Too many cooks!

I have been one of the first to voice out about the mushrooming of medical schools and the  production of too many doctors as early as a few years ago.  I have expressed my concern on the quality of new doctors as the sudden mushrooming of medical schools have resulted in an acute shortage of good medical teachers.

Now, even the ministry has acknowledged this fact and a moratorium is now in place to prevent granting of more license to set up more medical schools in the country.

ALready, our healthcare system is facing the problem of producing too many nurses.

Nurses are an important part of any hospital care. A good nursing standard is necessary to ensure that the hospital patients getting the care prescribed by the doctors, and very often the mental state of a patient is influenced by the manner in which nursing care is being dispensed to that particular patient, and that how that mental state ends up to be actually plays a crucial part in the recovery from an illness.

We are now producing more than 12000 nurses a year, and the requirement for new nurses is only about one to two thousand a year. There are now so many public and private colleges conducting nurses courses that i have lost tract, and nurses are being churned out like cars in an assembly line.

What has been noticed is that as a result of having  so many nursing colleges in a short time, nursing standard is on the decline since  the mushrooming of nursing colleges put strains on the availability of qualified teachers, as well as the practical aspects. Some of the nurses under training confessed that they sometimes have only one or 2 patients in the assigned hospital to practise their nursing skills, and this is grossly inadequate for them to perfect their nursing skills.

As a result, some of the nurses being produced are below par when compared to nurses produced in the 70s and 80s.

This is similar to the too many housemen problems that I have brought out in my serials on ‘a doctor too many I, II , III …..’

so i envisage that the good healthcare standard that was put in place by the British– I am against colonialism and am just uttering a fact  —  is now being slowly and surely been eroded, and that we are trying to replace quality with quantity.

The same thing is happening to the Medical lab technologists (those who conducts the blood tests in lab) as well as radiographers ( those helping the radiologists to take Xrays). There are simply too many of these, too!

I was told that even there are also too many pharmacists being produced. This will lead to competition and undercutting in future, and this will inevitably lead to some pharmacists, in order to survive,   placing their own profitability ahead of their professional ethics.

The whole healthcare manpower situation is a mess.

This is the direct results of the mushrooming of private colleges and universities, set up by those who care not so much about the needs of the nation, but more for the profit that they can reap by setting up such colleges(  Tuition fees are now many times higher than before).  These people are usually those who have political connections and they can easily get licenses to set up and operate such colleges.

You would expect a college to have at least a few buildings and a small campus. But no, some of these colleges are housed in just a 4 storey building.

More importantly, because of the competition among each other for teaching staff, some of the teachers barely meet the minimum requirements and lack experience . Because of competition for sourcing students, student entry standard is also being compromised.

Professional course such as medicine, nursing, pharmaceutical field requires hospital and patients to train as basically these are apprenticeship. BUt with so many colleges and schools, there is just not enough training positions to ensure that these people get the proper training which they need to become a competent professional.

This leads to the state of having too many graduates in these fields which have little practical experience.

In the end, we will end up like in the Philipines, where doctors are being retrained as nurses, but with our nurses being in surplus too, maybe some of the nurses need to be retrain to become hospitals Amah and attendants. Don’t be surprised that some of thes health personnel will end up selling nasi lemak ,  chicken rice or roti canai by the road side.

Malaysia boleh!


19 Comments (+add yours?)

  1. CYC
    Feb 06, 2012 @ 14:18:34

    I read from some article claiming private nursing college students has lower passing rate than MASHA college in govt sanctioned qualifying exam. Is this another STPM vs Metriculation system in work ?


  2. Li Li Fa
    Feb 06, 2012 @ 19:16:10

    Here is a case of placing preference on quantity rather than quality. When there are too many cooks, what do we get?

    Besides spoiling the broth, how are they going to manage the quantity of cooks?
    Are there enough medical institutions available to absorb them. This is even before screening their qualifications, aptitude and attitudes.

    When supply is more than demand, where will quality be slotted and gauged?

    Similarly, more doctors are being churned out for the people. Again, where is the quality of these new doctors, against the numbers that are being produced?

    On top of that the incumbent government is coming up with the Icare system. Maybe to absorb these new churn-outs. And the whole system goes hay-wire and thoroughly needs overhauling and health-check. Otherwise, the health of the people in the hands of these new churn-outs will suffer.

    This also reminds me of once, I read a cartoon drawn by our famous LAT about a dozen Tenaga workers who stood in line, waiting for their turn to pass an electric bulb to the last person standing on top of the ladder fixing a damaged street lamp.


  3. cardiprin
    Feb 07, 2012 @ 03:04:38

    Malaysia can now enter the guinness world record of ‘Country having the highest no. of medical school per capita population’.

    For a population of 28 million, we are ‘blessed’ with about 34 medical schools, as compared to UK, where it doubles Malaysia’s population, with only 25 institutions.

    Not to mention that the passing rate of private institutions is almost 100%, with those who failed to make it through the first attempt, with eventually pass. Now it seems that everyone with money, can be a doctor.

    We are currently producing about 7-8k medical graduates/year and this number will continue to rise as I doubt the ministry is serious about the moratorium. With quality being replaced by quantity, it’s the people who will suffer in the end as healthcare standards are expected to deteriorate.

    I seriously hope the government will reconsider in bring back their initial plan to implement a common qualifying exam for all medical students. But then, will the ministry ensure that it is conducted in a transparent manner? I doubt it.

    All the best to the Malaysian healthcare.


  4. kittykat46
    Feb 07, 2012 @ 13:09:03

    A relative of mine was a staff nurse at a private hospital , back in the late 1980’s when there was an acute shortage of trained nurses.
    I can remember it well because she lived with us for a few years. She had a punishing work schedule and there were never enough nurses to meet the overall workload.
    In those days, training requirements were strict, and few private hospitals or colleges were willing to take on the task of training new nurses.

