Sub-standard housemen

By Pauline Wong, The Sun

PETALING JAYA (Nov 7, 2011): Government hospitals have been seeing deteriorating standards among housemen in recent years due to, among other things, the proliferation of medical schools which produce sub-standard graduates.

A source told theSun that too many medical schools, too few good lecturers, and the “pampering” of housemen have contributed to the serious situation.

The source said standards have been falling as more opportunities to study medicine both locally and overseas emerged, and housemen are getting used to having it easy.

He noted that sadly, many housemen tend to “disappear” and cheat on their logbooks, are irresponsible, lazy, ignorant and unprofessional in carrying out their duties.

“There are some who are good, but some just don’t cut the grade,” he said, adding that not all the blame rests on the housemen’s attitude, but rather, it is a downward spiral brought on by the lack of proper training.

“The sheer number of universities offering medical courses has led to standards set by the Malaysian Medical Council (MMC) not being met, because there are not enough good lecturers and trainers.

“Its bad enough that good doctors do not necessarily make good teachers. What’s worse, in some local public universities, lecturers are sometimes only senior civil servants with some medical background,” said the source, a department head who sees hundreds of housemen in a major government hospital each year.

“And now, exacerbating the situation is the government’s decision not to make the Medical Qualifying Examination (MQE) compulsory for all medical graduates from foreign varsities,” he lamented.

Health Minister Datuk Seri Liow Tiong Lai had earlier announced that the current list of 365 recognised overseas foreign universities may be abolished in favour of making it compulsory to pass the MQE before practising medicine here.

However, the cabinet recently quashed the idea and instead directed that the list of recognised universities be shortened and reviewed more frequently.

theSun had, today, front-paged concerns that the cabinet’s decision may have negative consequences when Malaysia opens its doors to foreign medical practitioners under the World Trade Organisation (WTO) agreement.

The medical community had voiced the view that the MQE should be made compulsory for all medical graduates from foreign varsities, to act as a filter and maintain a benchmark in medical standards.

The poor quality of housemen was recently highlighted in a letter to theSun, published under the heading ‘Young doctors mollycoddled’.

The writer, a specialist at a government hospital, had expressed his frustrations over the low quality of housemen whom he said had “bad attitudes and were lazy and incompetent”.

Asked to comment on the issue, Malaysian Medical Association president Dr Mary Suma Cardosa warned against generalising the negative comments.

“There are some very good housemen who excel, and these are the doctors we (and the public) want to have and to nuture. But we also find poorly-trained housemen and it is very challenging and tiring to get them up to scratch,” she said.

She said the root cause of frustration and resentment among clinicians is having to teach these housemen things they should have already learnt in medical school.

“The housemanship period is to teach young doctors how to apply all the knowledge and skills they have acquired in medical school to real life situations, but if they don’t have the basic skills and knowledge, how can we train them?” she asked.

“Unfortunately, some housemen are not interested and are unwilling to learn and to change, but have the cheek to complain that they are being ‘abused’ by their seniors,” said Cardosa who is however not convinced that the fault lies entirely in medical schools.

“Yes, some medical school are at fault for not having enough experienced teachers or fail to provide their students with enough patient exposure. But in other cases, it is simply because the medical graduates have a poor attitude,” she said.

“Young doctors (and their parents) should be made to realise that a doctor’s life is a hard one, especially in the early years. Long hours are a necessary part of the training and the work.

“No one should study medicine because of the glamour, status or because they think they are guaranteed a job which is certainly not the case,” she said.

Deputy Health Minister Datuk Rosnah Rashid Shirlin said the ministry took a serious view on the matter, and was extending the training period for housemen.

“We are very concerned with the quality of our young doctors, which is why the training for housemen was extended to two years from one year in 2008. The quality of doctors and patient safety cannot be compromised,” she said, giving an assurance yhat only competent housemen will be given full registration by the MMC.