Letter to Editor
The last few months has seen a lot of discourse in the media on the plight of young trainee doctors or housemen as they are called.
We saw a lot of shocking headlines – ‘not cut out to be doctors’, ‘grappling with housemen woes’, ‘housemen buckling under pressure’ – just to name a few.
The most shocking revelation was that housemen comprised the highest number of civil servants who were sacked.
According to some media reports, 1 out of 5 housemen drop out annually with the total dropouts numbering up to 1,000 or more annually.
The average cost of studying medicine at a foreign university branch campus in Malaysia is around RM500,000 excluding living expenses.
Just taking this as a benchmark you’re looking at a loss of RM500 million.
This is a colossal waste of resources.
After spending years in tuition and training only to drop out just at the threshold of their medical career.
Of course, the obvious question that arises is ‘why’.?’
The rigidity of training during the two-year internship period could not have changed much.
If anything it was perhaps worse in the last few decades as there was always a shortage of doctors in the government service and hence a heavier workload.
The notion of working through 36 hours is not new.
Most senior doctors have gone through this and while it was tough and gruelling – it was seen as part and parcel of the rigorous training that was required for this noble profession of saving lives.
So why is it now that there are not enough places for housemen training, in other words when housemen are in plenty and hence one would assume a lower workload than in the past, are these young people dropping out and not able to cope with the demands of the training?
It has a lot to do with the attitude and aptitude of these students towards medicine as a career.
Why choose medicine as a career when the attitude and aptitude are lacking.
In secondary school itself, it can be assessed whether students are cut out for medicine as a career.
Let’s examine some of the reasons for the current trend.
Indiscriminate mushrooming of medical schools
There are 34 public and private medical schools in the country churning out thousands of medical graduates every year.
In 2014 over 7,000 new medical graduates passed out from these schools. The number increases every year.
How did so many medical schools appear suddenly?
Was a needs assessment done before these schools were allowed to be established?
Considering that the compulsory housemen training can only be done in government institutions surely some assessment should have been done on the number of medical graduates that will be coming out annually and whether the health system had the capacity to absorb them.
Lower entry standards
With so many schools and the need to fill up space, the entry requirements would have been lowered over the years.
At one time, entry to medical school was one of the toughest and only the brightest and toughest students made it.
Now it seems to be relatively easier to gain entry to medical school.
The quality of teachers and teaching too would have simultaneously lowered.
It is common knowledge that education is a big business and some medical schools have been set up for financial reasons.
Perhaps the most important issue is the capability of the students and their aptitude and attitude for medicine as a career.
Despite the course being long and expensive, the demand is there.
Many are lured by the notion of glamour and money that comes with the medical profession.
Many others are unfortunately pressured by their parents to study medicine.
Some families who want to carry on a family business or practice in medicine go to extreme lengths to enrol their children in medical schools even though they do not meet the academic criteria or have the aptitude.
It would not be far-fetched to say that the genre of students now is of a different quality from a generation or two ago.
The present generation is a much-pampered lot with a much-lowered tenacity to withstand stress and reprimand.
Hence the increasing drop-out rate during the housemen training period.
The situation is dire and immediate measures are required to stop the rot from further setting in.
The medical profession deals with human lives and any erosion of standards due to policy failure is a grave misgiving on the part of the government.
CAP calls for an independent panel of experts to be set up to look into the quality standards of medical education in the country.
This panel should comprise not just of medical experts but people from other fields as well such as legal, engineering, nursing etc.
The aim of this panel would be:
- To conduct an assessment of all medical schools in the country in terms of entry standards, quality of teaching, standards of examinations. External examiners should be considered.
- To ensure potential students have the right attitude and aptitude for medicine and are fully aware of the challenges in a medical career.
- To set standards and ensure these are monitored and adhered to.
S.M. Mohamed Idris
Consumers Association of Penang