Stand Up !

Choose medicine

2009-07-04T19:19:27+02:00

Choose medicine.

Choose nights, choose PRs and scrotal exams, choose being bleeped when you’re taking a shit, choose bare below the elbows, choose and book, choose being so hungry you enjoy hospital food, choose never seeing your friends again, choose not washing your hands for a change, choose dehydration, a f***ing big cannula, Quality Street over Roses, MRSA, choose scrubs (watching it or wearing them). Choose cyclizine the morning after the mess party, choose Adele the Australian physio, choose sitting in the mess watching mind-numbing, spirit-crushing game shows, stuffing junk food into your mouth praying that you’re bleep won’t go off. Choose MI over PE because someone’s got to make a diagnosis. Choose bd, tds, qds, those f***ing T’s with the dots on them.

Don’t choose life, choose medicine.

(for the medical students)

From MMR

There is still light...

2009-06-03T14:41:33+02:00

In The Star on 3rd June 2009. At least someone up there still cares:

Government doctors still not being paid their due

THE Malaysian Medical Association (MMA) would like to refer to the letter “Deal for government docs reasonable” (The Star, May 12) by the PSD which stated that the initial salary of government Medical Officers was the highest compared with those of other schemes of service in the public sector. The MMA acknowledges that there has been a significant increase in the salaries of government doctors over the past few years, and we would like to thank the PSD for having given due consideration to our requests to improve the remuneration of such doctors. However, we would like to clarify a few points made in that letter. Firstly, with regards to the on-call allowance, we would like to point out that the RM150 per night is only for medical officers doing “active” on-call duty, i.e. working 16 hours per day beyond their normal working hours. These are usually the medical officers in the Medical Unit, Surgical Unit, etc. Medical officers working in less “critical” clinical departments like Pathology or Radiology are only eligible to claim RM50 or RM90 per night while on call depending on the number of hours spent at the hospital after office hours. There are also some medical officers such as those working at the health clinics who do not have any on-call allowances. Secondly, paying RM80 per hour for locum work is a very good initiative by the Health Ministry. Unfortunately not all medical officers are given the opportunity to do this, as the extended clinic hours (5pm to 9pm) only involve 16 polyclinics out of more than 800 government clinics in the country. The locum work is mostly done by the doctors working at a particular polyclinic and doctors working at other polyclinics (which do not have locum services) in the same district do not get any chance at all. Thirdly, the statement that in 2010, newly appointed medical officers would be receiving a salary of RM6,000 per month as they would be promoted from UD41 grade to UD44 grade upon completion of two years’ housemanship and upon confirmation in service is exaggerated and misleading. The actual UD44 salary at P1T1 is RM3,028.90 with fixed allowances of RM1,450.00 (including critical allowance of RM750, housing allowance of RM400, elaun khidmat awam of RM300 and COLA RM100 to RM300 depending on the location). Although a doctor may earn up to RM6,000 by doing a lot of active calls or working many hours doing locum, this would not be the salary of the majority of the first year medical officers. The MMA has repeatedly requested the Government to introduce a separate service scheme for government doctors from that of other civil servants, as a doctor’s undergraduate training is longer at between five and six years, compared with other professionals. Our working hours are long and protracted and there is a period of five years of compulsory government service which is not a requirement for other professionals in the civil service.

DATO’ DR KHOO KAH LIN, President, MMA.

Malaysian Doctor's Vow

2009-05-23T18:03:17+02:00

This has been, and will always be our vow as Malaysian government doctors. We don't use the Hippocrates oath here. Its in Bahasa Malaysia.... feel free to translate.

