Should we be taking his word for it?
From the NST,
Ministry denies drugs available at centres
Mar 31:
THERE is no truth to claims that drugs are widely available at drug rehabilitation centres nationwide, said the Internal Security Ministry.
The ministry's parliamentary secretary, Datuk Wira Abu Seman Yusop, said in actual fact, there were only attempts to smuggle in banned substances into the centres.
"The allegations are false. What happened recently was that some people smuggled in non-drug items like tobacco, alcohol and equipment to manufacture samsu," he told Hashim Jahaya (BN-Kuala Kedah).
He said the items were probably smuggled in by the inmates' during the course of their community work. cont.... |
Here we have the Internal Security Ministry trying to rebuff allegations of drug smuggling in rehabilitation centers. Unfortunately, he dug a bigger hole for himself. Note the highlighted statement. If non-drug items like tobacco, alcohol and equipments to manufacture samsu could be smuggled into these centers, I see no credibility in his insistence that drug smuggling is non existent. There is no way that you could stuff a bottle of alcohol or samsu-making equipments in your anus! Only one explanation remain, that is the presence of corruption. Facing the reality of the situation is important in our battle against drugs. The Minister should take more proactive measures to ascertain the true scenario and then to take the necessary but essential measures to correct the situation.
I strongly urge the Ministry to relook into this matter. Just the fact that smuggling continues to be rife, common sense should lead us into believing that drugs are going in via this similar route. We definitely will not be taking your word for it. All this for the betterment of our beloved nation.
Vitamin E: false HOPE
For those of you who are taking Vitamin E supplements, do step back for a moment and consider what the evidence holds for the reason you are taking vitamin E. If it is for heart disease and cancer prevention, then you are sorely mistaken - vitamin E has not been shown to be useful.
From Journal Watch:
In a previously published, randomized, placebo-controlled trial of vitamin E (400 IU daily) in 9541 subjects (age ≥55) with known vascular disease or diabetes, researchers found no effect for vitamin E on the incidence of cardiovascular events after a mean follow-up of 4.5 years. In this extension of that trial, 3994 subjects agreed to continue receiving their assigned treatment, and an additional 738 agreed to continue passive follow-up; data were carried forward for all 9541 subjects.
During a median follow-up of 7 years, no significant differences were noted between the vitamin E and placebo groups in cancer incidence, cancer deaths, or the combined endpoint of myocardial infarction, stroke, or cardiovascular death (21.5% vs. 20.6%). Vitamin E recipients did have a significantly higher risk for heart failure than did placebo recipients (13.5% vs. 12.1%). |
Ref: The HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: A randomized controlled trial. JAMA 2005 Mar 16; 293:1338-47.
A recent
meta-analysis suggested increased all-cause mortality with high-dose (≥400 IU) vitamin E supplementation. Together with this recent data, there is cause for concern especially since the recent study shows an increased risk for heart failure.
There are a few areas where vitamin E may be beneficial and an important one is in the ophthalmology field where in an ophthalmology trial, an antioxidant-plus-zinc combination that included 400 IU of vitamin E daily delayed the progression of age-related macular degeneration. Clinicians should always balance the risk versus the potential benefits in vitamin E supplementation.
Pop those pills with care!
Unrecognised universities : Beware
Reprieve For 200 Medical Graduates Of Unrecognised Universities
TANJONG KARANG, March 29 (Bernama) -- About 200 medical graduates of foreign universities not recognised by the government will undergo training on attachment in government hospitals under a one-off scheme this year, Health Minister Datuk Dr Chua Soi Lek said Tuesday.
He said that under the scheme, aimed at overcoming the shortage of doctors in the country, the graduates would sit for an examination after a six-month training stint.
The examination would be arranged by the ministry under the auspices of a committee which would have representatives from the University of Malaya, Universiti Sains Malaysia and Universiti Kebangsaan Malaysia, he added.
"They will be paid a monthly allowance of RM500. This measure is a second chance for them to serve; there is no other way because they are from unrecognized universities," he told reporters after visiting the Tanjong Karang Hospital, here.
