Monday, November 29, 2010

houseman glut

that was the front-page headline in saturday's Star. read here

those within the medical fraternity have already known for some time that the rate at which the government is trying to achieve the magical figure of 1 doctor for every 600 people is just too fast & too furious.

establishing private medical schools at an average rate of 1-2 a year for the last 10 years has obviously lowered the qualifying requirement of the students since these schools, currently 17 in all,  require numbers to be profitable. & where are they going to get competent academics to teach the students? manipal, monash & newcastle may benefit from their collaboration with the respective home universities.

my colleague Dr L is assoc prof in one of the public medical universities in the klang valley. in his ward, there are 2 housemen for every patient & as many as 5 can go missing at any time & no one will notice the difference!! remember, it's our tax money that's paying their rm4000 monthly salaries!!

during a particular clinical teaching session, some were asked to describe how they'd catheterise a patient, ie. pass a rubber tube to help the patient pass urine. none of the housemen could give the right answer & the worse part was that none seemed interested to want to learn the proper way to do it.

when my peers were housemen, we were criticised for being young & inexperienced; apparently, you could add indifference to that list now.

at this rate, it's only going to get worse. 

& that's putting it mildly.


Unicorn Girl said...

doc , who is to be blame for all this ' medical rucus ' ? Mentality changes based on enviroment too...

Medie007 said...

i feel the frustration too. sigh. :(

house-tai said...

woowee, really sounds like the local docs in vietnam! they operate on the principle: "you have the cash, they have the MBBS" (or MD)

but yes, i do know of a few ex classmates in malaysia who ended up being docs (hampalang anenehs) even though they used to be in the bottom of the class. it must be magic - to possess medical degree despite scoring C5 or lower in biology and kimia SPM.

doc said...


the politicians - for being obssessed with the 1:600 ratio, for blindly giving out licences to start medical schools, & even now when there is a glut in housemen, comes out with the blooper that more training posts will be created. where are they going to get the trainers? they are digging deeper & deeper...

don't blame the students because now that the doors are wide opened, if they don't get in now, someone else will & the door may not remain open forever.

the ultimate victims are the ordinary people who depend the public health service.

doc said...


get that post-grad - by hook or by crook! even if you have to go another island-state to do it.

doc said...


you could call this a housemen tsunami.

Yvonne Foong said...

I really do not like the fact that I would be monitored by housemen when I'm warded in hospital especially after critical surgery.

I know of a case where a teenage boy died after undergoing brain surgery in one of the Klang Valley public hospitals. His parents sought the help of an MP who called in the press. But because the parents are not yet suing, editors decided not to make this case into news yet.

My friend, a reporter got hold of the discharge summary. It is said that the boy died of infection. But what exactly happened was unclear. The discharge summary was signed by various housemen working under a neurosurgeon I personally know and have handled my case before. I know that he is a nice man. It's the system that he works for that is faulty.

Hello Kitty said...

How awful. Imagine ... all of us will be patients one day. No matter how healthy we try to keep outselves, we might end up at the hospitals one day (eg due to accidents, infections, old age etc). What can we do abt this, doc? For many of us, migration is not (or is no longer) an option, and in any event, many who migrated might end up worse off elsewhere. I hope there are some competent doctors at private hospitals, and I have the financial means to go there when I need to.

doc said...


you have been treated by one of the best neurosurgical hospitals in the US. unfortunately, not many of us will have that privilege & will have to make do with the fresh-faced & starry-eyed housemen at the public hospitals.

only political will can make it better for the masses, but so far, there's no light at the end of the tunnel.

doc said...

Hello Kitty,

for most of us who depend on public hospital, we have no choice but to hope & pray for the best. for those who can afford or have medical insurance, private healthcare is an alternative.

if you need info/assistance on private doctors, i may be able to help. email me.

Anonymous said...

1 doc to 600 people is insane!

zewt said...

i've said it time and time again... the healthcare system in kl has collapsed. the population is just waiting to reap the fruit from it.... very bad fruit.

doc said...

Mei Teng,

apparently, that's the WHO standard for a developed nation, which seemed more like an illusive for us with each passing day!!

doc said...


the whole country is affected by it, esp the rural areas.

Anonymous said...

Lately, the competency of HO's seem to be the hot news.

I feel that many parties are to be blamed.

1) MMC + MOH + Higher Education Ministry
Why do they recognise so many below par universities?

2 years ago, a bunch of us had a meeting with some MMC officers. Some of them (I won’t name them here) actually admitted that the 'higher authorities' in MMC & MOH are fully aware that they're recognising below par uni's. However, the lucrative monetory returns from the ‘agents’ was far more important, thus the compromise on quality.

So if MMC endorses these lousy uni's, can we entirely blame the students who study there?

2) Parents
Many parents are bent on making their children doctors by hook or crook. They spend all their sweat and blood to ensure their children graduate as doctors.
For these parents, it's prestigious to have a child as a doctor, or probably they're reliving their lost dreams of becoming a doctor through their children. Thus, they force their children into med schools, and with lousy grades and lots of money, the agents come into the picture...and hey Bingo! These children graduate as lousy doctors, but thanks to MMC's unfair recognition system, they get to practise medicine! I’ve seen one of my distant relative do that and he’s now in RSMU!

3) Agents
These unscrupulous agents should be fined and asked to return all the money they've taken from students for sending them to unrecognised uni's. They have no morals at all!!!
(Well, parents/students should have checked out the agents and uni’s also!)

