Enough talk, time for action

This article by Dr Timothy Cheng appeared in The Star

BY now one would have realised that there are two main schools of thought regarding hospital housemanship training.

The first believes that housemanship is a period of toughening up and that those who cannot withstand the training are deemed not fit to be doctors. The other believes that house officers cannot work more than 12 hours a day and cannot be shaken out of their comfort zone; any form of comments or criticism is deemed as bullying or putting down.

I completed two years of housemanship and have been a medical officer for five months. During my two years as a house officer, I received my fair share of scolding and criticism.

Mind you, there were medical officers that went around bullying house officers for the sake of it. Name calling such as “stupid”, “brainless” was uncommon but real.

Extension of house officers is a very subjective thing. Different departments have their own system of evaluating house officers and this varies from hospital to hospital. When the evaluation system involves an oral viva – it is also very much examiner dependent.

On the other side of the coin, I have seen many house officers who just aren’t interested in their work. Some were forced into medical school just because they obtained straight As in SPM; others for family pride and so on.

I had colleagues who would come to work late, disappear during the day and leave early.

Others would be so calculative when it came to shift work and would be sour-faced minutes past the end of the shift.

During my two years, most of the medical officers and specialists that I worked with were very keen in mentoring house officers. We had regular teaching sessions and some would even stay back after office hours to teach and guide us.

We are as usual barking up the wrong tree over this issue. I can go on and on and give more examples showing that both schools of thought have their valid points.

Here are two practical (and necessary) steps that should be taken to improve this situation, instead of bashing each other through the newspapers and social media.

> Conduct a nationwide aptitude test and interview for all enrolments to medical schools.

No one has had the political will or courage to implement such a ruling but this is extremely fundamental and necessary in handling the quality of medical graduates.

Why do damage control for a situation that can be prevented? Most of the issues that are being raised are caused by poor attitude and a lack of interest in the medicine.

> Revamp the house officer distribution system at the national/hospital level.

Some departments in certain hospitals have house officers working 120 hours a week, others work 60 hours and have time for four meals a day. Something is definitely wrong somewhere.

Finally, to current house officers – toughen up and learn to adapt to circumstances given to you. The harder you train the better you get – but do not keep silent if you reach the limit of your physical/mental capabilities.

To senior doctors – get rid of the “because I suffered so you must suffer too” mentality. Long working hours do not translate directly into competent, mature doctors. Focus on mentoring and apprenticeship instead.

DR TIMOTHY CHENG

Lahad Datu, Sabah