Stresses of being a Houseman in Malaysia

When I was in med school a year ago, I’d say “nahh, I’d survive housemanship, it’s not that hard… Hurdles? Bring it on!” But now that I am in the middle of HO posting, I feel like “enough laaaa…”

So what stresses a houseman?

1. The working hours – All HOs are required to work from 7am till 5pm, if the HO is oncall, the HO must stay in at night till the next day’s 5pm. HOs work 34-40 hours straight. In med school, I didn’t think this should be a problem for me because I am young and I am strong. But imagine doing this in 2 years of housemanship, or if you still wanna continue being a doctor, for the rest of your life till you retire. Just imagine the awesome tiredness. You’ll get old and weak faster than you think!

2. The tagging – Tagging is for department’s newcomers. Usually tagging is about 1-2 weeks. But I have heard people tagging for 2 months. Imagine tagging from 7am till 10pm everyday for 2 months, without weekend off.

3. The oncalls – This isn’t a big problem for me because I am able to sleep about 4 hours whenever I am on-call and I am quite the “anti-jonah” aka not a patient magnet (means not many admissions or problems whenever I am on-call). But imagine you jonah (many admissions when you on-call) with never-ending work and no time to sleep, some more have to do EOD (every other day) calls. Plus have to go back at 5pm the next day after on-call. In other hospitals there is such thing as pm off, but not in the hospital I work in 😦

4. The workload – It’s very tedious. I don’t mind the basic procedures (chest tube, CVP line, LP etc) because that is what we have to learn to do. We HOs actually spend little time clinically but more time on writing and documentations. It is as if we are treating the papers more than the patients. No wonder patients only see doctors writing and poking their veins only. Not to mention the whole documentations for clerking, reviews, referrals, drug prescriptions, discharge summaries etc. Some more the nurses will bug us HOs to sign bureaucratic this and bureaucratic that. To be fair, the HOs few years ago were more overloaded with work that they didn’t have time for lunch, toilet or go home on time.

5. The social life – Read back all the abovementioned stress factors (the working hours, the tagging, the oncalls and the workloads). Do you think you’d have a social life or spend time with family? In hospitals where consultants keep harping on that houseman are too many like in my hospital (400 HOs, thank you!), we do have a little bit of free time. Imagine Sibu Hospital where they only have 7 HOs in one department…

6. The bosses – MOs, specialists and consultants have their own characters and personalities. Some HOs think this boss is “baik”, some think this boss is “cibai”. It’s all subjective to one’s perspective. In the end, they’re still the boss and whatever orders they give, the HOs must carry them out, else trouble awaits. Yes, some of them yell at the HOs (it’s true what the media says). Who isn’t feeling “bengang” when we are yelled at? Of course we do, but we cannot yell back because firstly they are the boss and secondly they’re quite right. It is somewhat true that is how we learn (from the yelling and humiliation) for the next 2 years of housemanship. But imagine the stress.

7. The nurses – This depends on the nurses you work with. I have worked with the good and the bad ones. The good ones help HOs in a lot of things, I did even learn from them. If the nurses are in bad terms with a HO, they will screw the HO hard enough that they will bug the HO to sign all the bureaucratic shits sheets, else they’d report to the sister and sister will report to head of department. Some more during oncall, they’d wake you up at 3 am in the morning in the middle of your sleep just to set a line. I am still convinced the nurse deliberately took off the line just so that I’d set it up again while I was still drowsy. Don’t play with the nurses. They rule the ward. The HOs are far to the bottom of the food chain.

8. The colleagues – this is quite a headache especially for the houseman monitor who does the on-call roster. Some HOs don’t want to on-call this day or that day, especially weekends. It’s quite unfair that other HOs do on-calls on weekends while one or two refuse to do so. Some of HOs take EL (emergency leave) or abscond without informing (for me it’s fine if they wanna go anywhere, but just finish the work and inform lah…) ending up the other HOs have to do his or her job. I don’t mind the slow and incompetent, but I do mind the attitude.