If the graduates pass the examination, they would serve as housemen, he said. But if they fail, they would be allowed to sit for the examination a second and last time, he added.
Dr Chua said the 200 graduates had studied at their own expense at universities in India, Russia, Indonesia and China.
He said the ministry's proposal for the one-off scheme was approved by the Cabinet recently.
The minister said that 30 graduates who sued the government last year seeking to have their degrees recognised would not be included in the training stint.
-- BERNAMA |
Looks like a little victory for our medical graduates from unrecognised universities. At last, their dreams of coming back to serve in Malaysia will be realised. As for the 30 graduates who decided to sue, it looks like things may get tougher provided those charges are withdrawn. I do not see them winning the battle considering that the list of recognised universities is easily available from MMC.
Therefore all to-be medical students, please check that the university of your choice is fully recognised by the MMC (ie in List A). No one should make the same mistake again.
Malaysian Medical Council (Note list may not be up to date on their site. Please double check in person)
Bird Flu Watch
From Medscape,
Bird Flu Clusters May Signal Virus Change: WHO
HANOI (Reuters) Mar 14 - A cluster of human bird flu cases among relatives and possibly health workers in Vietnam may show the virus is changing into a form that can be passed on by humans, the World Health Organization said.
The WHO is worried that bird flu, which has killed 47 people in Asia, could mutate into an easily spread form that sparks the next influenza pandemic, killing millions.
"Such cases can provide the first signal that the virus is altering its behavior in human populations and thus alert authorities to the need to intervene quickly," the WHO said in a statement seen on Monday.
|
The case scenario that we fear most is beginning to materialise. A deadly virus capable of human to human transmission via air droplets is the last thing that we need. It reminds us of the tuberculosis era which claimed the lives of many. Influenza viruses have the capability for frequent mutations and can render recently produced vaccines useless. The question is "Are we prepared for this invasion which in my opinion, is inevitable?"
MCAT : Clear guidelines first
From The NST,
Written tests for medical courses KOTA BARU, Mar 28:
Candidates wishing to take up medicine at local universities will have to sit written tests beginning this year.
Higher Education Minister Datuk Dr Shafie Mohd Salleh said the tests would enable the ministry to determine to what extent the students were interested in becoming doctors. |
A medical college admission test(MCAT)may be a good way to judge aptitude. Unfortunately, Malaysia is not a country that can pride itself with upholding meritocracy. There is always a fear that these MCAT examinations will be another hurdle in government bureaucracy. The fairness in assessment will always be suspect. There has so far been no clear guidelines as to the method of assessment in these examinations. A mechanism to ensure unbiased assessment needs to be present first in order to allay fears that this will not be another ostentatious display by the government.
New Director General
From The Star Updates,
 Dr Ismail Merican is new Health Ministry DG
News Update by The Star Newsdesk
PETALING JAYA: Datuk Dr Ismail Merican has been appointed as Health Ministry director-general following the retirement of Tan Sri Dr Mohamad Taha Arif.
Health Minister Datuk Dr Chua Soi Lek, who announced this Monday, said the appointment was effective March 5, adding that Dr Ismail would serve for two years.
"He is both an administrator and clinician and has represented the ministry in many international conferences. He has a lot of experience," he told reporters after opening the 20th Asia Pacific Academy of Ophthalmology Congress.
Dr Ismail, whose most recent posting was deputy director-general of health in charge of research and technical support, came under media spotlight two years ago for his daily briefings of the Severe Acute Respiratory Syndrome (SARS) situation in the country. |
Congratulations to Datuk Dr Ismail Merican. We hope that the Ministry of Health will progress under his stewardship. We wish him all the best!
First Cut
Kevin Ooi in "
The first cut is the deepest" has written part 2 of his account in medical school - the anatomy years. Yeah I hated dissection too. Nowadays there are beter tools such as computer programs and 3d modelling to better aid the understanding of the human body, and also tools such as PDA study guides which help jog the memory.
