I understand the intention behind limiting House Officer (HO) working hours. Burnout is real. Fatigue is real. Patient safety matters.
But honestly, I feel like nobody is talking about what happens after HO hours are reduced.
Does the number of patients also reduce? No.
Wards are still full. Emergency cases still keep coming in. Referrals still need to be attended. Bloods still need to be taken. Discharge summaries still need to be completed. Patients still collapse at 3am.
So who covers the remaining workload? People like us – Medical Officers (MOs).
I am currently under Master’s training; the burden is becoming increasingly unrealistic. We are expected to do HO-level service work, carry MO-level responsibilities, supervise juniors, manage unstable patients, attend calls lasting more than 30 hours, study for specialist exams, read daily, prepare presentations, complete thesis and research work, and still maintain service efficiency.
Sometimes it feels like we are expected to become specialists while simultaneously functioning as the workforce that keeps the entire hospital operational.
What makes it even more frustrating is that many of us feel trapped in the middle. HOs are now increasingly protected, which is understandable.
Specialists mainly give instructions. But the actual execution, overnight burden, ward work, referrals, documentation, firefighting, and service continuity frequently fall onto MOs.
Again, not every specialist is like this. There are excellent specialists who work very hard and truly support their trainees.
But many MOs will understand exactly what I mean when I say this: sometimes it feels like the system survives because MOs quietly absorb everything.
Despite all this, we are still paid relatively poorly compared to the workload, responsibility, medicolegal risk, radiation exposure, sleep deprivation, and sacrifices made daily.
What makes this situation even more ironic is that my current hospital does not even have House Officers.
We are already functioning without HOs, meaning MOs are directly covering many service tasks ourselves. Despite this, we still understand the burden carried by our counterparts in hospitals with HOs because we came from that system too.
We were once HOs ourselves. We know the exhaustion, stress, sacrifices, and emotional toll of housemanship. At the same time, we also understand the burden currently being endured by Medical Officers who are carrying increasing service responsibilities within an already strained health care system.
I am not against improving HO welfare. But I am asking: Why is MO welfare always ignored?
If fatigue is dangerous for HOs, then fatigue is also dangerous for MOs. If burnout matters for HOs, then burnout also matters for MOs.
Reducing HO working hours without solving manpower shortages simply transfers the burden upward. Eventually, exhausted MOs will leave. Some resign, migrate overseas, or quit public health care entirely.
Then one day people will ask: “Why is the health care system collapsing?” The answer is simple. The people holding it together were stretched beyond human limits for far too long.
The author is a medical officer at Al-Sultan Abdullah Hospital, UiTM. CodeBlue is providing the author anonymity because civil servants are prohibited from writing to the press.
Editor’s note: The author’s name was removed upon the author’s request.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
