Since my last article in June 2019, there has been a lot of happenings in our country, as well as in other parts of the world. Is it for better or worst, only time will tell. The tragedy that is affecting our young graduates is something I predicted almost 15 years ago. As usual, our suggestions and warning to MOH was just for filing purposes with no definitive action or plan. It was all about money and how much you can make out of our society’s ignorance and demand. Over the last few months, I have been watching and reading numerous articles in the newspaper in regards to housemanship waiting period and what is happening to those who have completed housemanship and floating around while waiting for MOH/SPA to make a decision whether, you are going to be absorbed permanently into civil service or just an extension of the contract. The frustration among the doctors is palpable but trust me, it will not just end there!
Early this month, there was a circular from MOH:
I find this circular very interesting. As I wrote in my article dated 15/04/2019, the first batch which started their contract housemanship in December 2016, most completed their housemanship end of last year and eligible to apply for a permanent post. Unfortunately, they were waiting for months. While they were waiting, they were kept in the same hospital as a floating medical officer with the same salary as a housemen. As long as the contract is not renewed, they will not receive the U44 promotion. They will remain in U41 as per the earlier contract. The first contract was for 3 years, to cater for any extension of housemanship. That’s the reason the contract has to be renewed after you receive the full registration as only then you can receive a U44 salary. Fortunately, the bright side is the fact that you still have a job till the contract expires.
In June 2019, I was informed that almost 500 of them were absorbed into permanent civil service and only about 50 were given extended contract to complete their compulsory service. Those who were given permanent post were mostly transferred out to where the post is available. A lot of them ended up in Sabah and Sarawak. Either you take it or leave it! There were actually more than 1000 doctors who had applied, following completion of housemanship, end of 2018. What happened to the rest? From my understanding, till September 2019, there were no news about the rest. While waiting, the number of applicants has been increasing as subsequent batches of contract officers began to complete their housemanship. What a mess we are in!
Then, out of no where, the circular above was issued by MOH, dated 30/09/2019. The circular basically says that while waiting for the decision, you can now be transferred to another hospital, klinik kesihatan aka anywhere!. You will not be in the same hospital as a floating officer. It also says that you will be notified of the decision of your application 3 months before your 1st contract ends (which is 3 years from your date of starting housemanship). Basically it just confirms that you will remain a floating medical officer till about 9 months after completing your housemanship (assuming you complete in 2 years on the dot) but in a different location!
The most interesting part of the letter is the fact that, if you manage to secure a permanent post, you will likely be transferred yet again to another location depending on availability of the vacant post that you are being given! Basically means, you will be transferred again within a year to another location! Is this a tragedy or a comedy? The best is yet to come: those who receive extension of contract can remain at the same place where they were transferred as a floating officer! In another word (the way I interpret this), your life in civil service ends there within another year aka completing 4 years of compulsory service. It’s just a diplomatic way of putting it !
All these just points to a simple fact: medicine is not a guaranteed job anymore. The market will be flooded with doctors and no one is going to be bothered whether you have a job or not. How many of them, who did not get a permanent post (can be about 2-3000/year) going to end up opening a clinic? As per my last article in June 2019, the GPs are already struggling to survive!
This is not something that is happening in Malaysia alone. In August 2019, Singapore Medical Council announced that the number of recognised medical schools will be reduced from 160 to 103, effective January 2020. Many universities in Australia, India, Ireland and Canada were de-recognised. Singapore believes that they are now producing enough graduates of their own to fill the vacancies. Only UM and UKM degrees are recognised in Singapore and I heard that many who applied for a job in Singapore are not receiving favourable response compared to 10 years ago.
Similarly, as I have written in April 2019, Australia is also reducing their dependency on foreign doctors. In April 2019, I wrote that effective March 2019, Australia has introduced a new rule for employers who are recruiting foreign doctors to be a GP in Australia. They must first apply and receive a certification from Rural Work force agency confirming a genuine need to fill the position. In July 2019, Department of Health has reclassified areas which can recruit an International Medical Graduate (IMG). What use to be known as DWS (District of workforce shortage) area is now being replaced by DPA (Distribution Priority Area). These are the areas where an employer can recruit an IMG as you will not be given a medicare provider number(for medicare billing) if you are not working in these areas. Interestingly, many of the areas which use to be DWS areas till June 2019 are now non-DPA areas. DPA now only covers rural and remote areas. For example, in Western Australia, the entire Perth up to Mandurah and even small suburbs like Bunbury and Geraldton are considered non-DPA areas. And you have to work in DPA area for at-least 10 years (the 10 year moratorium) even if you become a PR. The whole idea is to cut down the number of foreign doctors. Furthermore, you can only work in Australia after passing both your AMC Part 1 &2 exams (except Monash Malaysia), where the passing rate is as low as below 20%. As for FRACGP, as mentioned in my April article, those who enter the program in Malaysia from January 2019 will not be receiving FRACGP and will not be able to work in Australia directly. Everyone works under contract in Australia and there are many specialist in Australia who can’t find a full time job. Many work on part-time or sessional basis. There is no such thing as automatic job for a specialist in Australia, upon completing their fellowship. So, don’t assume that doctors are guaranteed a job anywhere in this world!