9. The patients – there are some who have poor compliance, there are some who demand many things including AOR (at own risk) discharge, there are some who think they are doctors and say “why not you do like this, you do like that”, there are some who yell and criticize the doctors. There are some with all the things mentioned. And sadly, we still have to treat these people, with passion. Ergh!

10. The assessments – Actually I think it’s weird that a working adult still has to sit for exam. As for HOs, there are at least 2 assessments for every posting. The specialist wants HOs to know in and out of the topic discussed. The stressful part is that when you approach a specialist and got an appointment for assessment, suddenly the specialists cancel at the last minute and postpone to a later date. Furthermore, they will keep postponing the assessments. Imagine you study so hard a few days before with all the hopes to pass the assessment, only to know that the specialist keeps on postponing the assessment. That is the never ending stress. If HOs fail the assessment, they will be extended for another 3 months in that department. That is just for one department, mind you. The housemanship of 2 years is already long enough, adding another 3 months per department is just stressfully demotivating.

11. The breaks – Each department grants 8 days of break in a 4-months posting. Even if a HO is extended till 7 months, the break is still 8 days. Imagine having to work everyday, only to have average of 2 days off in a month (average one day off in a month if extended). Some departments are not so easy to get day off. Don’t ever think you don’t need a break because you really do. Especially if family matters come up or suddenly you got sick.

12. The others – working in a big city like me, other stress factors also count ie the traffic jam, no parking, expensive cost of living, unfriendly people of the city etc.

So, for all the doctors-wannabe, you still wanna be a doctor?

P/S: I am currently finishing my second posting (pediatric) and will move on to third posting (medical) starting tomorrow. Life will be busier, but I am enjoying housemanship despite the stress πŸ˜›

57 thoughts on “Stresses of being a Houseman in Malaysia

  1. hey, all true about stress.

    a lot of people should be thankful to get a 8 – 5 job. I’m in kuching and work starts as early as 6am (depending on patients) and usually finish at 6pm. when it gets busy, sometimes until 8pm – even though we have also about 400+ housemen in Sarawak GH.

    nice sharing and all the best in medical, its one of the most educational posting you’ll ever get.

    • reubangoh..

      well dont say..the flexible hours..havent they implemented it there in on purpose all in the tretence of teaching that it has been not implimented..only particular dept..what are they wanting to teach a already over worked houseman..God knows..from 6 am..till 11 sometime till 12.30am..they intend to teach us..genious arent they?..i think somebody up there truelly has to do his job we have entrusted him to do so..coz he is all comfortable just talking through his nose about quality in housemanship..lets see..will the strain one goes..beyond humanlly possible way..he expects quality..well lets see who in one one od us takes his place someday and make it a safe working paarameters for houseman..

      we are treading on soft terrain..but courage and character..will get one somewhere..dont you think the corrupted system should change?..

  2. Hello. πŸ™‚
    I’m a future medic student. Will enroll in Meds school this coming july insyaAllah. I’ve been reading your blog.
    Just wondering, after all those experience you’ve been thru as a houseman, if u are given a choice to change jobs, would u stay as a doctor or go to other field? Just wondering. πŸ™‚

  3. I’m on my way for the next year H.O. Quite scary after heard all the ‘tingle’ news. May I know where do u practicing your H.O?

  4. if all above u mentioned are happen at ur time, couldn’t imagine how about mine next.. it really scary to enter HO life. not to forget how my life gonna be as becoming doctor soon. i’m really enjoying my life as med student right now, & not sure am i still can enjoying my life as entering those HO time..

    just wondering question u asked to all the doctors-wannabe like me…

  5. Reading to this post already make me tired…Such a tough but noble job…Well done…

    But I like the environment in the hospital, after watched “Grey’s Anatomy”. A nice serial drama for you guys to see the life as a doctor…

  6. Everyone goes through the same thing, nothing special about you. Your MOs, specialists and consultants went through the same process. If you want changes, it starts with you. When you beome a MO, you make change.