> "IKRAR WARGA KESIHATAN
>
> Kami
> Warga kesihatan
> Tidak akan mengeluh
> Walau bekerja berhempas pulas
> 36 jam tanpa henti
> bagaikan seorang anjing
> walaupun menteri kami menidakkannya
> kerana beliau
> bukan warga kami.
>
> Kami
> Tidak akan bersungut
> Pabila muka kami terpercik darah,
> Nanah,
> mahupun air ketuban hijau.
>
> Kami
> Tetap membedah siasat
> mayat reput dan berulat
> demi keadilan si mati
> Walau keluarga menunggu di rumah mayat
> dengan pisau dan parang
> dan ahli politik.
>
> kami
> warga kesihatan
> tidak akan mengeluh
> menghadap kaki berkulat
> mengutip ulat langau daripada kudis
> mengorek najis daripada dubur manusia yang sembelit
> serta menghendap faraj berdarah,
> berlendir,
> bernanah hijau,
> mahupun mengorek lidi yang disumbat
> untuk menggugur janin.
>
> kami
> tidak akan bermogok
> walau kami dicemuh manusia yang tidak mengerti,
> juga di berita dan akhbar
> serta oleh orang yang sepatutnya
> membela nasib kami.
>
> Kami
> Akan sentiasa ikhlas merawat
> Walaupun ada ketika
> pesakit kami
> Lebih sihat daripada kami sendiri.
>
> Kami
> Akan sentiasa rela bergaduh
> Dengan ibu bapa
> Yang sanggup melihat bayinya terencat akal
> Daripada menerima rawatan
>
> (dan mereka akhirnya menyalahkan kami
> Kerana mental anak mereka kini terjejas
> sebab kedegilan mereka sendiri.)
>
> Kami akan sentiasa
> Menjaga ibu bapa yang tidak dipeduli anak
> Anak-anak yang tidak peduli ibu bapa
> Dan pesakit-pesakit mental yang tiada harapan sembuh
> sebab lambat rawatan
> kerana ibu bapa malu sekiranya anak mereka
> dilabel mental
> dan akhirnya mereka sendiri meminta
> anak-anak mereka ini
> dibuang jauh-jauh.
>
> Kami
> Akan sentiasa ikhlas
> Walau kami
> Tidak berpeluang makan dan minum
> Rehat dan mandi
> Dan bersembahyang lima waktu
> Demi kepentingan kerja."

Vow created by an anonymouse medical officer. Thanks a million.

Doctors are lazy

2009-04-30T20:24:35+02:00

Yet again, doctors are put in the limelight, not for their courageous efforts in saving lives, or their efforts to provide their best service despite a pathetic lifestyle and “ridonculous” (from Bolt) government salary, but instead accused for reading a paper or appearing to lag and laze in the hospital. It’s typical of Malaysian media and gossip to only highlight the negative of doctors compared to the massive amount of good that they do. Only of course if it’s politically motivated.

This, as yet again, has proven for a fact that being a Malaysian government doctor may as well be the DUMBEST but noblest job in the world. Getting slammed by the media and by a public figure has done so much to further “impress” the public upon the fragile integrity and image of Malaysian government doctors. In short, Malaysian government doctors are underpaid, overworked and now scrutinized for every slip up without much support for their own welfare. Its either Malaysian government doctors, are ignorant, oblivious, too passionate or just so clueless about their own well being and rights. Can anyone tell me who has an occupation that forces them to work 36 hours a day? And on weekends too? (And if any of u are claiming that a new ruling of house officers having the day off after a 24 hour call by MOH recently; I’m sorry to say that the order is not carried out in most of our govt hospitals).

Doctors are human too. Whether the doctors who were lazing around on the job in HKL were truly factual or were misinterpreted by certain individuals, only God knows. Although it’s the emergency department, not all doctors there are posted there or are on duty. I’m a paediatrics doctor. I see children only. And when I come down to emergency department to see a child patient and linger there to wait for their results, I may flip my phone, call someone for a referral or flip thru some case files. Probably sitting on my ASS. But if a so called public figure would have seen me doing that, with “20” adult patients waiting in line in the emergency dept, his assumption would clearly state I was lazy and not intuitive. DO NOT ASSUME!! One of many lessons taught to doctors but not to idiots. There are emergency doctors there on 8 hour shift duties. They are considered the “jack of all trades” of doctors who can deal with any emergency and are mostly running on their toes with constant energy (as of the Energizer bunny) just to cope with the amount of emergency cases. Despite the increase of emergency cases, since the rich can no longer afford the private sector due to economical depreciation, these doctors still manage to carry out their duties, even though being understaffed. My salute to them.

