,600 (SPM 2011) to 1,000 (SPM 2012) and 600 (SPM 2013).
The exam grading system in this country has never been transparent. Ironically, it goes with government’s funding.
Dr. P, thank you for your sharing. After reading your post, I start wondering whether or not to pursue medic course. I want to do medicine merely because I am intrigued by human anatomy and I want to know more about it. With this reason, should I study medicine? If not medicine, what field should I go into? Pharmacy? Radiotherapy and oncology? Looking forward to your reply. Thank you.
If you are doing medicine just because of human anatomy, you are heading the wrong direction!Medicine is not about human anatomy!
Medicine is a profession which is unlike any other which require tons and tons of PASSION,period.passion to heal and more importantly,minister the sick for the rest of your life,again with passion for the rest of your life?
passion? more like stamina +++++
or does passion fuel stamina? hmmm
Hi Dr. P,
As we speaks, Im now in my last 6 months hurdles of MBBS. I do agree with “students dont understand medicine before leaping into it”.
I do feel it that way. It seems like Im not as keen as i was before.
Im thinking of not doing my housemanship and pursue my studies in any other medical related course. But here I am not knowing what my options are.
Hope you can enlighten me of other path that I could take.
Thanks Dr. P!
If you don’t do housemanship, you will never be able to work as a doctor. Options are rather limited. You can try going into basic science courses to become physiologist, anatomist etc.
Just venture into the research track–i.e. not clinician track—you’ll do fine.
Get a post-grad degree from probably Aus (or any developed country) and enter any of the available research institutes in UK/Aus/Sg, you might develop decently
Neuroaspirant’s case is very interesting.
A 28 year old, completed MRCP, and gazettement was delayed with perception of ‘bias’ against him. I agree that this bias exist, and would argue that everyone has tasted his or her version of it as some point while at service.
Having said that, to be gazettes as a specialist, if I’m not mistaken, despite having fulfilled all hard requirements, there is a caveat to it, as it also depends on your superiors ‘soft’ assessment of you. Don’t criticize the system for the sake of it all the time.
I would not completely agree that Singapore is perfect for everyone and every Malaysia whos not happy with the system should migrate to Singapore. Obviously you can’t compare the two nations for a multitude of reasons.
I have personally worked with very young MRCP grads, gazettes as specialists. Most are humble, happy to learn, and willing to take a whack or two along the way from their superiors. Most are also smart enough to work ‘with’ the system as far as possible.
Malaysian healthcare system has a lot of defects. Not gazetting young MRCP holders as early as possible is NOT one of its problems.
Ignore my autocorrect in the above posts
Gazetted = gazettes
Etc.
Damn you autocorrect.
Dr Paga, the main issue is the perception of “success”. Many people still equate graduating as a doctor as automatically being “successful” in life.
On the contrary, its the beginning of all the problems one will face.
So I’ll say it loud and clear.
Being a doctor is NOT a good thing to do unless you really love sleepless nights, chronic fatigue, limited social life, and anxiety of screw-ups in the pursuit of superior clinical outcomes. Sure like any field out there, there will be the Merc, BMW, Jag drivers; but don’t forget the blood, sweat and tears it took for that to happen.
Well said
Dear Neuroaspirant, your case doesnt make sense. I did pass my exam early too at 2011. At that time I was about a year plus medical MO. The requirement for gazettement is 3 years of medical MO + 18 months. The earliest one can become specialist through MRCP is 4.5 years after HOship or 6.5 years in service which is correct in my case. What do you mean by early gazettment? You cant jump the queue, brother… I did apply for TTSH for job and was accepted. But I had to make choice, Malaysia, my home country or Singapore, a foreign land after all.
For bad or good, I decided to stay here. I wont say the system is perfect, but so far it has been fair to me. Plus, if everyone complaints and want to leave the country, who is going to improve it?
Yup
While I applaud those high flyers who pass exams quickly, the making of a competent specialist is more than passing exams. It is the sum total of knowledge, and the wisdom of how to use that knowledge, something called experience.
That part, you CANNOT fast track. You need the process of TIME to gain experience. That is what the gazettement process is all about.
FYI, in the UK, getting your MRCP/FRCS does NOT make you a consultant. Completing the requisite programme and getting the CCT does. And you will need to complete the necessary 2 years CT and 3-6 years ST, regardless of when you obtain the MRCP. Most people get it within the CT period. Yes, they still have to complete the ST.
Bro, cutting the que? Haha not at all. All i wanted was appreciation. If you are good you should be treated well not just shut down. It is not like success just came over. People worked hard for it. Anyway again i still think Singapore is way better because the system is talent based. We have junior consultants at the age of 34 who respects you and treats you like a brother. In Malaysia you are hooked to prehistoric superiority complex. Bullocks la… no wonder Um is ranked 200 plus whereas NUS is ranked 21st in the world. Thank you la Malaysia.
Several posts up, you seemed think that you were entitled to being gazetted a specialist in Malaysia at 28yr just because you had the MRCP.
MRCP is only a *minimum* entry requirement for entry to specialist training in the UK, which takes at least another 4 years. If all you have is MRCP without a strong track record of publishing and presentation in addition to good clinical ability, you will not get a specialist training number.
And then you made some sad-ass excuse that the UK specialist training system is designed for prolonged training due to an excess of doctors with a prevalent 1:800 ratio. This is of course completely wrong since the minimum number of specialist training years for each particular specialty was defined on account of experience required for a qualified specialist to practice independantly to a “Day 1 UK Consultant” standard. This is not attainable by age 28yrs in any country with excellent standards of healthcare (this includes Singapore).
So yes, it appears that you think you are in a position to cut queue and entitled to preferential treatment. In the UK system, a 28yr old doctor in any training system (hospital, general practice, non-clinical specialties etc) is still wet behind the ears. And all of us knew it and would be the first to acknowledge as such when we were at that stage.
Hubris, much?
PS: If a merit based system was so important to you, should have toughed it out to get a specialist training post in Oz, no? Or if you felt such a burning unhappiness with the system in Bolehland, why quit? Should have toughed it out till you got to a high enough position to effect change at least within your domain of authority (as Dr Paga did and continues to do).
Jon J,
Very well said⚠️hit every nail right at the coffin⚠️
Winners never quit & quitters never win.
Jon J boleh, Paga boleh, NeuroAspirant pun boleh 👍👍👍
Basically he is trying to say that he past early he is smart. People should respect him and he deserve to be call specialist
He just dislikes the system with so much uncertainties. Nothing to do with “wanting to be called smart”. About the “respect” part, I believe every one should respect one another, regardless of rank, merit or skin colour.
“maturity of mind is the capacity to endure uncertainty” John Finley
I am just into HOship, so I actually have very little experience with the system but I just want to say something about it.
1) Yes, scolding is common. I can relate to those feelings of exasperation when your juniors don’t know basic things. After all, I’ve been a senior to someone since standard 2. I approach such situations regretting my ignorance/lapse of logic, that’s all that I can do. But there are also many times when the senior raises their voice to cover their own shortcomings/uncertainty, to discourage the overly eager bunch, or simply to solidify some cheap sense of superiority. That is sad. I’ve received so many scoldings, from various levels, for consultations or referrals yet ultimately receive orders for actions I’ve already tried, failed and reported in that same conversation. A complete waste of my time and their own blood pressure.
I’ve also heard of seniors mistreating juniors for mistaking the senior as a fellow junior or a non-doctor at their first meeting. Complex much?
2) Biasness runs rampant, but that is human and I can tolerate it to some degree.
3) Generalisation also seems to be the norm for the bosses now that little effort id being put into knowing your eventual successors. There was 1 bad egg, but my entire batch was criticised as being the same. Why preach individualised patient care when there isn’t any acknowledgement of individuality amongst your underlings? I’m not saying our bosses should know all his subordinates in and out, but grouping them as a collective feels very self-contradictory.
