Tuesday, June 28, 2011

Sad But True


Now that i finally graduated, i am reluctant to start working or practicing as a medical personnel. I hate having to do 2 years of Housemanship here. I hate the Malaysia medical system, disappointed with the Malaysian government, and not wanting to even live in Malaysia altogether. I have read too many articles and news about the Housemanship in Malaysia, the broken medical system here. I hate having need to work like a dog, have every-other-day 'on call' which means work 36 hours non stop. I hate that i will not be treated fairly, not paid handsomely, not taught sincerely by specialist, and not appreciated by the hospital staffs and the public. Frankly speaking, I regretted choosing this field altogether. Even in my batch, around 30-40% of the students regretted entering this field. I have gone through the hectic schooling life, the demanding exams, the tiring clinical practice. The worst thing is that after studied like mad for the last 5 years, it doesn't mean anything. The MBBS degree, which everyone else thought is a big "wow", is nothing but a passport to enter another deeper layer of hell.

Now, there are way too many HOs in Malaysia, and too few MOs and Specialist. In 2015, there will be surplus of doctors in Malaysia. 5 years ago, there are only 5 universities in Malaysia, both private and government, which provide Medical degree. In 5 years time, the number had increased to 15. There are hundreds of undergraduates still to graduate from the unis and colleges, not counting those who went for study abroad. It wont be long before we see doctors unemployed on the streets, because the number is too great but the posts provided by MOH is limited. Imagine seeing doctors, after studied so hard, have to search for jobs in unrelated field. The phenomena will be the same as the nurses in Malaysia right now. 

Becoming a newly graduated doctor in Malaysia now, is to me, like a never-never land, because you will mostly end up no where. Last time, having an MBBS degree is more than enough. You can open a clinic, and your life will prosper. Now, the patients demand more; they are more well informed, more educated, and knows how to fight for their rights. People nowadays would always prefer to search a specialist's advice rather than a normal physician. However, even after houseman, a Malaysia Houseman has very very limited chances to further his/her career. Now, as of 2011, there are already 7000+ HO, but only 800 seats of master scholarship provided by the Malaysia Medical Council. Talking bout competition? Unfairness? Racism? Cables and Connections? There's no need of explaining it further. Worse, EVERY single masters abroad are NOT recognized in this Bolehland, except 3 from UK: MRCP, MRCPCH, MRCOG (and they're going to de-recognize MRCPCH anytime soon. The phenomenon will continue to be the same - many many HO's and MO's, but still very limited Specialists. Why are there so many of the Malaysian 'genius' doctors who studied abroad do not come back to serve Malaysia? That's because the whole system is screwed up. The pay elsewhere is much higher, you are protected better, and have less working hours. So, i would tell everyone, including myself, if possible, if financially able, leave. Leave this Bolehland where nothing is boleh, and never never come back again. The government is screwed up, whole Malaysia is hopeless.

In every day's newspaper, we can see that many people are complaining bout the deteriorating quality of the health care in the country, and most of the fingers are pointed towards us, the Housemans. But i can understand why. It's all because in the first place, a HO basically dont know anything, have no experiences, naive, and yet we are overworked (36 hours without any rest, no time for even a drink), not guided well by our supervisors, not encouraged but discouraged, being despised by even the nurses, over-stressed. There are many HO who are depressed, or even gone crazy, quit, became suicidal etc. Statistic shows 60% of HO seeks psychiatry consultation. How can a mere young person handle so much, and yet without any support from their supervisors, but being scolded, kicked around, insulted all the time by them. Today, most of the old doctors holding high posts are totally crazy, inhumane, irresponsible, inconsiderate in their behavior towards HOs. And as the HOs are being treated like shit, they would later become the same and take revenge on their juniors, and the vicious cycle goes on.

Last week, i was called up for the Induction Course in Hotel Midah, KL.. It was a 4 days induction course .. It was fun, resourceful, and at the same time, stomach filling.. One of the things we are taught about is 'Soft-skills', which means ways to communicate, ways to engage and be empathy towards patients. All these qualities are totally neglected by the Indian medical system i was used to, where everything is just about how much you study. Today, a doctor's job is not only about auscultating with stethoscope and prescribing drugs, but to 'talk' and behave humbly and nicely. Knowledge no longer counts much because anyone can know anything by just a click of mouse. It is about how you talk, how you present yourself, how to approach, how you keep silent and listen, how to touch, and what to avoid doing. Besides, we also informed that the On-Call system is going to be cancelled altogether, and be changed to Shift-system, where HOs work in 8 hours shifts rotation. Yes, it is a good news that we will not be too tired and can have some 'life', but the negative side is that, there will no longer be any On-Call allowances, which means around RM1000 loss per month.

I reported to duty at Hospital Tengku Ampuan Afzan Kuantan on Monday, 27th June.. This time, there were only 2 of us who reported to Kuantan GH- me, and another Malay friend Hamid. The first day was all about formality and documentations. Had to go to KWSP, the bank, and fill up a bunch of forms at the admin section of the hospital. That's all we did that day.

2nd day, we had a briefing on Standard Precautions practices. It was about what to do and what not to, all the steps of hand washing, way of handling needles, way of throwing medical waste, ways to protect oneself etc. All these qualities are again, over looked by the Indian system, where you simply throw anything anywhere, and nothing is being stressed upon. Before we start our posting, in Kuantan, there's a new rule that states that all new HOs are to be placed in the Blood Collection Room to collect at least the blood of 50 patients. Having done that only we are allowed to meet the head of the hospital for posting in a particular department. The purpose of it is to prepare the new HOs to work efficiently in terms of dealing with needles well, collecting blood skillfully, and dispense each waste in particular bins, ultimately to minimize the incidence of sharp injuries in the hospital to 0. So for now, we're just chilling around, taking blood in a small AC room, chatting with the staff nurse, and leave at 4 something. We both had reached the target in just 2 days, but we plan to linger on till Friday, then we will have holiday on Sat & Sun, and to meet the head only next Monday, so that we can continue chilling around, jobless, tension-less, at the same time getting familiar with the hospital surroundings, prepare ourselves knowledge wise and rest while we still can, before we enter hell.

Since i came back to Malaysia, many juniors asked me for my advices as they are also interested in becoming a doctor. My first thing telling them would be: think again! it's better not! There's no future! And if they really want to be a doctor for whatever noble reason? Go study abroad, and never come back!!

So, since my foot is stuck in this puddle of mud, how can i drag myself forward?
1. Keep thinking and setting sights on my goals: To be an eye specialist, work in a private hospital, earn a lot to have a good living, have much free time for myself and loving family, and be respected and appreciated by the public for my good service.
2. Pray. Pray to God for strength, guidance, skills, wisdom, knowledge; to show me favor, to pave the path straight for me, to help me achieve my goals.
3. Think of the On-Call system as a chance to earn more while i can, as the shift-system is just around the corner.
4. It is my calling to be in this healing ministry of Him. Spread His love with my open heart, let people feel that i am different, and may many be healed under my care.
5. Keep reminding myself i am getting paid. I am currently stay at home, have a super nice room with all new furniture and bed, and i do not need to use a single cent by logic. I can save up a lot in 2 years time, i will invest, and get a Toyota Altis after that to reward myself! 
6. Will keep energy bars and loads of water in my bag, to keep me going on.

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