  7. i’m a 6th poster and this is my last posting (A&E)
    i get through all other postings without any problem.
    for the 1st time in my life….i absconded from work today after being extend tagging for another 2 days bcoz i failed the assessment.
    damn i’m sooooo tired to tag.
    i feel so down, very sad, tired, and depressed rite now.
    i hate this feeling. can someone help me!!

    • Extend tagging 2days only n u abscond work? they dont extend u for 3 months isnt it? Arent u supposed to be a role model to ppl like me bcoz u r almost MO?

      • i must be stupid. but it sucks when u have to tag from 7.30am – 10pm for 1 week with non-stop patient and only few doctors. i didnt even get cuti for raya eventhough there are 2 other non muslims taggers.
        i have no life at all for the past 1 week and this specialist ask me to tag 2 more days!!! WTH
        sometimes i feel i should change my profession….

    • Yeah, I did da same!..I know how da feeling is, even 2 dayz is a lot 2 ask 4!..I got in2 sum trouble but I was right back on da horse da next day!..sum alone time really helps da mind n soothes da soul!

  8. salam.
    your blog is very entertaining πŸ™‚
    im currently in my 6th year of service and i can truly relate to all the stuff that you are going thru.
    all i can say is that things may not get better when you become an MO.
    suddenly you are the front liner. You must make decisions and you are accountable for actions that you take, of course you can consult the specialist but you can’t be calling them every second of the night. I think as an MO the ‘physical stress’ is a bit lesser but the mental stress is 10x amplified when you realize that at that split second , what you do can either save or kill a patient.
    My worry for the current batch of HOs is that i feel they do not get to deal with paients very much becoz as you rightly mentioned previously , HOs are bogged down with paperwork and trivial stuff.

    I would advice the following for junior Drs -:
    1. Pray to Allah for patience and strength to get thru – it will give you peace and maintain your sanity
    2. Betulkan niat – try to think of it as your jihad and not so much ‘work’. On very bust days i will imagine that i am in the war zones of bosnia or palestine and be thankful that at least there r no bullets whizzing pass your face
    3. Have a good attitude – don’t abscond , clerk case ala – kadar or leave your work unfinished. It is very childish and unfair to your co workers. Learn to have good team work, When you have good rapport , you frens can ‘cover’ you if you have to rest for awhile and they may even be willing to help you with your duties.
    4. Try to have a good relationship with the senior nurse , team leader , sister , matron ect. This people can greatly influence your work environment. Just have patience and remember that one day , you will be more superior that your ‘tormenters’. They know this and some of them do feel jealous of Drs. You earn more and they know that you will always be ahead of them even though you are younger and less experienced. On the plus side, they can also teach you alot of things that you didn’t learn in med school.
    5.Try to talk to examine patients as much as possible even tho your MO or specialist have seen them. You will remember cases better and have an appreceiation of what is normal or abnormal.
    6. Increase your knowledge – read , read , read : with more knowledge you will be pleasantly surprised that work wil be more enjoyable
    7. Dress well and speak in a confident and manner – Be humble but let the nurses know who’s boss. Your superiors will also pick on you less. Trust me , when you don’t appear confident , it gives your superiors the aura that you don’t know what’s going on we’ll start to focus on you.
    8. Ask questions – before you realize it you will be an MO shipped off to some pendalaman and you have to survive.

    OK, all the best to you guys.
    Ps – doakan saya nak exam minggu depan πŸ™‚

    – MO kanak kanak

      • salam.very good advices…ive beeen through a hard time..just because the complaints from pt’s relatives, & it cost me my carreer..they dont even know how we work..the only thing they know is pt’s always right. then,what’s our right??…we keep smiling upon scolding,we keep standing even other people tried to bring us down, we sacrifice everything just to improve the health system but yet they still complaining…are we human being or a robot?

  9. thank you for setting up things straight! . It very good that you have your own reflection of being a housemenship so that in the near future when you become MO, you’ll be considerate and empathy for you HO colleague.

  10. It is nice to hear from you about life as a houseman. If you have the appropriate attitude and your action is safe, I think you will be allright. The current problem is that some of the houseman are not interested in their work and do not know anything about their patients. Some are very irresponsible and leave the work for other people to complete. Just imagine that these people will be the doctors that are treating some of us in future. Our priority when training these houseman remains to be able to ensure them to be safe and competence. Safety is still the major issue. Some of these drs are downright not safe and will become dangerous to patients in future.