4) There is too much discouragement for passion. When I did my elective in the uk, i remember sitting at the admissions desk with a handful of bored Drs, from FY to consultant, all just waiting for a case to come in and we’ll all jump on it. Here? “Man i hope no cases come in today… please don’t have difficult cases come in… hey hey, don’t jinx us… You’re weird for wanting work to do.” I’m thankful for the couple of MOs who encouraged my eagerness and even advised on how i can find more opportunities.
I also volunteered myself for a few extra night shifts when the dept seemed busy and the scheduled staff didn’t seem enough. Instead of a simple ‘thanks for helping out’, i got responses like ‘u’re a workaholic’ ‘dont be a hero’ or exaggerated praises like ‘u should get an award’ or ‘a legend is born’.
I feel like if I quit this field, it won’t be because of workload pressure, but the sheer frustration of interacting with colleagues.
Dont be discouraged. In every posting/rotation you will encounter those who are just jaded with their jobs and those with superiority complexes and ego issues. Long story short: There will be [http://youtu.be/EuULjB8xKdY?t=6s]. Dont let the [http://youtu.be/EuULjB8xKdY?t=6s] get to you. Chill out and keep moving forward. Dont take it to heart. Remember you are here to treat patients first and foremost…safely. Consult your seniors in a professional manner. Be clear and concise. *Document* their responses after every interaction. If you are serious about your job and your seniors know it, along with the fact that their name goes down in your notes every time, trust me they will take you seriously. They will still be [http://youtu.be/EuULjB8xKdY?t=6s], but ultimately you have fulfilled your obligation to the patient and spread the risk if shit hits the fan.
When you are in a position of authority one day. Be like the nice consultants. Dont be a [http://youtu.be/EuULjB8xKdY?t=6s] with ego issues. Its a karma thing. Be humble (not stupid) and professional.
Tree-hugging physician!
;-P
“Foundation studies, which are NOT standardized, should NOT be used. Established standardized Pre-U courses like STPM, A-Level, IB, AUSMAT etc should be the sole entry qualifications. I also support a common entry exam as practiced in many other countries but of course it is a politically unwise move as many MARA, Majlis Agama and JPA scholars may have a problem if they do not pass the exam.”
When you said common entry exam do you mean exams like UKCAT or BMAT ?
Nope. I am talking about licensing exam like PLAB, USMLE etc
thank you doc for this blog! keep on inspiring people 🙂
i’m currently waiting for my SPM 2014 result.
wish that someday i can be like you.
God Bless!
HOs are not educated or trained to be functional right after graduation. Only when you step into the real working world of doctors that you need to absorb the knowledge and the technique of the Doctors who have sufficient experience.
However, it is sad that this is being view as a burden by the seniors, MO, Specialist and HOD. If everything can be gain from reading a book or surfing the net, then what is there a need for a lecture/teacher/mentor ??
In the days of the old, doctor are train personally by another doctor. It is like a master teaching his knowledge and technique to his student so that this student may excel and perform as good as the master.
Now?? HOs are being guided by senior HOs who doesn’t really have an idea what they are doing. They are not taught about why,what,where,when,how is this relevant to the procedure / treatment they are performing. Instead they are expected to read from a text book. I myself heard a junior HOs ask his senior HOs on why the procedure is done in that sequence, the senior replies “Dunno.This is how this department do it”. MOs / Specialist expect you to read up why is it done that way but lets face the cruel reality, how many of us read it?
Luckily now we have “Internet”.
Learning from whatever source you gain knowledge.
But being taught by experienced Specialist you gain wisdom.
Only when you have both knowledge and wisdom you gain the upper hand in performing your work in saving someone else life.
By saying that HOs quality have decline,
it is not fair to pinpoint that the person is the main reason but the system
of medical training itself may be the flaw.
Can it be the college / uni they attend is not providing sufficient knowledge?
Can it be the MOs / Specialist of the department not providing sufficient support?
Taking myself as an example,
throughout my form 4 & form 5 up to SPM, i failed my physics, got C for Biology, and D for Chemistry.
When i enter college again i took up all the above subject, i signed with the college that if i couldn’t get credit during my mid term evaluation i shall drop the subject and risk repeating the course.
However, the guidance and teaching of my lecture was far more superior than of my secondary school teacher. I actually get distinction in the subject and pass my college years with flying colors.
I am learning much more advance physics
a harder biology
a more complex chemistry
Therefore, for those who manage to graduate from Medical College / Uni. They are not “dumb” or “stupid” as if they are of this category. I doubt they could even survive the exam.
So can we really say the HOs quality is bad?
Or is it the guidance & support from the MOs / Specialist has decline??
HOs should be nurture not torture
they are the Doctor who 1 day will be treating your family.
So is it that hard to sit down, spend a few hours with the HOs teaching them the essence of being a Doctor. So that 1 day in future when you are in their care, you know that you’re in good hands of which you have nuture and trained.
That depends on which medical school you are talking about. I am sure you are aware that most medical schools in Malaysia have 100% passing rate. You are right when you say that HO begin to learn real management of the patient during housemanship. However you are expected to know the basic such as taking history, examining patients and coming to differential diagnosis and investigations to be done. The rest you will learn along the way. Unfortunately, if you can’t even do that, you should not have left the medical school! This is where the problem arises. No one is going to teach you basics. The declining quality of HOs is due to this and not anything else. No one expects you to known how to do a procedure etc.
As for your college exams, was it standardised nationally? With all the dubious foundation courses out there, I know many who can get straight As in colleges just because their own lecturers set the question and teach you.
Yes i do agree, which is why i mentioned that the system itself is flawed in the selection process.
Foundation courses by itself have a lot of flaws as certain colleges to boost their rating may have use underhanded method. However, Medical College/Uni should have been harder and with external examiner involvement it suppose to be the first level of filter for HOs.
Without knowing the basics i doubt someone can pass his finals in Medical School, unless he is crazy lucky for the last 5 years in his Medical School.
While i do agree that fresh HOs are expected to do history, examining and coming to differential diagnosis, i think the problem is during Medical year you are given 1hr for history taking & examination, but in a real world setting you have 10mins on average to complete everything from A-Z.
So can a fresh HOs do this?
Even now freshly graduate HOs is thrown to their senior HOs to teach them on how to settle everything in 10mins and to show them how to perform certain procedure. If you get a good experienced senior you are lucky but what about those who have HOs that is in the opposite?
If all fresh HOs, are to be attached with their MOs which will sit with them and guide them on their first week of tagging. I believe the standard of their basic will be greatly improved. If not there is only a few reasons, the HOs is weak or the MOs himself is weak or both of them just don’t care about it. The easiest and common excuse is, we are busy with patient. Well, is HOs not busy with the same exact number of patient in the ward?
In this contrast i must share about the internship in Taiwan & UK.
Every fresh intern is the responsible of the specialist, they will be guided throughout from history taking to examination and how to derived and plan your investigation and coming to the differential diagnosis.
The specialist do not question or scold the intern openly, everything is done professionally and mistake is being told privately to them. A weekly topic of study is given by the specialist to their intern based on the patient in the ward and if require specialist will often shows the correct manner of examination no matter how basic it is.
Look at the differences.
Our system train HOs with HOs,
while other train HOs with Specialists.
Medical to me is more like art.
Is an arts of senses. If you can feel, see, listen and understand the problem
you will most definitely get your differential diagnosis.
Most GP train this art to perfection over years of practices.
This is how you know that when the patient walk through your doors before even they could tell you what is their problem you already have 60-70% of what they are here for.
It is just like learning from the Master.
Even the weakest among HOs if they are being taught by the Master, no matter how weak they will improved.