Doctors at time do procrastinate. But I can assure that most Malaysian government doctors work their ASS OFF, whether it is to provide their best service, to save a life that can’t be saved, or to study for another 4 years (making a total of 10 years studying from undergraduate) to pursue their specialization in order to work their ASS OFF some more to give their best service. And no, the pay increment is not much. Ask a government specialist; with all the PTK and such.

So, the next time a doctor saves a life, intubates a premature baby, repairs an open fracture, conducts CPR and revive a dead, runs like a headless chicken for group and crossmatch blood, cries with a relative when a patient dies, protects an assault patient from gang rivals, delivers a baby of a complicated pregnancy, gets stuck in op theatre for 8 hours for a kidney transplant, or even muster a SMILE to a patient after working 35 hours non stop….

WRITE THAT IN THE F*CKING PAPERS!!!

Nuff said…..

“CUT MALAYSIAN DOCTORS SOME SLACK”

Malaysians love GORE

2009-03-27T05:30:49+01:00

The Malaysian media really loves gore.... whether its their explicit enjoyment of flesh and blood or their particularly detailed report or incidences. Either way, whoever the relative's of the victim would be put in despair for reading the article.

Boy killed in gory accident

MUAR: A 15-year-old boy on a motorcycle was killed in a gory accident, his head crushed and left hand severed. He is believed to have hit a dog, fallen and run over by a car.

Muhammad Syahiddin Ibrahim, from Parit Jawa here, was riding his brother’s bike when the incident happened near Kampung Parit Besar at about 1.30am yesterday.

Villagers who heard a crash rushed to the scene and were shocked to see a headless body and a hand lying on the road, and a car in a drain several meters away.

They also saw a dead dog about 100m from the body and believed that the boy could have hit the dog, fallen onto the road and got run over by the car.

The villagers thought the boy’s head had gone missing, but police at the scene to investigate found that the head had been crushed and the teeth scattered on the road.

The driver of the car, from Bakri, suffered some injuries and was warded at the Sultanah Fatimah Specialist Hospital.

The victim’s father, Ibrahim Saipan, said he was shocked when he received calls about his son’s accident at about 3am.

His son, a Form Three student of SM Raja Muda, was to be sleeping at home but had left the house without telling anyone, he said.

Nonetheless, recently I attended a seminar by one of our reknown hand a micro surgeon's seminar. He was explaining on his miracle surgery which involved a femur to femur reconnection of an amputated leg. Before explaining further, he showed us the video of the victim involved in the MVA!! What??!! How??!! u may ask...even we were stumped...apparently, some of the passerbys had a camcorder and recorded the whole incident, from when the initial accident occured, to people helping the victim, then WHAM!! a truck rolled over the left leg amputating it entirely!! blood, flesh, peices of meat and muscle all over the tarmac (is that gory enuff for ya?).... and of course the amputated leg lying a few yards away.... then after the victim was brought to the hospital and recovering after the surgery.. this "good smaritan" gave the victim a copy of the video. He might have said :" Hey, I caught your accident on video, and it was soooo cooooooll!!!" My god. If I ever were in an accident, I hope to God that no one is recording it!! especially if its gory!!

Really fair - is fair

2009-01-29T18:48:39+01:00

I knew that someone would actually support the punishment by KKM in my previous article:

"I think the ‘punishement’ is fair. Imagine that O&G MO........ (by poor doctor in MMR)"

My rebuke:

“poor doctor’s” comments is as typical as our director’s point of view. It is the doctor’s (HO’s) fault for not following through their logbooks and confirming an APC for practise. It is their fault for being careless and with their “takde ape ape” attitude, that causes their demise. “no one to blame but yourself.

