Pagalavan's Avatar

Research and Publications in MOH: Worth the Effort? 

                   Medicine is a life long learning process. The knowledge that a doctor acquires is never enough even to the day he goes “six feet underground”. After a doctor graduates from a medical school, there are numerous options a doctor can choose in what they want to do in their life as a doctor. They can become a general practitioner (GP) after completing their 4 years compulsory service, remain as a medical officer or public health officer till retirement or pursue their post graduate degree. Post graduate education will take another 4 years of their life. Of course after that they can proudly call themselves a “specialist”.

                   Now, does everything end there? Definitely, not. For some doctors what they have achieved till their postgraduate education is enough in their life and they call it a day. They remain in service or leave to the private sector to start making money. Some will pursue subspeciality training for another 3 years to increase their market value in the private sector. But there are a small group of doctors who want to achieve something more in their life. They want to be known internationally and build a name for themselves in the field of medicine.

                   These are the group of doctors who are interested in doing research and publish their research papers in journals either locally or internationally. They want to build a name for themselves in medical fraternity and be someone who is recognized by people around the world for their work. In Ministry of Health (MOH), these doctors have to spend hours of extra time and take their own initiative to do all these. Sometimes they have to do it all by themselves without any help from the hospitals or MOH. No special “research” leaves are given to them like their counterparts in university hospitals. Clinical Research Centre (CRC) of MOH have been allocated millions of ringgit to encourage doctors to be involved in research but does this really help these doctors.

                   To get grants from CRC involves a lot of paper work. After obtaining the grant, a full financial statement has to be provided to show where all the money has been spend. Unfortunately all the work and effort to do the research has to come from the doctor himself. After the doctor has successfully completed the study and have successfully published it in a local or international journal, will he be given any sort of acknowledgement or reward? Well, regretfully I would say that no such recognition exist in MOH. You do everything for your own satisfaction and recognition. So what if you are internationally recognized, for our JPA friends, you are just a routine government servant. Your promotions are never dependent on it and it will be very frustrating to see your friends who have not done such an effort getting promoted the same time as you or even earlier than you. The only time it may be considered is when you are applying for a promotion to JUSA Khas C. Even then, I know some doctors who have been promoted to JUSA Khas C without any publications in their name.

                   I give you a very good example of an anaesthetist from my hospital who has been rewarded by an international body but of no value in his promotion. This anaesthetist, married with 4 children (wife not working) is a smart and brilliant guy to my knowledge, completed his intensivist subspeciality in 2004. He is among the very few intensivists in the country (roughly about 8-9 in the country). In addition to that, he had spend his own money to go to Amsterdam to sit for the European Diploma of Intensive Care (EDIC) exam which he passed with flying colours achieving 7^th highest marks out of 214 people from around the world who sat for the exams. Now, don’t you think that this is a national achievement? He should have been given a national award for this but who cares?

                   In 2004, he started a remarkable interventional study in this hospital’s ICU to bring down the number of Ventilated Associated Pneumonias. His paper was accepted in the recent “100 Year Centennial Conference of the American Thoracic Society (ATS)” in San Diego. The story of his achievement doesn’t end there. His paper also won an international merit award from the ATS, 1 of the 7 people to win the award. What an achievement but yet again, who cares? It took him 2 months and uncountable number of phone calls and letters to get the MOH to sponsor his trip to San Diego. Upon returning, what he received was only a letter of appreciation from the DG.

                   Now let’s look at the sad side of his story. He missed the promotion from U2 to U1 by just 3 months when SSM took effect. People who got their U2 just 3 months ahead of him have got their U1 during the transition period of SSB to SSM. Now, it has already been 5 years since he got his U2 (U48) and just recently got his “memangku U52”, a miserable RM 100-200 increment. So don’t you think all his effort was a waste? This is a man who wanted to be someone and at the same time had made Malaysia proud in international scene but what does he get in return? He had finally call it a day and have submitted his resignation to leave to a well renowned private hospital who would probably appreciate his achievement better.

                   This sort of recognition for doctors is something that is lacking in our MOH. We should change our MOH hospitals from service based to academic based hospitals. At this point of time, if anyone interested in academic life, he or she has to move to a teaching hospitals under the universities. University lecturers are given research leaves, sabbatical leaves and their academic achievement are recognized in their promotion to professorship. JPA has also surprisingly given privileges to Universities to allow their teaching staff to jump grades. For example, a lecturer can skip grade and jump from DU45 to even DU54 depending on their academic achievement decided by the senate. Why can’t this same benefit given to the MOH doctors? Of course multiple excuses will be given by our JPA friends.

                   So, at the end of the day, if any doctor in the MOH is interested in doing research and publications, please do it for your own interest. Don’t expect any form of recognition from the government. You may not get any medal for it. You may just end up getting more frustrated for all the extra effort that you have put in. Either you leave to a teaching institution or just remain as how all the other government servants are in the MOH, remain dormant.

                   In the SCHOMOS workshop held in Putrajaya in January 2006, various proposals were put up to encourage doctors in MOH to get involved in research such as research leave every 3 years and sabbatical leave every 5 years. I hope the current exco would keep track of these proposals. If not, there is not going to be any incentive to make our MOH hospitals progressive and academic hospitals.