The changing landscape of junior doctor jobs in Malaysia

jobless doctors
(Picture sourced from – Telegraph UK: Thousands of junior doctors left jobless)

Times are a-changing. No longer will fresh medical graduates in the future be reassured of a doctor’s job in Malaysia. It will be a very competitive scenario. We say so based on the startling facts from the Berita MMA December issue report on the 2nd Housemanship Training Seminar

There is an ever increasing number of medical graduates and in the year 2012 it is 3,655 and 50 percent of them are from overseas. In the year 2014, there will be appropriately 600 graduates reporting every month.

600 graduates a month, or over 7000 new medical graduates a year!

Currently there are 48 Housemanship Training Centres, out of which 45 are Ministry of Health hospitals and 3 are university hospitals (UKM, USM and UH). Though MOH has 144 hospitals, there are not enough specialists and infrastructure facilities to increase the training centres. The Armed Forces hospitals are willing to train their army scholar House Officers. In the year 2015, MOH will open up 2 more training hospitals.

As we already know the housemanship training hospitals are already strained to breaking point. There are simply too many housemen and too few trainers.

The House Officers have to undergo 2 years training. Five disciplines namely Medicine, Surgery, O&G, Orthopaedics and Paediatrics are compulsory. In the sixth posting, they have a choice either to do Accident & Emergency, Anaesthesia, or Psychiatry and Primary Care which the MOH shall be introducing as choice postings. The current salary and allowance for a house officer is appropriately RM 4,000.
Most of the training hospitals are crowded but MOH from November 2012 will introduce a modified flexi hour system to ensure these House Officers have enough contact with patients.
Each Houseman will be in charge of patients in 3 beds. In 1970, it was a ratio of 1:19. One in five Housemen have their housemanship training extended to more than 2 years, and most of these are graduates from Ukraine, Russia and Indonesia. A maximum of 1 year extension is given. MOH has terminated 18 house officers who were found to be unfit.
Few of the Housemen have undergone mental stress and emotional problems, and about 19 have resigned.

The MOH is trying to adapt but if you add a large number of graduates who are fundamentally weak, you’ll end up with an increasing number with extended Housemen postings, terminations, resignations and stressed/suicidal housemen.

What else can be done?

The MOH and Ministry of Education are planning to increase the minimum requirements to enter medical courses.
By 2017 or 2018, if the number of House Officers increase to 10,000, then MMC may conduct a qualifying exam for both local and overseas graduates for employment as House Officers.

As we reported earlier, the MMLE or Malaysian Medical Licensing Examination is coming. Be prepared.

But there is more in store for junior doctors

By 2017, the Medical Officer’s post will be offered to competent House Officers. The MOH is planning to issue a certificate to each qualified House Officer to state whether they are satisfactory, good or excellent, and this will be helpful in seeking employment. The Minister advised for the newly qualified graduates to be passionate, industrious, and well-equipped with good communication skills. Never say ‘No’ to extra work.

As we predicted, jobs will not be assured. It looks like in the future, completing Housemanship will not assure one of a Medical Officer’s post. You’ll have to be “competent” enough! Well, if it is truly merit based competition then we say well and good. Competition will weed out the incompetent. How this turns out we shall see.

In the meantime to future students we say good luck but think very very carefully if you want to pursue medicine as a career. Do so only if your heart is truly in it. It’s a long and hard road ahead.

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Malaysian physician, haematologist, blogger, web and tech enthusiast

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