Basically, “poor doctor” clearly is thinking “in the box”. A qualified surgeon who is competent in TURP or gastrectomy, but does not have a proper Malaysian APC (suggestively he graduated and further studied in Congo and returned to Malaysia), is technically “incompetent” in view of his “paper qualification”. No papers, no go (Nazi attitude). Anyways, its true enough that a license is pertinent in medical practice. The issue at hand is how these doctors ended up where they were and how the bureaucratic red tape has made their situation worse rather than giving ways or methods for resolution. Remember, these doctors underwent housemanship the same time and and handed up their logbooks to the office together, but subsequently got lost without their knowledge. Why were they ignorant as “poor doctor” may ask? Its because they were neck deep with work and were dedicated in achieving a pinnacle in their career by further studying. Their HODs can vouch on their efforts and hard work. However, they seem to have overlooked to check the office (who ensured them that they will do everything) to ensure that all paper works have been submitted.

Whether these doctors are functioning within the law of Malaysian medicine, it is totally a subjective matter. If they are convicted of malpractice, they may be labeled as Murderers as “poor doctor” suggested. But in the true eyes of practice and doctoring, these doctors cared more for their patients rather than their own bureaucratic well being.

A story; my sister in law is a lawyer, she also has so called “logbooks” to fill out. Once completed, they hand it up and the Malaysian Justice Dept will process the papers followed by “2 support letters” and subsequently “called to the bar” once the registration has completed. Not much effort was done by my sis as updates and progress of her registration were sent via mail to her by the justice dept as they believe that lawyers are very busy people.

But I guess doctors in Malaysia are treated differently. Therefore they have to be vigilant in every sense of the way; while working with patients, bearing with consultants, handling “takde ape ape” HOs and the bureaucratic crap of MMC and KKM. Nobody watches their back here in Malaysia. “pseudomallei” has given very valuable advise for new doctors in Malaysia.

“poor doctor” sounds like the typical KKM doctor.(Specialist or consultant maybe?). One that we have too much of and would never change the system for the betterment. Everything “by the book”. (r u Ismail Merican? )

My plea: “Give these doctors a break for God’s sake….they really need it”

A blue weekend...

2009-01-23T10:36:58+01:00

I have a lousy weekend ahead. In fact, I’ve been having many lousy weekends. Thanks to being on call. Yup… the usual drag of working in a hospital for 36 hours. Why does it produce a lousy weekend? Well, if u’ve worked for a solid 5 days a week (with 1 – 2 on calls in between), u don’t have the weekend to look forward to especially if ur on call on Saturday. And nope, usually u don’t get the next day off as u would need to do the weekend morning rounds the next day which usually ends by 2-3pm (on a Sunday). And then ur off to work again on Monday. So it actually feels like uve worked for 2 weeks straight. And to top it off, u might get another Saturday which then makes it feel like 3 weeks straight. No wonder doctors are a bunch of grumpy a$%holes. Even I know that I’m grumpy at times.

But to make matters worse, married to another doctor whose on call schedule is as crappy as mine, we end up not seeing each other as often as a stewardess and a pilot. As of this weekend, I’m on call on Saturday (cant see my wife), she’s on call on Sunday (cant see my wife), and then I’m on call again on Monday (EOD). So technically, I wont see my wife from Saturday till Tuesday afternoon. And the one I pity the most is my son, who will only get to spend time with one of us during the weekend. I guess its tough to be a Malaysian govt doctor, and worse of all would be the children of Malaysian Govt doctors whose parents are so busy with work, patients, on calls and so on. So much for family outings and family quality time.

Once a paediatrics consultant confided in me when her daughter was prepped to go overseas for studies in engineering. She claims that her daughter refuses to do medicine as both parents are doctors and are barely around for anything much. All of a sudden, my fierce consultant looked at me with tears in her eyes a said “I was a bad mother, a very bad mother”. But hey, her kid turned out ok, just not close to the parents. I guess that’s not important for doctors. Well, as I said before in my posts. Being a doctor is a noble job. Being a doctor in Malaysia is the dumbest job in the world. If u had a lifestyle (or life even) before medicine, u can kiss it goodbye once u start serving this country.

