Wednesday, May 27, 2009

Why treat houseman shabbily? - a reply to R.K.S.

I'll like to respond to a letter in The Star:

Why treat housemen shabbily?

THERE has been so much hype on the tough life a houseman faces.

As a parent of a final-year student, l totally agree how depressing it can be for young housemen just graduated after a gruelling five to six years of study – and not all are government sponsored – to be treated so shabbily that they would want to leave the service, no thanks to the system.

Even as final-year students, they are sent to hospitals and are kept on their toes for anything between 10 and 12 hours a day without a weekend off.

How do you expect them to study with the exams around the corner? Mind you, most students already decide to leave as soon as they graduate.

To make matters worse, the consultant comes in and verbally abuses those poor housemen who have been in the hospital for over 24 to 40 hours.

They are even called “stupid” and “donkey” in front of their patients!

It is really absurd to be made to work continuously in the most inhuman manner, depriving them of sleep and rest.

What irks me most is why aren’t housemen subjected to the same labour laws of the country as other civil servants – eight hours of work and overtime to be paid for on-call duty and a rest day in between calls?

Why is it so difficult for us to follow the foreign practice in which housemanship is for one year and subsequently, the houseman can decide whether he or she wants to continue or leave the service.

Come on, doctors need a life too!

Bidor, Perak.


Dear R.K.S,

Speaking from the point of view of a final year student, I think final year students are expected to performed almost like a doctor, perhaps the reason why they were sent to hospital for 10-12 hours each day. It gives them early exposure of what they will be facing during housemanship, therefore, they will not get a ‘cultural shock’ when they step into the working environment. I am not too sure about your son/daughter, but from where I was trained (UKM-University Kebangsaan Malaysia/National University of Malaysia) we were even expected to be oncalls. In my opinion, it is worth it, to attend these calls, when there are consultants to teach us during these calls. In fact, I enjoyed on-calls very much, as we get to see many cases at night, and we get to learn a lot more. Especially during O&G (obstetric & gynaecology) where we do Labour room calls...The thing is, medical school is very much different from high school, or other courses, perhaps. The knowledge and skills we need to obtain, are not merely from textbooks per se. Ward works, clinics, theaters, clerking patients, case presentations, are very important too. I guess many students would agree that they preferred their clinical years to pre-clinical years.

About verbal abuse, do bear in mind that not all consultants are like that. I have seen consultants who give compliments and encouragements to students and housemen. I believed that consultants/ MO should be more careful in their choice of vocabulary, especially when addressing other doctors as they are all colleagues. I had once had my share of embarrassment, when my friends and I were called ‘brainless’ during my medical school years, but I guess, we deserved that, as we just started our posting and had very little knowledge at that time, being third years. I was indeed motivated to work harder and prove myself. But that was being a student. However, I guess, for the doctors, and the house officers, surely, they deserved more respect.

The working hours, I must agree, is crazy. Sometimes, to think of it, would you want to be treated by a doctor who had back to back calls? a doctor who had not been sleeping well for the past 48 hours? That thought itself is scary I suppose. It comes back again, to our health system. The government trained many doctors yearly, sent many overseas, yet there were never enough housemen. It is about time they ask the question – WHY? A huge proportion of the people chose to do their housemanship overseas, get their post graduate degree and return to out country as specialist. Some perhaps, never return. Why you may ask? The answers are very obvious, other country offers more.

You know, when compared the salary of house officers in Malaysia to other countries in Asia, Malaysia ranked third from the bottom, following Indonesia and the Philippines. Housemen in Korea is earning 6 times more the salary than those in Malaysia.

Today, we even have patients complaining about doctors... sometimes, they forgot that, doctors are humans too! and yet, they really need encouragements from time to time, and they too need acknowledgements, appreciations... very much indeed... to boost them on, help them get by...