  11. What a great post and awesome blog in general! Enjoyed reading this so much. Thx heaps πŸ™‚
    -Soon to be houseman in 5-6 months time.

    *scared stiff*

  12. Really helpful article!!it was a long list of sad truth!! πŸ™‚ I’m gonna be a houseman in a couple of months..was wondering if some of the senior doctors can shed some light…is it better to apply for HOship in KL or outside KL ?? I am from KL by the way… thanks in advance!

  13. Another victim has fallen… More to come… Today our health ministry put the blame on the HO himself by saying that … there are no pressure on HO and this is a drug abuse case.. Whatever they say.. Well this is not the first case and will not be the last… Everyday there are HO’s going depressed, having thoughts of suicide, involving in road accidents due to lack of sleep, fatigues.. etc. Solution – Flexi hours.. yes .. well not every hospital HOD agree with that. Some are just so called flexi hours. All are just political gimmicks. When will this Government will understand its not about the real work but it is the working environment and the hospital administration is the cause. How many victim had to fall before someone makes some real changes. Every minute and every decision made by the government only resulted in taking more victims to the grave. Why this doesn’t happen in other countries? We could just look into our neighbors for an example. Nope they are just fine. Then what’s wrong here. Housemanship for 2 years was just implemented recently guys.. not long ago. Since then a lot of problems emerged.. No body realize that, in fact. Think about every aspect of this problem. Do not see only from one side only. Why a ‘happy’ HO can suddenly …. Well, whatever it is we just lost another colleague today.. We take a moment of silence for him ……………. Rest in peace now. For the other slaves (HO)… lets get on as if nothing has happened… Sorry for being sarcastic….

  14. truly agree wif ‘fellow houseman’…it is not easy to undergo this stress…of course every job has stress…but being a houseman n handling the stress is far more different n a houseman too…recently joined,2months ago..ive no idea how many times i hv visited da psychiatrist.working non stop,walking non stop, n having various thoughts non stop r da only daily routines ive been goin tru…its very easy to say ‘be friendly to all the nurses,staffs n etc,work hard, read all the time n etc’…but to put it into practice is a big senior HO once told me ‘we r not treated as doctors but ‘dog-ters’ y?i was just fine when i did internship in my medical school (indonesia)..i have worked 36 hours non stop too..but y am i breaking dwn in every corner during houseman?its because we hv got nooo space to breathe!! we dnt mind working hard but give us rest!we dnt mind reading after a long hard work but give us the time! we dont mind following instructions but give us respect! flexi hours is just an order of implementation.but in reality,is this system being carried out as per the order?if we r oncall tonite,is it true that we dnt hv to come in the morning n can have a pre-oncall break?nooooo!! not in all places!!
    houseman prob is not gona be solved.i have given a 100 thoughts abt quitting,but i hv invested 6 long yrs! and we all shud understand,being treated like this is da main reason y most doctors r migrating frm our country n also y most medical students choose to do internship in european countries!better respect n better prospects.
    thngs shud chnge…at least for the betterment of future health of the public.
    sorry if i said somethng outta emotions!

  15. hi there..its nice to know that you have penned down some troubling issues houseman’s are facing as i am penning down my thoughts..

    i personally am facing distress at my work place..its not easy to put up with pressure that we all face as you have mentioned earlier..but more than that just standing for what is right will leave one singled out and placed as an target where you are threatened and abused verbally in front of your workmates leaving you your workmates do not want to seen with in fear for themselves..i dont need to ellobrate..i am pretty sure you know what i mean..

    standing for what is right..what do you think that we are not served with justice?..that’s because there is no unity among the houseman and that we fail to realize..i have been through enough challenges defending my rights as a houseman..which i will do till justice is served..