PS: All this for a solid cool RM 3500 a month. I love this job!!!! Should get Mike Rowe (of Dirty Jobs on Discovery Channel) to come and do a stint of doctoring work in a Malaysian Govt Hospital. I’m sure it would be a highlight in his documentary. And I’m still doing it……

Oh, by the ways… HAPPY CHINESE NEW YEAR!!!

Really fair - update

2009-01-20T22:03:58+01:00

Here's an update to the log book incident. Apparently, a decision has been made by KKM (Ministry of Health) and our beloved Dr Ismail Merican. 4 unfortunate doctors in my hospital have fallen victim to the "late logbook" incident and have received the punishment as I have dictated before. But to add more salt to the wound, KKM has released an order that the 4 fellow doctor's APC are not fully licensed and are subsequently not allowed to do clinical practice. Its funny, these doctors have served for 5 years without any incident, one of them have a part one in MRCOG and another has part one in MRCS. And now, they are going to be clerks. Or doing statistics or whatever KKM would give them. For a country that claims not to have enough doctors, they sure as hell take red tape seriously. That's justice for ya.....

Late bloomers

2009-01-03T22:18:07+01:00

Malaysian government doctors are late bloomers. Yes, it took me 5 years of working in this line to actually realize it and to eventually succumb to the cruel reality. It actual fact, no matter how many of u may deny it, life is none other than a "rat race". (I'm sure some can picture Mr Bean in the movie similarly entitled Rat Race). Once children become school goers, their life has entered the never ending race for high achievement. Heck, some as young as 4 years old are sent to pre schools where they start teaching these toddlers hi fi subjects and send them home with homework. Once in school, its the race for excellent grades, to ensure the excellent university (most likely overseas for Malaysians) and subsequently to pursue the excellent career. Now in Malaysia, if ur a straight A student, then ur destined to be doctor. Nothing else. Read the news papers - " Straight A student for SPM did not receive scholarship to pursue medicine", "Straight A student dies in freak car accident - aspired to be a doctor", "Daughter of padi field worker got straight As, acquired a spot for medicine"...and the list goes on. Its blasphemy for those with all As not to do medicine. Anyways, as to late bloomers, those doing medicine will undergo a grueling 5 years medical course. Not to mention some universities having pre medical subjects (core sciences) for 1 or 2 years, thus making studying medicine a total of 6-7 years. By that time, those doing other fields may have a head start in working and in their careers 3-4 years before a med student graduates. "So what?" some may say. "Once doctors start work, their salary are high". Maybe, but no longer in keeping with current economic turmoil and inflation. And in the government service (Ministry of Health), a doctors salary climbs at a snails pace. I've worked for 5 years and my current salary is RM3300 a month. Plus another RM 900 for sleepless on calls (paediatrics). Which makes a total of RM 4200 a month. It may look big, but its just keeping my head above the water for now. Now many of my colleagues have reached a basic salary of RM 10,000 a month. Of course after working for 8 years, me only 5. Some even RM 15,000. Of course, they have been dwelling in the private sector. To them, the sum above is AVERAGE. So with that, they are able to buy a teres house costing RM 380,000 or above (in the Petaling Jaya area), and a non Proton car. With all that baggage, they still have extra to spare for insurance and other luxuries such as vacations. Ok, as for me, I just bought a house (apartment) costing RM 250,000 - monthly loan of RM2000, and a Proton Persona - monthly loan RM 607. Then my maid for RM500 a month. Then my kids insurance for RM 500 a month. All in all, my expenditures are RM 3607, which leaves a balance of RM 593. My wife earns RM 2700. She's a doctor too but of 4 years. She has her own car loan and parents to support. Now, my private colleagues have moved in to their respective houses, renovated and furnished them beautifully. I just bought mine and will only move in mid of 2009. Still staying with my parents. In short, I felt left behind in the "rat race". All said and done, my friends have progressed ahead in life whilst I'm just beginning to explore into it. Furthermore, now in a Master's programme, I'm now a doctor cum student. Which makes the feeling even worse. To my surprise, I'm not the only one suffering this slow paced feeling. My wife's specialist in Urology, (whos a qualified surgeon, now in his 4th year of Urolgy sub specialty), does not own a single property. He has yet to acummulate the finances to attempt to buy a property in Selangor. He's still renting with his doctor wife. Many of u may yell at me now and suggest private practise, or even to stop whining and get on with the job. But I have just one problem - I wanna serve. And the best place to do it is in a government hospital. I guess u can't get everything in life, and being a late bloomer in the "rat race" may well as be the folley of medicine. Or is it a sacrifice? I'm not too sure anymore, as doctors sacrifice so much already.

