One of my loyal follower sent me this 2 articles below which appeared in The Sun (http://www.thesundaily.my/news/167606, http://www.thesundaily.my/news/175519). I have said this many times that medicine is different. You are dealing with life and it does involve a lot of stress. That’s the reason why I started this blog to educate the people of what medicine is all about! Don’t just jump into doing medicine just for money and glamour.
Being a doctor is not about working office hours and going back on time like many other jobs. You are dealing with life and you have to make sure that you do whatever necessary for the patients before you leave. Of course I don’t agree working long hours like 36 hours continuously but even if you work shift hours, you still need to finish your job!! Life’s are at stake! I am rather amused with the first author below because at one point he is talking about long working hours and on another note, he is talking about excessive work load. Who said that when you become a doctor, you workload is not heavy? Even if you are doing shift system, the number of patients that you are going to take care will still be the same! And finally, he is saying that there will be a paycut!! I mean, I don’t know what this author wants? I guess he wants a comfortable, office hour work for his sister with a lot of money. Then, don’t become a doctor, that is my answer.
I think the reply by the specialist below sums up what is actually happening in our hospitals currently. I have said it along the way in my blog. If you think being a housemen is stressful, wait till you become a specialist especially in private hospitals. You are the housemen, medical officer and the consultant for the patients. You work 24 hours a day, 7 days a week. You can be called at anytime of the day.And you will sued for any mistake that you make. No one cares whether you are tired or not! So, don’t think only as a housemen, you are overworked!!!
The day you choose medicine as your career, that’s the day you have committed to life long learning, hard work, stressful life and poor social life. So, if you are NOT into it, then find another job!
Overworked housemen
Posted on 5 October 2011 – 10:09pm
Last updated on 6 October 2011 – 09:57pm
THE term houseman refers to an advanced student or graduate in medicine gaining supervised practical experience. In Malaysia, it is compulsory for doctors to undergo housemanship for two years after completing a medical degree.
During housemanship, they are rotated between six departments – emergency, medical, paediatric, general surgery, orthopaedic, and obstetrics and gynaecology – spending four months in each.
My sister is a houseman in a government hospital in Selangor. For the past eight months, I have been surprised to notice her working hours. There is no maximum number of hours a houseman can work.
This has led to a situation where my sister is often overworked and has hardly seen daylight since she embarked on this respected career. She had always wanted to become a doctor, but eight months into her housemanship, she seems to have snapped. Such conditions may result in wrong decision-making and management, and poor performance.
The work load is too heavy and the hours too long. When she is on call, she sometimes has to work for up to 36 hours straight. Unfortunately, housemanship is taking its toll on many young doctors. After completing a gruelling course, they get to face endless working hours.
Previous Health Ministry director-general Tan Sri Dr Ismail Merican had revealed that many medical graduates were unable to cope with housemanship.
My sister informs me that a shift hours concept has now been introduced in housemanship as a measure to address the problem of too many new doctors and of overwork. I’m not sure that this system will work, but I really hope it does.
The only drawback of this system is that you are not entitled to “on call” allowance.
Currently, with housemen required to do 10 “on-calls” a month, this adds another RM1,000-RM1,200 to their monthly salary. So indirectly, shift hours means a pay cut.
Furthermore, there is also sometimes an element of bullying and high-handedness in the way some senior medical officers and consultants treat their junior house officers. They become Little Napoleons and are dictatorial. They say they went through the same regimen which made them good doctors.
So it is decided that the current crop of newbies needs to go through the same process.
Housemen are often screamed at by specialists. This is bad work ethics and I find it to be uncivilised as research has shown that the result of such an attitude would result in less effective staff.
Finally, I hope the ministry is aware of this matter. May the relevant authority ensure that these public service doctors are happy and capable of providing the best service to the nation.
F.A.
Alam Impian
Young doctors mollycoddled
Last updated on 12 October 2011 – 10:00pm
I REFER to “Overworked housemen” (Letters, Oct 5) and other grouses that increasingly make their way into our media by Generation Y housemen. As a specialist in a government hospital in Selangor, I feel that instead of silence that may be misconstrued as guilt, there is a need to reply.
We are now at a crossroads in our health system. The high standards that were maintained through the years have fallen by the wayside. This is especially evident from the constant complaints of the younger generation, although the system and the government are bending over backwards to accommodate them. The reasons:
— An overload of new housemen/doctors – 500 a year in 1998 and 7,500 in 2011, with the number estimated to rise to 10,000 in coming years.
— Too many medical schools in the country – 42 at the last count, with some having very low standards. Indonesia with a population of about 300 million has half the number. How did these colleges come to be recognised?
— Too many medical schools recognised overseas, with the standards, especially of Russian ones, being extremely low.
— So we are now inundated with housemen to train, wherein 60% are of very low standard – meaning not even fit to pass the finals in a medical school exam, let alone to treat patients.
