'Housemen not over-worked in hospitals'

The Health Ministry has not received formal complaints from any trainee doctor (housemen) about stressful work conditions in government hospitals, said director-general Dr Ismail Merican.

He countered that, to his knowledge, some hospital wards have too many trainees who end up being under-worked.

"I'm surprised (that there are complaints)... if you go to the surgical ward, there will be 20 housemen floating around, and they will be fighting to do an appendectomy," he said in an interview.

He was asked to comment on an issue frequently raised in the 'Letters' forum of newspapers. These have highlighted work shifts for up to 36 hours if the houseman is on call - and there have been claims that call-duty could go on for 15 days a month.

Ismail conceded, though, that he has received complaints from parents of trainees, describing it as a "problem" that did not exist when he went through the system as a houseman.

"We worked much harder then and we didn't complain to (our) parents...I'm approachable, (the trainees) can e-mail or SMS me or drop by my office, but no one has complained other than the parents," he said.

In Europe, the practice of long shifts has been banned, with doctors allowed to only work a maximum of 12 hours without a break.

Housemen in Malaysia have further claimed that they are affected by bullying and the high-handedness of senior doctors, in a carry-over of treatment they themselves had suffered as trainees.

Interestingly in 2008, Ismail had revealed that many trainees cannot cope with housemanship, succumbing to neuroses (mental disorders) including anxiety, fear and anger, due to the competitive environment.

The long hours and emotional pressure are also a bone of contention, according to some trainees, because of the relatively low pay.

Their counterparts in Singapore earn S$40,000 (approximately RM86,000) a year after tax, which is almost five times more than the pay in Malaysia.

The relatively low pay has also been named as the reason for the number of doctors opting out of public service, a claim that Ismail refuted.

"A lot of government doctors and specialists are staying on because of faster promotions, better career development and perks with the civil service," he said.

In fact, he said, many private general physicians are "complaining" and "accusing (the government) of providing a better deal because (the government pays) RM80 for locum (work)", which can be undertaken in a doctor's free time.

'We won't have too many doctors'

While housemen complain that they are feeling the strain due to a shortage of doctors, Malaysian Medical Association education committee chairperson Dr N Athimulam said the country is headed for a day where doctors will need to "clamour for patients".

He said 1,200 doctors graduate from local institutions annually, with seven more private institutions to offer medical courses in the next few years.

Ismail disagreed to some extent, pointing out that the challenge is that there will not be enough doctors to serve areas in the interior of the country.

"We were thinking that perhaps by 2015 we may reach (a national doctor-patient) ratio of 1:600. But even then, I don't think it will solve the problem because there are states like Sabah, Sarawak and Pahang (which will still face a shortage)," he said.

"In Kuala Lumpur you can get a ratio of 1:300 or 1:400, better than in Britain. But if you go to Sabah, it's about 1:3,000 or 1:2,500. There's a disparity in the doctor-patient ratio," he added.

source: http://www.malaysiakini.com/news/122859

seals: Houseman's out there...you should comment....