I was recently asked to comment by “afterschool.com” regarding the problems with the shift system which appeared in NST last weekend (https://pagalavan.com/2012/09/02/for-future-doctors-the-hurricane-is-coming-part-2/). Thus I was obliged to give my comment. It was published yesterday on their website http://afterschool.my/news_details.php?nid=251.
With the current overflow of graduates than what the system can cope, whether it is the old “on-call”system or the new “shift” system, the clinical exposure and training will definitely be compromised. That is for sure. The horror stories that I am being told everywhere really scares me at times. The situation will only get worst within the next few years when the number of graduates reaches an unimaginable level of 7000-8000/year.
The attitudes are another matter. I just heard a JM (Jururawat Masyarakat) who was so disgusted with the attitude of housemen in a general hospital, decided to deliver in my hospital instead. When she went to the hospital for leaking, the housemen were laughing among themselves and was not even paying attention to her. In fact the housemen got guts to even question her on why she went to private hospital to do Ultrasound and why she had so many Ultrasounds being done in private hospital, in a sarcastic manner. FYI, this is a lady who is having her 1st pregnancy after 8 years of sub-fertility! Of course, they did not know that the patient is a JM and her husband is a businessman who was with her when this happened!! I can give you lost of stories like this . I will say this again, if you are not interested in working as a doctor, please leave !
| Too Many Trainee Doctors; Too Little Clinical Exposure |
| The new flexi-hour shift system was supposed to improve the quality of life of medical house officers (HOs) yet it appeared to have its trade-offs.Seventy-five percent of the 908 HOs surveyed felt that they were not getting adequate clinical exposure and were unable to complete enough procedures as required for their training. This came out from the survey results conducted by the Malaysian Medical Association (MMA). Sixty percent felt there was no continuity of care for patients, with 52% saying the previous on-call system was better than the existing system. The former on-call system would take up 24 to 40 hours of a trainee doctor’s time whereas the flexi-hour shift would only require 12 to 15 hours with adequate days off. According to Dr Pagalavan Letchumanan, a renowned consultant physician and rheumatologist, it is not whether the on-call or the shift system is better. “It is about overflow of doctors. We are producing just too many doctors than what the system can cope.” He said that the shift system reduces the number of HOs working at any one time and without it, there will be close to 50 housemen in each department which will also reduce patient exposure time and learning. “The root problem is too many medical schools with too many unqualified graduates,” he emphasised. MMA President, Dr S.R. Manalan said that those interested to learn the skills under the new shift system will have to go the extra distance to attend procedures. “Basically, training is the time for HOs to consolidate and build on both their practical and theoretical knowledge, and sometimes, they need to take the initiative to acquire knowledge for themselves if they are serious about a career in medicine.” |
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