“Times have changed,” said a future contract doctor. “We are from an entirely different generation. We think differently and work differently. And you have to come to terms with that. If it takes so long to realise that, it’s just utter ignorance. Please, move on.”

Such were the words of the anonymous writer, whose letter to the local newspaper highlighted his concerns of the housemen training in Malaysia. Sharing that his housemanship was around the corner, the writer lamented over the long working hours of a junior doctor, questioning the necessity for long hours of “tagging” with the surplus of housemen in hospitals.

“Is this how we treat the crème de la crème?” the writer asked, adding that young doctors choose a career in medicine for the passion to serve patients.

“We chose this path out of love. Please don’t make us hate what we have set out to do.”

Building mental resilience through rigorous training

The letter circulated on social media and was met with mixed responses – some were angry, while many others were amused by the writer’s opinions. The work challenges and stressful environments faced by doctors has become an evergreen topic for discussion, particularly amongst healthcare professionals.

It was recently revealed by the Ministry of Health (MOH) that at least 20% to 30% of junior doctors fail to complete the two years of houseman training due to stress. The Health Ministry then announced that medical graduates will be provided with counseling before commencing housemanship, in order to prepare them for the stress they will face at work.

But are the arduous work demands with intention to set doctors up for failure?

“We acknowledge the existence of this “tagging” part of the houseman training,” wrote an anonymous doctor in response to the earlier letter. “Yes, it is rigorous, and definitely one of the most exhausting portions of our training.”

“Its purpose is to extract the true creme de la creme who will go the extra mile to save a patient’s life and not whine every time the going gets tough.”

Health professionals need to give their best despite long hours of work and lack of sleep, and the doctor continued by explaining that “tagging” hours are part of training that help build mental fortitude and psychological strength in young doctors.

“Daily, we make decisions that affect lives, and people don’t stop getting sick at 5pm sharp,” he wrote.

MOH: Many fail to complete housemanship due to ineptitude

According to Deputy Health Minister Datuk Seri Dr Hilmi Yahaya, the estimated 30% of housemen who are unable to complete their internships within the two-year time frame fail to do so due to incompetency.

“Admittedly, the problem of housemen is perpetual...because of their incompetency, they have to extend their training period and many other graduates cannot do their training,” he said, adding that the situation has contributed to the congestion of placements for house officers in the country.

Last week, Hilmi announced that hospitals with placements for housemanship will open up more slots to accommodate for the growing number of medical graduates. The plan to increase number of vacancies is in addition to the contract jobs that are being offered to health graduates by the Health Ministry.

"Now, there is an increase in the number of medical graduates, whether locally or overseas. There are 5,000 graduates a year,” he said of the current situation.

"(The issue with them is), during training, between 25 and 30% of them get stuck. They are not so competent in their posting, hence they have to continue (extend),” he added.

"Due to the group getting stuck, many others cannot get placements.”

Health Minister Datuk Seri Dr S. Subramaniam added that the MOH had been informed that some unscrupulous agents were encouraging students to sign up for further their studies overseas despite not meeting the minimum grades.

Thus, he said that those who failed to achieve the minimum grades required by the Malaysian Medical Council (MMC) before beginning medical studies may not be accepted as housemen once they graduate.

"We are going to do it soon," he confirmed, when asked when the move would be implemented. MIMS

Read more:
MOH to expand number of housemen training slots in Malaysia
Malaysian medical graduates to be counselled before entering housemanship
MIMS Survey: 43% of HCPs in Singapore and Malaysia dissatisfied with working hours