This is fair...REALLY FAIR...

2008-12-25T01:05:34+01:00

I've got a story to tell. Nope, it aint a Christmas carol or tale. Its the usual misfortune of doctors to work in a unforgivable place such as the government of Malaysia, particularly, the Ministry of Health (MOH). In a way, I knew this doctor since housemanship days. She was hardworking, intelligent and constantly works without a single whine (such as myself). She completed her housemanship and progressed onwards to become a Medical Officer. Now, for those who are not aware, housemanship takes about 18 months to do but for the first 12 months, you undergo 3 major postings of 4 months each with a log book filled up at the end. The major postings may include Medical, Surgery, Obst and Gyn, Paediatrics or Orthopaedics. So at the end of 12 months, 3 logbooks must be handed up to the department and subsequently confirmed by the Malaysian Medical Council (MMC) and MOH for the Anual Practise Certificate (APC), thus rendering a doctor "safe" to practise.

Now, the story begins when this doctor mentioned fulfilled the criterias of passing up all her logbooks and proceeded forward and became a Medical Officer (MO). She was a good MO. She was in Medical, then went off to Nephrology whereby she was loved by her staff and her consultant. She was a nephrologist prodigy in the making. She remained there for almost 4 years and plans were made to further her studies.

However, on one fateful day, she received a letter notifying that her 3rd logbook was never received 4 years ago!! To her surprise, and after inquiring the department of her hospital, the logbook never reached MMC or MOH, thus meaning that the logbook had gone missing in the hospital itself after being handed up. Unhappily but undeterred, my friend made an appeal, and MOH/MMC requested thst she hand up the last 3rd logbook. So off she goes collecting signatures again with a new logbook and finally hands it up once completed.

You think it ends there? Not yet. She then hands up the new logbook to Putrajaya MOH and was finally at ease. So she thinks. She then received another letter with regards to the late completion of her logbook and to face disciplinary action for her delay. Nothing much was thought at first, especially with a her consultant and HOD of nephrologist backing her up.

Then the dreaded letter arrived. Her punishment:

1. Her 4 years of service will not be recognized.

2. She will lose seniority and therefore will gain rank and pay slower than her juniors

3. Since her service is no longer recognized, applying for Masters is even more difficult as Masters require at least 3 years working experience

4. There will be a black mark in her professional record which will affect promotions and applying for Master.

She just stood quiet, silent, when she got the news. All the above had to be explained to her as of to a little child. Shock I guess. Pity.

Doctors save lives, but not many would want to save ours.

Nuff said.

Another response.....to whining

2008-08-21T07:53:10+02:00

This was another response to the letter from Concerned Citizen. This was printed in The Star:

Docs just want to be appreciated

I WISH to comment on “Stop whining, government docs,” by Concerned Citizen (The Star, Aug 12).

First of all, I would like to clarify that when we are on-call, we are doing “active call”, meaning that we have to be in the hospital for 24 hours.

This is unlike pharmacists who can stay and sleep at home when they are on-call as

they only need to come to the hospital should any problem arise.

Other healthcare personnel work according to shifts either in the morning, afternoon or at night. Therefore, they are not considered on-call and should not be paid on-call allowance.

When on-call, doctors are in the hospital 24 hours attending emergencies sometimes

even sacrificing meals and

sleep.

