Houseman bullying issue: more than meets the eye – a senior doctor
From lax standards to shortage of healthcare centres, problem goes beyond medical officers, specialists
The government and relevant bodies keep recognising more and more medical colleges – locally and overseas – as they are more concerned about public outcry or losing public support, which has contributed to the surplus of medical graduates in the country, a senior doctor opines. – Getty Images pic, May 12, 2022
THERE have been many articles written on the medical fraternity recently especially with regards to house officers (HOs). Generally, the reaction points to the quality of HOs and a few pathetic individuals talking on behalf of the fraternity who have been working tirelessly.
It is more disappointing to see politicians and opportunists jumping on the bandwagon to gain some brownie points for their efforts, as well as some overseas doctors peddling their opinions with a shallow understanding of the real situation.
The problems of HOs are multifactorial.
First, in Malaysia, everyone can become a doctor, like the AirAsia slogan “Everyone can fly”. We have 31 medical colleges, of which 11 are public and 21 are private.
We also send students to study in Indonesia, India, the UK, Ireland and other countries. The students can be self-funded or sponsored by the government or other organisations, for example.
Do we need so many doctors all of a sudden for a country of a 32 million population?
Perhaps, we needed them a decade ago. But now the doctor-to-population ratio has been reasonably achieved. The Malaysian healthcare system is in need of more specialists instead.
Do the government and relevant bodies take a serious look into this matter?
Sadly, they don’t. They keep recognising more and more medical colleges – locally and overseas – as they are more concerned about public outcry or losing public support.
Moreover, they don’t build enough healthcare centres and conducive facilities to cater to an increase in patients. Most of the government hospitals have cramped wards with so many medical disciplines sharing beds. New government buildings do not finish in time, and shoddy work often leads to further delays.
So, what they do instead is pressure the senior doctors. On top of being responsible for providing excellent patient care, they are condemned if HOs fall into depression.
Isn’t this an act of bullying by the public and the government towards this group of hardworking and dedicated doctors?
Also, the problem lies in inadequate assessment by the medical colleges prior to accepting students. The overall interest of the student in this field is not properly assessed.
Each college has its own intake exams, so there is a severe lack of standardised assessment. To add to the burden of the public medical service, no private medical college in this country has their own hospitals. As such, the private and some public medical colleges depend on government medical facilities.
As for doctors who claim that conditions overseas are better, let me highlight that in most countries, the number of undergraduates making it out with their medical degrees is low.
As such, the quality of HOs and the facilities are conducive. Developed countries absorb the best medical officers (MOs) and specialists from other countries. It is not like in Malaysia, where anyone can enrol in medical colleges.
Many of them with real interest enrol in medical colleges; few do because their parents want them to be doctors, and few have good exam results. Some join although they have no interest, but are instead victims of circumstances.
So, with students of this variety joining medical colleges, how will their response be in the face of a high-pressure working environment that deals with life and death daily?
Is it the job of senior doctors to monitor such occurrences, or is this due to the structure and system developed by the government?
Finally, I am really puzzled that the moment HOs become MOs or specialists, there are no complaints.
Why is it so? My conclusion is that there are very few HOs who actually have an interest in the work. As such, they cannot cope with the nature of working as a doctor.
If one complains of work hours or the nature of being a HO, it has reasonably improved – from on-call to shift systems – and each department has around 20 to 40 HOs.
Once they become MOs, there are no complaints of a tough working environment. Why is that so? It boils down to the fact that most HOs who become MOs are the passionate ones. They enjoy the work and career progress in servicing the sick and ill.
I am not saying there is no bullying in the system. It has very much reduced, with more MOs and specialists overseeing the 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 punching bags due to flaws in the system. This demoralises everyone in the medical fraternity. Alas, we, too, are human beings with feelings. – The Vibes, May 12, 2022
The writer is a surgeon of more than 20 years at a government hospital
THERE have been many articles written on the medical fraternity recently especially with regards to house officers (HOs). Generally, the reaction points to the quality of HOs and a few pathetic individuals talking on behalf of the fraternity who have been working tirelessly.
It is more disappointing to see politicians and opportunists jumping on the bandwagon to gain some brownie points for their efforts, as well as some overseas doctors peddling their opinions with a shallow understanding of the real situation.
The problems of HOs are multifactorial.
First, in Malaysia, everyone can become a doctor, like the AirAsia slogan “Everyone can fly”. We have 31 medical colleges, of which 11 are public and 21 are private.
We also send students to study in Indonesia, India, the UK, Ireland and other countries. The students can be self-funded or sponsored by the government or other organisations, for example.
Do we need so many doctors all of a sudden for a country of a 32 million population?
Perhaps, we needed them a decade ago. But now the doctor-to-population ratio has been reasonably achieved. The Malaysian healthcare system is in need of more specialists instead.
Do the government and relevant bodies take a serious look into this matter?
Sadly, they don’t. They keep recognising more and more medical colleges – locally and overseas – as they are more concerned about public outcry or losing public support.
Moreover, they don’t build enough healthcare centres and conducive facilities to cater to an increase in patients. Most of the government hospitals have cramped wards with so many medical disciplines sharing beds. New government buildings do not finish in time, and shoddy work often leads to further delays.
So, what they do instead is pressure the senior doctors. On top of being responsible for providing excellent patient care, they are condemned if HOs fall into depression.
Isn’t this an act of bullying by the public and the government towards this group of hardworking and dedicated doctors?
Also, the problem lies in inadequate assessment by the medical colleges prior to accepting students. The overall interest of the student in this field is not properly assessed.
Each college has its own intake exams, so there is a severe lack of standardised assessment. To add to the burden of the public medical service, no private medical college in this country has their own hospitals. As such, the private and some public medical colleges depend on government medical facilities.
As for doctors who claim that conditions overseas are better, let me highlight that in most countries, the number of undergraduates making it out with their medical degrees is low.
As such, the quality of HOs and the facilities are conducive. Developed countries absorb the best medical officers (MOs) and specialists from other countries. It is not like in Malaysia, where anyone can enrol in medical colleges.
Many of them with real interest enrol in medical colleges; few do because their parents want them to be doctors, and few have good exam results. Some join although they have no interest, but are instead victims of circumstances.
So, with students of this variety joining medical colleges, how will their response be in the face of a high-pressure working environment that deals with life and death daily?
Is it the job of senior doctors to monitor such occurrences, or is this due to the structure and system developed by the government?
Finally, I am really puzzled that the moment HOs become MOs or specialists, there are no complaints.
Why is it so? My conclusion is that there are very few HOs who actually have an interest in the work. As such, they cannot cope with the nature of working as a doctor.
If one complains of work hours or the nature of being a HO, it has reasonably improved – from on-call to shift systems – and each department has around 20 to 40 HOs.
Once they become MOs, there are no complaints of a tough working environment. Why is that so? It boils down to the fact that most HOs who become MOs are the passionate ones. They enjoy the work and career progress in servicing the sick and ill.
I am not saying there is no bullying in the system. It has very much reduced, with more MOs and specialists overseeing the 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 punching bags due to flaws in the system. This demoralises everyone in the medical fraternity. Alas, we, too, are human beings with feelings. – The Vibes, May 12, 2022
The writer is a surgeon of more than 20 years at a government hospital
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