Longer wait for medical grads
Further delay in housemanship offers due to Covid-19
AS of Sept 15, some 635 medical graduates are still left waiting for their housemanship placements at government hospitals.
Although the wait is expected to end when the sixth housemanship intake of the year starts on Oct 26, placement offers are still subject to vacancies available, Health Minister Datuk Seri Dr Adham Baba told Parliament last month.
On average, an aspiring doctor can expect a nine-month wait for the two-year housemanship offer but the Covid-19 pandemic and resulting movement control order has exacerbated the wait.
While the government has attempted to speed up the process by increasing the number of graduate training hospitals from 38 in 2009 to 48 in 2019; collaborating with the Consortium of Malaysian Public University Hospitals to increase housemanship placement slots in university hospitals like the University Malaya Medical Centre, Universiti Kebangsaan Malaysia Medical Centre and Hospital Universiti Sains Malaysia; and increase housemen training slots from 10,835 in 2013 to 12,153 at present, the long wait for housemanship placements will continue to be a problem unless more is done.
Malaysian Medical Association (MMA) president Prof Datuk Dr Subramaniam Muniandy said the delay is made worse by the pandemic but the lack of training slots, the extension of existing house officers in certain departments, and housemen going on maternity or medical leave, need to be addressed as these are long-standing issues.
“There was a gap between March and July where there were no new intakes for medical graduates as the country was battling the virus.
“But there has been at least five housemanship intakes within the last few months whereby on average, 1,000 medical graduates were hired per intake. It is a step in the right direction in the ministry’s effort to clear the backlog,” he told StarEdu, adding that Covid-19 isn’t the sole reason medical graduates are not getting slots.
Agreeing, former MMA and the Medico-Legal Society of Malaysia president Datuk Dr N.K.S. Tharmaseelan said house officers not completing their training within the stipulated time has resulted in the lack of vacancy for fresh graduates.
There is a massive backlog in the waiting list, he added, because there are only a fixed number of slots available so a post only becomes vacant when existing house officers complete their housemanship.
Last year alone, over 1,000 house officers failed to complete their housemanship training within the stipulated two-year period, he said.
“The fact that there are so few hospitals allowed to train house officers makes things worse.
“The ministry introduced contract employment for medical graduates to reduce the wait for housemanship but it hasn’t helped the situation,” he said.
Dr Tharmaseelan, a professor of obstetrics and gynecology at Melaka-Manipal Medical College, said the problem isn’t that Malaysia has too many doctors. Rather, it is a result of the unequal distribution of doctors across the nation.
Covid-19, he added, has led to some countries shortening their medical course to allow students to graduate earlier so that they can be absorbed into the system.
“More doctors are needed as frontliners during the pandemic.
“So the pandemic shouldn’t be seen as the cause of the delay in employment of new medical graduates.”
Medical Practitioners Coalition Association of
Malaysia president
Dr Raj Kumar Maharajah points to bad planning for the long waiting period.
“The problem has snowballed as medical colleges mushroomed over the last two decades.
“Varsities have been over-producing medical graduates, further contributing to the long waiting periods and lack of guarantee in securing a job in the service,” he said, adding that Malaysian doctors could end up on the “export list” if nothing is done to address the problem soon. – By SANDHYA MENON
THE perennial problem of medical graduates having to wait for months for their housemanship was made worse by the Covid-19 pandemic which resulted in the suspension of recruitment of new housemen.
In a bid to address the issue, the government, through the Higher Education Ministry, has applied for an extension on the 2011 moratorium on offering new medical courses in higher education institutions until 2026, Health Minister Datuk Seri Dr Adham Baba told Parliament on Sept 15.
The original moratorium would have ended next year.
Seniors in the medical field, however, are optimistic that there is a solution to the issue that has long plagued Malaysia’s aspiring doctors.
Malaysian Medical Association (MMA) president Prof Datuk Dr Subramaniam Muniandy called on the government to conduct a review of varsities that offer medical courses.
This will ensure the quality of graduates and prevent an oversupply of doctors.
University hospitals, he added, should all be allowed to train medical graduates.
He also suggested gazetting new training centres for housemen.
“We are pushing for extended contracts so doctors can become specialists in different fields.
“With enough specialists posted to district hospitals, more centres can be gazetted as housemanship training centres,” he told StarEdu.
While the government through various ministries is seriously looking into the issues, it is unrealistic to expect a promise of permanent positions, he said.
“Last year, critical allowances were reinstated and for now, extended contracts are being studied.
“We hope that with constant engagement, there will be a favourable solution for our junior doctors.
“The current waiting period is nine months because of Covid-19. It was previously six,” he said, adding that the wait has gotten shorter over the years. There was a time when graduates had to wait almost a year before they got their postings.
The MMA, said Dr Subramaniam, is doing its part by providing shortterm training such as the “ABCs of Housemanship”, to sharpen graduates’ clinical skills during their waiting period.
Former MMA and the MedicoLegal Society of Malaysia president Datuk Dr N.K.S. Tharmaseelan proposed making it mandatory for the country’s private medical colleges to have their own hospitals for the training of housemen instead of leaving it to a limited number of government hospitals to do the job.
“Most established medical colleges would have no problem building hospitals as it can also cater to the healthcare needs of Malaysians.
“With a well-thought out plan, this could be an effective way to resolve the perennial housemanship problem,” he said, noting that Malaysia is one of the few countries where it is not mandatory for medical colleges to have their own hospitals for training purposes.
And if more specialists are posted to district hospitals, these hospitals can be transformed into training centres for house officers, Dr Tharmaseelan, who is also a professor of obstetrics and gynecology at Melaka-Manipal Medical College, said.
The ministry, he opined, should look into improving the deployment of trained staff, facilities and specialists to enable new and upgraded hospitals to function and be gazetted as training centres for medical graduates as housemen.
He also called for a common qualifying exam for foreign medical graduates to level the playing field and assure the quality of medical graduates being employed.
Elaborating on the common qualifying exam, Universiti Putra Malaysia Faculty of Medicine and Health Sciences dean Prof Dr Zamberi Sekawi said it is currently in the proposal stage.
Describing it as a common licensing exam, Prof Zamberi said only graduates who sit for it and pass are eligible for housemanship.
“Many countries, except for Malaysia, already have this in place.
“Those who are well-trained and competent will easily pass and complete their training on time.
“It may not be a foolproof method of tackling the issue, but it is one way to shorten the waiting time for medical graduates and to ensure their quality,” he said.
Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah urged the government to put a cap on the number of medical colleges in the country.
“Slow down the churn. Focus on producing quality medical graduates instead.
“Hardworking and high performing housemen should be allowed to complete their housemanship earlier so that they can proceed to do their specialisation.”
The Public Services Department, he said, should allocate more posts for housemen and absorb the deserving ones as permanent medical officers.
“A less spoken about, but equally important aspect, is educating parents to stop forcing their children to study medicine if they are not interested,” he said.
With enough specialists posted to district hospitals, more centres can be gazetted as housemanship training centres. Malaysian Medical Association (MMA) president Prof Datuk Dr Subramaniam Muniandy.