A doctor too many III

This is the number of house officers as of end of April 2010 in HKL , the biggest hospital in our country:

Unit Number of housemen in the unit
Orthopaedic Department 52
O & G Unit 50
Medical Department 72
Surgical Department 57
Paediatric Department 62

Just as an illustration, the orthopedic unit mentioned in the table above has 182 beds. With 52 house officers, it amounts to 1 houseman to slightly more than 3 patients.. A ratio you would not be able to find anywhere else in the world, believe me! Not even in the most advanced country!

Gone were the days when we had only 2 or 3 house officers in a unit. I remember during my time, when I was doing housemanship in Penang GH, I was for 2 weeks the only houseman in the orthopedic unit. Now I heard they too had 60 housemen in the unit (Jan 2010 figure).

Just imagine, if you have 60 house officers following a consultant doing the ward round, how are those at the back going to learn? I do not think there are even enough standing room for all of them. How are they going to examine a textbook case ( a case with classical signs and symptoms), since to do so would have subjected the patient to examinations 60 times– if the patient does not die from his illness, he might die from too much handling from these housemen!!!

The figures I quoted are real figures. I am sure those of you reading now would agree with me that there are now simply too many doctors being produced, and since there are not enough hospitals to place them in, there is no choice but to place them in the same units…

No wonder i received emails after my last posts saying that many house officrs are seen spending most of their time in the canteens, since they just have nowhere to go…

And in no time, these same people will be treating you and me, including the politicians. Perhaps I should warn them here that Healthcare is different from education. In education, if our schools are no good, they can still send their children overseas to study. But when these politicians get a stroke or heart attack, it would be too late for them to fly out to even Singapore to seek treatment. They would be treated by the same local doctors that they help in mass production.

Our healthcare standard is going to deteriorate with this sort of training of our doctors..Just like almost everything else.

I am now in the process of writing a memorandum to be submitted to the Ministry on this problem and I hope my writings can bring some sense to this madness of  indiscriminate issuing of licenses to set up medical schools.

related articles:

A doctor too many II** (This article also published in Malaysian Insider and many blogsites). Someone has  translated this into Chinese and the Version is posted here.

A doctor too many I


20 Comments (+add yours?)

  1. pilocarpine
    May 04, 2010 @ 15:38:15

    a memorandum sent too late.

    i had too many HOs in my dept as well, and the ‘council’ of the hospital proposed that to make sure adequate training, at least 8 on calls per month…

    BUT to accommodate to that 1 day, we have to put 6 HOs on call, doing things for what meant to be for 3HOs, even so, they gone to maximum 6 calls per month. I guess if we put one more HO in, all the HO will do is take out the trash.

    with so little things to do, mainly they slept through their on calls, and learn nothing solid, and get the day off the next day as per suggested and imposed for KKM.

    the only solution is limit the post of HO in each hospital, and if the KKM decided to approve so many medical schools, the appointment SERIOUSLY needs to take a queue.

    I know they will come out with an excuse saying this phenomenon is temporary because of the conversion of 18months to 2 years housemanship, which is just another small factor contributing to this major problem.


  2. Dr Hsu
    May 04, 2010 @ 16:19:59

    Thanks for sharing this info.

    Someone has told me that the 25th license has already been given. UK has only 26 medical schools, for a population of 61 millions, and they have one of the best healthcare in the world.

    We are going to overtake UK in the number of medical schools. But while UK’s medical sshools typically produce about 100 plus doctors, our medical schools produced 200 (like UKM) and even graduates from MAHSA college will be awarded either UKM’s MD degree of University North Sumatra’s degree.

    If they want to twin with foreign universities, they should make sure they twin with reputable ones. Not just any Tom Dick and Harry.

    It is a bit late to send in memo now , but at least better late than never. And at least we can let the public know about this problem…


  3. CYC
    May 04, 2010 @ 16:59:37

    Its good for insurance industry. They will soon increase the premium for professional indemnity policy. It is also likely to increase premium of all medical coverage as the risk of repeated treatment is on the rise due to inefficiency of our medical practitioners.

    We used to have well trained nurses even in private clinic during the 70s and 80s. But now we don’t even have enough well trained nurses in well known medical centres. Why? another “Songsang” or “Reverse Gear” policy of BN?


  4. Tpg2Sg
    May 04, 2010 @ 18:05:40

  5. ketuanaan Cina
    May 04, 2010 @ 20:23:21

    Only in Malaysia, can u get a local grad doctor whom refuses to touch a patient that is of a different race, religion and gender…… ie. Using a pencil/pen to gauge a patients temperature.

