I believe most of us have read Dr. Hsu’s famous article A doctor too many. When I was doing my elective posting in IJN, the supervising doctor told me that Malaysia will have surplus of doctors by 2015 and for the first time in history, medical graduates will be jobless. But our health minister said there would be no surplus of doctors. We’ll see.
Soon, 4000+ medical graduates are going to graduate annually and only 38 hospitals for their housemanship training. The surplus isn’t good. No more job security. Less clinical and practical training for the houseman. Longer period to become specialists.
Inevitably, Malaysia will face surplus of doctors. The main problem is not enough training hospitals. Malaysia still uses the UK system, which is actually one of the best in the world. The housemanship, the compulsory service and all that.
Russia has the doctor-patient ratio of 1 to 230, the 4th lowest in the world. Nizhniy Novgorod, which has the population almost as same as Kuala Lumpur, has 53 hospitals! (I kid you not). I guess the socialist medicine can still give Russian doctors something to do.
Malaysian doctors are exposed to many areas of medicine after graduation, which is really good actually. A Malaysian cardiology specialist would still know how to conduct birth, a Malaysian pediatrician knows how to make a simple appendectomy.
A Russian cardiologist would probably know very little about Mullerian duct and the Russian surgeons know nothing about the limbic system. The same goes for the US doctors after passing the USMLE. After med school, they choose specialties right away. All the rotations they did in med school, well, bye-bye.
In a few more years, houseman placement is going to be a problem, even Borneo will be crowded. It’s either provide more training hospitals or emulate US/Russian system.
In US and Russia, instead of crowding housemen/interns only in medical, surgical, O&G, pediatrics, A&E and orthopedics departments, they can be accommodated in anesthesia, ophthalmology, dermatology, ENT, radiology, psychiatry etc etc etc based on the specialties they like. If they think the specialty isn’t right for them, they can rotate until they find the right one.
Of course there are lots of money needed to spend to train from housemanship to specialist. But we do need more specialists, don’t we?
I really don’t know what are the implications if Malaysia switches from the UK system to the US/Russian system of medical training though. It’s probably going to be a very messy disaster. I am no expert. At least this kind of system can accommodate a lot of medical graduates.
Well, since the minister said there won’t be any surplus, we can stick to the status quo.