4) Students/Medical graduates
Lastly, a student should not take up the medical profession if he has no desire in this field. Medicine is not all that glamourous! It involves lives! There should be a deep sense of passion, desire and longing to serve patients correctly. I have many friends who managed to get into CSMU, RSMU, MMA, Kursk, Nizhny Novgorad etc but they had no desire in medicine at all. They were busy going on Euro tours, partying away & getting drunk, bribing lecturers to pass their exams and now they’re doing their housemanship in various Malaysian hospitals while real proper quality medical graduates from unrecognized uni’s are suffering out there in the lurch when they should be the ones doing their housemanship!

Such utter unfairness!!!

Anyways, as unfair as this may be, I trust in a God that sees all this unfairness and shall avenge the just (Romans 12:19)

doc said...

Just Me,

it's like a comedy of errors, isn't it - the authorities, the parents & the students?

except that this ends in tragedy - the patients suffer.

fishtail said...

Your last 3 paragraphs scare the daylights out of me. No wonder TCM is getting more and more popular these days. As for me, my 'doctor' for the past 5 years has been Dr Google. So far, it has been ok.

doc said...


net-savvy people are more knowledgeable about health & diseases now, & that's quite a good thing, the drawback being a little knowledge can be dangerous.

TCM at best should complement modern western medicine, not replace it.

Anonymous said...

Dear Dr.

I am a high school graduate (finished my spm in 2011) and will be taking foundation in science this year. My results thus far indicate I am academically able to go into medicine. But that may or may not change.

So hopefully if everything were to go well I could enroll in a medical program in 2013 or and maybe finish the MBBS 5 year program by 2018. Would it still be worth it by then?

I’ve always wanted to be a physician since I was kid when I could finally understand what an auntie and uncle of mine did for a living. I have no illusions of it being easy or being a millionaire by 25. Its just a meaningful profession to me. Not just a job but a profession.

Recently, news of over supply of medical graduates and imcompetency of some HO’s have dampened my spirits of entering this field. Will I have even the slightest chance of prospect?

Or will I be operating a restaurant with a doctor’s degree? Nothing wrong with that, but you ge twhat I mean.

Your honest opinion on this matter would be greatly appreciated.


doc said...

dear Anonymous,

thank you for commenting on an old post but current issue.

when you asked if it's worth doing medicine now, you have to ask yourself what your objective is.

if you're making your parents' dream come true, hoping to join a glamourous & elite group, or if you're planning to make big bucks, then i'd say you may be bitterly disappointed & you may not feel it's "worth it."

however, if you want to realise your lifelong ambition to sincerely relieve pain & suffering, to help the sick & serve the community, then i'd say, GO FOR IT!! the long years of study, the long nites up without sleep, the rude & demanding patients & the overbearing bosses could not possibly deter that burning conviction in you.

however, be prepared for obstacles along the way, the greatest of which is the government's preferential treatment for certain groups of students not based on merit, unless you plan to self-finance.

that's right, don't label it a job or even a profession. it's a most noble CALLING.

btw, i'd much prefer to patronise a restaurant owned by a doctor than a businessman; at least i can expect a high standard of hygiene & quality of food.

all the best!!

Anonymous said...

hello doctor,

sorry this might be a long question.

i finished my SPM in 2011 and i want to be a doctor since i was young. its just a meaningful calling for me. i know i won't get loads of money or fame especially in government service.

but my SPM results were not that great. i admit its my own fault because i was overconfident since i did well in UPSR and PMR. so my SPM results, relevant subjects only:

bahasa inggeris - A+
bahasa melayu - B+
matematik - A
matematik tambahan (addmaths) - C
biologi - B+
fizik - B
kimia - B

so I'm planning to take MOE matriculation or GCE A-levels. So hopefully if I score well (4-flat) in matriks or AAA/AAB in A-levels will i be eligible for a medical program in or outside the country?

does my spm conform with MMC pre-requisites? no offence but the MMC website is a mess. i can't find the info i needed.

in a nutshell, my question is if i do well in MOE matriculation or gce A-levels it will be able to get me into a medical program?

or will universities still look back at my SPM and deny me entry? have i destroyed my only chance at medicine?

thank you for any advice/answers to my question.


doc said...

dear SadStudent,

thanks you for commenting on an old post. you remind me of Anonymous who commented last month, & my response to that may help you.

i seriously don't think you can get into matric with those results; you might have to do A-levels/Foundation & you must start applying now.

the varsities will admit you based on your pre-U exams, not SPM. you need to get much better results if you want to do medicine. of course there are medical colleges that accepts lower qualifications, eg. russia, indonesia, in case you can't get into your desired med schools.

for now, get into a pre-U program, choose the right combination & work HARD!!

all the best.

Anonymous said...

thank you doc,

i read the Anonymous comment above mine and it did help a little. and i actually can get into MOE matriculation, i pass the requirements to enter matrics. now i'm just contemplating between matrics or A-levels.

i'm just confused/worried because i heard that MMC requires, in addition to pre-u studies.. B's in addmath, math, bio, physx, chem at SPM level. is that true?

thank you for the suggestion of varsities that accept lower qualifications but i don't think i want to graduare from a "shady" university. i want to be a good doctor, not sub-par, if possible.

well no matter what career, i'd still have tomstudy hard in pre-U. but i really want to have a chance at becoming a doctor. as dr. wong says to serve humanity.. or in my case, hopefully i can serve the rakyat.


doc said...

dear SadStudent,

there's nothing you can do about your SPM results now. do well in your pre-U & apply for the course you want & leave the rest to God.

all the best!