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a doctor too many by Dr Hsu

HEY, EVERYONE..I GOT THIS ONE FAMOUS ARTICLE WHICH INTERESTS ME ..ITS BY DR HSU:: 

~It's much of a woe for medical students though ;( ~

a doctor too many by Dr Hsu

Malaysia, a country with about 26 million populations, boosts of 24 medical schools now.

Just a few years ago, the number was less than 10. In fact, when my eldest son entered medical school 10 years back, i could count medical schools with my fingers. Now even with my toes and my fingers, I could not do so. Some of the names are so new that I, as a doctor, do not even know they exist until I did some research for this article.

The list is below:

Public universities:

• University of Malaya, Faculty of Medicine

•Universiti Kebangsaan Malaysia, Faculty of Medicine

• Universiti Sains Malaysia, School of Medical Sciences

• Universiti Putra Malaysia, Faculty of Medicine and Health Sciences

• Universiti Malaysia Sabah, School of Medicine

• Universiti Malaysia Sarawak, Faculty of Medicine and Health Sciences

• International Islamic University Malaysia, Kulliyyah of Medicine

• Universiti Teknologi MARA, Faculty of Medicine

• Universiti Sains Islam Malaysia, Faculty of Medicine & Health Sciences

• Universiti Darul Iman,Faculty of Medicine

Private Universities and Colleges’

• UCSI University, Faculty of Medical Sciences – School of Medicine

• Monash University Malaysia, School of Medicine and Health Sciences

• International Medical University, Faculty of Medicine

• AIMST University, Faculty of Medicine and Health Sciences

• Allianze College Of Medical Sciences, Faculty Of Medicine

• Management and Science University, Faculty of Medicine

• Cyberjaya University College of Medical Sciences, Faculty of Medicine

• Royal College of Medicine Perak, School of Medicine

• Melaka Manipal Medical College, School of Medicine

• Penang Medical College, School of Medicine

• MAHSA University College, Faculty Of Medicine

• Newcastle University Medicine Malaysia ( NuMED)

• Taylor’s University College, School of Medicine

• UTAR

These are the medical schools in Malaysia. These schools when fully functional will produce about 4000 doctors a year. There will be thousands more Malaysian doctors being produced overseas, since many Malaysians are studying medicine in UK, Australia, New Zealand, India, Indonesia, Russia, Taiwan and even Ukraine. (Nana adds IRELAND  here! hee =) )

The sudden mushrooming of medical schools are apparently due to shortages of doctors in the public sectors. This is because most doctors in government service resign after their compulsory services and opt for the supposedly greener pasture in the private sector.

In most other countries, the logical thing to do to counter this brain drain of doctors to private sector is to find out why doctors are resigning from government service and then try to address the woes of the doctors , and hopefully keep them in service. I call this common logic.

The Malaysian solution , like in many other instances, does not take common logic into account but rather uses the sledgehammer approach. After all, we do have Malaysian logic which is different from common logic practiced in most other countries. For example, if we cannot have spacecraft of our own, we can still produce Astronauts by sending Malaysians into space hitchhiking on other countries’ spacecraft.

In most other countries, the common logic will be to try to improve the working conditions in public sector so that doctors will stay back. But Malaysian logic is sledgehammer logic, and is very different.

If the doctors do not want to stay in government service, then Malaysia shall flood the market with doctors, so goes the Malaysian logic. Never mind that setting up of medical schools and training doctors are expensive businesses. We have petroleum and huge amount of development funds. By building more buildings and buying expensive medical equipment to equip these medical schools, billions will have to be spent and of course, in the Malaysian context, everyone will be happy, down from the planners, the contractors, the parents and all others involved, since the perception is that projects in Malaysia inevitably will have some leakages and wastages and many people are very happy with these leakages and wastages. Never mind that we may have the hardware but we may not have enough qualified people to man these medical schools.

The Malaysian logic seems to be like this: If enough doctors are produced, the market will be saturated with doctors and thus doctors will have no where to go but to stay put in government service.

