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U48 DILEMA

“From the back and to the Front”

                             The hottest topic that is currently going on in the minds of the Ministry of Health (MOH) doctors is the U48 Dilemma. This dilemma is like a Tsunami hitting the Ministry of Health. As for the doctors or rather specialists who are caught in this Tsunami, it’s probably the end of their route in Government sector.

                             In my article published in June Berita MMA, I have elaborated the problems that the junior specialists in MOH are going through at this point of time. What I have mentioned in that article is the U48 Dilemma “From The back”. Those who were gazetted from January 2004 have to undergo the entire “bureaucracy” of SSM. This has resulted many U41 specialists already contemplating to resign by the end of this year if they do not see the MOH taking any measures. Our sincere hope now lies in the hands of our new DG, Dato Dr. Hj. Ismail Merican.

                             What about the specialists who are already in U48? Their journey forward seems to be impaired by SSM as well. We can see this effect from the number of U48 specialist who has resigned so far from various hospitals. Johor Bahru hospital has witnessed almost 8 U48 and 4 U41 specialists resigning from January till August this year. Ipoh Hospital already had 6 U48 specialists resigning. Why is this happening? The last promotional exercise that was carried out by JPA was in 2003 in which they promoted all those who were given U48 (U2) before December 2000 to U54 (U1). Since the SSM took full effect in 2004, there has not been any promotion. There is a group of specialist who were promoted to U48 in March 2001 and June 2001 respectively but still in U48 just because they missed the dateline by 3-6 months. This people were gazetted as specialist in 1998 and 1999. Where as the doctors who were gazetted in 2003 was given U48 during the transition period of SSM. This resulted in doctors who are almost 4-5 years junior to them sitting at the same grade, just because they missed it by just a few months. How frustrating and demoralizing is this going to be to this group of doctors who are suppose to be in U54 by now if they follow the SSB system. “My houseman is now sitting at the same grade with me” cried one of the consultant specialists in Selayang Hospital who is caught in this phenomenon.

                             So, what about their promotion to U54 then? Well as a new grade of U52 has been created between U48 and U54, they are now forced to go through this bureaucracy again. Once they have passed the PTK course of U48 they are entitled to be promoted to U52 and subsequently, probably a few years later to U54. But until today, even the U52 is no where to be seen. What they missed by just a few months is going to take another 5-6 years for them to achieve. No wonder they are saying “Good Bye” to MOH.

                             “Carrots for Docs”, this was the headline in Star on 12/07/2005. Few announcements were made by our Minister such as the number of new approved JUSA posts for 2005 till 2010, tax exemption for on call and specialist allowance, extension of contract to the age of 65 for doctors, promotion of nurses and MA’s to U41 if they have a degree etc. etc. This news had misled the public in believing that specialists are going to earn RM 7 000 to 15 000 a month. Many of my non-medical friends called me and even congratulated me but when I really told them the truth then they understood what is actually happening.

                             If a promotion from each grade takes a minimum of 3 years, then a specialist who is in U41 now will take a minimum of 15 years to even reach JUSA C post. So if they are 33-35 years old now, they will be almost 50 years old to achieve the so called JUSA C post. 15 years down the line RM 7000-15 000 may not even mean anything. But of course SCHOMOS is very happy for those members who are currently in U54 as they would definitely be promoted to JUSA C within the next few years. But the agony among the junior specialist is growing day by day.

                             Nurses and Medical Assistants (MA) sitting in U41 and can be promoted up to U54 and can even become Pengarah’s of Hospitals? Is this a joke or reality? I am afraid it is going to become a reality soon. The Government has approved the reappointment of nurses and Medical Assistants who have a degree to U41 and this would be backdated to January 2005. In one hand we are happy for the nurses and MAs as that is what they have been fighting for many years but yet again it is a real demoralizing event for all doctors. Doctors who have done 5 years undergraduate study, 1 year of Housemanship and subsequently another 4-5 years of postgraduate degree and another 6months to one and a half years of gazzettement (not including another 3 years of sub-speciality) will now be sitting in the same U41 grade with the nurses and MAs. Furthermore these doctors might even end up taking orders from these nurses and MAs who are going to become our Pengarahs!. “Laughter is the best Medicine” – is that what is happening here?

                   The massive brain drain that is occurring right now may leave the government hospitals with no senior consultants to guide the junior specialist in years to come. At the end the “rakyat” is going to suffer with inferior care. This was the main concern of our DG. We hope that our schedule meeting with the DG on 21/09/2005 would answer some of these questions above and hope that we may have some good news in our next Berita.

                   If nothing changes, below would be the scenario that we may be seeing soon:

 Consultant Surgeon U41

Consultant Physician U44

Consultant Obstetrician U44

Consultant Pediatrician U41

Pengarah : Jururawat Terlatih U54

                To add salt to the wound;

“Do you know that the starting pay of PTD (Pegawai Tadbir dan Diplomat) officers in JPA is only RM 164 less than a Houseofficer ? Qualification – a degree on admin from any university!”

“Laughter is the best Medicine”