But if you think studentlife is tough, it's only going to get worse, beginning with housemanship.
I just finished reading "
House of God" which is a semi-fictional account of Internship at a New York hospital (loosely based on the Beth Israel Hospital I believe) of a Dr. Roy Basch. The account was written during the Nixon years so it was not far of from the time I did my housemanship. Maybe things were not as bad as to drive us to suicide, but I sure remember our share of gomers, gomeres, keepers, bufing and turfing patients ;). Yeah and the days when we dreaded the MOs manning the ER who were more Sieves than Walls. I still recall the great Save Dr. LKG (now a fine surgeon) made when one Sieve of an MO admitted in an "Anaemia for Investigation" to the medical ward and the patient turned out to have a potentially fatal ruptured Ectopic Pregnancy - easily diagnosed if the MO had bothered to take a Menstrual History. Those were the days when HOs were really front line in the wards and we were much more than clerks and runners which some HOs in the bigger hospitals are today, unforunately.
Yes, things are going to get tougher, and you'll learn from the experience. Tough it out and quit griping....
Sorry no links yet as I am blogging this from my PDA as dial-up net access where I am vacationing is really slow and I have to post this blog via GPRS!
[Posted with hblogger 2.0 http://www.normsoft.com/hblogger/]
Terri Schiavo Saga : Who is right?
From The Star,
Terri Schiavo's parents' legal battle nears end
PINELLAS PARK, Florida (AP) - After another round of devastating losses in the courts, Terri Schiavo's parents kept watch over their dying daughter Saturday as their attorneys acknowledged the tenacious fight to reconnect the brain-damaged woman's feeding tube was nearing an end. ......... |
We have by now familiarised ourselves with the courtroom battles in deciding whether Terri Schiavo should be kept alive via feeding tubes. Here is a lady whose heart stopped briefly but sufficient to inflict irreversible brain damage. She has since been diagnosed to be in a persistent vegetative state. A persistent vegetative state, which sometimes follows a coma, refers to a condition in which individuals have lost cognitive neurological function and awareness of the environment but retain noncognitive function and a perserved sleep-wake cycle. They are not brain dead but technically alive. In this saga, her feeding tube has been removed as ordered by the courts in favour of her husband. She has since been left to die of starvation.
There are no right answers in this situation and you could sympathise with either side. Caring for her would be a monumental task but certainly not impossible. We see stroke patients who require an equal amount of care being nursed daily by individuals dedicated to their well being. There are no thoughts of removing essential apparatus vital to their survival. There should have been no question as to whether treatment should have been continued. It is somewhat similar to treating a chronic disease.
On the other hand, caring for such individuals can be exhausting both physically and emotionally. Seeing your loved one in such a state can be an extremely painful experience. In the absence of an advanced directive, people closest to her may be the only ones capable of knowing her innermost wishes in such a circumstance. Was it her husband in this case scenario? Or do her parents know her better?
Ultimately, we have a lady here literally being starved to death. The level of her cognitive function will always remain in doubt. As her death now appears imminent, many questions will remain unanswered. We can only pray that this is what Terri Schiavo would have wished for in such circumstances.
Feedback: Ethics etc
Dr Deborha Zion writes:
I am working on the ethics course for Monash Medical School in KL. I am looking for information or contacts for medical ethics in KL, as I am coming over in late April
|
Well if anyone has information on medical ethics for Dr. Zion please send in
feedback or post a comment here.
Katherine also wrote in to say that we are an "oasis in the usually banal blogs on the net". Err, the MMR is more than a blog as we have lots and lots of links to other Malaysian Medical websites but thanks for your kind words. How to find time to blog? Try 5:30 am, weekends and when you are on vacation as I am now ;)
Mohd Haminuddin also wrote in to ask for information on other sources of scholarship (besides the JPA which is providing a loan for his medical studines in Russia only from year 2 onwards). If anyone can help please post a comment here.
I am surprised the JPA will not provide a loan for the first year which to my mind is the most crucial! I don't understand the logic or lack of it....
