Post-call accidents – time to revamp the system

(image credit to FMT)

In the last few months we have seen couple of young doctors losing their lives in road traffic accidents post call. In May Dr Nurul Wahida Md Noor died in an accident having been on call the day before. Just 2 days ago, a young anaesthetic MO, Dr Afifah Mohd Ghazi tragically died in an accident also post-call, leaving behind her husband a neurosurgical MO and a 1 year old child.
Our heartfelt condolences go out to their families and we can’t imagine the grief they are going through.
Medical Officers go “on-call” which is different from going on shift duty that House officers and other medical staff perform. This requires the doctors to spend long hours in hospital, sometimes 36 hour work stretches, and the doctors are often sleep deprived. In our doctors forums and social media group, there is an ongoing survey to try to gauge the extent of post-call MVAs and it seems quite a number have experienced accidents post-call.

FMT reports on the MMA president’s comments

Dr Ashok Zachariah Philip, said in a statement that it was a tragedy for the family and a loss to the profession. “It is clear from the outpouring of messages of praise and sorrow from her colleagues and seniors that Dr Afifah was a well-liked and hardworking doctor,” he said. Dr Ashok said that “though we cannot be sure yet, it is likely that post-call fatigue and perhaps low blood sugar were factors in the accident”. He said the MMA would like to support the efforts of the Ministry of Health to increase the number of posts available for medical officers throughout the country. “Though civil service posts have been frozen, we feel special consideration should be extended to the medical field, because both patient load and patient expectations are increasing rapidly, and new services are being offered,” he said. Shortages have the potential for devastating effects on patients and doctors alike, and the MMA hopes the efforts of the Ministry of Health to increase medical officers posts will be successful, he said.

While it’s true that there could have been other factors other than post-call fatigue which were contributory to the accidents (e.g. hypoglycaemia during the fasting month), the timing and nature of the accidents (not involving other vehicles) strongly suggests driver fatigue. What can be done about it? It is very easy to tell post-call doctors to rest before driving home, but they are precisely going to do that – to go home to rest. Should the hospital provide alternate transport home for fatigued staff?
Perhaps a better solution is to make sure that there are no longer extended calls and no doctor should be made to work longer than 24 hours at a time. After all, there is now a glut of Houseofficers and these will become Medical Officers unless the freeze in Civil service posts puts paid to any hopes of the Health Ministry increasing the number of Medical officer posts.
In the UK, hospitals were told to cut the working hours of junior doctors after a young doctor lost her life in an accident following intensive back-to-back call duty, and even then only after a campaign by the doctor’s father.
Last year, the Health Minister was quoted in the press as saying Tiada isu doktor tidak cukup rehat. We wonder after these two tragedies that the Honorable Minister still maintains this opinion?
The ball is in your court, KKM. We need to see the call system revamped before more young lives are lost. Don’t wait to act only after families of deceased doctors start a campaign here.

Have you as a doctor ever been involved in an MVA post-call?
Share your experience in our Doctors forums – in our Dobbs Facebook Group or in the Dobbs Forums (instructions on how to join are posted at the bottom of the page and membership is free for all Malaysian doctors)


Malaysian physician, haematologist, blogger, web and tech enthusiast