Stop blaming on medical college.
Is like parents blaming the school for not teaching your son manners.
There is no 1 standard grading system.
If there is, then there will be no Bill Gates or Steve Jobs who couldn’t even pass high school.
So if we look at this from all point of view,
If we can improve the medical school to not only prepare them based on academic, but also prepare them in the real life working conditions.
If we can improve the training of HOs to be more than just filling log books in to a more “Hand On” guidance by the Specialist.
If we can acknowledge that not every HOs is the same, some may be weak in certain few and strong in others.
Then i believe, to improve the quality of HOs is just a matter of changing your perception.
How you inspire & guide your children will make them what they are in future. This is the same with Doctors and all other professions.
Plant the seed of knowledge, nuture them with guidance, and it will grow into a beautifully trained HOs into MOs and Specialist who in future will train others the same way they are being trained.
Trust me, I have seen and heard enough graduated doctors who can’t even take a simple history and examine a patient. So, YES, they did pass the medical school. You must remember that there are many dubious medical schools as well. That’s why a common entry exam is recommended.
I have also said it many times that it is the SYSTEM! As long as it is a civil service, nothing will change. Most of the good specialist/consultants has either retired or left to private sector. I did write in MMA magazine almost 10 years ago that the result of senior consultants leaving the civil service will give rise to a situation similar to a blind leading a blind. FYI, housemen suppose to be under specialist supervision and NOT MO/Senior HO. Unfortunately, most of the current generation specialist do not bother much. Very few take interest of the HOs. Furthermore, the current quality of HOs simply put some specialist off. I know a specialist who told me that only 2 HO turned up for his CME class! So, who to blame?
Medicine is an art but you still need certain level of intelligence to do medicine.
Probably I will write what hails the medical community in Malaysia next
IN response to Khusari: Medical to me is more like art. Is an arts of senses. If you can feel, see, listen and understand the problem you will most definitely get your differential diagnosis. Most GP train this art to perfection over years of practices. This is how you know that when the patient walk through your doors before even they could tell you what is their problem you already have 60-70% of what they are here for.”
****************************************
The current secular practice of medicine is not an art. It’s about having solid knowledge to practice safely. You *feel* a young patient with chest pain is safe for discharge because at the back of your mind he/she has cleared the PERC rule and has a WELLS score of zero and a convincing history and examination suggestive of a musculoskeletal cause and an ECG that has ruled out all the channelopathies and is plum normal.
Doctors who go by “feel” without having the appropriate background knowledge is very dangerous. “Oh the young patient with intermittent chest pain is unlikely to have anything serious and can be sent home”. When a doctor says “I feel this patient is safe for discharge”, it means that a certain chain of solid logic has gone through his head. All red flags excluded, and the patient is really safe for discharge.
Going by “feel” and not knowledge is like playing the lottery for a candle lit dinner with the coroner.
This is true for all of medicine, not only the specialities including GPland.
Bill Gates not only passed high school, but he managed to enter Harvard undergraduate program too. You knowledge inadequacy not only makes you look dumb, it also makes your entrance into medical school questionable.
Back when HOs were lacking, the seniors had no choice but to hand train them for the future. Now with so many HOs, it’s going to be the same as any job market. You either have the brains, dedication and talent to start with, or be left behind in smoke. After all, we’re settling the menial/tedious tasks, so those above wouldn’t mind keeping us down here forever to save them work.
how much you earn dr pagalavan??? in a month…I know it depends on number of patient and can fluctuate…how about u???how much per month average??? thanks! 🙂
haha, no one will declare their income openly! If I take leave the whole month, my income is ZERO.
I mean any idea of earning? for example a general practioner? I jz wan a rough idea on the monthly income…lol….
A GP nowadays earns an average of 10-20K/month by working 12 hours a day, 7 days a week. Of course some successful and established GPs can earn more. BTW i had written about doctors income before. Please check the topic: how much do doctors earn
(Sorry Dr, for complete off topicness, but i wanted to spread this to as many juniors as possible)
———————————
An open letter to all first year house officers, from a 2nd year (technically 10 months in, but who’s counting?)
Hi there Doctor,
Yes you. Not your registrar. Not your boss. Stop looking over your shoulder, you’re a Doctor now. Straighten your stethoscope and listen to a slightly more jaded junior doctor. Please.
If I can math correctly sleep deprived, you’re about 8 weeks in, yes? So whoever you are, you will have done long days, you will have done weekends.
You will have been exhausted and survived. Congratulations. (A bonus if all your patients have, sometimes shit happens. )
I hope you’ve felt proud of your admissions and plans. Even if they’re not remotely perfect. It’s not easy work, seeing and assessing people and coming up with treatment, however simple. Yes, even 1g paracetamol qid reg needs thinking and courage to implement. Well done.
I hope you’ve almost crapped yourself with worry. It shows that you care about your patients. I also hope that whether it was a simple decision you were agonising over (slowk? K+in ivf? Clorvescent?) or a complex one, it turned out well. And if it didn’t, I’m sure you’ve learnt heaps from it. Give yourself loads of credit.
I know you have had lots of coffee with colleagues, be it free lousy styrofoam cup coffee or proper trim flat whites. And i really hope that you have put your job list aside and not discussed work for some of these sessions. Because your workmates are your sanity savers and so are you to your colleagues. Be there for each other. (That includes nurses and allied health, too!)
I hope you have had shared both laughter and tears with your patients. They are the ones that truely make the job worthwhile doing. I know you will remember that medical care is more than drugs and interventions. It is also, perhaps more importantly, about providing comfort, care, reassurance and love. And if you have sighted a dying patient, you will have done it carefully, and as respectfully as you could have(under your circumstances). Thank you.
I know many of you will still feel like you have not improved at all as a doctor. Or if you have felt improvement, it was agonisingly slow. Do not worry. I (and this have also been noticed in others) have felt that for the last 9 months. Then it felt like everything came together suddenly, magically. You will wake up one day feeling like a doctor, not a medical student playing dressup. Yes, most probably objectively its a process of gradual improvement, but subjectively is like you’re stagnating clinically. I can tell you right now, you aren’t. Hang in there.
I hope you have been keeping in good health. Remember, if you aren’t medically well yourself you won’t be doing the best doctoring, either. Do everyone a favour and just hit that dail button to Call In Sick if you’re unwell. And yes, having emotional or mood disturbances count as being ill. Get yourself a good, local GP if you haven’t already done so. Take care yourself, doc.
Above all, as a colleague, I truly appreciate your good work. Wherever you may be.
Thank you.
Doctor.
Yours truly,
Eve.
Totally spot on…i myself practised for almost 5 years before i resigned and now doing something totally different from medicine…appreciated all the knowledge/experience i acquired, but to stay and endure the system is a no no.
Hello there, I’ve been reading your blog last year and it does change my mind from becoming a doctor.
Could you give us some information about veterinary future in malaysia. I’m currently doing my foundation program ( UPM ) and I hope you can give me some advice before I pursue my course in vet.
Dear AJ,
Confucious said “行行出状元”，meaning “one may distinguish himself in any trade”.
You don’t need advice from anyone.
Just follow your ❤️ & do your best.
Confucious didn’t say that phrase. I appreciate that people tend to say any proverb developed by the Chinese as said by Confucius, but it is not the case.
I’m just afraid that the vet’s industry will be less demanding but lots of supply. And I dont really want to end up jobless, according to what doc PA stated ‘ one day a fresh graduate with degree in medecine could end up jobless ‘
im not a doctor but an engineer, i see why i dont fit into doctor, because im more technically precise lol just kidding, i still want to be a doctor even now, im just not so good in bio or chemistry, atleast i tried.
i just want to correct u one thing, our government done nothing wrong with it’s economy, http://en.wikipedia.org/wiki/List_of_countries_by_future_gross_government_debt
our debt are decreasing by years, it is the 53% population are fooled by populis policy which could ruined our economy.
and no such unstandardized education, there seem to be range of acceptance, atleast that is how our government determined which university to go and sponsor.