HIV/AIDS : An intelligent battle
It has been reported in the local papers today highlighting Malaysia's failure in stopping the increase in the number of HIV infections. We are said to have 3 times the number of HIV cases as compared with Australia despite having similar population numbers. It is obvious that current strategies are not working. It does not come as a surprise when we have failed to even control the "epidemic" of drug addiction and prostitution. We have to come to the realisation that perhaps just trying to keep people away from such menace may be a little too idealistic. No doubt, there must be a continuing battle against drugs and prostitution but ignoring the fact that such vices can never be totally eradicated can be detrimental.
We need to control the spread of HIV urgently before our nation degenerates further and join the ranks of African countries. The battle plan should include measures to arrest the spread of HIV at this point in time. As we strengthen our fight against drugs and prostitution, we should also provide support and education to drug addicts and prostitutes alike. In this light, I am a strong advocate of needle exchange programmes for drug addicts. This does not equate advocating drug use but rather facing the reality that sharing of needle among injecting drug abusers occur to this very day. This fuels the rise of HIV cases in this country. Another plan should also include advocating the use of condoms for any sexual promiscuity involving a partner of unknown sexual history. We have to propagate the information that usage of condoms offers a significant protection against HIV.
We should no longer fool ourselves into believing that Malaysia does not face a troublesome problem with drug addiction and prostitution. Eradication of these vices is probably close to impossible. As such, measures promoting safer practices among these high risk groups should be incorporated as a plan in an intelligent battle against HIV/AIDS.
A good start?
From
Bernama,
Universitiies To Get RM300 Mln For Research Activities
KANGAR, March 24 (Bernama) -- Higher Education Minister Datuk Dr Shafie Mohd Salleh Thursday said an allocation of RM300 million would be made available under the Ninth Malaysia Plan (9MP) for local universities to do research work.
"Research is the most important element for universities and their success is determined by their ability to do research work," he told reporters after launching a research journal produced by Kolej Universiti Kejuruteraan Utara Malaysia (KUKUM) in Kuala Perlis near here Thursday.
He was confident all universities in the country would make full use of the allocation to intensify research activities to not only win fame for their respective institutions but for the country as well.
cont.... |
A good move by the Government towards achieving research orientated institutions of higher learning. However, fame should not be the top priority of any research. A research should be done for the betterment of mankind. Doing research projects that attract fame may not be in the best interest of the country and may neglect more important but less glamorous areas of research.
However, the main concern now is the actual disbursement of these monetary allocations. It has been notoriously evident that money pledged does not equate money received. The fairness of this distribution is also a concern especially when cronyism is blatantly practised. In addition, corruption cannot be discounted.
There has to be more transparency and consistency with regards to eligibility for these funds. Eligibility criterias should be drawn and strictly adhered to. There should be no favouritism and only the best research projects should be considered based on their research topic, objectives and methodologies.
My fear is that all this monetary allocation will eventually be diverted to supposedly "more important" areas in the near future. We can only wait and see. But no doubt, this is probably a good start for a country so deficient in research capabilities.
World TB Day
Today is
World TB day. So pause for a moment and reflect that we have still failed to eradicate this killer. We are also now faced with more resistant strains and the need for changes in treatment strategies like implementing DOTS.
Incidentally how many of you are young enough to recall the Vans going round the country doing the
other MMR (Mass Miniature Radiography) as a screening procedure for PTB?
CM or Chairman?
The NST reports that a furious
CM hits out at hospitalThe strange thing if you read the article is that the said Chief Minister is also the Chairman of the hospital. I didn't know busy Chief Ministers could find time to be a Chairman of a private hospital! Is this a first?
Heart doctors losing heart
Something's rotten in the state..... Is it true that
IJN Doctors are losing heart?The plan to make the National Heart Institute (IJN) a world-renowned heart specialist centre could hit a roadblock following a disagreement between its new management and long-serving clinical consultants.
The plan, which included raising bonds to form a special purposed vehicle (SPV), restructuring IJN into several new subsidiaries and initiating changes to its non-medical management and clinical structure, has ruffled feathers among IJN staff.