    no one has the right to take one’s individuality away..KKM has to stop pampering the speacialist placed as HOD’s as they are not all qualified to be one..KKM preaches about standards for houseman and even went on to increase they year of training for what way did it bring quality..those who served a year in training..are they thoroughly well lets keep that issue away..back to where i was..why is it only the houseman that is thought to be the black sheep? the DG and the health minister trying to say that the speacialist are all supreme beings?..they dont make human errors?..why the issues faced because of them are not addressed? come they have not been corrected..why are they still in safe heaven..

    the man that i admire and will go admiring will be our former health minister Datuk
    Chua Joon Ming.. a man with true insight and new what standards to apply to create a better future for doctors..current minister is only seen penalizing houseman for no reason..our training 4 months..we endure every thing one could not imagine outside from the realm of medicine..then comes politics..likes and dislikes..scrunity all in the name of extension..and that goes down our one endures extension from a particular dept..but no it just doesn’t stop there..before the houseman can reach the other has traveled..gossips of HOD..then there is another hurdle..and its a stigma that will you this what is DG doing?..houseman just labelled as stressed and depressed..due to whom is the issue..why has it not been addressed..speacialist..tell me that there is one perfect one that has not made a mistake medically and as a human..even if they do they get off the hook very easily..

    we all thrive to be a good competent doctors..i know just like there are worst human being adorned with title as speacialists and HOD’s there are roses among the thorns..true proffesional that one could look to and get inspiration from..countable ones..that doesn’t mean we houseman are perfect too..some of us are to blamed..i’m speaking for the real affected ones..suicide..never adressed..covered with blames hurdled on the deceased as depressed..suicidal..its actually murder..driving one to pint of death is murder..and its a cover up..i tell whoever who is reading not think standing for what you beleive will not get you will surely come..make those who cause you those pain pay..its a long process..KKM is slow..DG has to please the speacialist..push him…we have right as human’s and it is being violated..dont bend in..just day you will be taking their will need character..let this time be a character building time..i dont blame those who are afraid..but just know..whats goes around always comes will have to make stand..

    houseman..stand for all..then all will stand for you..God Bless my fellow houseman’s..

    • Very very well said..I used to be such a jovial person back then..but ever since ho began,I thnk I’ve never given much work to my facial muscles coz I hardly laugh/smile..wen I speak this out esply to someone relevant to da field,all I get is. ‘Oh its ok.ho is depressing n wil be the hardest part or ur life..just go tru it’ ..or when I say I wana quit,they say ‘ no way..u cnt do anythg wif ur medical degree until u complete ur ho’..I dnt knw wic part of ‘I wana quit’ they dnt understnd.I agree,I was forced to do medicine.its been a pride for our elder ones wen their children become a one bothers wats da actual ambition they dream to do..likewise is my story.its quite common among doctors.wen I finishd my medical sch,I had thoughts of pursuing into masters (in non clinical subjects) n enter lecturing.I tot its stil not to late to be wat I might hv been..then everyone started saying ‘oh no,u hv done ur medical degree for 6yrs..dnt waste it..practice it,later u cn bcm lecturer’…I just dnt get da point.I dnt wana practice medicine,so wats da point of doin ho??plus I wana leave tis country within few yrs time?then y ho?? Just to get a place in da local uni?2 yrs of ho,2 years of m.o then another 2 yrs of postgrad..6 yrs of long cycle to end up in lecturing??oh pls,I’m a woman..I cnt bear to spend so many yrs doin this wen I knw I dnt wana practice it tats da reason I wana quit..I rather quit ho than quitting my life..I understand 1 thng clearly..this job doesn’t need good grades.any tom dick or harry can b a dr..but it needs passion n true having that,any hurdle or hardship during ho can b faced.I dnt hv that passion bcz I hv never loved it…so hardship wil seem like a hell-full dead end to fellow students,decide with all ur heart..u wana b a dr,make sure its ur interest n make sure u hv passion for da job..if no,dnttt everr give a ur years by doin wat u like.

      • I feel you. May I knw what ure doing atm? Im searching for plan b c d.. currently stl a ho. And its killing me softly.

