After a couple of months working, I still have culture shock. Firstly is everything has to be written down, secondly, if you can’t manage it, always refer, refer and refer. A patient with poorly controlled BP in surgical ward must not be managed by surgical MOs, they have to be managed by medical MOs.
Even when refering (calling to the MO), HOs must record in patient’s file. Sometimes, if the medical MO doesn’t answer, we have to write down “called Dr. Siti Medical MO three times, went to voicemail” or something like “Dr. Abu said COAD is not medical’s case, he refused to see, must refer to IPR (Institut Perubatan Respiratori)”. Sometimes the patient’s file becomes a gossip documentation anyway, but better save our ass first because in Malaysia everything has to be done in writing.
MOs are sometimes stupid lazy asses, they’re not keen on seeing patients. Maybe it’s just the place where I work. I did call MOs of the other hospitals to refer or transfer out patients for further management, they’re much nicer and willing to see the patients.
Competent or not
Then comes the question whether HOs nowadays are competent or not. It’s a known fact that HOs nowadays are not as tough as HOs of the past. I have to honestly say that Russian/Ukrainian are the most incompetent ones as the first posters, but once they went thru several postings, they become skilled and competent.
Once we start work as HO, we start from zero, be it local, Russian/Ukrainian or Indonesian graduates. But knowledge and skills will develop with experience as we go thru postings, only ATTITUDE that matters now.
Compared to the West, our MOs are more skilled and independent. Malaysian MOs do more appendectomies and amputations than the specialists in countries like Australia, UK and Singapore. That is why those countries are really eyeing on Malaysian young docs, because our torturous training force us to learn to be independent thus we become highly skilled. Even the Masters program in Malaysia are far more difficult than MRCS, FRCS and whatnots.
The gazettement for specialists who did their Masters program in Malaysia is only 6 months compared to those who did overseas (2 years). The overseas specialists claim that they are trained in prestigious institutions and become specialists at very very young age, but are they as skilled? Probably all they got to do over there is assist to hold retractors only while their counterparts in Malaysia are already cutting limbs off. Probably they got to assist to do CVP Line when HOs in Malaysia are doing every week. How prestigious indeed! 🙂