It is understood that several long serving senior consultants are planning to leave and this has caught the attention of the Government as IJN consultants have long been associated with monitoring the health of the country’s leaders.
The recent resignation of one of IJN’s top consultants has also raised questions. |
I find that sometimes management just does not want to listen. They will bulldoze ahead with their money-making plans ignoring their staff and forgetting that their most valuable resource is the human resource. They can plan all they want but without their skilled staff they can forget it. Are there so many pointy-haired bosses out there?
Texting tendinitis
Everyone's sending SMSs these days. If you thought that recent TV ad with the youngsters thumbs all swollen ridiculously funny, it actually isn't very far off from what may happen:
From
BernamaMobile Phones Create Texting Tendonitis
Mobile phones have created an illness dubbed texting tendonitis.
Dr Robert Menz, of Adelaide, reported the case of a 13-year-old girl who walked into his surgery earlier this year with a swollen right forearm.
"There was no history of trauma, or recalled change of activity," Dr Menz wrote in the Medical Journal of Australia. "Further inquiry revealed that she had been given a mobile phone in December."
Dr Menz said the teenager's plan allowed A$100 (A$1 = about RM3) credit that had to be used in a month, equating to nearly 300 SMS messages, or 10 a day.
"The phone and plan also allowed up to 760 characters per message, instead of the usual 160. The patient had been using only her right thumb to press the keypad," he said.
Dr Menz diagnosed texting tendonitis, which settled rapidly with rest, application of naproxen gel twice daily for two days and the use of both hands to operate the keypad of her phone.
"To my knowledge, this is the first report of this condition in Australia, although other unusual overuse injuries of the hand have been described with Nintendo playing," he wrote.
"Perhaps the manufacturers of mobile phones should include health warnings of the risk of overuse injury as part of product labelling." |
Any sort of excessive repetitive action may result in injury.
So don't go overboard with all that texting!
Drug addiction : An unfinished war
There is no nation on this planet that does not suffer from the menace of drug addiction. Malaysia is not spared. Drug addiction remains a major problem and our progress in our fight against this enemy has stagnated. Despite having the threat of a death sentence for drug trafficking and addiction, the number of drug addicts in Malaysia has certainly not declined with an estimated number of drug addicts hovering around 300,000. Why have we failed?
Our proximity to the Golden Triangle in the Thai-Myanmar border certainly does not help matters. Border control remains a problem with corruption a grave concern. It is almost certain that drug traffickers cross through our borders daily. This multi-billion dollar industry is thriving and promises its players great rewards including collaborators in government bureaucracy. Our continuing denial that our police or immigration officials are corrupt certainly has stunted our fight against this deadly invasion.
Nabbing drug addicts alone does little in our battle against drugs. They are the soft targets. Our battleplan should stress on curtailing the activities of drug cartels themselves and their supply lines. Unfortunately, with a police force that is often "under equipped" in terms of firearms and a paltry salary, they remain on most occasions reluctant to contront an enemy that appears more formidable. Risking their lives is just not worth it. In fact, some may even join the fray in this lucrative environment.
Rehabilitation programs in Malaysia leaves much to be desired. The "pusat serenti" programme has been deemed a failure with many of its former inmates returning to old habits necessitating frequent readmissions to these centers. Anecdotal experiences have confirmed that corrupt officials at these centers would turn a blind eye to the presence of drugs in return for money. Poor support of inmates that have graduated from these centers are also contributory factors to their failure in remaining drug-free.
The stakes are now higher with the emergence of the HIV/AIDS epidemic. Devastation from this epidemic is now no longer confined to injecting drug abusers but their friends and spouses. With the bulk of HIV cases directly or indirectly related to drug addiction, this problem needs an urgent redress. Perhaps entertaining programs like needle exchange for drug abusers and propagating the use of condoms among prostitutes, may be necessary in giving us a short-term reprieve.
