Review housemanship training

AS a senior retired government specialist, I wish to comment on junior doctors and their current two-year housemanship training. As the saying goes, “The writing is on the wall!”

If doctor after doctor, and parent after parent write in to complain to the press that something is not right, then “Something is not right!”, and the authorities concerned must look into it.



Some years ago, a patient died during surgery in Britain due to an error by a trainee doctor. The Health Ministry investigated and came to the conclusion that the trainee doctors were overworked. It then introduced a rule capping the maximum hours of work that any trainee doctor is allowed per week.

Currently, I understand that some of our young doctors work for up to 90 hours a week! With a two-shift system, the hours will definitely be long. Thus, giving a day off after a gruelling six-day week, is hardly the remedy.

Many of us “elderly” doctors will recall our time when we were the only houseman in the ward and we worked seven days a week, often twice a week being on call i.e. working up to 36 hours in a stretch.

However, there was a major difference then. We could often get off by evening and be home for dinner with the family if we were not on call. On Saturdays, we worked till 2pm and were free for the rest of the day. On Sundays, we come in early to do our rounds and we were free after that. Work then officially began at 8am and ended at 5pm.

Not so now. Many of the young doctors start their shift as early 7am and work till 5pm or up to 10pm during their tagging period, which can go on for a few weeks. And this routine goes on through the weekend.

When on call, they begin as early as 5pm or 6pm and work through until 11am the next day.

Their social life is effectively “zero” for two years. Housemanship duration was a year previously, until recently.

My sympathies go to the young mothers, who have husbands and perhaps infants and toddlers to look after, besides their ageing parents or in-laws. Those two years will definitely be their most challenging, if not depressing working years.

The least sympathy, as always, will come from the senior doctors, who are forever saying, “We went through all that and survived. Why can’t you stop grumbling and get on with your work!”

This attitude is incorrect and not forward-looking. It is time for the senior doctors and administrators change their mindset.

For a start, we had houseman quarters located within walking distance from our place of work. Hence, we could walk back and flop into our beds within minutes. Now, the young doctor has to travel a distance and risk falling asleep at the wheel.

Secondly, in the name of progress, working conditions should improve and not worsen.

While we worked hard, we enjoyed our work and had good rapport with our seniors and consultants, except for a few notorious “tyrants”.

Working as a doctor should be fun and stimulating, if there is good team work and understanding from the boss downwards. There should never be bullying or intimidation.

We need to review the way we carry out our work, too.

In the past, the trainee doctor may be working under one medical officer and one specialist, hence doing daily rounds with the medical officer and once or twice a week with the specialist.

With the increase in the number of medical officers and specialists on the team, the trainee doctor may have to do several rounds a day with the medical officer, the specialists and the consultants.

The fact that we went through that tough and strenuous path before does not necessarily mean that we can apply the same method to train our younger ones.

The medical training programme is already a rigorous five to six years. Add in another two years of unpleasant work conditions, and we do not produce a healthy generation of able doctors.

We should be nurturing the next generation and encourage them to rise to greater heights, by setting good examples for them to emulate.

EX-GOVERNMENT SPECIALIST

Kuala Lumpur