You know, if the conditions is not that bad… and the pay is more or less the same, and opportunities for a postgraduate program good, I am sure that many doctors will opt to stay in our country… thus more doctors, less workload, less stress, happier doctors, happier superiors,.. see the cycle? I hope the people up there will put some thoughts into it… and i hope that more and more doctor would opt to stay back and serve the rakyat... together, we can make a difference...

Yours sincerely,

shinyin WU


  1. send to thestar, nst, nanyang , whatever newspaper in msia.

  2. hey this is a very good post, shinyin.

    i must admit, my parents sent me to overseas to continue my medical studies coz they foresaw better opportunities there. and since they had already spent alot of money on me, i had no choice but to heed their advice to continue work here after graduation as a way to make up for the money they spent on me (coz the pay and conditions here is much better!!)

    but to be honest, if the working conditions, pay and postgraduate opportunities in msia are much better, i really wouldnt mind coming back to work since i miss malaysia very much...

    sigh i wonder if that day would ever come, with a government like this.

  3. Yaya..should send to TheStar as part of the reply.

  4. Wooo..a strong statement from Shinyin....but good to see your opine on the matter

  5. hey shinyin.. well that's a very noble! and I highly respect you for that. Stay strong beb! :)

    Rant all you need, the grossly misinformed public needs to know a bit more about the medical society.

  6. Many things must be questioned when it comes to medical education its environment in Malaysia.

    I have never had more than 2 months in terms of experience in a Malaysian hospital but I have friends and relatives who have been in the system for very long periods.

    It seems to me that many of the degrading things done by superiors in the malaysian hospital setting are just unnecessary and very counter productive. To address the reply above about third year medical students being called 'brainless' for example; it just shows how unprofessional that person was for saying that to medical students. Did they expect first timers in hospital to have clinical knowledge similar to professionals who have gained experience first hand through work? And to reinforce what was stated above, knowing the contents of the books and appyling it to real life takes lots of work and experience, something that is just not possible for the average medical student. And students feel afraid and anxious when it comes to answering and asking questions to superiors of this sort and the vicious cycle of -being yelled at- scared to answer- being yelled at- scared to ask questions- being yelled at for not knowing answers-. This does not encourage a good learning environment.

    I am currently studying med in an australian uni. And ever since i started (im about to graduate hoorah!), not once have i heard a consultant y
    ell or degrade another person. And still everyone did their jobs. People met professional requirements. People arrive on time for work. Patients get high quality care. Medical research goes on.

    If we are saying that such treatment (that students and interns in malaysia get)is necessary to provide good care to patients and to prepare people for gruelling work, the why is it that in countries such as australia, these things dont happen and yet, pts receive good care and doctors are still able to do their work. Australians are not much different to malaysians, they are still people who have the same needs and do similar things.

    I guess my point is that we need a shift from this old school counter productive hard love teaching style to more evidence based, professional and encouraging environment. This will not detriment our system in any way apart from having to scratch some huge egoes. If you do feel a need for proof, just look up any articles about giving positive reinforcements and the learning process. There are scores of them and whole studies have been made on this topic.

    If we feel uncomfortable studying in the heat standing under the sun, rather than keep on standing and trying to read soaked in sweat, why not step into the shade and study peacefully?

    1. I cannot help but agreeing with you... the degrading torture faced by house officers, or even medical officers and registrars is indeed UNNECESSARY...

      The good news is, the system is changing. The old school practice is slowly facing out, and finally, more and more house officers and medical officers are respected and appreciated...

      And for those who are yet to join the transition, all i hope is: what does not breaks you, make you stronger... HANG IN THERE!!

  7. Hai, hws sibu for housemanship? Good? Hard?^_^ thanks!

    1. unfortunately, i have never experienced housemanship in Sibu. A couple of my friends who were from Sibu, they enjoyed their housemanship there very much.Small hospital, not too busy. If you are keen for more exposure, Kuching Hospital can offer more as it has more specialist there and it is a good training centre. Be prepare for its busy schedule as well. all the best!


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