— We, the specialists, are forced to retrain and even reteach these incompetents.
— There are only so many times you can give advice to a person who doesn’t listen – sometimes when a patient’s life is at stake, voices have to be raised! Don’t you agree?
— Increasingly, our politicians get involved when some VIP’s son or daughter who can’t cope, just wants to float through. Many specialists have been given letters of warning, when all they were doing was enforcing appropriate disciplinary action in respect of housemen who had gone AWOL.
— The number of litigation cases against the Health Ministry due to housemen is at an all-time high.
— The shift system was opposed by all senior faculty in the ministry, vis a vis all senior specialists, but it was forced on us. Who is going to monitor all these housemen under the shift system – the specialists?
— When these housemen become medical officers and specialists, are they also going to go on shift?
— We have better things to do than mollycoddle a tsunami of sub-standard doctors. If we are not careful, there will be a great exodus of specialists from the public health system in the next few years.
All you see in government hospital nowadays are the poor and the illegals – everyone else has an insurance card! So to the powers that be, wake up and smell the coffee.
S.A.
via email
Pagalavan's Avatar 
I would like to highlight that housemen are being overworked in the medical department in Hospital Kuala Lumpur. Under the Graduate Medical Officer Flexi Timetable system, introduced last September, housemen can only work up to 60 hours a week with two days off. However, this is not the case in Hospital Kuala Lumpur.
Housemen are expected to work 7 days a week with NO BREAK AT ALL, only the allocated 8 days every 4 months in each posting (including MC). And we have to do 2-4 on calls duties per week. Those who are not on call, work from 7am-5pm Mon-Fri and 7am-12pm Sat-Sun. However, on call duties are 2-4 times per week. When you are on call, it means you work from 7am today to 5pm the next day. Sometimes the call can be every other day, means you don’t even have time to rest. How can someone work non-stop. We are not robots. And nowadays even domestic maids and foreign labourers have holidays.
No mention personal life, social life or family life. If you calculate our wage, we are being paid around RM8-9 per hour, which is much much lesser than what the general public without a university degree is earning. We are using the old system where we do on calls, but we are not getting any extra allowance of RM100-200 per call. We do not have rest days we do not have public holidays. We have studied so hard and would like to train to become a competent doctor in these 2 years, but we really cannot understand why are we being treated so terribly.
The Employment Act 1955 (EA) mandates that overtime pay at double the normal wage-rate and triple the normal wage-rate must be paid when employees work on rest days and public holidays, respectively. Where do we stand?
It is unfair and too much to expect human beings to work so long hours, It is harmful as 36 hours without sleep is detrimental to health and may cause harm to the patients. We are so tired after working so long hours and cannot think or function properly. This kind of working hours has caused 8 housemen to go MIA in the past month. And a few others are appealing to change hospitals. It is a vicious cycle. There are so many housemen that are having depression and require counseling. So can no longer smile or laugh or be happy. It is so sad and depressing to go to work daily.
It is wise to look into these issues to enhance patient safety. May the relevant authority ensure that these public service doctors are happy and capable of providing the best service to the public. I really hope that our lives can be improved.
Welcome to the real world. What you are doing is exactly what others have gone throu all these years till the shift system was introduced. However, I am rather surprised that the shift system is not being implemented in HKL as HKL comes directly under MOH !! You can bring this matter up to the DG since he said that he will make sure the shift system is implemented properly.
If HKL is not implementing the shift system then they should pay the oncall allowance as before. Pls bring this matter up with the Pengarah or your SCHOMOS rep.
Employment act is not applicable to government sector. Gevernment sector follows the general order(GO). Under the GO, professional group is NOT entitled for any overtime allowance. It took MMA almost 10 years of fight before the call allowance was introduced in 1996.
Quote:
“Those who are not on call, work from 7am-5pm Mon-Fri and 7am-12pm Sat-Sun. However, on call duties are 2-4 times per week. When you are on call, it means you work from 7am today to 5pm the next day”
You rest at all the other times not mentioned, as simple as that. It is up to you to manage your time properly at this point of your life as a houseman..
“exactly what others have gone throu all these years till “. So you are trying to say it’s a correct thing
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i did my HO in HKL too. Trueeee.. but during my HOship it was in 2015-2017 only certain posting got shift system. In medical posting we work min 72hrs/week up to 90plus hrs. andd almost everyday i am thinkingq about to quit my HOship that time. but i end up doing my work as usual every morning. Evryday before going to work, i said to myself that i want to quit. Medical was my 3rd posting and surprisingly, i am able to finish that posting on time. Regarding MIA HO, and depressed HO, yes that’s true.. even now, there is still a lot of HO that i know said they are so stress and some quit HOship.
Medicine is a stressful job which many people don’t realise when they intend to do medicine. Everyone thinks it is a easy job of sitting in a room, talking to patients and make easy money!