Some times, I wonder whether our DG knows what he is talking about http://www.thesundaily.my/news/209582. Does he know what is happening on the ground? Firstly, we do not have enough specialist to supervise all these housemen. Secondly, many of the HODs are not interested to extend the training of the housemen. They do not want the headache of doing more paper work. Thus the saying is ” get him out of my department, no point extending as it won’t make any difference etc etc” I must say that these HODs are selfish and one day these same doctors will land up in your department! This is one of the reason why you see almost 95% of the HOs passing out, on paper! HODs are not just bothered as long as the HO is out of their department and not their headache anymore. Only very few HODs conduct exit viva and proper assessment of housemen. Many of the HODs who use to extend housemen are not in MOH anymore, either retired or left to private sector.
I really don’t know what our DG means by training ! There are just too many housemen with too few specialist to supervise. The shift system only makes the situation worst by even less supervision as mentioned in the letter below.
I think the DG should go down to the ground and find out what actually is happening, rather than listening to the politicians. A common entry exam or an exit exam after housemanship may need to be implemented.
Continuous efforts to improve housemanship training
Posted on 16 November 2011 – 05:07am
I REFER to “Sub-standard housemen” (Nov 8). The Health Ministry appreciates input provided on housemanship training. Continuous efforts are being made to further improve the training programme of our housemen which is conducted in 41 accredited government hospitals.
Among the objectives of the programme are to further improve their knowledge, clinical experience, attitude and ability to carry out treatment procedures in a safe and competent manner. They are trained for a minimum period of two years in six major disciplines – internal medicine, paediatrics, general surgery, orthopaedics, obstetrics and gynaecology, and emergency medicine or anaesthesia, with a minimum four months in each discipline. The majority of our houseman are competent as more than 95% completed their posting within the stipulated time and a good officer will be able to complete training in two years.
On the other hand, to ensure the quality of medical graduates, the Malaysian Medical Council has set the standard in recognition of universities offering medical programmes locally and overseas, while the Malaysian Qualifying Agency and the Higher Education Ministry ensure these universities conform with standards set by the governement.
Datuk Seri Dr Hasan Abdul Rahman
Director-general of Health Malaysia
Shift system ill-defined
MUCH has been said about the standard of House officers in Malaysia lately. Most of the write-ups have been rather negative.
As a doctor practising here, I have a few points to share. A patient who came to my outpatient clinic, asked: “Dr, I hear your trainee doctors from (this and that country) are not performing. Are they qualified to treat patients?” I just smiled. A colleague recently said: “I wouldn’t send my family members to doctors with MBBS/MD from (this and that country).”
Many more are extremely concerned about the performance of housemen in this country, as are parents who spend hard-earned money to put their children through medical school.
Media write-ups are gradually tarnishing the image and future of these young doctors. I agree there is much to be done to improve the training system, including filtering “sub-standard” medical schools, improving the lecturer to student ratio in universities etc. We should now at least concentrate on improving the knowledge and performance of trainee doctors.
We are seeing a trend among patients to select doctors based on which country and medical school they graduate from. There is a worrying trend of patients losing confidence in doctors trained during this period of time. This in future will have a psychological impact on the doctors themselves, causing them to lose confidence in medical practice. Remember, they spent five to six years in medical schools recognised by their own country.
Having been through the houseman system here, I should know – it was very hard indeed. The ministry’s policy of running houseman-ship training on a shift system now (fewer working hours) aimed at improving performance, might be a popular approach, but to me, is ill-defined. We can’t expect results when you compromise on the number of encounters with patients, doing fewer procedures, following fewer ward rounds with specialists and attending less CME (Continuous Medical Education). On the shift system, house officers have time, in fact, plenty of time. We should offer them re-training, re-introduce the MQE (Medical Qualifying Examination), and most importantly, early specialty training. Incentives should be given to those taking the initiative to study and obtain a post-graduate degree in a specialty. This will encourage self-improvement or at least, improve basic medical knowledge. Incentives of RM600 might be popular, but we don’t expect results.
Finally, I strongly think we should take a better approach to discussing the quality of houseman in this country.
Doctor with recognised degree (hopefully respected)
Kajang
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