Surplus of houseman?


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.

10 thoughts on “Surplus of houseman?

  1. what are the major factors that influence a person’s health? lifestyle, the environment and genetics. Doctors help by ‘soothing’ the after-effects of these factors. so. the more we progress, the more our health suffers and the more doctors we need to handle this problem. in other words, the increase of healthcare personnel is positively correlated to development. so it’s good that we have a substantial amount of doctors!

  2. ni mama- don’t worry 2012 memang no of doctors will saturate but specialist yang tak cukup. Perlu ramai specialist lagi. No worries, banyak area or specialiasation are needed. Setakat training grounds biasalah semua tempat ada masalah.

  3. surplus of housemen….it’s true..
    department of medicine in Queen Elizabeth Hospital, Kota Kinabalu has 50 housemen..hospital likas, KK has 70 housemen doing O and G posting..

    the day when i was a housemen looking after 20 patients alone is over…

  4. Lets not knee-jerk reflex this issue. What we have right now are only sentiments. None of Dr Hsu’s views are backed by hard facts. Neither does the statement of saturation of doctors in Malaysia by 2015. In the current situation, we do see a housemen sometimes even outnumbering the patients. But remember, the first batch of the 2-year program has yet to leave the program. So in the last 1 year or so, there have been no new MOs appointed other than those who have worked abroad and are coming back, which number is almost negligible.

    Come June when the first batch of the 2-year program finishes their training, the number of housemen will stabilize. Newer hospitals are now excepting housemen. Hospital Kemaman is the latest on the list.

    Once there is a steady flow of housemen in AND out of the training program, and more hospitals being opened for housemen, this problem will slowly resolve.

    Take my situation. I’m one of the 28 pioneering housemen in Hospital Sandakan. Yes. 28 housemen in the whole hospital. The bed strength and population here is comparable to Batu Pahat, which hospital sees 20 or so housemen per department. So, yes, we are still seeing breed of housemen needing to look after 20 patients everyday.

    In my opinion, the current training program is perfect if the person (the houseman) himself/herself takes it seriously. Having to go through all the postings is essential. To at least know something of everything is important. No need to fast track specialists. Bad base builds bad buildings. In face, in the long run, this reduces the cost of health care (but this is another long and different topic altogether).

    So relax. Take a seat. Give it sometime. We rise in uproar every time the government flips after it flopped. Aren’t we doing the same here by wanting change after change?

    p.s: If overcrowding is your concern, apply to work in places like Sibu, Miri, Sandakan, Kulim, Kemaman, Kangar (you get the drift). No point discussing this issue if you go through your contacts to find a big, thick cable to get you to ‘atas’ places like Putrajaya, Selayang, Serdang, HSA, HSI, Penang when applying with Ministry of Health. All the best, buddy.

    • Azman (not sure if you will read this), just out of curiosity, do you still find Dr Hsu’s comment baseless? Malaysia now has over 30 medical schools and many are studying overseas, we will have 5000 to 6000 grads per year with only ?800 to 1000 master training program seats available.

  5. u russian grads should not be given housemanship spots over better quality medical graduates from US,Cananda,UK,Australia,Ireland,New Zealand and of course our own local grads

    • Bring it up to DG… Not my problem.
      Maybe we’ll start a referndum doctors who discriminate russian graduates will have their license revoked

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