Haha, these are estimates. It does not mean it will happen. With the current income from dropping oil price and weakening ringgit, the debt will increase. Also don’t forget the household debt.
As for education, i am only talking about medicine and local universities. Overseas university entrance criteria is standardised.
housemen need to work long hour and shall not complain about it (and are advised to change profession) because… jeng jeng jeng…. if not they won’t be able to serve like what doctors in kelantan did! i’m sorry Dr Paga. that is one hell of a crap,
i don’t seem to remember those heroic doctors in flood affected area ever attribute their selfless sacrifise to their arduous housemanship experience. and neither do i think it’s relevant at all.
Haha, you the one who is talking crap. The way you interpreted the statement shows how immature you are! Doctors work long hours no matter at which category you are in, whether housemen, MO or specialist!! That’s what it means. So, if you not willing to do that, you can change your profession at any time and stop complaining!
“if you not willing to do that, you can change your profession at any time and stop complaining!” LOL aren’t you displaying the same mentality with our stupid politicians? talking about being immature.
here, read this. and don’t start with another ‘this is malaysia, if you don’t like it you can go out of the country crap’
http://bma.org.uk/practical-support-at-work/ewtd/ewtd-juniors
I will say it again, no one forced you to do medicine. So, if you can’t handle it, you can always find another job!Every country have their own problems with the healthcare system. Please read over here:http://www.mirror.co.uk/news/uk-news/nhs-crisis-nurses-crying-doctors-4931160
The situation in UK is not rosy either!! No matter where you are, doctors work long hours as needed. If you want office hour job, do something else!
and I will say it again, that is one hell of a crap!
demanding for decent working hour is not equal to wanting office hour job btw. No one should be put down or bullied for wanting a better quality of life. housemen deserve it and so do you.
Then find another job! All specialist in private hospitals work 24 hours a day 7 days a week! The last I know, housemen were doing shift duty!
oh my *facepalm
Anon & Paga,
Confucious said , “吃得苦中苦，方为人上人”， simple means ” no pain,no gain”.
Both of you can argue until the cow come home, but the facts remain.
Even Bill Gates works 16 hours a day, 7 days a week.
Anon, with your current mentality, you will not succeed in anything.
Not as a doctor, not as an insurance agent & definitely not in direct selling.
Dear anon,
If Confucious is still alive today, he will probably use a local proverb & advise you to “balik kampung, tanam jagung”🌽
Dear jimmy lee,
Do you even have anything substantive to say?
Anon, being a surgeon myself in a developed country (in my second year of practice), what jimmy and dr Paga are saying is the most substantial and rational advice. The current work hours rule is only protecting doctors at intern level. Upon graduation to become a specialist, there is no work hour rule and we are obliged to take care of our patients round the clock as well as partaking in 24-hour or sometimes 48-hour on call in public healthcare. The best way to be prepared for this is to go through it as a trainee. It is not wrong to fight for better and safer working hours but at the same time, it’s not a completely sensible thing to do as once you are out in the adult working world, those rules aren’t applicable anymore. So better be prepared and come to realization if one can truly handle the workload/stress!!!
Why senior doctors are cringing about work hour restriction – not because we are against the safer work hour rule, It is partly because it has changed the working culture/etiquette in medicine. I have noticed that interns and junior doctors are getting calculative at their working hours, calculative to do things when it’s actually educational and beneficial to them and most importantly the poor/lack of signover that lead to deterioration in patient care. These are just a few examples.
That’s my two cents.
Great to hear this.
how could “…but the facts remain. Even Bill Gates works 16 hours a day, 7 days a week.” as quoted from Jimmy Lee, classifies as “the most substantial and rational advice”? i’m not trying to be picky but does he even know what ‘fact’ means and regardless of the accuracy of the statement, how is it relevant to housemen’s working hour?
I wanted to believe you regarding the noble intentions of the senior doctors when they object to housemen having decent and as you cleverly put it, safer work hour rule, but I would call bullshits on anyone who are adamant that junior doctors need to suck it up working 16 hours straight simply because ‘during my time, i had it worst.’ surely there’s a middle ground, no?
I will say it again: no one force you to become a doctor. If you can’t handle it, you can always find another job. Even GPs who are running their clinic work atleast 12 hours a day 7 days a week. Since you became a doctor to help people, you are suppose to work to help people. Furthermore, don’t think that only doctors work long hour!
need i say it again that you are talking one hell of a crap? yes GPs who run their clinic might need to pull long hours to garner enough profit to sustain their business and make a living. how is this relevant?
Haha, you seem to be lost! Of course, everyone works for money? Are you going to stay in government service forever?? Will you work 19 hours if you are going to be paid extra?? Stop talking non sense. Everyone work! That’s the bottom line. If you don’t want to work, leave!
i can’t even….. *double facepalm*
anon,
“Balik kampung, tanam jagung”
this the best thing you can do for yourself & your country.
i wish you all the very best, may you grow the biggest 🌽in the world!
I hope to pass this on to everyone who is looking into any kind of profession. A mindset. Look at what you wanted to do and be not afraid of hardship.
Have anyone asked their parents, their grandparents and their great grandparents (if there is) about their jobs? What are their occupation, working hours and pays?
In anything you do, do take note of this.
Work ethics.
If you want easy work, fame and bonus without going through hardship, there is no such thing. No matter how hard you study and become who you wanted to be, you still need to work hard. If everyone just expect an easy job, sit in their office, walk out a little and money will come in, the world will be a mess because nobody will be doing their job. Imagine Doctors and Nurses sat in their office, who will take care of the patient? Imagine Engineers let the engines run on its own and if it failed, there are no production, therefore no sales and no income. Businessman does not attend to their customers. Artists who can’t act or play their instruments or sing. Farmers don’t want to take care of the crops and livestocks, where will you get the food? Where did the money come from to spend for these? Will you want to spend your money on them? We all should work together and do our part and that is how the world is running. There is a cycle for everything including money.
Work attitudes.
Work attitudes and respect towards supervisors and even juniors are just as important as work ethics. It defined the strength of the workforce. If everyone treated each other kindly, will there be anyone who would suffered from any biased or poor treatment?
Lastly. work for the job.
We all have one job and that is to make this world a better place to live.
If you do have the ability and if you do have the right mindset, you will walk far in any of the profession of your preference. Be professional.
Find what you have the ability to be responsible for or passion for and work on it if you have the chance. There are people in different kind of profession who has earned their gold, so will you. Most of them has the ability and passion. There you will always find somebody like-minded as you and there, if there is anything wrong, will stay together as a team to bring changes for a better environment.
I was brought up from a very diverse environment. I met all kinds of people and I have to say working hours and pay-check will not make the difference between professions. Almost all professions worked 12 hours and some even more. As the beginners, roughly all of them earned the same, slightly more or less. It will only increase with time based on your ability to bring in profits. Work with what you loved and you wouldn’t mind the hardships.
I wished someone in the past do tell me these but then I have to learn it the hard way. That is through experience.
Confucious said, “万事开头难” meaning “it is always difficult in the beginning”.👍
You are right about that. It is always difficult in the beginning.
Well for RM50-100/hr for doctors. It is reasonable. Remember about the beginning?
Before that, what the doctors have to gone through?
What about the nurses, the equipment (who build them and how much it cost) and medicine (who produce them and who gave them)?
However, it is unreasonable for patient who doesn’t earn that much per day. The solution is that, make sure everyone can earn that amount of money without demerit or downgrading everyone else profession. Work for the better and not making things worse.
