Houseman Glut : Why are we not surprised?

Too many new doctors and
too few hospitals to train them
By LOH FOON FONG
foonfong@thestar.com.my PETALING JAYA: The number of medical
housemen undergoing clinical training in most government hospitals
has increased and this has given rise to concern that they may not
get sufficient experience. With new medical schools
opening up locally and lower fees being offered at new institutions
abroad, around 4,000 Malaysian medical students are expected to
graduate annually from 350 universities all over the world in the
coming years. Senior Hospital Kuala Lumpur (HKL) consultant
physician Datuk Dr S. Jeyaindran said each specialist was
supervising four times as many housemen compared to a decade ago.
?Five years ago, one houseman looked after 10 patients in hospital
wards at any one time but now it is one to four patients,? said Dr
Jeyaindran, who is HKL department of medicine head and national
head for medicine at the Health Ministry. ?The concern is that
these interns are seeing fewer patients and hence, have fewer
opportunities to carry out adequate procedures. In some hospitals,
there are more housemen than patients.? Dr Jeyaindran said they
were not only concerned about the increase in numbers but also
their attitude. ?Some lack responsibility towards their patients,?
he said, adding that there were also those who did not know how to
give an accurate diagnosis and relied too much on investigative
tools instead of clinical skills and getting the proper patient
history. Continuing
story

Editorial
Note
It is no surprise that finally someone has
spoken out against the sudden rise in tide of houseman arrivals.
With the production mill at full capacity, Malaysia is seeing a
varied quality of graduates arriving at our wards. Every new
houseman is so different depending on where they have studied that
it is almost impossible to tailor make a specific program during
their housemanship years. Now with more dubious medical schools
being allowed to operate, the quality is sure to drop, resulting in
a more strenuous effort in training them during housemanship years.
Building more training hospitals as suggested by our honourable
health minister will not solve but in fact aggravate the problem.
As it is, our current hospitals are poorly staffed by experienced
doctors. With a surge of housemans, more hospitals will only dilute
the expertise in these respective hospitals. Malaysia wants to
achieve a good doctor patient ratio in the shortest possible
duration. Unfortunately many policymakers are unaware of the actual
situation on the ground and therefore implemented a quick fix
solution by approving more medical schools in Malaysia. There is no
foresight to plan for the future careers of these newer doctors as
post graduate places are even more limited. Now the current medical
officers and specialists are left to retrain many of these new
doctors with the barest of resources. Recent decision to allow
foreign medical institutions to set up camp will only result in a
potential mass efflux of experienced doctors from our local
hospitals and universities. Smaller medical schools can only hope
to pick up the remaining few to fill their academic positions. This
will further widen the already gaping difference in competency
among our new medical graduates. Malaysia needs to solidify the
existing institutions. They should seek to develop collaboration
between local faculties and foreign medical schools, not just
allowing them to set up camp here, which can potentially further
isolate disadvantaged local faculties. Why is it that General
Medical Council refuses to recognise local medical degrees, when
their universities are setting up camp in our backyard and
populating their academia with local expertise, many of whom are
from local universities prior?? The Government should therefore
strive to strengthen our local universities by establishing and
encouraging collaboration with local medical faculties. Ultimately
it is the public that will be the losers with less than competent
doctors attending to them.