    Only in Malaysia, can u get a local grad doctor whom knows less about medicine than the medical rep…..

    Only in Malaysia, can u get a local grad doctor whom cannot converse with an English speaking doctor during an op.

    Only in Malaysia, where a local grad doctor can take and are given credit for op’s performed primarily by a visiting doctor.

    ect…. ect…… ect……..

    There are many great doctors in Mal, BUT very few are local grads……


  6. svmbanu
    May 04, 2010 @ 22:56:56

    The country has gone to the dogs. Its very sad but true. I don’t think we can reverse it. In the very near future even Zimbabwe may look like a good place to move to.



  7. klm
    May 05, 2010 @ 14:58:41

    There is one way to solve this problem. Sue the doctors for mistakes. Sue them for every cents they have. Then I think these new doctors will be more careful and half past six.



  8. disgusted
    May 05, 2010 @ 15:41:10

    Kim, Ever heard of a man with a slight sickness, but persuaded by family members to see a specialist and it got worse. The end of the story was also the end of him. He was figuratively speaking, “mis-treated” and his sickness got worse. The logic was that if he had let his own body heal it (minor sickness), he would have got well.

    But he spent thousands giving to specialists to buy his death, virtually.


  9. CYC
    May 05, 2010 @ 16:32:29

    A doctor will never point their finger against another doctor when he/she were summoned to testify in any medical negligence or mistreatment case. The most they are willing to do is giving a piece of inconclusive opinion. Some may disagree with me but this is the norm. Why is it so? I really don’t know.


  10. klm
    May 05, 2010 @ 17:10:01

    Remember the old story of how many people do you need from Tenaga to change a light bulb?

    So, how may doctors to you need to confirm a disease. The medical profession called it a second opinion.

    You cannot have a situation where there is a stalemate. i.e two doctors disagree. So you need to consult 3 or 5, any odd number.

    (This is like the on board computer systems in the
    Space Shuttle. There are 5 redundant computers made by different companies doing the same computation. The results must all be correct before any decision is taken).

    So if you have many half past six doctors, then we need to have the same system as the Space Shuttle onboard computers. At least 3 doctors must agree before a treatment.


  11. Lawyer
    May 05, 2010 @ 17:18:47

    Soon, the number of doctors will rival the number of lawyers.

    The reason why there are so many lawyers in this country is due to the liberal approval of external programmes.


  12. CYC
    May 05, 2010 @ 17:29:14


    This is a good one. Acting according to consensus, no favoritism, no nepotism, objectively done. 1Malaysia, 1 injection, all doctors do it together.


  13. ketuanaan Cina
    May 05, 2010 @ 18:00:05

    One problemo with the theory guys….. Each time u r sick, imagine the amount of money u have to pay to the quacko’s, errr i mean doco’s.

    Malaysia should by now have a health card for all citizens whereby health care is subsidized. Only problem is, some idiot is gonna yell at the top of his voice that equality of health care benefit is unfair as his race should be getting more, as he is a son of the soil.

    On second thought, U’ll might want to join me in NZ as migrants. Guaranteed same same for everyone……

    New Zealand Forever!


  14. disgusted
    May 05, 2010 @ 18:46:18

    Kim, bingo! You got it right, always getting 2nd opinion. It’s happening now. Malaysians are always getting 2nd, 3rd…etc opinions. Because quantity too many, quality inferior…

    So when are we having doctors driving taxis and petrol station assistants? Soon, I think…..

    Tak Boleh Land


  15. Trackback: Housemanship Stuffs « Efenem's Weblog
  16. klm
    May 05, 2010 @ 21:49:42

    Dr. Hsu. By using the Tenaga solution, I am sure Malaysia can use all the half past six doctors it can produce. But, I am afraid it will affect the pride of professionals like you.


  17. pilocarpine
    May 05, 2010 @ 22:10:22

    “He say not enough HO”
    He’s right.
    all the right-minded, or high chance of being right-minded dr is leaving to s’pore, while leaving us with the greater evils…


  18. stevent
    May 05, 2010 @ 23:04:19

    Why can’t we just sent the newly fresh grads to do their training with the red cross etc all around the world? I’m sure places like haiti or africa would welcome many more doctors. Better yet let them train there for 2-3 years before coming back to malaysia.


  19. MKO
    May 05, 2010 @ 23:15:59

    Dear Doc,

    So is it dangerous to seek medical treatment in government hospitals ?


  20. Trackback: Go back lah~ « Zizimun's.Home 23.07.09

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