There are other professions that earn 50 to 100/hr. Some even by minutes. Examples, Casino, lawyers (one signature is about 80), restaurants or other businesses, supermarkets, theme parks, consultants, Engineers (the one who are highly qualified), Lecturers, networking (some) and etc..
How do they get there? Lucks? Hard works? Opportunities?
Whatever it is, only hard works are what you can do and then when the lucks and opportunities come, you may strike the deal. Do what you can do and don’t look at what others do.
Well said. Many wants to become a doctor because they felt it is an easy job with good money. What they see is a doctor sitting in a room and after talking to you, charge you RM 50-100! Thus they get carried away but realise their mistake when they get into the real job!
We have to work hard for money. Nothing is easy in this life. Even you start a business, you need certain amount of money to start with. Those engineers who earned big bucks are not just a fresh graduate with plain degree, but they are equipped with extra certificates and training, same goes to specialists who earn a lot sitting in office. They have completed their training and passing exams as well as research thesis for those who are postgraduatres To achieve all this, we need knowledge, time and practice.
In the end, a lot of people still refuse to listen and believe in what they see. Reality hurts.
“百闻不如一见”- hearing something a hundred times is not as good as seeing once- seeing is believing.
unfortunately, the meaning of the proverb is taken out of context.
Paga can say 100 times about the hardship & sacrifices, but once they see a “5 minutes consultation” that makes RM 100… everybody wants to become a doctor. It all about 💲💲💲💲💲💲
In any field, one second gone may be bucks gone or for doctor, life gone. Well, let’s just say don’t let the irresponsible ones represent the professional ones. Once a person saw one, they will assume all of them are like that. They forgot about all the other hard workers and to them, they are just a background scenery. That is why I posted about work ethics and attitudes (these are called professionals).
Any profession need to upgrade themselves. Either 8 hours or 12 hours work, if you let yourself rest for a while, you may be kicked out soon or downgraded. With the improvement in scientific innovation, scientific personnel need to use their working hours or their own times to do researches and studies for their works and knowledge to upkeep their position in the industries. Even though I said the use of working hours (which should be officially), but most of them happened only after working hours because you will not have time with all the projects coming in and each of them is very urgent&important. They will also have to deal with new knowledge and problems. Management somehow introduced work-life balance for employees in some countries to prevent overworked professionals. Salute to them. It is not by doing less, it is by increasing the efficiency through a better system.
With no certificates and training or experience, it is hard to get employed in these industries. Not to forget how many actually did graduate in the Engineering field or other field (You may estimate them with the number of university in the field). Every year or every half a year, graduation happened.
Supply and Demand is the key factor. With no demands, supply get wasted. That is your certificates may worth nothing (you may cry but there are nothing you can change). I guess this is the main point that youngsters are worried about as well. What differentiate you from others is how you can do the job and how keen you are. There are those who go into a career different from their studies when this happen. This depends on luck. Some company are willing to train them.
Sitting in the office is not a problem. The problem is the thing that the person does while sitting in the office. Sitting in the office may means this person is working on a project, phone calls (not for personal use), planning, emails to customers inquiries or complains, reviewing or drawing, reports, research, analysis of results and anything else for the work. This is pretty tough for me because I have to stay focus in front of a computer screen for like 10 hours a day (no complain to interruption for urgent meetings or instant discussion). 5 days a week. If your computer froze, your brain froze too. Your legs will cramp and constant backache. I am an Engineer anyway. At times, I envied or admired those who do lab works or operating the machines (they have their own problems too). Vice versa anyway. It is true that Grass is always greener on the other side but actually, it is the same everywhere.
However, if you are sitting in the office, doing other things than work…. The company has wasted money on you. Profits were less because of you. Other get less bonus because of you and the possibilities of everyone losing their jobs were the worse, disrespect from others because of you. Can they do without you to increase their profits and well being of the company?
Exactly
Just thought I’d give my 2 cents regarding this matter. Despite the obvious glut, many are still trying to get into medicine or dentistry nowadays. Prolly because they think that these fields will pay them more. And I also think that a lot of these people seem to think that people will perceive them as more intelligent or something. As someone who has wanted to do medicine all my life but now doing accountancy, I see this often. Many of my relatives have asked me things like; “Why are you studying accounts lah? You got all A’s for A Levels right? Why not medicine?”
I have my reasons for doing this instead of medicine; I don’t want to be under the mercy of a faulty system and I want the flexibility of migration but people just don’t seem to understand the current situation in Msia. And this may deter many students from studying something else. Until this mentality that only doctors and engineers are intelligent changes, I don’t think the glut can be remedied.
Every field need intelligence… not one doesn’t
Dear Ip,
Let me tell you a story.
Once upon a long long time,
1. only the best students got to do medicine.
therefore, doctors are perceived as BRIGHT.
2. before the era of credit card & medical insurance,clinics took CASH only.
therefore, doctors are perceived as VERY RICH with pockets full of cash.
no headache, no need to chase after debt.
3. if some patients can’t afford to pay,
doctors gave free treatment because medicine was cheap at that time.
therefore, medicine is perceived as a HOLY profession.
Then, a group of doctors started building private hospitals.
They made even more MONEY.
therefore, the public nicknamed them “大百鲨” -“great white shark”.
That was the era of our parents & grandparents.
Hoping that their children will become even “great great white sharks”
Then come all the private medical colleges & nonsense.
PAGALAVAN saw the inevitable & started this blog.
Unfortunately, “good advice is often least heeded”.
Now we all end up in a very big mess.
Nobody is going to clean up this mess.
Everybody is pointing finger at the next person.
Everybody is kicking the can down the road until the drains got all clogged up.
Soon, we will end up like our some country where the public dont even trust their own doctors.
But still there are many who still want to do medicine because of the story of “the great white shark”
Nice story jimmy!
Hahah, couldn’t have said it any better!!! BTW, the era of doctors building hospitals are gone.
Many feel that being a doctor upgrades their family social status in the society
Also, to survive in today’s ultra-competitive world, I think students need to focus on how to manage money rather than working long and hard for it. Capitalism is killing the middle-class. Making lots of money is not the case now. If you truly want to be rich, you need to know how money works.
It’s all about money but then it is also not about money. We co-exist for each other. How do you think stock works? Economy works? You sure know more than I did because I never had the chance to do accountancy. I only knew a bit about them from work. we are in the education system where people go into science field.
My mum do accountancy while my dad a businessman and they all thought scientific field earn more money and a better future. Only my mum told me, perhaps I can innovate a medicine towards immortality or a medicine that can cure any illness. She likes to take things apart, experimenting them and she is someone who can fix a tv/radio which still broke after a few use anyways. She will tell me about it sometimes. She has interest in them but then the fees to study engineering and doctors cost a bomb especially in the past where most people studied until form 5 only or not even have the chance to be educated. I was interested in Science because of her. To make things up until now, I don’t think I have earn more than my dad did (Still falling far behind). I am also interested to become a doctor but I was too playful to become one.
Imagine a world of accountant? no doctors and no engineers?
Imagine a world of doctors? no accountants and no engineers?
Imagine a world of engineers? no accountants and no doctors?
We should find the balance. Work hard but make sure to make results and efficiency is important if you don’t want to work long hours.
I am not sure about what accountants do anyway, I know you do need to have certain professional certification after graduation but for science, we need to read up when new things come up no matter what certificate we have (like it or not), develop new ways to solve problems when they arises, always find ways to improvement, it may be new and it may not be. I always hope its something new so I can learn new things. If one didn’t like it, one has to change to work with no such uncertainty nature where the work became routine and less likely to have to meet changes. They can always ask someone to leave when they cannot meet their requirement.