      • @broken houseman
        Im in the same boat like u.never liked medicine.planning to be pursue non clinical once im finish ho but the things is now im in2nd posting,i know that i never really can endure another 1 year and 8 sucks and basically dragging my leg to go to work.can i know did u finally be a lecturer ,how did u do it?do u apply for master programme coz everywhere i look u must have fully registation with mmc before u will be accepted to master programme.can you enlighten me?

  16. broken houseman.. god just know what d best 4 u.. keep moving.. theres benefit behind everything we do.. when u had an ‘enough’ practical n ‘experience’, when d time u bcome a lecturer, then at least u have a lot thing to story n teach ur student.. then u will bcome a more respectable lecturer.. got it?? people always believe who had d experience in that labour.. so u had had it.. u must feel proud of it.. there’s no success in this world with laziness n who act to be nothing..

    • husnul….that is really a convincing reply…but really,not many will be as supportive as u said…in fact,my own relatives started to look dwn wen i took a decision not to continue ho.whatever,they were not there during my medical,i dnt wana consider their views in any aspect of my life…thanks for spending some encouraging words to reply me.hope u succeed as a good dr.just hold the passion for the job.ultimately u will! πŸ™‚

      • U won’t believe it but I did quit once n I’m back dng da whole routine all over again!..I signed a deal with da devil dis time..LOL..but I’m preparing 2 leave Malaysia 4 Australia whilst dng housemanship, I don’t plan 2 complete or cum back till i a specialist!

  17. Hey thanks for the blog, it helped me to prepare mentally, just a question, if i am attached with another aspiring houseman, is it possible to be sent to the same hospital as her? is there a way to appeal?

  18. I just want to ask your going to start my HOship during this coming fasting family keeps on telling me to defer the offer..should i just agree with them or start my HOship so that i won’t be finishing my HOship late?

  19. so for example i finished graduate at taylor’s,, and i want to choose to undergo housemanship at kuching general hospital,sarawak as it is my state. but is it possible?

  20. Hello, about to report in as a HO this coming monday πŸ™‚
    hope im strong enough to survive it. Nice blog & all the best to you

  21. Im doing my 3rd posting, in medical currently in one of the klang valley hospital..our hospital facing shortage of ho for the past 1 year..imagine there are 6 to 8 ho in a ward before this and now only 1 to 2 ho per ward..the comments u hv posted in this blog are absolutely right. My department 3 shift jus started 2 weeks ago..previously od shift from 6 am to 7pm however we back home 10pm some even 12am due to workload. I used to skip my lunch n my dinner almoz everyday..n now im having severe gastritis. .the presurre from superiors, nurses, patients is above our expectations. .although the tds shift system jz started we still working extra 3 to 5 hours. Ho never appreciated by superiors no matter how good u are, only getting scolded. .I hv few friends did their few housemenship posting in uk and they said the superiors there is totally different than here, the working environment is not stressful n they can go back on time, basically what my friends told me is they enjoyed their housemenship there plus with adequate knowledge they gained.. n y in malaysia (not all the hospital) still practising the old system..I feel like im doing slavemenship rather than housemenship.. finally some of the housemen ending up in psychiatric problem and gastritis, kidney stones etc ..need changes in malaysian housemenship system..I hope the government will do something about this..

  22. my friend is still on HO phase. he always told me that he cannot get enough sleep. then, f he has free time he can get to sleep. im so worried about him . can u suggest to me what do u do to tolerate with all kinds of stressor? how do u manage with ur sleeping cycle? i think most of HO dr have problems with sleep right?

  23. Thanks for really good experience. Hope every level of management read through these experience. The experience given give choice for us to adapt and restore good management of work. It may take time , but every level of management try to restore good effort without prejudice for others. Hope the system will be matured

  24. I’m graduating soon.Can someone suggest which hospital is the best to do my housemanship?Currently i’m in dilemma not sure where to do my HO.some seniors of mine suggesting me to do in Sarawak.Some saying it is too stress to do in sabah/sarawak.Can someone suggest me where will it be like stress free to do my HO?