This interesting letter from a doctor is worth reading, ” Medical Profession is no longer lucrative”. It is well written, not to mention the increasing litigation and patient demands. Do medicine only if you are determined to overcome all the obstacles. Reading my blog/books will inform you the real life of a doctor and not what the public wants you to believe. It is never as simple and cosy as what the public tells you. Till today, when I look at the comments in social media, the public still believe that doctors can work anywhere in the world. They got NO idea that a doctor cannot work in another country unless his/her degree is recognised in that particular country. They got NO idea that you need to sit and pass an entrance exam which can cost thousands of ringgit without a guarantee of a job! They got NO idea that there are jobless doctors in many countries, Malaysia is on the way to join those countries………
Happy Delayed Deepavali 2019 greetings.
IS THIS A TRAGEDY OR A COMEDY…………………..
Very well explained.
It is a tragedy
So the countdown begins as to who shall have to leave government service? We are looking at December 2020 or 3 months before December 2020?
those first batch who just get extended contract, will expire in December 2020.
Sounds like it’s tragic if one is posted to Sabah and Sarawak…must be a special kind of hell, or some purgatory or sorts.
*of sorts
Actually not bad at all. Many enjoy their postings in Sabah and Sarawak and learn how people leave in deprived areas. Most get married to locals as well! The issue would be, will they be able get out from there since almost all post are full!
“Special kind of hell, or some purgatory” wow this is the kind of views you West Malaysians have. Please come and see what East Malaysia is like before you make comments like this. I have tonnes of West Malaysian colleagues who love staying in East Malaysia because we are more accepting of race and religion compared to you guys. And if you’re a medical doctor/student/graduate and have this sort of mentality I feel very sorry for you for having this mindset.
Another incoming reality is that, many of the contract houseman will try for mrcp to get a permanent post in kkm, then university will end up with no students in internal medicine program, then the maybe universities will later try something, such as, try to make mrcp not valid to be a phsyician in Malaysia?
The issue of not recognising MRCP has been going on for almost 15 years. Our current DG is supportive of parallel pathway, so I don’t expect it to be de-recognised. However, UM is working on a standard post graduate curriculum to be implemented throughout the country for post graduate degree, where even the MRCP guys have to fulfil.
Does this mean that the current implementation of logbook for mrcp is only for short term solution?
In Malaysia, nothing is planned for long term! Anything can happen at any time!
The Minister just made a statement in Parliament on Medical Officers placement. The information is now available in codeblue.galencentre .org website .
So It can be inferred the issue is now becoming more serious.
The minister just confirmed what I said and told the reality. It was mentioned almost 3 years ago that civil service job is not guaranteed anymore.
It is ironic that many become doctors or enter civil service to get a so-called stable job. This mindset is very common in both Malaysia and Singapore. Possibly they can study medicine in western countries such as the UK and US
and work there. Get specialist training over there.They will have a brighter future over there than in Malaysia. Even Singapore seems to push every new medical graduates to GP pathway.
Our education system is flawed. Our education should aim to produce more entrepreneurs that can create more job opportunities.
It is not as rosy as people expect in UK or US as well. In these countries, all jobs are under contract and getting into speciality program is highly competitive and preference is given to locals.Studying medicine in these countries are also NOT cheap and how many parents can support such high cost? As for GP pathway, that is the way forward in the future. Many countries are moving towards the same pathway. US learned the hard way. Malaysia refuse to learn. BUT GP pathways in these countries is a speciality by itself.
Our education system is totally outdated! WE still believe that jobs like Doctors, Engineers, lawyers are never jobless! The world has changed compared to 30 years ago.The good ones can still survive but we are producing too many mediocre ones just to fill up the quota and to glorify.
I am one of the contract officer from batch December 2016 and unfortunately I didnt manage to get the permanent posting. A month ago MOH offered to renew the contract and guess what? There were no grade promotion and no allowance increment anymore as we were a offered a UD41 post for another 2 years. What a joke and what a heartbreaking decision that MOH have come to. No details explaination as to date regarding this issue as no one is discussing this matter at the moment
Are you super busy as a contract-based MO?
That is something that should not have happened. Can you email me your contract extension: pagal72@gmail.com. Blackout your name
Good day , from the circular mentioned in the post . This gives rise to an interesting scenario to my junior colleague.