There are difference between people who “work smart” and “work efficiently”. For fairness, don’t mix them up. Hardship in terms of being able to take on challenges or encounter obstacles. If you found a better way to meet these challenges and conquer these obstacles, you are efficient.
Rachel,
Your comments are so long. I hope your boss doesn’t catch you sitting in the office writing all these comments.
Dear Jimmy,
I am already out of job. If I am working, I absolutely won’t be anywhere reading blogs, commenting and never did in the past until this blog was shared by a friend. Hope you are not working now.
Sorry, I used the wrong term, I was an engineer. Maybe I will never be an engineer again.
Rachel,
your comments are intriguing. You are not a doctor and no longer an engineer. what do you do for a living?
The world is too small and I am back to the engineering world. I was planning to do my own business or a change in field. Nowadays, the only other path for changing field is doing sales (especially insurance company wants you). Other employers will look at relevant experience only to consider you for their field. If you accept a new field, you will have to start from scratch (throwing away the experience credits that you have accumulated)
So when you choose a profession, make sure you know what you want in the long run. If you do it for money, the job is going to make you sick. If you become deranged because of a job, possibly that job is not the best for you. Or the best example is someone who would lose their patience or tempers easily in the workplace (probably you have seen a lot). I worked with and interviewed quite a lot of my colleagues or ex-colleagues or other random people I get in contact and from the way they did things, you can tell roughly whether they love it or love the money. Lacking money is also partly where the stress came from too. I have friends (very little) who like their job, they don’t mind eating less or living a frugal life as long as it’s peaceful and well-balanced.
I visited this blog because a doctor friend shared this on fb and my younger brother planned to do medicine (which I think, is not a good decision considering how he lived his life).
What a nonesense here. Come on, stop talking all the horsemen or MO here. Forget all that bunch of useless lazy doctors especially Russian educated.
Now, if u want to comment about medical profession, wait till you become a specialist, cause many Tom and Dick can become a doctor but not specialist.
Regarding the Shark of the shark story, come on, nothing is being guaranteed in this world, besides Death. so, one day, u might come to Pagalavan for arthritis problem.
GP nowadays can make RM 20k rough figure? I doubt. But, I can tell u something for sure, a Dermatologist can easily make rm 60k a month and Gastro can make even higher.
Above 100k, u should consider Cardio and most popular, Nephro…
Pagalavan, agree?
Dear Lobak,
Plato said “wise men speak because they have something to say, fools because they have to say something”.
Paga & me are senior consultants. We know what we are talking about.
Obviously you belong the the other group.
⚠️If you want to swim among the sharks, you better be prepared to take the heat
Otherwise go to some other professions & swim among the anchovies.⚠️
This is THE MESSAGE of this blog.
“horsemen” lolol. The england is powderful in this one. Hehe ok ok just kidding sorry for the ad-hominem.
Srsly, you need to factor in the time value of money and lost income from studying. Also the extra hours spent studying during speciality training (while working full time)…and the time value of money invested into education.
Studies have shown that, in a stable first world country (eg. UK or Australia), the earning potential of an accounting or business major is similar to that of a doctor once all costs are considered. In fact, the doctor gets paid less per hour of work (assuming an age of retirement of 65, which is common in the first world).
Here is a nice diagram explaining it: http://www.bestmedicaldegrees.com/salary-of-doctors/
Please read my blog post on ” How much do doctors earn?” Then you will know about the working life and the money you earn ? worth it?
Tonnes of advice have been given by senior doctor/ consultant. Never do medicine for wrong reason because you will not be able to walk far if your intention is incorrect in the first place. Medicine has to be life long learning, and never ever be able to exchange human health with money earning. That’s the reality. Many senior doctors have walked thru the pathway and encountering the different segment of life, from HO to consultant level, with the distortion of social and family value just to reach the top level. The worthiness of sacrifice has been mentioned to the younger age doctor, just to share their life experience and pre-warning the younger doctor to be practical and realistic. If the younger doctor insist on their presumption without acknowledge the advice, definitely they will walk thru and encountering the life difficulties and hardship as well. This blog are being created to educate and increase the awareness of the younger age group.
Dream and Reality are always clash each other in real life. But you can always achieve your dream and make it to be reality if you able to work hard. That’s life, nothing come easy in life.
Hi Dr Pagalavan,
A keen follower of your blog here. I’ve got a query I hope you can help me with – could not find an email address on your website hence resorted to posting a comment here.
Currently I’m a junior doctor in my first year of training in the UK, but I am thinking of returning home to Malaysia end of this year. The plan would be to complete F1, sit for the MRCP part 1, and then return home. My question is, would I have to repeat all 2 years of housemanship in Malaysia? Or would I be exempted from the specialities I have covered here – medicine and surgery?
Also, if I choose to delay my return by 1 year and complete 2 years of housemanship here in the UK, would I have to do it again in Malaysia?
Any input at all would be appreciated, thank youvery much! 🙂
Dude, If you are in the UK, why bother coming back to Malaysia? Finish your MRCP ( all 3 parts in the UK), compete for the BST prog, and you can keep your option open. You can join Singapore ,Ireland,Australia ( thru The Specialist pathway depending on your interest). Oppression and Biasness is very rampant in Malaysia. Unless you have a personal reason like me, don’t consider coming back. Cheers. Regarding the HOship it is likely that these people will ask you to repeat your training for another 2 years. It is an unwise decision to come back because the system is marred by Russian/ Ukrainian graduates. Your chances to learn during grand ward rounds are so limited these days as Many consultants have given up teaching !
I wonder nobody ever mentioned working in Canada in this blog?? I thought Canada has some of the most prestigious training hospitals for some specialty fellowships??
I personally know a few returnees from UK who had been exempted from doing rotations which they have completed during FY. I agree with neuroAspirant, it is probably wiser to stay in the UK until you have become a qualified specialist although I could totally understand the temptation to return home as soon as possible. I wouldn’t put the blame on the Russian/Ukraine graduates for the flaws in our system though as I feel many of them are also victims of our stupid policy makers.
Are you bonded by the JPA? if you’re planning to work straight away upon returning to Malaysia, I guess it would be wise for you to start applying through SPA from the UK, like 2-3 months earlier, since that’s probably the duration you have to wait for before being called for an interview. Dr Paga has elaborated about the issue of housemanship employment in this and previous posts. Anyway, if you decided to come back, please keep an open mind and brace yourself with the entirely different culture and work attitude. The seniors, specialists and consultants are less interested in teaching and they mostly just want you to get the work done for them. any difference in opinions or feedbacks/complaints will be treated with much hostility and you would often be advised to leave the job or country if you voice out your opinion. to scratch a senior’s ego is the worst sin/error you could ever done.
I would personally be excited for you to return and I am sure you would be a terrific addition to our medical fraternity. just remember to practice and preach what you have learnt there, and apply it here to the best of your ability 🙂
Take it from me. It is way easier to pass your MRCP In the UK compared to Malaysia and of course I m talking about the PACES. Malaysian examiners and Singaporean examiners just love failing candidates. Blame it on their ego. Plus why on earth do you want to come Malaysia bro? The system is never fair here. While the system in the UK and Oz encourages you to think independently in Malaysia we are still stuck with the goddamn superiority and hierarchy. If you something similar and nearer I encourage you to consider Singapore although I must warn it is competitive there, but if you are good hardworking bred no problem
Veen1990,
It is best to complete your MRCP in UK and then contemplating your return to Malaysia. At least, you would not need to work as a junior doctor here.
NeuroAspirant,
I don’t think Malaysian and Singaporean examiners just love to fail their candidates. Bear in mind that the standards expected in Malaysia/Singapore are much more higher than in UK and that is because an MRCP holder would be considered as a specialist in Malaysia (after gazettement etc) and is ultimately responsible for patients’ management from admission to discharge. However, in UK having MRCP in hand does not mean anything. The ultimate decision on patients’ management comes from the consultants. In fact, one can even complete their MRCP by the end of their Foundation Programme in UK.