Well, the people may be clapping hands and rejoicing that with more doctors than are needed, medical costs will come down.

Unfortunately, things do not function like this in medical education. Experience in some countries tells us that some doctors in private practice , when faced with too few patients will charge higher and do more investigations, some of which may not be needed, so instead of medical cost going down , it will go up.

In any advanced nation, the setting of a medical school requires a lot of planning and not on ad hoc basis. Planning that must include where to source for experienced and qualified teachers, where to build new or source for existing teaching hospitals which are big enough for the placement of these medical students to do training. Planning such as facilities, equipments, classrooms, curriculum. In the west, it takes many years of planning for a medical school to be set up; whereas in Malaysia, we see more than 10 in the last 5 years.

In Malaysia, due to the sudden ‘exponential’ increase in medical schools, we have medical schools pinching staff from each other, even the mediocre ones, and with that number of qualified teachers only, it is unavoidable that many teachers may not have the experience and qualification to be medical lecturers.

The early birds (medical schools) are more fortunate. Their students are placed in bigger hospitals like the General Hospitals of Kuala Lumpur or Penang. Now, some of the medical schools just opened have to send their students to smaller district hospitals to do their training. The smaller hospitals are often manned by more junior doctors who are not qualified to be medical teachers, and these hospitals have only very basic facilities and equipment.

This is just the beginning of the problems. For a doctor, graduating from a medical school is the beginning of a life long journey, and the basic medical degree is more like a license to start to really learn how to manage and treat patients.

The most important year after a doctor graduated is the houseman-ship. If a doctor does not have proper houseman training, then he would face a lot of problems later on. He or she may know all the medical knowledge in the world (just for argument sake only since knowledge of medicine is so vast that no one can know everything), but without the proper houseman training, he or she will not get the hand-on experience so crucial and important to doctors. A doctor without proper houseman training is not unlike a person, who has played only racing in the arcade games, suddenly being asked to race in a real life race. He would not have the hands on experience to do well. A doctor without proper houseman training would be like a person given a license to kill and a disaster waiting to happen.

Now, with 4000 doctors being produced in a year, where do we find so many houseman positions for these young doctors? Even now, with some of the medical schools just starting and not yet producing doctors, and the number of doctors being produced is much less than the 4000 , the wards in some of the bigger hospitals are filled with so many housemen that in some wards, there are not enough patients for these housemen to learn management skills. About a year back, I was told, in HKL some of the units have more than 20 housemen. Recently one doctor told me that in some units, it may have even more than that. I was aghast. Since with that many housemen in a single unit, and so few senior officers to guide them and so few patients for them to learn from, how are they going to learn the skill of doctoring?

When there is not enough training for these housemen, what do you think our policy planners do? In the typical Malaysian style, they increase the length of houseman-ship from a year to 2, hoping that the longer time will help to give better exposure to these doctors. Compared to Australia, New Zealand, and United Kingdom, houseman-ship is still one year only. By increasing the length of the houseman-ship, it is a tacit admission that our one year houseman training is not as good as the above mentioned countries. A poorly trained houseman will become a not so good medical officer, and since now most of the specialists are trained internally, it will be a matter of time that future specialists may not be as well trained as present.

Many parents do not know about the actual situation and still encourage their children to take up medicine. They are not told of the actual situation. The day will come when there are simply so many doctors that none are adequately trained. There will come a day when a doctor graduating from a medical school cannot even be placed in a houseman position.

That day is actually very near.