    Looks like the situation is totally reversed now…


  5. AcHoo!
    Feb 07, 2012 @ 17:02:56

    Just a thought!
    As an ordinary fella. Will it be too bad if all doctors started out as nurses? And only nurses with proven competency can be accepted as doctors.
    Similarly for all other professions too! Is it too bad if we become a nation of highly skilled professionals.
    The trick is getting highly skilled and competent people. Definitely we need to ensure our factories are also real world class too!


  6. Cardipin
    Feb 07, 2012 @ 18:15:36


    Your idea of having all doctors to be started off as nurses is not feasible. What differs between a doctor and a nurse is that a doctor is trained to make clinical decisions, whilst the nurses are there to carry out doctors’ orders. That’s why in 5 years of medical studies, medical students are being trained extensively about normal body functions, pathological basis of diseases, clinical skills, and management of a clinical problem.


  7. Phua Kai Lit
    Feb 07, 2012 @ 18:38:19

    In the USA, they have a category of health care worker called
    the “Nurse Practitioner”. These are allowed to provide primary care
    to patients under the supervision of a doctor.
    A related category is the “Physician Assistant”.


  8. klm
    Feb 08, 2012 @ 10:48:54

    This the what BN do to everything in this country. Making a mess. This is the result of incompetence plus corruption. A big bloody mess.


  9. Phua Kai Lit
    Feb 08, 2012 @ 16:13:13

    Dear Dr Hsu

    Looks like “Cowgate” is becoming a bigger and bigger public relations problem for
    kleptocratic UMNO-BN.

    As the saying goes “A week is a long time in politics”


  10. Winston
    Feb 09, 2012 @ 09:17:48

    During all these decades that BN is in power, either the minister in charge of the health ministry just sat on his hands and did nothing or they came out with all sorts of ideas that completely fouled up the system!
    No wonder then, that we usually came to know when a rich and well connected personality died in an oversea medical facility that these people prefer to get treated overseas!
    Their lives are too precious to be messed up by the locals!!!!!!
    Only the poor and unconnected will have to face up to the mess created by the government.


  11. CYC
    Feb 09, 2012 @ 11:56:01

    Never trust the Brutus who lied several times without offering any apology. Hope Bentong voters dump him in GE13. His integrity is worse than porn star.


  12. Li Li Fa
    Feb 09, 2012 @ 13:44:00

    It is learnt that the cowgate has taken a new turn. After all the moo here and moo moo there, it has given birth to two more condos. The cowgirl attended a ‘tea-party’ of enquiry.

    I wonder any cow’s milk served.


  13. Phua Kai Lit
    Feb 09, 2012 @ 14:00:12

    I’m not religious.

    But someone commented that “cowgate” is divine retribution for the
    very nasty and malicious “cow head incident” staged by the
    local fascists in Selangor last time.


  14. CYC
    Feb 09, 2012 @ 16:16:25

    The compulsive liar admitted 1Care to be made mandatory. Perhaps we need another version of Bersih to voice our disapproval and send this govt to “Hollan”


  15. Tim Wong
    Feb 10, 2012 @ 09:32:28


    we started out discussing about too many cooks, then the 1 scare or care, then the kondo lembu; how about discussing about EPF and how soon it will be sucked dry ? just my humble thought. thanks.


  16. Phua Kai Lit
    Feb 14, 2012 @ 08:41:31

    Dear Mr Tim Wong

    I was waiting for other blog readers to comment first.
    Since there aren’t any, here are my thoughts:

    The large sum of money in the EPF pool is indeed a tempting target for the
    UMNO-BN kleptocrats currently in power. We already see evidence of raids on the pool. The govt can always “print more money’ to cover its EPF borrowings and budget deficits. In other words, the people will pay the price through the “inflation tax” i.e. escalating inflation will erode the purchasing power of our life savings.
    This should get us very upset as thoughtful and informed voters!

    (Govts can finance budget deficits through other ways too i.e. raising taxes and issuing bonds domestically. The most hazardous would be reckless borrowing from overseas — we would have to pay back eventually in hard currency and not in deflated Malaysian ringgit. The IMF and other similar de facto
    international enforcers/debt collecters for the multinational banks would come in and force “structural adjustment” programmes down our throats, just like what the unfortunate Greeks are experiencing over and over again today!).


  17. CHEW EL
    Mar 09, 2012 @ 19:38:02

    My dad was admitted to a private hospital and the way these young young nurses behaved were a huge contrast to those retired nurses trained in the colonial times.
    They felt irritated when my dad groaned as he was bed ridden due to old age and was semi-conscious for just a few days.
    They complained that my dad was noisy.
    They were scared to get close to him or touch him to administer drugs/monitoring body temperatures/blood pressures and the way they took blood samples are just like amateur.
    If these nurse feel that this is not their profession, then go and work in other industries which is less stressful and demanding.
    Well, our nursing and medical schools are just mass producing nurses and doctors to meet our 1 (means “Finished” in Mandarin or “Twisted” in Hokkien) Malaysia’s dream.


  18. Dr Hsu
    Mar 10, 2012 @ 09:11:54

    I was just old by one of my old classmates staying in Shah Alam that a young doctor there woud not even use hands to touch patients. Instead, she uses a pen or a pencil to point at the spot where patient complainted of pain.

    A disgrace to medical profession!


  19. CHEW EL
    Mar 10, 2012 @ 15:37:33

    Dr Hsu,
    I went to a seminar recently.
    One of the speakers joked:”If I were to say majority of the members in this professional body is corrupted, I will not be sued. But if I were to say this professional body (and others) is corrupted, then I will be sued because there are still some honest and humble professional human beings.”


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