Housemen dilemma : A tad too late?

311294_10150365059275148_5717802_nBy Dr Timothy Cheng,

In response to an article in The Star, “Waiting list for housemen positions at government hospitals“.

It is with amusement as I read the article – Waiting list for housemen positions at public hospitals, June 21, 2014.

The health ministry is ‘in discussion’ with the education ministry to review minimum qualification for entry to medical schools. I believe we are years too late.

20140622-082721-30441297.jpgComing to end of my two year housemanship training (notwithstanding an extension), in Queen Elizabeth Hospital< KK, Sabah, I realize that the government needs to take drastic and swift measures to handle the crisis that we have in this area of medical education. The government needs to bear full responsibility for the current situation that we are in. How did we come to this state of having 33 medical schools nationwide? The moratorium to stop the formation of medical schools is merely damage control to a situation that will spiral out of control if not handled wisely. And what does a moratorium of five years mean? That new medical schools will start to spring up after the year 2016? I sincerely hope not. Our situation is 'extraordinary' indeed because we have allowed new medical institutions to spring up without control. Entry requirements to medical schools are almost non-existent. I personally have friends from medical school and colleagues who are in this field because of parental/peer pressure and have no interest in it whatsoever. A nationwide interview and aptitude test should be compulsory to all students before enrolling into medical school. Criteria for enrolment to medical schools need to be revised and implemented. Foreign/local medical schools that do not meet basic requirements should be deregistered with immediate effect. But does the government have the political will and courage to do so? Or are we just going to continue “looking into it”? Putting house officers in psychiatry and primary care postings is a desperate knee-jerk measure to handle the overload of house officers into the system. It is already difficult to mentor, train and guide house officers in tertiary hospitals, let alone primary care clinics with one specialist. If at all implemented, these postings must not compromise the basic training of house officers in the core disciplines of medicine. The system for the distribution of house officers across hospitals nationwide needs a revamp. In certain hospitals, house officers work weeks without a single off day while in others (such as mine) we sometimes have a doctor:patient ratio of 1:1. As a result, we have house officers who are either overworked and perpetually tired; or those who lack training and experience. Perhaps more effort could be directed into the even distribution of house officers rather than implementing one shift system after another. We need to stop treating the situation symptomatically and start addressing the root cause of the problem. The crisis is already upon us and we must not tarry.

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