-THE END-

you should go to Dr Hsu page for the responses....highly recommended!  AND TAKE A LOOK AT THE INSTANT CAMERA BELOW! I LIKE IT! <SHARING IS CARING>

why do some of the questions not being shown here??

plz visit www.formspring.me/missjijanornana or my blog missjijanornana@blogspot.com for the missing questions =)

Ask me anything

suke mengutok org x??bad habit aperr???hehe

nana answers>>>i remembered the moments i once a "pengutuk"..but mrsm pc taught me alot.. <insaf> (^_^)v .. bad habit? ape eh.. um, byk kowt.. for one thing , ak xleyh keje cepat...slow r kire (but cool r..hakhak)..but the bright side of it, i just remain calm whenever i have problems =)

Ask me anything

dont smile and show your teeth till 26th May!

haha..yesterday was a-bloody-mouth day for me... not that i became a canibal or something lol.. ;) i went for a mouth operation. there's a tooth of mine which didnt "popped out" till now that i have to remove it by surgery ( o my Allah, it hid at my lelangit u noe!!).. what most painful was at the very moment the Dr injected me the anesthetic.. uh, my whole body was like jerking that time...4 injections mehh~ besides removing that "hidden" one, i also had normal removal of my other two teeth.. haha.. 3 teeth removed in one day is a big loss heh? but it'll be paid with something i have been dreaming for since the past two years...- I GONNA HAVE BRACES ON 26TH MAY!! but looks like i cant smile wide till 26th May..haha.. cz i da rongak ;p nadia ismadi, seha shawal, n syafiq kamal azmi, ill be joining your club except that u guys have been alumni =)

~congratulations to my sweet Nadia Ismadi for WINNING the Petronas' scholarship!!!!
go. go fly, babe! =) pray for me too-

A Hysterical Letdown

A mother passing by her daughter's bedroom was astonished to see the bed was nicely made and everything was picked up. Then she saw an envelope propped up prominently on the center of the bed. It was addressed, "Mom." With the worst premonition, she opened the envelope and read the letter with trembling hands:

Dear Mom: It is with great regret and sorrow that I'm writing you. I had to elope with my new boyfriend because I wanted to avoid a scene with Dad and you. I've been finding real passion with Ahmed and he is so nice-even with all his piercings, tattoos, beard, and his motorcycle clothes. But it's not only the passion Mom, I'm pregnant and Ahmed said that we will be very happy. He already owns a trailer in the woods and has a stack of firewood for the whole winter. He wants to have many more children with me and that's now one of my dreams too. Ahmed taught me that marijuana doesn't really hurt anyone and we'll be growing it for us and trading it with his friends for all the cocaine and ecstasy we want. In the meantime, we'll pray that science will find a cure for AIDS so Ahmed can get better; he sure deserves it!! Don't worry Mom, I'm 15 years old now and I know how to take care of myself. Someday I'm sure we'll be back to visit so you can get to know your grand children.

Your daughter, Judith

PS: Mom, none of the above is true. I'm over at the neighbor's house. I just wanted to remind you that there are worse things in life than my report card that's in my desk center drawer. I love you! Call when it is safe for me to come home.

- An e-mail

I LOVE YOU, MOM

pengharapan::

".....dan berdoalah kepadanya Dengan perasaan bimbang (kalau-kalau tidak diterima) dan juga Dengan perasaan terlalu mengharapkan (supaya makbul). Sesungguhnya rahmat Allah itu dekat kepada orang-orang Yang memperbaiki amalannya. (07: 55-56)"

sering kali rasa berdosa tatkala rezeki yg telah Allah janjikan tidak aku yakini.. berdoa dengan tidak yakin, risau dan sebginya.. sedangkan doa itu perlu dipanjatkan dengan penuh keyakinan kepadaNYA, Maha Pemberi Rezeki! sedangkan aku sedia maklum bahawa Allah akan memberikan aku apa yang terbaik buatku- he'll gve me what i need, not what i want.!!

my soul is waiting for MAra Oversea result..i hope, hope n hoping for the chance to study in IrelAND,SO MUCH (only Allah knows how much i wannit).. BUT rumour saying that ONLY 10 medic applicants will be sent to UK, n 10 ONLY will be sent to Ireland.. to be turth, to be frank, that troubles my amotion much..::

anyway, i have gotten two offers now,LOCAL:
-matrix penang (my first choice when filled the matrix application form)
-asasi perubatan UIA (my first choice when filled the UPU application form)

both of them are my first choices, will i get the offer on my first choice for MARA SPC? (royal College of SUrgeon Ireland)...wallahualam~