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CURRENT QUALITY OF MEDICAL DOCTORS

ARE WE GOING DOWN THE DRAINS ?

                   Around June every year we see the same headlines in almost every newspaper in the country: “Top scorers unable to get medical seats in varsities”. Is it destined that all top scorers have to do medicine in their life? Me being a top scorer myself 15 years ago knows exactly what is taking place in this student’s life. Although my father advised me to do engineering, I was adamant in doing medicine but I must say that till today I have never regretted for being a doctor. But that’s not the same thing that is happening to everyone. For example, many of my fellow students from the University of Malaya batch have either resigned and became a GP or housewives. A few did not even practice medicine and joined family business etc etc. Only around 30% of my batch students actually did postgraduate studies. What a waste?

                   Many of these students do not actually know the mess that they have put themselves into. I understand that 20% of medical graduates in Australia were not interested in being a doctor after they have finished their medical school training. I think we should also carry out a survey to determine the exact number of medical graduates in our country who feel that they have just wasted 5 years of their life. Subsequently, the frustration that this medical graduates undergo with the ever increasing workloads in government clinics and hospitals, government bureaucracy in promotion and postgraduate masters applications and the inability of the government in giving due recognition in the sacrifices of government doctors results in many doctors living the public sector. How many doctors in government sector are given state or national awards such as “Dato” or “Tan Sri” unless they serve the royalty or politicians? Every other top government officials and businessman seems to have these titles!

                   Are we really short of doctors? Every year we see many graduates entering Housemanship training in the country. Now, we even have many more hospitals in the country that have started excepting medical graduates for housemanship training. But what happen to them after that? They seem to have disappeared into thin air. The actual problem seems only to exist in public sector. When I was working in Hospital Sultanah Aminah, Johor Bahru we struggle with never ending shortage of doctors. Each medical ward of 40 patients is managed by only 1 specialist, 1 medical officer and 2 houseofficers. But when I arrived in Hospital Selayang for my subspeciality training, I was shocked to see that 1 ward with 28 beds are managed by 2 specialist, 2-3 medical officers and 3-4 houseofficers!! So are we really short or is it merely “maldistribution” of doctors in public sector. I have also noticed that many JPA scholars who were forced to return to the country from UK have joined UiTM medical faculty or other universities as trainee lecturers. So what is the purpose of bringing them back when they are going to be stationed in Klang Valley when the actual shortage is outside the Klang Valley? One of them directly told me that he joined UiTm because he does not want to be posted elsewhere in MOH. This totally defeats the purpose of bringing them back.

                   With the background of “shortage of doctors” the government over the last 5-10 years has approved many medical colleges in the country. Every year I seem to hear new medical colleges being set up. Let’s look at the number of medical colleges that we have today (to my knowledge): 

1) Selangor/WP               University Malaya

                                              University Kebangsaan Malaysia

                                              UiTM

                                              University of Cyberjaya (soon)

                                             University Putra Malaysia

                                             UCSI (University College Sedaya International)

                                             Kolej Universiti Islam Malaysia(KUIM) – soon

 2) Negeri Sembilan                  International Medical University

 3) Malacca                                Malacca Manipal Medical College

 4) Johor                                 ? Monash Medical College

                                                   UTAR medical college(under planning)

 5) Pahang                            UIA medical faculty

6) Kelantan                         University Sains Malaysia

 7) Perak                              Perak Medical College 

8) Penang                           Penang Medical College

                                             ACMS (Allianz College of Medical Science)

9) Kedah                         AIMST

10) Sarawak                    UNIMAS

 11) Sabah                       University Sabah

                            With the mushrooming of these medical colleges, do we have proper teaching academicians and are we producing qualified medical graduates? The lecturers seem to be jumping from one university to another depending on which university is going to pay them higher. These scenarios have resulted in dilution of medical lecturers among the medical schools. The shortage of lecturers has also resulted in the medical schools taking junior doctors into their lecturer training programmes. At the end this would be reflected in the quality of our current medical graduates.

                        Being in charge of Houseofficers for the last 2 years in Johor Bahru hospital, I have witnessed the deterioration of the quality of medical graduates. Not only are they lacking in good medical knowledge but also in their attitude as a doctor. Most of them seem to be not interested in working as a doctor. Their impression of a doctor is being a GP. Some are there because their parents want them to be there. Many of these doctors have even approached me to discuss about their future in a “non-medical” field! Are our very own medical schools recognized by international council? 

                             With the departure of senior consultants and specialists from public sector recently (as written in my earlier Berita article), we are going to be left behind with junior doctors training these type of houseofficers. These will result in the quality of our future doctors going down the drain. We are going to be left with under trained doctors as well. I totally agree with the DG that Houseofficers who are not qualified to be a safe doctor should not be signed. There is no such thing as automatic completion of housemanship after 1 year. The responsibility lies on the specialist and the head of departments who are supervising the houseofficers. As a person who has extended houseofficers, I totally support the stand of the DG in this issue. 

                             Many at times we were complaining regarding the quality of foreign doctors who were recruited by the ministry but are we going to see the same scenario in years to come among our very own Malaysian doctors? I leave this question for the readers to ponder upon………