I have worked with local specialists with MRCP and also with those who worked and received their MRCP in UK and came back to Malaysia as specialists. Personally, I find it obvious that the locally trained specialists are generally way better at patient management than those foreign graduates.
@GP, is it your opinion that getting one’s MRCP in Malaysia is better than getting it in the UK? Also, can one really be a specialist here, with just MRCP in hand these days? If yes, what kind of specialist? Internal Medicine? Family Medicine?
If you return now, you will need to do whichever posting that you did not so in UK during housemanship. It would be advisable to complete your MRCP before coming back as it may exempt you form doing housemanship here.
Dr Paga, what are your opinions on doing a medical science degree then go for master in Public health?
Thanks
To understand public health, you have to be a doctor
Most think that UK is better, but yet some still chose to come back to Boleh-land (for reasons best known to them).
“If the grass is greener on the other side, there’s probably more MANURE there”
On either side of the fence, the taste may be different but all are equally pungent. you will still need to work very very hard & dont aspect to get gazzetted before the age of 30.
I agree with Neuroaspirant.
Do not. I repeat: Do not return to malaysia until after postgrad qualifications.
Not only will you be able to achieve fellowship faster, but upon return to malaysia you will be an intern for a full two years. Arguably , this would make you a more versatile doctor. Hardcore Rural O&G rotations, ortho, etc.
But seriously, two more years of internship?
hi Dr Pagalavan. I’m planning to apply for master in medical sciences by research in the UK in order to pursue an academic path to be a lecturer in pre-clinical subjects. However, is it preferable to do so before or after the housemanship (? I’m worried that after completing HOship, I might loss the opportunity to do so.
student,
If you just focus on the smallest details, you never get the big picture right.
if you don’t do your housemanship now, you will lose much much more.
you can always do your master / PHD later but you may never get your houseman job if you miss the boat.
If you don’t do housemanship, you will not be able to get MMC registration and will never be able to practise as a doctor. Unless you are very sure of ONLY working as an academic in pre clinical science for the rest of your life, it is advisable to complete housemanship.
So Dr Pagalavan, can you please explain more on the academic career pathway in medicine? It is difficult to find infos on this matter actually, when almost everyone is talking about being superb clinicians. Plus, it’s not that I don’t want to do HOship, it’s actually about doing which one first. As there were some MBBS grads with intercalated Bsc, so I would like to take Msc first then do HOship if it is required to be a lecturer. Thanks Dr.
Those who do preclinical sciences can become lecturers and researchers but will not be able to practise as a doctor.
If I’m not wrong, intercalated Bsc degrees are done after yr 3 or yr 4 of the MBBS program, not after completion of the degree.
student,
1. in medical courses, traditionally there are pre-clinical & clinical years. Although some medical colleges have different ideas nowadays.
2. if you want to be a lecturer in the medical faculty, you must first be a superb clinician.
“A good teacher explains.
A superior teacher demonstrates.
A great teacher inspires”
As a superb clinician, you will inspire your students to be better than you!
3. About which one to do first, HOship or master… we already told you to do HOship first.
4. if you want to be a lecturer in clinical years, be a specialist. if you want to teach basic sciences, then take Msc.
5, either way, do your housemanship & get registered with the MMC first.
keeps your options wide open.
jimmy_lee is a troll! Darn!!
raymond loh,
that is very kind of you.
under my supervision underperformance will not be tolerated:
1.subpar housemen will have their housemanship extended.
2.subpar MOs will have SKT marks less than 80… so that they can’t get into master programme. those who still refuse to inprove themselves will have to do HO oncall.
3.subpar master students will be barred from taking exams.
4.subpar registrars will be demoted.
5.subpar specialists will not be gazzetted & have to do MO oncall.
there will be no compromise when it comes to patient care.
i have been called a lot of names behind my back, to be called a “troll” is simple too kind.
not just a troll. he’s also so full of himself. suddenly wanna elaborate who he’ll let pass and who he’ll not. i can’t have enough of this guy’s antics 😛
What is Physician in Malaysia ? A physician in Malaysia is basically just a compulsory pathway in order to pursuing your sub specialities, such as Gastro, Nephro, etc. this only apply in Internal Medicine. If you think you could not complete the MRCP in the short period of time, Master Program is another alternative.
Passing Mrcp early is a Great thing. I passed my Part 1 when i was a housemen in Ipoh, 9 years ago, with 1 attempt, i passed my part 2 sebsequent year with 2 attempts, and part 3 1 attempt. all finished within 4 years period.
once you passed MRCP, u are declared as Physician, well, nothing to be proud about physician, the only plus things are, u dont need to do the monkey donky job as a MEDICAL OFFICER, and you dont need to on call. u will be gazetted as a physician, at the same time, ONCE GAZETTED, u will be selected ( depends on your luck ) to further in sub specialities.
so, what is next after Physician ? u need to apply into the sub specialities that interest you. for my case, i sub in Nephro. well, u need another 3 years so in this miserable period, how hard and easy depends on your knowledges and interests, and also, most important, the SIFU aka consultant. lucky me, i have one of the best sifu in Malaysia. for this 3 years, u will be sent to a respective country to further training or aka attachment for about 1 year plus.
after all these, u will be proudly declared as nephrologist.
WELL, IT IS NOT EASY TO BE A NEPHROLOGIST.
To the parents out there, to give u a hints of 2, i finished my STPM with distinction, i enrolled into UKM. My late parents is not wealthy, the only way i want to study Medicine is i have to excel in academy and curriculum. With God blessing, i succeeded. What i am trying to bring up is, if your lovely kids, are not smart enough ( sorry for being harsh ), forget about sending them to the PAID MEDICAL SCHOOL, for the sake of all Malaysian.
If your children are smart enough academically, with god blessing, they will be enrolled into Local Medical School.
Lastly, trust me, in Hospital Training, most of the below-par-oversea-omney paid medical school will be looked down by others…. perhaps, this is also the reason some young trainee doctors are depressed.
derrick,
we get the message.
basically you are telling us that you are very smart; and extremely ARROGANT too!
HI Derrick !! I think i knw u lolz. BTW ignore Jimmy Lee, He’s probably suffering from some vascular dementia. Didn’t know so called ‘senior consultants’ are some jobless ler. He doesn’t obviously know what is proferessional contact. All he does is quotes and more quotes.
funny i didn’t get the same message. Jimmy Lee, you really like to troll around a lot for your age, don’t you? 😛
oh wait, I know what you will say next, either ‘confucius says bla bla bla’ or ‘balik kampung tanam jagung’
here is a “pantun” (poem) for you guys :
“bangun pagi, gosok gigi,
lulus MRCP, hidung pun dah tinggi,
junior sekarang beresmi ayam,
bertelur sebiji, riuh sekampung”
anon,
“berakit-rakit dahulu, berenang renang ke tepian,
buatlah oncall dahulu, baru jadi consultant kemudian.
nafkah sebagai hasil keringat,
kenapa kerja berkira sangat?”
Paid or none paid, there is still a certain criteria to meet. If you feel that being a Doctor is the only intelligent thing to do, better start looking around you. Should I mocked you for not being rich enough? Your parents must not have the intelligence to be wealthy? Just to mention, mocking upon or condemning others is a double edged sword. It doesn’t make you or anyone better.
I used to think all Doctors in Msia has no standard just as you think for those in med school. What is the success rate of students getting scholarships to EU or local uni? Malaysia’s uni is not even in the top 50. Should I mock that too?
Well, until i met a few good and professional ones who had totally changed my mind about them. We should judge one by what they did and not what they are. I apologize for my rude comment above. Just wanted to show some most common arrogance available.
