The reality about medicine
WE have too many doctors compared to houseman spots available.
This is due to the mushrooming of medical schools in the country, and a large number of students doing medicine overseas, Malaysian Medical Association (MMA) president Dr Mohamed Namazie Ibrahim says.
There are some 6,000 local and foreign medical graduates. About 5,000 are offered training positions as contract house officers in the Health Ministry and university hospitals. These are the only hospitals accredited to train house officers. The contract is for four years - two years as a house officer, and the remaining two as a medical officer. House officers may have their training extended if their performance is unsatisfactory, he explains.
Those who fail to complete the training in three years will be asked to leave. They won’t be able to practice as registered medical practitioners.
House officers who complete the training will continue as registered medical practitioners who must serve as medical officers in the government hospitals for another two years under contract.
“By now they would have been practicing for four years. Currently, the Health Ministry can only absorb about 2,000 doctors in permanent positions.
“The rest will have to seek employment elsewhere unless the government opens up new healthcare facilities.”
Common licensing exam
The government’s projection for the doctor-population ratio is 1:400 in the next two years, Dr Mohamed Namazie says. The projected population of Malaysia in year 2020 is 33 million.
Based on this ratio, we would need 82,500 doctors. As of this year, we only have some 50,000 doctors. So to meet the projection, more doctors are needed, he says.
He worries that the government won’t be able to provide adequate training and permanent civil service positions. The private sector will also be hard pressed to absorb all those who complete their four-year service, he points out.
“In view of this, the moratorium on licensing new medical schools in the country should be extended and the admission criteria to medical courses be made more stringent,” he says, adding that it’s essential for the regulatory agencies to ensure the medical schools maintain adequate standards in teaching and training and not hesitate to close down under-performing institutions.
“A common licensing examination should be introduced to ensure that only well-trained medical graduates are employed or allowed to practice independently,” he opines.
What it takes
The medical profession is a calling. It requires mental aptitude and physical resilience, says Dr Mohamed Namazie.
Consider the long duration of the undergraduate course, followed by many more years of training to be a specialist. Scholarships are difficult to come by. Private varsities are expensive. And learning, he warns, doesn’t stop with graduation. It goes on as long as one continues to practice medicine.
“As a trainee after graduation, you spend long hours in wards. It’s daunting. Sleepless nights are common. It’s not as glamorous as what TV shows depict. Even as a senior doctor, the working hours are long. You cannot put down your instruments in the midst of an operation or while attending to an emergency.
“But, for those with the correct attitude, it’s extremely satisfying especially when you see a patient at the brink of death, recovering and going home.”
Excellent grades are essential but aspiring doctors must be resilient, altruistic, empathetic, and willing to serve.
“You need a burning desire to practice medicine, and have the ability to overcome the trauma of seeing the patients pass on, in spite of your best efforts.”
Prospective medical students should do a mandatory attachment in hospitals to expose them to the reality of life as a doctor, he suggests. This requirement can be used for entry into a medical school.
“Those who have served in voluntary organisations like the Red Crescent or St John’s Ambulance, may have the aptitude to serve and they should be considered above others, the scholastic achievements being equal.
“Often those who have achieved lesser school grades but with the right attitude and aptitude have performed better as doctors compared to those who have only good grades but appalling attitude,” he feels.
Above all, parents shouldn’t force a child to do medicine if the interest isn’t there.
“Often, young medical graduates who drop out of the profession say they didn’t want to be doctors in the first place, and go on to do what they like.
“This is extremely sad as these young people have not only wasted their time and resources, but deprived others of a place in university.” By Christina Chin