I refer to the letter Health Ministry circular for doctors unhealthy by Dr Lin. I am a specialist in a public hospital. I too, gone through the journey of being a House Officer (HO), Medical Officer (MO), specialist in training and eventually specialist.
I must say I do not entirely agree with Lin's views. However, I do agree that the Ministry of Health (MOH) does not treat its doctors well in term of welfare.
Being a doctor is a noble profession. But ironically, after medical students become doctors, they complain of too much work, too little time for themselves, refuse postings to remote places, want bigger pay, bigger allowances and all sorts of things
Everything except wanting to see their patients more.
As doctors, our first priority is our patients whatever the working conditions. Being a HO is the first stage of a doctor's practical training. In this respect, housemanship is the most important training process for the profession.
The MOH introduced the extra fourth and fifth postings because the one-year housemanship period was deemed inadequate. Previously, even if you had completed the basic postings of medical, surgical and obstetrics and gynecology (O&G), you would still lack of orthopaedic and pediatric experience.
All these postings are important as many doctors choose to become general practioners (GPs). Doctor need to undergo all these five essential postings for without them they would be inadequately trained.
The MOH seems to have learned from its mistakes over the years and that's why these postings are compulsory for all doctors now.
Thus, it is not to be argued that a certain doctor should be treated as a HO, junior MO or MO after the first year of housemanship training. If you're doing the fourth posting in pediatric and you are fresh, obviously, you will be treated as a HO until you are adequately trained.
Obviously, when the doctor is new, they will be treated as such and thus the need to start from the bottom and be upgraded through the posting accordingly. No one would allow them to carry out MO responsibilities if they haven't acquired the skills needed.
It is amazing that many doctors complain of long hours and the need to work on weekends and so on. But the fact is, this is the nature of the job. This is where I feel that many medical students are not counseled well regarding a doctor's life before they take up their course.
Many of them think that they can make big money as doctors (of course, if you ask them, they will deny this saying they just want to help people). But while they will complain of long hours on the job, they will have no qualms doing locum, even overnight as the money is good (up to RM720 a day).
I have seen doctors taking leave to do locum. I have seen doctors doing seven days locum continuously. So the root of the problem is not the long hours but the remuneration. The MOH does not pay us well at this moment but this should not be used as a reason to complain as we owe ourselves to our patients the moment we choose this profession.
But the MOH is not entirely without blame. HOs are paid RM25 per call which is for 16.5 hours for weekdays and 24 hours for weekends. This rate is worse than what Mcdonalds or KFC pays their worker.
The MOs and specialists are no better of for they are being paid RM75 or RM113 for similar time durations. The MOH never seems to appreciate its human capital assets especially experienced doctors or lecturers or professors in universities.
The ministry seems to be more interested in numbers and not quality. They have even required doctors to take the Peperiksaan Tahap Kecekapan (PTK) competency evaluation test for promotion. Apparently the MBBS and various stringent specialist qualifications are now deemed useless.
You may be the most experienced and dedicated doctor with great qualification and able to do the most advanced surgery but if you don't clear this ridiculous exam, you are considered incompetent and should not be promoted.
As for working conditions, I would say the situation is not going to improve significantly in the future. Each year we produce close to a thousand doctors through the public universities excluding those from private colleges and foreign universities.
The number is increasing each year and in the future, there will be a shortage of places to train them as HOs. This is already happening in many developed countries. There will come a time when the MOH will not really need to improve job conditions because there will be a glut of new doctors all wanting to do their housemanship. Market force comes into effect.
In conclusion, my opinion is that you need to have a certain degree of passion in this profession. Difficult working conditions are to expected but our patients' welfare must be our top priority. We should still fight for our welfare and this can be done through the Malaysian Medical Association, the Malaysian Medical Council and other relevant bodies.
For the youngsters out there who want easy working conditions and good money, my advice to them is this - don't become doctors. A good doctor is one who has passion the job and that's why there are still many left in our public hospitals despite the poor terms offered by our MOH.