For example
DrA and DrB are the same batch of contract HO serving in Sabah starting from 1 Jan 2017 and they competed HO training on 1 Jan 2019 . After 5 Months of floating . DrA applied transfer back to West Malaysia and was given extension of contract for another 2 years (from June 2019 to June 2021), starting to work officially as a contract MO . whereas Dr B continue to float in X department , final placement is still yet to be determined and Dr B has not received any extension of contract MO yet until recently , Dr B will continue to work as contract MO , from Nov 2019 to nov 2021.
So DrB has more advantages as Dr B has more time for preparation in getting more credit points , such as post grad examination .
You can’t apply! It is up to MOH to decide where you get the post depending on availability of post.The new contract start date is from the old contract end date. So, no difference.
[…] wrote my last article on 29/10/2019, throwing a question whether our junior doctors are facing a tragedy or a comedy. I modified the […]
I am JPA sponsored currently in 3rd.year MBBS in Newcastle University Medicine, Msia( NuMed ). With the uncertainties and the long wait for placement of housemen and medical officers, should I opt to work in UK after my graduation? Kindly advise, sir.
Firstly, you need clearance from JPA. They may ask you to pay some amount back to the government. There is also no guarantee that you will get an internship post in UK, a lot of changes can happen along the way.If I am not mistaken, from 2016, JPA sponsorship is a convertible loan?
Excellent question.You need to write to JPA to release you first. Will JPA release you? What happens if they tell you to pay back the fully- sponsored money back before releasing you?You need to be prepared to pay back to JPA. One HO I know intends to go to UK just after eight months . JPA will not let him go. It is tax payers` money and if everyone does it , then what is the purpose of signing the bond?
When you go to UK, how sure are you will be absorbed there?No doubt it is better to try rather than keep waiting here. Very important to check with new doctors there in UK and understand the Government `s policy there. Now only you are the third year, When you complete two years later, lot of changes would have taken place.Governments change along comes new policies.It could be better or or could get worse.
Always search for all the necessary information. Final decision is always yours.
It is indeed a debatable question. One of factors is the GMC provisional registration which somehow needs to be converted to GMC full registration .
Added to this is the factor of Medical Licensing Assessment UK coming into force in 2023.
yup, similar to USMLE. All graduates within UK will need to sit for it as well. Interestingly, even those who pass PLAB have to sit for MLA!!
Hi Dr Pagalavan
Love reading your article,
Just to throw some random questions:
1) Is there any chance a houseman officer (top student) to perform surgery, if he/she posted in surgical department?
2) In Master Programme (MSurg), did we will earn money when we are doing coursework and take part in surgery?
Curious medical student here,
Thank you
Housemen don’t do surgeries. In medicine, it does not matter whether you are a top student or not. Everyone starts from zero. However, you can assist in surgeries.
No, you don’t earn anything except your pay. You need to pay for the coursework aka Master’s.
Uk has acute shortage of medical drs now,if u check the occupational shortage in immigration list, doctors of all specialisties r lacking in uk.almost all who passed the PLAB exams r able to gt a job in uk. Due to acute shortage, gaining acceptance for training posts do not require International Medical Graduates to undergo the RLMT. All applicants will be treated equally.
Yes, it is a temporary thing as many left due to pay cuts 4 years ago. Don’t expect the workload there any better than Malaysia.
Dr Paga once said medical doctors in the UK are contract jobs. I am not sure whether he referred to doctors in public or private hospitals or both.
Think carefully. Are you willing to risk your permanent job in Malaysia to get a contract job in the UK? Can you come back to your permanent job if your UK contract is not renewed?
It is highly possible that only UK citizens and possibly UK local medical graduates are preferred for longer term positions.They possibly have better network there.
All jobs in developed countries are under contract. There are no such thing as permanent jobs. Even in Australia it is the same. Even in Malaysia now , there is no guarantee that you will get a permanent job.
Thank you fr the valuable insights doc. I am a fresh graduate, waiting for my HO posting. Over the years, I’ve developed an odd condition, where it limits me from pricking patients with a needle, for blood withdrawal. It has gotten worse during my final year of M.D study. On the contrary, I have assisted in many other open injury cases; skull fractures, open fractures and I am able to do so. The problem arises only when I come in contact with needles for blood withdrawal. How do I overcome this?
In need of help, Thank you very much doc.
Unfortunately, blood taking is going to be a daily routine for all HO in the hospital. Thus, you need to overcome this as soon as possible. It’s all in the mind
[…] 2019 by the cabinet, KKM and JPA. The new contracts are still renewed at U41 as of April 2020. On 29th October 2019, I wrote this […]
Hi Dr Paga,
What are the prospects of GP in private practice in Malaysia who are doing the parallel pathway of icFRACGP with AFPM?
The Prospect Is the same as any other GP. Malaysia do not differentiate between normal GP and specialist GP.