KUALA LUMPUR: The perennial problem of long hours and bleary eyes is taking a toll on young doctors doing the two-year housemanship in Malaysia each year: one in five in quit.
This is an alarming rate considering the high cost of studying medicine: up to RM500,000 to study medicine in Malaysia and up to RM1million for a foreign medical degree.
Some newly graduated doctors have also quit because of the long wait to be posted as housemen.
“About 1,000 of the 5,000 housemen employed each year do not complete the two-year training stint,” said Deputy Health director-general Dr S. Jeyaindran in an interview with The Star Online.
The number of housemen quitting has also been increasing the past three years.
These “unhappy” doctors have been found working as waiters and even running pasar malam stalls and a trainee doctor has also taken to the skies as an air stewardess.
The reasons for not completing the housemanship are manifold:
- unable to cope with the long hours,
- unsuitability for the profession as they were pressured to study medicine by their parents,
- having a totally different perception of a doctor’s life,
- and suffering from burnout.
A houseman’s workload in Malaysia is lighter than those in other countries, said Dr Jeyaindran.
A Malaysian housemen takes charge of four to six patients in a ward compared with 8-12 in Singapore, Australia and the United States.
“In Malaysia, a houseman works between 65 and 72 hours compared with an average of 80 hours a houseman puts in Singapore, Australia and the United States,” said Dr Jeyanidren.
Terminating the services of these unhappy Malaysian doctors by the Public Services Department (PSD) is tedious and could take up to several months to more than a year.
The termination process gets long and complicated if the houseman leaves without tendering an official resignation letter.
“Until the houseman’s service is terminated, the vacancy cannot be filled and those who replace them have to wait for their turn to start,” said Dr Jeyaindran.
The large number of medical students graduating each year is another reason for the long wait for postings as a houseman, especially under the new e-houseman system, which allows for newly qualified doctors to choose the place of their posting.
While the average waiting time is about six months, it can be longer for the more popular postings in urban hospitals.
“With 10,000 housemen in all the 45 training hospitals nationwide, these hospitals have varying degrees of waiting periods except for hospitals in Sabah, Sarawak, Kelantan and Terengganu,” Dr Jeyaindran said.
He said the ministry must explore other ways that allow for greater flexibility in employing housemen to replace those who had left.
He said the proposal to have a common entry or fitness to practice examination as proposed by the Malaysian Medical Association (MMA) was among the steps being considered.
Another was a longer induction period for housemen to have better understanding of their work.
“It is not to control numbers as proposed by MMA, but to ensure a minimum standard of competence,” said Dr Jeyaindran.
“The common entry examination is already in place in some Asian countries, the United States and Australia and it might become necessary to ensure safe medical practice, especially once there is a liberalisation of trades and services.”