We can no longer ignore a problem that is threatening to devour our nation. Unfortunately, the future will be gloom if politicians and drug enforcement officials alike remain plaqued by cowardice and corruption. Confronting the enemy may have consequences requiring the ultimate sacrifice. However it is a war that we must continue to fight!
Feedback: Hiya
TL writes in
Hello from a Malaysian right now studying for an upcoming exam at Flinders Uni, Adelaide, Australia. I am researching to present for the Overseas Medical Student Association on the procedures to return/go to Malaysia to practice and stumbled upon your website/blog.
Thanks for the great info. Maybe after my exams, I'll just have that little bit more time needed to read through all the interesting little tidbits on medical practice in Malaysia. How about a section though, listing all the pros and cons of practising in Malaysia, especially for those studying overseas (note that I've actually gotten both a BS and MS in Engineering in the US previously, and have worked for Motorola, also in the US, for 5 years prior to embarking on this new journey... so Malaysia is a bit foreign,except for the good food :). Oh yes, if you make such a section, don't forget
that...). Also, where's that list of medical schools approved by the MMC? :P
I can actually help you OCR them and give you a clean HTML/TXT if you need that! |
Thanks for the email TL.
Well, pros and cons of practising in Malaysia?
I guess that would also be affected by a large degree on the stage of one's career. Other influences play a large part, not least family concerns.
Anyway, perhaps everyone could chip in and Comment on this aspect. If there is enough useful feedback, I could compile it into a separate section.
List of medical schools? Well would you be surprised that the MMC has not sent it to me? Nothing in the mail! Malaysia boleh!
Looks like I'll have to make another call to Putrajaya. I wonder why they can't just update their website and make life easier for them. Instead now they want to put even more red tape for students want to study overseas - not only make it difficult to find out if the college/Uni is truly recognised by the MMC but also now students have to get some sort of "certificate" from the authorities first. I can't find the news link but I recall reading this not long back and thinking how ridiculous bureacracy has become!
Money talks
From The Star,
Prince concerned by drug firms’ bias against tropical diseases
IPOH: Raja Muda of Perak Raja Nazrin Shah has expressed concern over a lack of research on creating vaccines for tropical diseases when compared with the huge amount of money spent on producing drugs to fight baldness and erectile dysfunction.
Although he was aware that drug companies were responding to market incentives, he said it was unacceptable from a humanitarian perspective because millions of people died from diseases like malaria, sleeping sickness and tuberculosis in a year.
He noted that medication for tropical diseases was often regarded as unprofitable by multinational pharmaceutical companies. |
What makes the world go round? No prizes for guessing. Medicine is a field driven by the forces in the pharmaceutical industry. I had only recently commented to a colleague of the multitude of researches in Cardiology that are often overlapping. The true incentive of such researches are, on most occasions, for promoting the marketability of a certain drug. With uncontrolled escalation of research costs, such drugs are often expensive. So would pharmaceutical companies invest in a research project regarding tropical diseases when the market for such a vaccine or drug would be mostly "Third World" nations?
Diseases like dengue and malaria still wreck havoc in many countries in the mosquito infested tropical regions including Malaysia. The development of drugs in these areas are at best snail paced. Deaths occur annually for such diseases but little is done. Money for research is hard to come by and as such shuns away many potential researches in this area. Vector control is only temporary and epidemics are bound to occur. Apart from vector control, we are practically defenseless against diseases like dengue.
The Prince is right. Why on earth do we need so many versions of erectile dysfunction drugs with similar efficacies (despite drug companies spending tonnes of money telling you otherwise)?
In the end, it is the Governments who must invest in such researches for the benefit of its citizens. Depending on the pharmaceutical industry may be an exercise in futility. Malaysia still lacks technical expertise in research. Medical schools should incorporate teachings on the methodologies of research in their curriculums. Creating interest in research may be the only way to promote more researches in areas pertinent to our own country. Even current researchers should be supported adequately, both financially and academically. Tying them down with daily ward chores may cause disillusionment and dissatisfaction, driving away talented researches to other countries.
The reality of this modern era is MONEY TALKS. Medicine is no different.
Hear ye! Hear ye!
