Farewell Letter From An Ex-Contract Medical Officer UD43

To me, being a doctor is just another job. Like any profession, it’s not worth sacrificing your life over.

It has been one month since I left KKM (Ministry of Health) and started my new job and I am…happy. Alhamdulillah. Hopefully, I’ll stay happy. Grass is greener on the other side, guys. For me to focus on my new job, I felt that I needed to write this letter as closure.

Although I felt KKM had little respect for us, contract doctors, KKM made me a better doctor and person. That’s a debt I will never forget. Thank you. This is for past, present, and future doctors of Malaysia. Hopefully, this letter will benefit you at whichever stage you are in.

I remembered before housemanship, I read a piece where a senior doctor said housemanship training is parallel to the “Navy SEALs training”. When I read that, I was like, “Get out of here”. However, spending most of my time practicing at one of the oldest and busiest hospitals in Malaysia, I stand corrected. I have no experience in Navy SEALs training, but my experience in housemanship training was brutal.

I experienced physical torture where I had painful blisters on my soles from running to the lab and blood bank and body aches from performing cardiopulmonary resuscitations (CPRs) on patients the whole day.

I experienced mental torture from senior colleagues throwing verbal abuses (like telling me that I wasn’t good enough to be a doctor and I should quit) and sleep deprivation (imagine sleeping at 2am and waking up at 4am). It was brutal. Yes, there were good memories during housemanship. If asked any doctors, housemanship is something we all had to go through and memories that we will treasure forever, but wouldn’t repeat it even if they offered us US$1 million.

One of the things that kept me going was that I wanted to be a better doctor than I was yesterday, in order to serve my fellow Malaysians the best I can. That’s the motto of KKM: “Kami Sedia Membantu [We are ready to serve]”. Despite how exhausted we were or sad that we didn’t get to see our families, we were ready to serve.

No matter how barbaric the working conditions were, I never made an official complaint or raised any problems. It was for the country.

I believe most of the contract doctors feel the same way. Even when Covid-19 happened and most of us were deployed to the frontlines (some even had to move states), putting us and our loved ones at risk, we didn’t complain.

We believed that the Ministry would take care of our welfare and future. Maybe not permanent positions; we understood why we had to move to a contract system. However, at least a pathway of furthering our studies and equal grade and treatment as our permanent colleagues. After five years since the first batch of contracts was taken, our future still seems bleak.

When I decided to leave, I had a year left in my second contract and was about to welcome a baby boy. I apologised, but I don’t have time to sit, wait and hope. I had to secure my future. A friend of mine, who has left KKM, once said to me: “Bro, would you stay in a company where you worked for five years, and they never promoted you? At least, the permanents will become UD48 and UD52 in a few years. You want to stay UD43 till 40 years old?”

It’s not worth it. The recent announcements of contract doctors can apply for the Hadiah Latihan Persekutuan (HLP), or Federal Scholarship, is great news. However, there are still questions or concerns that haven’t been clear up. As we know, entering the master program is competitive.

  • How are contract doctors with a maximum of three years of experience able to compete with permanent doctors who have 10 years of experience?
  • How many contract doctors will be able to enter?
  • If they gave two or five contract doctors only, what would happen to the other thousands of contract doctors?

I pity my other colleagues who are still hoping. It fills me with anger that they are being left hanging just like that. Don’t do that. We gave our all working for you guys. Some lost their loved ones while working. Some lost their mind while working. Some lost their lives while working.

How do you expect the people who are responsible for Malaysians’ health to be treating Malaysians humanely, when you’re treating them inhumanely?

What is the Planning Division doing? Do they not foresee the inevitable shortage of specialists or doctors in the future? It may be next year or in the next ten years. But it will happen. What if we’re to face with another pandemic and, this time, most contract doctors are not in service anymore? As a Planning Division, one should avoid for this to happen at all. One should have a vision and prevention is always better than cure.

I’m proud that we’re one of the few countries that have accessible and free (practically) universal health care and that I served in it. The quality though is…questionable. This is not a dig to the people working there because I have great respect for them. Let’s be honest though, look around, your plans would be carried out better if there were more resources.

We get it, it’s a tight budget, therefore resources are limited. However, as we can see now, it’s not only cutting resources, but, with the contract doctors and other health care professionals, it’s also cutting manpower to sustain this system.

This system is not sustainable. It will collapse.

This pandemic showed that. Remember how bad intensive care units (ICUs) all over the country were suffering? Remember how we had to shut down the entire country and other economic sectors because our health care was overwhelmed, bleeding and failing? This system is a ticking bomb and once it explodes, the lower sociodemographic population will suffer.

Like I said, I don’t have time to solve all these never-ending problems. Although it has been painted in Malaysia that being a doctor is about being overworked, overburdened, and to submit one’s soul and body to them, to me, being a doctor is just another job. Like any profession, it’s not worth sacrificing your life over.

Now, being a doctor isn’t the only job I have. My other job is being a father. So, I must find the balance between two. After hearing and readings stories like “My Covid Experience as a Contract Medical Officer” by Dr Dhasheilah Manoharan, I don’t think I’ll be able to find the balance I’m looking for working in KKM.

It’s all about your status: contract or permanent. To me, it’s discrimination, toxic, and disgusting.

I’ve served my two years’ compulsory service and there is no career progression for me in KKM anymore. So I applied for jobs, went for interviews, and got offers. I picked which I felt best, handed in my one-month notice, and left. It was scary to leave my comfort zone and the false “security” it held. Was I ready? I wasn’t. It’s a leap of faith.

“That’s all it is, Miles. A leap of faith.”

Spider-Man: Into the Spider Verse

Yes, my name may not ever be in the National Specialist Register (NSR). Well, most of the doctors from my batch most likely won’t since most have left the service. Although most of us took part in fighting the pandemic for this country, most of us won’t be able to achieve our dream of becoming a specialist. No matter how talented, smart, or passionate we are. Hopefully, our childhood version of ourselves that was full of hopes and dreams will be able to forgive us for not achieving them.

When the time comes that Malaysia faces a lack of specialists in the future, they’ll look back at our batch. We will be known as the generation of the missing specialists of the Malaysian medical field. We may be the missing specialists or discarded by them, but it doesn’t mean that we won’t be able to contribute to the growth of the medical field in Malaysia. With the advance of technology and accessible to education, go!

Go gain more knowledge and apply them at your job at your private clinic!

Go and collaborate with other local and international industries on LinkedIn to improve the health care system!

Go and make medical videos that will be watched by thousands!

Explode!

I realised that no matter how many times we protest or petition, it’s pointless changing a system that doesn’t want to be change. I’ll continue to support and fight for the contract doctor cause for the future generation of doctors, but I’m not sure if anything will change.

They may have made us contract doctors to sustain their system without caring of our wants and needs, but let’s show them that we bring in a new meaning of being a doctor in this new age. We can make sure we are the generation of doctors that changed the Malaysian medical field.

Dr Azim Nasaruddin is an ex-medical officer UD43.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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