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ACADEMICIANS VS SERVICE PROVIDERS: CLASH OF THE TITANS ?

                   Seventeen years ago, there were only 3 medical schools in the country with each having their own teaching/university hospitals. Our lecturers were not only teaching us good medicine but were also involved in day to day running of the hospital which also provides similar service with better specialties, compared to MOH hospitals. Since the early-nineties when the government decided to allow private medical schools to mushroom in the country, this scenario of having their own hospitals were not allowed anymore including for some of the public medical schools such as UNIMAS, UPM, UiTM etc etc.

                        The decision was that these medical schools should use the existing MOH hospitals as their teaching hospitals. This started off with IMU using the Seremban Hospital, Penang Medical College using the Penang GH etc etc. Currently almost all the MOH hospitals in the country are being used by medical schools, both public and private. This has now brought a new scenario into the world of medicine in this country.

                        The scenario of using public hospitals as teaching hospitals for medical school is not new. The same model has been used in many other countries including Singapore, Australia, UK etc etc. Making public hospitals as teaching hospitals may bring a lot of benefits to the hospital which would invariably benefit the patients and the “rakyat”. Of course many may not know that the private medical schools pay a fee to MOH for each student every year as a payment for allowing the hospital to be used for teaching which, in my opinion is fair as long as the money is put to good use. The memorandum of understanding (MoU) signed between these medical schools and MOH basically allows the students to use all the facilities in the hospitals.

                        What are the benefits will this bring to the hospitals? The appearance of academicians in the vicinity of the hospitals would definitely bring a lot of differences. Academicians are not only involved in the teaching of students but are also by themselves a clinician with certain expertise and interest to share with the hospital. They will be involved in various researches in the hospitals in collaboration with the hospital clinicians which in long run would enhance the management benefit of patients in the hospitals. Postgraduate students can also take advantage of this and can upgrade their knowledge in various field of medicine. There is no doubt that academicians who are actively involved in research would keep up to date any development in the field of medicine. As such their knowledge can be put to good use by these hospitals for their patients’ care and benefit. I must say that the lecturers in these medical schools are not “shaking legs” and getting big fat money as some of my colleagues use to say. These lecturers are not only involved in teaching students and doing research but are also involved in curriculum development and implementation as well as running clinics in the hospital voluntarily. So they are actually doing at least as much or even more work compared to our service providers in the hospitals.

Clinicians in the hospitals who before had no time to do any research may now take this opportunity to liaise with these academicians to jointly do clinical research for their benefit as well. Publications in international journals should be encouraged and names of our public hospitals can be made known internationally. Isn’t this what the government wants, the branding of Ministry of Health? BUT unfortunately, things are not as what it seems to be at the ground level. There seem to be a war going on, between these “Titans”.

There seems to be a lot of territorial fight. The hospital clinicians seem to take the presence of the academicians as a treat to them and have come up with all sorts of restriction and rules to make the medical school’s life difficult. The question is, are they allowed to make such a decision when the ministry has already signed the MoU with the medical school. But of course I can’t say that this implies to all heads of department in the hospitals. Most of them are quite happy to have an academic institution associated with them. Those clinicians who are interested to do research and publications are keen to work with the medical school staffs. Some are even happy to take up teaching sessions for the students to keep up with their knowledge.

Some of these consultants who are causing these problems, I think, have forgotten the fact that they are who they are now because there were thought by teachers/academicians during their undergraduate and postgraduate era. As usual, people always tend to forget their past and gratitude to their very own teachers and let’s not forget the “Hippocratic Oath” which clearly states that we must impart our knowledge to our juniors. There are some heads of department who prevent their specialists from doing teaching for the undergraduate students. There are some who say that giving teaching to undergraduates during office hours are not allowed when they themselves can go on to give talks, lectures and postgraduate teaching during office hours. We are even blamed for interrupting hospital service!. What a double standard! At the same time there are also clinicians who demand to be paid higher if they teach the students when they themselves are not even interested before this to do any form of teaching for their very own houseofficers, medical offcers and registras. It all boils down to ego and money………!

Basically, doctors are fast becoming the enemies among themselves. We are killing each other. We should not blame anyone else if people do not respect us anymore. Medicine use to be a noble and respected profession before and teaching is also considered a noble profession. Without my lecturers then, I would not be where I am now and till today I still respect my teachers. Territorial fight and ego is not going to take us anywhere other than probably, hell. An academician’s duty is to produce future doctors and to upgrade clinical management of patients through research and teaching. There are still clinicians or consultants in the hospitals who goes on managing patients like how they use to do 20 years ago without any upgrading of knowledge. With the presence of academicians and proper consultation, this scenario can be improved by shortening the learning curve and improving patient care.

Of course there is no doubt that the presence of academicians in the hospital may cause some strains to the hospital management. The surgeons are always worried that if they allow the academicians to do surgery, whether he would continue with the post-op care or would he dump the patients to the hospital doctors. Some consultants are worried that they may look inferior to the academicians in terms of knowledge. Fortunately, all this are minor issues that can be settled in the usual manner.

Let’s face the fact that we became doctors to treat our patients to the best of our ability and knowledge. So I do not understand why the current generations of doctors are more interested in taking care of their ego and territory. I sincerely hope and look forward to the day where doctors can sit together and think for the benefit of the patients and not to look at petty issues of insignificant value. The “Titans” should stop fighting and work together………………….