Most of the time the surgical doctors will be operating in the wee hours with only two to three hours of sleep if they are lucky and they have to continue the next day operating on the elective list for another 10 hours.

Mind you, we do not even have half a day off after being on-call the previous day.

The writer said that a fresh houseman commands a basic salary of RM2,458.39. I’m not sure where he got the figure but I've been in the government service for seven years and my basic salary still hasn't reached that figure.

Furthermore, the on-call allowances of RM150 on weekdays and RM170 on weekends are applicable for medical officers and not for housemen as stated by the writer.

We have accepted that on-call is part of our job scope.

We are not whining or complaining. We are used to working on public holidays. We are used to sleeping in the hospital while others are celebrating Hari Raya, Chinese New Year, Deepavali and Christmas with their love ones.

Our children are already used to staying at home during school holidays while their classmates enjoy family trips. Our children are also used to seeing their father or mother at home only 15 days a month because of on-call duties.

These are the sacrifices that we have made for the sake of our patients.

We are not complaining. We just wish that people appreciate us for what we do. It takes a doctor to understand another doctor’s plight.

A CARING DOCTOR,

Petaling Jaya.

All doctors do is whine....

2008-08-19T12:14:41+02:00

In response to this remark, we replied with this:

We are replying to the letter from Concerned Citizen from Taiping entitled “Stop Whining, government doctors” issued on 12th August 2008. It seems that Concerned Citizen is very well versed with the fresh houseman (HO) basic salary and allowances. The fresh housemans nowadays get better pay than the senior medical officers 4-5 years ago. Currently the total sum of salary and allowances received by a senior medical officer (MO) and a fresh houseman is almost the same.

With regards to on call duty, in UK, doctors cannot work more than 16 hours non stop as it is impartial to the labour laws. A circular was formed by their Ministry of Health in UK to ensure that doctors do not exceed the legal working hours. They recommend doctors to rest after a 16 hour shift as judgement and managements of patients could be compromised due to lack of sleep/rest. However such labour laws do not apply here for Malaysian government doctors. It's bewildering that such a critically detailed occupation like medicine where lives of patients hang in the balance of precise medical decisions are given to the hands of doctors who have worked long 24 hour shifts. Its likely that mismanagement may occur as doctors are human and are prone to errors when physically and mentally exhausted.

In Malaysia, after being on call for 24 hours (I.E.: from 8 am to 8 am the next day), the doctors resume normal work in the wards immediately till 5pm. In short, the doctors work non stop for a span of 36 hours. There’s a shortage of doctors in the ward, thus the post call (after 24 hours on call) doctor is still needed in the hospital to continue on with his/her duties despite how busy it was the night before. These doctors attend a variety of cases during the call; emergency operations, CPR, intubation, child abuse case, premature babies, gun shot/stab wounds, drowning, head injuries, motor vehicle accidents, caesareans for fetal distress ..etc. Things that would keep anyone awake. This grueling on call duty would only earn us a measly RM150 a night (for MOs), which basically means RM10 an hour.

Concerned Citizen also mentioned that doctors (in his article Housemens) earn another RM 1000 – RM 2000 (totalling RM 5000 a month) a month for on calls. This would mean the poor chap has to do 10 to 20 calls per month as HOs earn RM 100 per on call. This poor doctor has to do on call every alternate day of his/her life (every other day) which basically means he/she has no life, as he/she would practically live, eat and sleep in the hospital. (We sleep after getting home from a call to recover. Most people do that. Its a natural body response.)

Basically, a senior MOs basic pay would comprise of RM 2600. Allowances would equate to another RM 1000, and on calls would provide another RM 1000 (if he/she were to do six on calls per month with RM 150 per day and weekend rounds), totalling to RM 4600. This is after 5 years of service in the government sector (MOH). Concerned Citizen should have checked his facts right before lashing out at government doctors.

