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I found this article in the Borneo Post interesting http://www.theborneopost.com/2012/05/17/50-of-housemen-in-sabah-cant-cope-need-retraining/. For once, a top civil servant in a state has openly said that the current generation of housemen are unable to handle stress and the workload of a doctor. It is indeed the truth. Many of these housemen have some serious attitude problems where they think that they know everything and don’t need to ask or learn from anyone. Trust me, patients are getting smarter and more patients are going around doing further investigations on their own and seeking 2nd opinion etc.

Just 2 days ago I had a patient who came for a check up. He was just discharged from a district hospital after a MVA with cerebral concussion. He is known to have complicated diabetes on insulin therapy and was told to have renal impairment by the klinik kesihatan quite some time ago (2010) where he is still under follow-up. He was admitted for 8 days , not sure why but was put on drip and some blood investigations were done. Towards the end of admission he complained of shortness of breath but nothing was done by the doctor. He was discharged with the following medications:

What do you notice ?

The moment the patient walked into my clinic , I knew what is the diagnosis. He was slightly tachypnoeic with sallow appearance, classical of a renal failure patient. His Creat was 640 mmol/L.

So, do you see what I am trying to say? I use to say that doctors can save lives and kill patients  with just a stroke of a pen!. This patient was given Ponstan (NSAIDS) which is contraindicated in renal impairment as it can worsen renal function and lead to acute renal failure! I am very sure the same medication was given right from the day of admission! I am also very sure a renal profile blood test would have been done. So, is this doctor who have completed housemanship successfully not aware of this, something that I knew even when I was a medical student?

Did you notice Ventholin tablet being prescribed? It has been ages since I prescribed Ventholin(Salbutamol) tablets to any patients. The fact that this tablet was prescribed to this patient shows that the patient did have shortness of breath before discharge!! Nothing was mentioned to this patient about his renal condition. His daughter brought him to see me as the shortness of breath was worsening. CXR showed fluid overload.

I referred him to GH for dialysis. I just hope he survives as he is just 50+ years old. I brought up this case as I feel very sad to see that basic medicine is not being practised. Did the doctor ever bother why this patient is having shortness of breath? Does he even care for this patient?

It is sad indeed………………..

50% of housemen in Sabah can’t cope, need retraining

by Mariah Doksil. Posted on May 17, 2012, Thursday

KOTA KINABALU: About 50 per cent of some 500 housemen in Sabah have to  undergo retraining after being found to be unable to cope with work-related  stress, while some of them were suffering from depression, according Sabah  Health Director Dr Mohd Yusof Ibrahim.

He said the new generation of housemen or medicine graduates  undergoing supervised practical experience is not the same as the housemen many  years back.

“My personal opinion, the new generation does not having the  ability to cope with stress and their field of training, especially those who  graduated from overseas, are unable to face the same situation in our country,” he said.

“Under the new system, housemen are only required to work for an  average of 60 hours in a five-day week with two days off, which is even better  compared to our times when we didn’t have days off,” he told the press after  launching the Queen Elizabeth Hospital 1 (QEH1) 8th State Clinical Conference on  Sports Medicine.

Yusof said that apart from failing to cope with stress, those  trained outside Malaysia experienced culture shock when facing the situations in  the country.

Some claimed they are overworked, but most doctors were trained  like that in order to be good doctors, he said.

Yusof said that apart from the hospital authorities, parents should  explain to their children that working as a doctor is tough as it involves  saving lives.

He stressed that the two-year training they received is not enough  for the new generation housemen because it is very common to see many of them  having to repeat their training before their posting to district hospitals.

“If they fail during the second training, we will send them to  another hospital. I am sure all specialists and senior doctors are willing to  help them because it is important to have