  25. Dear Sir / Madam

    Please consider circulating this opinion, the aim is to inform people , and hopefully enable them to carefully consider medical studies

    Recently the news has reported that malaysia currently has too many private medical colleges, too many
    young doctors..

    Many new medical graduates now will have to wait many months , sometimes up to a year
    before they will get a contract housemanship job .

    Housemanship jobs will be given on contract for 3 years and then , subject to satisfactory completion of
    housemanship the young doctor , may get a 2 year contract to do the 2 years compulsory service which is required
    for full MMC registration,

    Unlike previously , permanent employment with the govt & the ministry will not be guaranteed, but based on
    performance appraisals , reports, and reccomendations by the DG Ministry of health

    Recently 1000 of 5000, housemen have been reported to, not complete their housemanship , going missing in action
    because, they were not interested in medicine but were forced to study by their parents, disillusioned by the hard work,
    long hours, because they couldn’t handle the stress of a medical job, as well as the the scolding from their seniors

    Also it has been reported that of those who finally complete their housemanship, about 30 % have repeat a posting
    or get an extension because of unsatisfactory performance

    In addition , the keen competition, low prospect of being able to specialise (only about 5-10%), limited prospects of
    private general practice ( recently reported widespread gp clinic difficulties and closures),and the hignly likely
    prospect of unemployment, or underemployment or or employment in a different /lower professional level or
    in a different industry , individuals wishing to study medicine shoulder consider

    1 Are you brilliant- as the health care industry is knowledge based, values problem solving a, requires innovation and improvisation
    the average individual could survive in the past , but may find difficulty nowadays, as only the fittest survive.
    The average person may take longer to learn, be more often scolded, victimised, sidelined , stressed out, burnt out

    2 Can you cope with dissappointment Are you a kind , compassionate character willing to help the troubled,
    willing to work for next to nothing , ready to to give the needy a free meal wnen? where required

    3 Is there a back up plan- eg willing to accept a lower status job , help work in a family buisness

    4 Never, Never , Never take a big loan to pay high fees you cannot afford , This is stressful , painful and cruel to your family,
    good potential ,brilliant people have had to abandon specialist training because of socioeconomic reasons

    5 Do not be misled by education agents , Make sure , make sure that your qualification will be recognised, in the
    country you wish to work in and you will qualify for residence requirements , and that you have a realistically, a
    reasonable chance of being given a chance to get medical officer position

    6 Choose a medical college which/ with
    -reasonable fees, not for profit, run by established local Malaysian organisations eg UTAR, AMIST, Mannipal, IMU,Monash
    – a substantial faculty, with many experienced , staff members with full time appointments,

    7 Do not , Do not make the big , big mistake , Do not choose any medical college with/which
    – expensive fees , twinning programes linked to colleges overseas , or having preclicinal teaching overseas,
    – advertise , advertise excessively as excessive advertising chews up resources better used for teaching facilities eg library ,
    – charge fees of RM 500,000-00 but do not inform that the real cost , inclusive of the living expenses is about RM 1,200,000-00

    8 If in spite of the difficulties and difficult uncertain future of a medical career, you wish to study medicine then consider,
    a medical college with
    reasonable costs 250k – 350k
    recognised by Malaysian Medical Council
    full time academic staff , who have substantial track records in clinical service, teaching , research and publication

    9 Do not pay excessive amounts for medical college fees hoping that their degree is internationally recognised as claimed in adverts
    because the country you wish to get a job in may
    a) change the recognition , ie cease/ stop recognition of the degree in future eg as happened to one medical college
    b) not have a vacancy for a position at your stage of medical career , when you require one
    c) may only consider international medical graduates for temporary remote , rural jobs after which they need to pass difficult exams
    d) may only consider international medical graduates who qualify for permanent residence or citizenship

    10 Do not study medicine
    to emigrate
    become rich

    11 If a real internationally recognised programe desired , do the IMU partner medical school programe. Recently someone, graduated
    from a New Zweland University, through the IMU partner medical school [rograme, He could not get a housemanship job in NZ , but got
    one in S’Pore,

    Please feel free to edit or publish, Thank You

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