Give house officers their just dues
ACCORDING to what I have read in the newspapers, there are currently many medical graduates who are waiting to be absorbed into government hospitals.
On the other hand, there are many house officers (HOs) who are failing to complete their training within the stipulated period. The common reasons stated for their failure, as indicated in the letter extending their training period, are (1.1) not enough working knowledge/ poor knowledge, and (1.2) inadequate skills ( kemahiran yang kurang).
The Longman Dictionary of Contemporary English defines the first as the inability to use knowledge to do a particular job while “poor” is defined in the Cambridge Dictionary as very low quality or standard. In other words, these HOs are being failed because they are deemed to have very low standards in core knowledge and also lack living and practical skills. They are classified under “incompetent” which means they are incapable of doing a particular job or discharging their obligations and duties satisfactorily.
Ironically, these HOs are required to train, teach and guide fresh HOs. If they are expected to do this, they must be able to do all the work independently and satisfactorily and have sufficient and satisfactory working/ core knowledge and skills.
So, can “incompetent” trainers produce competent trainees?
The onus is on the head of department (HOD) to provide evidence to show what working knowledge they lack and what work they are unable to do. Are they doing this? Are they giving any warning to the HOs concerned? Is any remedial action being taken? Are HODs keeping a record of the incidents during which the HOs were not performing to acceptable standards?
Heads of departments can’t simply say the HOs lack knowledge or have poor skills at their whims and fancy. Do they realise that the life of a HO is tough and exhausting physically and mentally, and that they work under extreme pressure?
In training hospitals like the Melaka General Hospital and Hospital Sultan Ismail Johor Baru, if HOs do their work well, that is they can perform, are productive and not dysfunctional, they are not “failed”. HOs who don’t even know what to do every day or are unable to do their daily work satisfactorily despite all the teaching, counselling and warning given, should indeed be considered as “incompetent”.
Why are some department heads interpreting “incompetence” in their own context? This has resulted in an unusually high failing rate in departments that are managed by relatively new and inexperienced heads of departments.
Items 1.1 and 1.2 started being used over 10 years ago when there was an influx of medical graduates from several recognised foreign universities. As HOs, they were generally lacking in clinical skills and the intention was to provide more time for them to improve their clinical experience. The housemanship period was also changed to two years.
Could the Health Ministry look into this issue urgently and professionally so that (1) corrective action could be taken on those HOs who were wrongly failed (what is wrong must be made right); (2) Government’s money is not wasted on unnecessary/ wrongful extension of HOs; and (3) there is a smooth flow of fresh medical graduates into government hospitals.