I think we have all read or heard enough of the current issues revolving around the lack of competency of young doctors going through housemanship years. I realised that this subject has been made generalised making the entire Malaysian community perceive that all young doctors are unreliable and unprofessional. Some patients or their relatives would not even consider being polite to the young doctors because they keep in their minds that the junior doctors are not fit to be one. This might sting a little if not a lot to those doctors who have dedicated their hearts into performing at their best while at work.
It is undeniably true that there are a few under trained young doctors all over the place, be it in capital cities or those trained in peripheral hospitals in Malaysia.
From my observation having gone through the housemanship course it really was a good 2 years of practice. In my view, I think it was a good first step because we were exposed to so many departments like general surgery, obstetrics and gynaecology, medicine, paediatrics, orthopaedics, trauma and emergency and anaesthesiology. I think the duration of each posting to be of 4 months is perfect if not too long or too short a duration. If this is cut short, one may not have enough exposure to encounter different cases since there has been a marked increase in the number of young doctors. If this is to be prolonged, I think there will only be more complaints not from the young doctors (they don't have a say at anything) but from the team they are working with, their colleagues and specialists in-charge. Why is that so? Lengthening their comfort zone as being a houseman will not make them a better team player as they will be left behind since they will not be carrying any responsibilities towards their patients and there are no contributions towards the team.
It is true as a houseman one will not be held responsible for whatever mishaps because they are still in training "under supervision". However, some might take advantage of this situation taking refuge behind this quote and running away from his or her responsibilities. Mind you, there are eyes and ears all around monitoring these doctors' every move in the respective departments and the hospitals. Sadly, what stays in always stays in. When senior doctors were enquired about these problematic doctors, their answers would be they have no rights to take actions towards these doctors and the only available punishment to date is to extend the duration of his or her stay in the department. Hence the problems only get worse as the problem is still unsettled and they still will not be able to learn to be reponsible for their patients or actions. This in time turns into a vicious cycle.
Regarding the increasing number of freshly gradtuated young doctors, I wouldn't even think of it as a problem. Do not only judge something based on what is seen in hospitals in Klang Valley and Kuala Lumpur. I don't know the real number of young doctors in each department in those hospitals but after seeing Reggie Lee's comic on the ratio of young doctors to a patient, I think we can have a bit of an idea of what the situation is like over there. There are other hospitals which have very less number of houseman in their departments comparatively (please do not compare to what it was like 10 years ago to what it is like now, we know in the old times there used to be only one houseman taking care of 30 patients a day). Maybe what we need is a better system at dividing the appropriate number of houseman into each hospitals which is critical to ensure no decline in the experiences gained by the junior doctors.
We have understood the expectations of Malaysian Medical Council and what their concerns are. Maybe it is also time to look deeper into the issues and understand why the problems occured in the first place. I'm sure there are many controversies of what is really happening. This blog is not for me to leak our the dark secrets or fall up of the system but only to enlighten some dim corners that might have been overlooked.
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