But what happens when the HOs become MOs?

Further to the discussion on Houseman training and the complaints of “hardship” that are emerging in the press, I would like to highlight a letter CWD wrote to the NST yesterday

THE death of Dr Danny Lee Chang Tat, as regrettable as it is, has brought about a typical knee-jerk reaction — abrupt changes to a system without knowing its repercussions.
Dr Lee was found dead in the restroom of the paediatrics ward at Kajang Hospital by hospital staff on Wednesday morning.
Approximately five years ago, I started my housemanship in the country’s busiest hospital, where I was on call at least twice a week, working 36-hour shifts. Every ward was manned by three to four house officers, two to three medical officers and one or two specialists.
One could only imagine the workload, but we all managed to complete our work. In those times, issues of irresponsibility were practically unheard of. It was rare for house officers back then to be extended in service.
I have to admit that those were probably the worst of working conditions; we were so tired that at times we fell asleep while writing summaries, and occasionally, many of us felt like throwing in the towel.
Fast forward to this year, house officers now are working in shifts, their numbers have exponentially increased along with salary scales, but it seems that things are turning for the worse.
With so much focus on the well- being of house officers, the ones who actually shoulder the heaviest of burdens and responsibilities — the medical officers and specialists — have been forgotten.
What many people fail to understand is that house officers will one day complete their internships and become medical officers. The latter still work 30- to 36-hour shifts, sometimes with on-calls every other day.
How can one expect a house officer from the current shift system to be able to function as a medical officer later on if he or she is pampered all the way?
The behaviour of some of the house officers is appalling, as many of us can attest to the horror stories we hear and personally experience, which I feel the public should know. For example, house officers who go missing during rounds, not clerking cases but are instead sound asleep, and the list is endless.
This is not helped by the fact that the moratorium regarding medical schools is only paying lip service, with some medical schools, both local and foreign, churning out graduates of dubious quality, made worse by the fact that some of them are only studying medicine due to parental pressure.
Some house officers are even unable to tell what normal blood pressure or fasting glucose is.
I am glad that the welfare of house officers has improved for the better over the past few years, but I strongly feel that the well-being of the public is sacrificed in the process.
As the saying goes, the strongest of steel is forged in the hottest fire. The best doctors are those who have undergone vigorous and proper training, and sometimes, training comes with long hours.
So, I hope the Health Ministry will not, in its efforts to improve the welfare of the house officers, sacrifice the safety and health of the public.
Please also look into the welfare of the medical officers and specialists. For the time being, none of my family members will be seen by anyone else other than those in my profession whom I truly trust to be competent.

It’s not about working hours per se, but there are problems with the system which need to be addressed. There’s a post in the MMR which Dr TE Cheah made a few months ago where he makes pertinent points. Worth reading again:
Not solving the problem!


Malaysian physician, haematologist, blogger, web and tech enthusiast