Dilemma Of House Officers And The Medical Fraternity – Kanika

Very few HOs are actually interested in the work of medicine. As such, they can’t cope with the nature of work as a doctor.

There have been many articles written about house officers (HOs) recently. I have noticed that the moment something bad happens to HOs, there will be a lot of knee-jerk reactions.

It is disappointing to see politicians and other opportunists jumping on the bandwagon to gain a few brownie points for their efforts.

Has anyone noticed that the problem is only among HOs? There are rarely any complaints from medical officers or specialists, although occasionally we do hear from contract medical officers.

The problems of HOs are multifactorial. First of all, in Malaysia, almost anyone can qualify as a doctor. We have 11 public medical colleges and 21 private medical colleges.

We also send students to study in Indonesia, India, the Untied Kingdom, Ireland, and many other countries. The students can be self-funded, government-sponsored, or organisation-sponsored.

Do we need so many doctors for a country of 32 million? Perhaps a decade ago, we may have needed them, but now we have already achieved the required number of doctors. The Malaysian health care system is in need of more specialists, and we should reduce the intake of undergraduates and focus on quality instead.

Will the government and relevant bodies look deeper into this matter? Sadly, they won’t, since they keep recognising even more medical colleges, both local and overseas.

So what they do instead is to pressure the senior doctors. If the care of patients is compromised, the senior doctors are answerable, or if HOs complain, the senior doctors are held responsible and condemned. Isn’t this an act of bullying?

The problem also lies in inadequate assessment by the medical colleges prior to accepting students. Often, the students are not properly assessed. Each college has its own examinations, therefore there is severe lack of standardised assessment.

To add to the problem, no private medical college in this country has their own hospital. As such, private and some public medical colleges depend on government medical facilities to assist them.

Does anyone talk about this? Certainly not.

When it comes to doctors who claim that the grass is greener on the other side, let me say to them that in most other countries, there are very few medical colleges with sufficient HOs in the health care service. Therefore, the quality of HOs is not compromised.

Developed countries absorb the best brains from other countries as medical officers and specialists. It is not like in Malaysia, where anyone can enrol in medical colleges.

In the process, many with real interest in the profession will enrol in medical college, few will join because their parents want them to be doctors, and fewer will join because they have attained good results. 

With the various types of students joining medical colleges, how will their response be to a tense working environment that deals with life and death?

I am really puzzled with regard to complaints from HOs, since the moment they become medical officers or specialists, there are no more complaints.

Why is this so? I think that there are very few HOs who are actually interested in the medical profession. As such, they can’t cope with the nature of this job.

Regarding long working hours, the situation has reasonably improved with calls to implement shifts. Each shift does not have just one HO, as there are a few posted together. Each department would have 20 to 40 HOs in total.

Once HOs become medical officers, there are no more complaints about tough working environments. Why is this so? It comes down to the fact that most HOs who have become medical officers are the passionate ones who enjoy the work.

I am not saying that there is no bullying in the system. It has very much been reduced with more medical officers and specialists to monitor HOs.

Look at the problems in a holistic manner before reacting and pointing fingers. The concerned parties and relevant government bodies should be sincere in addressing the issue.

Instead, senior doctors are used as a punching bag for the flaws in the system. This will demoralise everyone in the medical fraternity, since we are all human beings with feelings.

CodeBlue is publishing this letter under a pseudonym because the author is a senior consultant surgeon currently working in the Ministry of Health in Penang; civil servants are prohibited from writing public statements without prior authorisation from their superiors.

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

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