On call pharmacists in the hospital usually do not need to stay in and do not need to attend to emergency cases in the wee hours of the night. If their services are required, the hospital will contact them via phone or page. Furthermore, if they were not paid for their overtime, they too are neglected in the sense of equal pay for equal service given. Pharmacists may be underpaid as well (which may explain why they too jump to the private sector).

Yes, fresh graduates of other discipline may earn less than new doctors but our pay remains on a plateu for donkey number of years unless we specialize and progress through the ranks and by going through PTK in the government. If a doctor remains as an MO for years (chronic MO), then don't expect their pay to exceed RM 6000 in the government. As the example above, an MO of 5 years only earns a total of RM 4600 a month.

We are merely asking for a suitable on call payment for our efforts in view of the rising costs in Malaysia. If the government can afford to pay RM80 an hour for doctors in health clinics who attend the usual cough and cold cases, then they should consider increasing the on call allowances for MOs in the hospital settings, thus preventing doctors from leaving the government for greener pastures in the private sector. (MOs in private hospitals earn RM8000 basic salary).

I wonder if Concerned Citizen is aware of how taxing an on call could be. Imagine doing 8 – 10 calls per month for the past 4 to 5 years. A lot of doctors become exhausted with this lifestyle. 2 to 3 weekends in a month are spent doing on calls or doing morning rounds. It is considered as the main reason why doctors leave the government service/hospital settings to try and obtain a more comfortable lifestyle.

Please don't regard this as whining from the government doctors. Some of us have stayed on for years to serve the public and have furthered specialized to provide a better service. However, in view of Malaysia being a developed country by 2020, we were hoping that the working condition and salary of doctors would improve and that we would not be the minority of professionals who suffer in silence. Its a gruelling job, but somebody has to do it.

Chaos

2008-03-11T11:31:33+01:00

This job can really push you over the edge. Literally...

Happy Holidays!!

2006-10-22T04:59:58+02:00

I would like to take this oppurtinity to wish everyone and very Happy Deepavali and Selamat Hari Raya Adidilfitri!! Once again, two wonderful celebration has merged together in one harmonious occasion. Truly a definitive testament of our strong multiracial unity. Happy Holidays!!

Condolences

2006-09-27T14:23:25+02:00

What a tragedy for a young Malaysian doctor who passed away due to a freak accident involving her ambulance. I remember posting in my blog several months ago with regards to doctors risking life and limb in our poorly maintained government ambulances and that I myself experienced a hair raising experience when my ambulance burst its tires at 160kmh en route via PLUS highway. Luckily, my number was not up that time. And I realized how significantly unsafe our ambulances are for the health workers. No seatbelts, doctors are positioned in awkward positions (sometimes above the patient to administer oxygen bagging), no airbags, or even the decency of a window to actually visualize what’s going on outside. It’s basically a moving coffin.

Well, my point is our budget for healthcare in Malaysia has never and will never bring our standards up to meet first world status. Mind you, the ambulance that the young doctor died from was ambulance from Serdang Hospital. Just operational for the past one year. It’s technically a NEW hospital, which by right should be accompanied with NEW facilities such as NEW ambulances which are well maintained. And as the usually Malaysian style, if the government can't cope, pass it to the private sector.

Oh well, I'm babbling already. I feel sorry for the doctor who has risked her life to send a patient, who was most probably stable, to my ....er... paperless hospital. She was not even compensated as her post was not confirmed. She has not gone for induction course and "belum disahkan jawatan". That would usually take 2 -3 years without cable. And insurance?? Like I said before in my blog. GO GET A LIFE INSURANCE. The government will not care for you.

It’s a dirty and dangerous job to do in Malaysia, but somebody's gotta do it. So let us morons do it. Just like my specialist in NICU always says, "I’m the Kuli, you MOs are my penyapu lantai and the housemens are pencuci jamban". Yup, I guess housemen’s are expendable in Malaysia.

I wish to extend my deepest condolence to the family of the young doctor and pray that her efforts and honest will to help others have gained her the right to the gates of heaven. Al- Fatihah...

PS: I've been busy in NICU (Neonatal Intensive Care Unit) and have very limited time to blog.