For Future Doctors: What if …?
First of all, I would like to wish everyone a very Happy New Year 2011. It has been a while since I last posted anything on my “For Future Doctors “series, the last being on “Housemanship Glut”. I have been observing all the comments and enquiries that were posted in my blog regarding my articles. I had many interesting questions by medical students as well as houseofficers regarding their future prospect in medicine. I thought of answering some of these queries’ in this posting.
What if I quit Housemanship?
I had a couple of housemen who asked me what will happen to them if they quit housemanship and what the other options are. According to Medical Act 1971, a medical graduate has to complete 1 year housemanship in order for them to receive their full registration under the Malaysian Medical Council. This has been increased to 2 years since 2008 (officially). I am not sure whether it is legally binding as the Medical Act 1971 has yet to be amended.
What will happen if you quit housemanship? The answer: You will NEVER be able to practise as a doctor anymore. If you quit housemanship, you will not get your full registration which means you will never be able to practise legally. Thus, whatever you have studied over the last 5-6 years is just a waste. It would have been better if you had decided much earlier that medicine is not your field and switch course during your undergraduate period. There are 2 parties to blame here, yourself and your parents.
Basically, you need to find another job or undergo another undergraduate training in another course. One of the person who wanted to quit housemanship asked me whether she can do Master’s programme in preclinical studies such as Physiology (Master’s in Medical Sciences) or Anatomy and subsequently become a lecturer. The answer is yes and no. Of course you can but in order for you to get a place for Master’s programme in Malaysia, you must be in service. You must have undergone at least 3 years of service with full registration and need recommendations from Head of Department as well as good SKT marks before being able to apply for the programme. As such when you quit housemanship, this is NOT possible especially when our Master’s availability is very much limited with high demand. Probably you can try overseas universities but however, the degree offered must be recognised in Malaysia as a postgraduate degree.
Can I join Pharmaceutical companies? Again it is a possibility. In fact, with oversupply of doctors in Malaysia in a few years’ time, we might be seeing a lot of medical graduates joining pharma companies to get a job. Sometimes, pharma companies also need you to have full MMC registration in order to join them.
Can I become a Lecturer by just holding a MBBS? The answer is NO. As I have said before, medicine a very peculiar field. If you are an engineering graduate, can’t find a job, you can be made as a lecturer if the university wants to. Of course an engineering graduate without field work is going to be a useless teacher but who cares in this Bolehland. I have seen so many engineering graduates who have become lecturers the day after they passed out! No wonder we have so many buildings collapsing. I also have seen many engineering graduates becoming school teachers. But for medicine this is not possible. Only doctors with postgraduate degrees are allowed to become lecturers, internationally and of course you will never be accepted as school teachers. But, who knows………………… in Bolehland anything can happen.!
Usually, my general advice to whoever decides not to continue as a doctor is to at least complete your housemanship, whether you like it or not!
To me, this is a distant reality. There were some comments which said that doctors will never become jobless but will become lowly paid. Remember, in Malaysia doctors has to join civil service in order to do your housemanship. Under the Medical Act 1971, housemanship can only be done in government hospitals.
It is a 2 parallel system. After you graduate you need to apply for a post in civil service which is done by the Public Service Commission (SPA). Only when SPA accepts you into the civil service, the Ministry of Health will decide on your posting and place of training. This is where it gets a little bit tricky. If you read my article in MMA written in July 2006: “Future of Government Doctors: Die Another Day!” (http://pagalavan.com/my-mma-articles/july-2006/future-of-government-doctors-die-another-day/), there is a limit to the number of post that is available. The number of post in the government sector is NOT limitless.
We are already suffering from an over bloated civil service. We have one of the highest numbers of civil servants in the world, compared to our population. Housemen start at UD41 grade in civil service. Due to recent promotional prospect, all medical officers have been pushed to UD44 grade and thus creating more vacancy in UD41 grade for houseofficers. But this vacancy has a limit and the government is not going to keep increasing the number of post as they need to consider the financial implications.
Thus, there will come a time where medical graduates will become jobless in Malaysia if the current trend continues. Despite a stop in new medical schools, the existing medical schools (total of 32) will continue to increase the number of graduates as it is a money-making business. Doctors will become like lawyers in another few years’ time.
If you don’t believe me, just take a look at nurses. About 10 years ago, the shortage of nurses made headlines in newspapers. The government began to approve private nursing colleges. Now, we have almost 100 over nursing colleges in the country so much so, you can get a place with just 1 credit in your SPM. At the same time, you are also seeing many nurses with no quality at all, can’t speak/write English and totally unemployable. There are so many unemployed nurses in the country at the moment, some even working in petrol stations! These nurses were guaranteed a job in government sector by the private colleges. However, only nurses trained in KKM nursing colleges are given priority to be absorbed into government sector. The rest has to queue up to get a job in civil service. The private sector is also full. The big private hospitals such as KPJ and Pantai have their own nursing colleges and they will absorb their trainees.
So what happen to the rest? Jobless lah...
Written by Dr. Pagalavan Letchumanan, taken at 17th April 2011 from http://pagalavan.com/education/for-future-doctors-what-if/
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