Don’t judge a fish by its ability to climb a tree. Some food for thought from Albert Einstein.
Else everyone think being a monkey is the most intelligent thing to do, then everyone wants to be a monkey because it climbs the tree faster than a fish. More quote from Einstein just to annoy,
Try not to become a man of success. Rather become a man of value.
As annoyance is to those whose cup was full. You can’t fill a cup that is already full.
Derrick,
Passing mrcp is a joke, it’s nothing compared to the fracp exam…
If you’re that bright academically, how come your English is of subpar standard? – I’m concerned about the selection process here.
Last but not least, for the sake of all Malaysians, if their kids are smart enough, they wouldn’t do medicine and end up talking with a “monkey donky” brain like yours.. Please- MOs are the backbones of hospitals and their jobs should not be underestimated. It’s also a crucial period in terms of learning.
“With God blessing, i succeeded. What i am trying to bring up is, if your lovely kids, are not smart enough ( sorry for being harsh ), forget about sending them to the PAID MEDICAL SCHOOL, for the sake of all Malaysian.”
Derrick, you’re one of the reasons the system is also pretty messed up. You just don’t see it because you are part of the problem and not the equation.
Anyway, what is your definition of “smart”? You must be so full of it.
[…] « For Future Doctors: Housemanship and Employment…….. […]
dear dr pagalavan,
i am a malaysian student currently studying medicine in the UK. i am planning to do my housemanship in the UK after i graduate, but eventually i would like to return back to malaysia (despite the downfalls in the healthcare system) because i would like to be closer to my family.
i was wondering if i would have to do housemanship again upon returning to malaysia after completing housemanship in the uk?
i know about the 4-year compulsory service, but would i be able to move on to being an MO after returning to malaysia? or would i have to start all over?
You need to do the postings that you did not do in UK before being given full registration to become a MO.
dear dr pagalavan,
i am a malaysian citizen. i have completed my mbbs in an unrecognized university and my post graduate medical qualification that i am pursuing, is on the list of recognized postgraduate qualifications on NSR website. i plan on coming back to malaysia after postgraduation.
but i was wondering do i need to take the MQE test to register with the mmc? also I’m confused, do i have to work as MO for 2 years for compulsory medical service, and then apply to work in a hospital?
You are definitely confused. What postgraduate degree are you doing? It all depends on years of service overseas. If you have had enough experience than MMC may consider registration but you still need to do 2 years compulsory service in a government hospital.
I’m doing paediatrics, its a 3 year program after which I shall take the board exam and shall be board certified with the American Board of Paediatrics.
If your postgraduate degree is recognised, then usually you do not need to sit for MQE. However, if you come back before 10 years of service overseas, you need to complete atleast 2 years of compulsory service in the government. Please read this
Thanks a lot for your help Doctor. I did end up reading about the compulsory medical service on the MMC website. So, that’s sorted out and I know its status.
Actually, I did call the MMC to ask if I have to sit for MQE and go through housemanship, and the person handling the MQE seemed confused. All she said was we see your basic medical degree, and if yours isn’t recognised you have to sit for MQE and she was confused about housemanship. So basically, I didn’t get a clear answer. That was pretty distressing and disappointing as they should have clear cut answers.
Thank you so much for your help Doctor. Your links and articles are a life-saver! I’ve been reading your blog, but I guess I missed those articles. Thank you so so much.
Welcome to Bolehland! If I were you, I will stay back where I am!
Haha! Thank you Doctor!
I know for a fact that although the primary qualification is not recognised, holding a recognised postgraduate can enable registration without exam. There used not to be need to repeat the Housemanship, but I am not sure how the amended 2 year Housemanship treats this now.
Hi dr paga,may I ask as a houseman in Malaysia are they legally protected if anything goes wrong as they are still under training like blood transfusion error?houseman in Malaysia need to get any membership from professional organization which serve to protect the interest,support and safeguard the welfare of doctors?or houseman also need to get medical indemnity insurance in Malaysia?as they are the one who tend to do mistakes and get blame most of the time
Housemen are suppose to work under supervision. Thus, if anything happens, your superior need to answer. Furthermore, you are a government servant which means the government will be sued and not you. MMA is the only professional body for doctors.
Indemnity insurance is not compulsory for government doctors as the government will take responsibility. However, under the new amended medical act, it may become compulsory for all doctors to purchase indemnity insurance
Dear Dr. Pagalavan,
I’m a SPM leaver this year. I’m going to take Foundation In Science in TMC college(beside VivaHome) for 7 months and then pursue medcine courses in Russia for 6 years. The universities in Russia include Moscow State Medical University and Russian National Research Medical University.
May I ask is the TMC college under the Medic Ed good? Is Medic Ed trustable? Is Russian’s medical course good?
(I’m very afraid that after 7 years when I come back to Malaysia, Msia will not recognise my degree and also the foundation. And , I googled and search about comments and recommendation regarding this TMC college but with no avail.)
Yours faitfully,
Victoria
If you care to read this blog from A-Z, especially under For Future Doctors page, you will find the answers. Generally, the impression we get from russian graduates are not that good but however I feel it depends on the type of students as well. Both the Russian college you mentioned are OK.
Based on MMC Guideline over here, they emphasised that your foundation course must be atleast 1 year long! However, medical course in Russia is 6 years, so it may be acceptable.
Whether you will get a job upon your return , depends on situation at that point in time.
Can I ask, in the light of so many local medical schools, and generally easy entry criteria, why are you considering to go to Russia?
Because the local schools r probably worse as well
[…] had also proven many times in this blog, even before the Minister confirmed it last year, that we are heading towards surplus of doctors. […]
Dear Victoria, DO NOT GO TO Russian Unis. Unless you want to be constantly mocked and hated by your senior consultants. If you have money join the Taylors/HELP/Methodist College do your A-Levels/SAM ! Get at least AAB/ SAM- 95%. Then Apply to IMU-Partner Universities. That is the best pathway. If you are money constraint- Apply Melaka Manipal. They have good teaching system. Forget Russia. They produce the worst graduates EVER !!!
Hi.
Dear Dr Pagalavan,
I intend to pursue my undergraduate studies in medicine.
I’m planning to take up A-levels in biology, chemistry and maths.
Is it ok to take up these three subjects only or do I have to take up four subjects?
If I do have to take up a fourth subject, should I take up physics or psychology?
Thank you.
May i know where you plan do your medical degree? If you plan to apply Oxbridge, you need 4As. Most Uk unis now require 3As-good ones that is like Glasgow, edinburgh and Leeds. If you wanna go IMU twinning, u need at least AAB.
Thank you.
Please read the MMc guideline
Hi doctor, may i know which specialist exam should i prefer in order to be a radiation oncology?
You need to do Master’s in Oncology. Similar to any master’s program. Or you can do it as a sub speciality after Masters in Radiology.
Dr, for your opinion, which is best, pursuing my master at local or overseas?
That depends on whether your basic degree is recognised overseas. If it is not recognised, you can’t do your masters overseas anyway!
Oh i see, thank you very much for your information.
Hi Dr Pagalavan. I am interested in doing dentistry. Is manipal medical college in melaka a good choice to do that programme? And i would like to know if pursuing a degree in india is costly or not and is it possible with a-levels result?
I am not a dentist but generally, it should be OK. A level’s is accepted in India but you need to take the subjects that they need.
Dear doctor, I tried to search about this but still couldn’t find any answer. Does doing research while study makes us getting job much easier after graduated? Thanks.
Not in Malaysia.
Not in Malaysia.
I know tad some hospitals like Sunway Medical Centre and Hospital Sg. Buloh are affiliated with some medical schools, does this help to secure training opportunity for med students??
Are you talking about Housemanship? The answer is NO.