From a letter to Malaysiakini,
Lorry drivers make more that gov’t doctors
Dr Muhammad Gowdh
Mar 16, 05 1:54pm
I refer to the letter Doctors should quit griping and get on with job in which the writer said that being a doctor was a ‘noble profession’.
True, but don’t members of a noble profession need to live decently like their ‘non-noble’ counterparts? Don’t they need to buy a house to live in, to feed and clothe their families, to save money to educate their children?
Don’t they need free time with their families? Aren’t doctors people too even if they are ‘noble people’? As Shakespeare says (of the Jews) ‘Don’t they bleed too ...’ when you cut them?
The writer seems to be suffering from a delusion along the lines of ‘If I had to suffer when I was a young doctor, why shouldn’t the present lot of young doctors suffer as well’!
Be reasonable. Times are changing. A lorry driver takes home a better pay than a young doctor in government service - and he doesn’t bother to worry about being noble to his fellow men either. And those working at McDonalds earn a better overtime rate than the on-call allowances paid to housemen.
If the writer thinks that there are going to be too many doctors pretty soon, why is the government still allowing so many medical schools to open locally and why are so many medical students being sent overseas?
What is wrong with improving pay, the amount of leisure time, the working conditions etc.? We don’t have to live in the Stone Age forever.
I, too, worked very, very hard with little or no rest at all in my younger days as a government doctor (no call allowances or ‘time off’) but I don’t see why things have to be the same forever.
The European Union has strict rules on how many hours a doctor (or, for that matter, any worker is allowed to work). Why can’t we make life more comfortable?. |
I cannot agree more with the author of this letter. It has to be pointed out yet again that doctors in government service are so poorly paid that it does little justice to a profession that requires great commitments. Despite the notion that doctors are supposedly noble, their endeavours should never be "shortchanged". A doctor is no Mother Theresa and should not be expected to behave like one. A passion of medicine does not extinguish the desire for a comfortable lifestyle for one's family.
Times have changed. Standards of care have improved and with that, so should the treatment of government doctors. Such higher standards can hardly be expected of a doctor that had little sleep over the past 36 hours and counting. This mental torture is archaic and should be shed.
The time for the government to review its salary scheme for doctors has arrived. It can no longer be ignored lest a continuing depletion of its most precious assets.
Building more hospital and clinics should be a secondary priority. Human resource is the engine of growth for without it, all else will fail.
Update & Query: Gastroenterologists
Simon writes in seeking Gastroenterologists in Penang.
Thanks for making the query Simon. Glad you asked because it made me look to see if there is a Gastroenterology society webpage and indeed the
Malaysian Society of Gastroenterology and Hepatology does have a webpage. I have updated the MMR and added in this link to the MMR's page of
Professional Societies and AssociationsWhile the MSGH webpage lists the members, there is no information on Gastroenterologists by State.
However, there is a link which you can take from the MMR's
Search Page - take the Specialist Register Search Engine provided by the Academy of Medicine. When you click on the Specialist Register page, select Discipline as Internal Medicine, Specialty as Gastroenterology and State as Pulau Pinang and you will be provided with a list of names.
It is not the MMR's policy though to recommend any particular specialist - I would suggest your local family practitioner make the recommendation.
Feedback: "Wrong diagnosis"
CYS writes in about a dilemma with a "wrong diagnosis".
I am not a lawyer CYS, but I must caution that diagnoses, even in the best of hands can sometimes be difficult. This goes for histological (tissue) diagnoses after biopsy.
The main thing is whether or not the doctor(s) concerned have performed their duty to the level of is expected of them/their peers. In a small percentage of cases, the diagnosis may initially be thought to be one disease but when further tests are done (which usually take more time), a different diagnosis is finally reached. This is a fact of life and it is never 100% straightforward.
It is not the policy of the MMR to give individual medical advice ( please read our
Usage terms and policies ) however I would say that patients are always entitled to a second professional opinion.
Doctors should have no qualms if the patient wants to seek a second opinion - I for one certainly welcome this especially in less straightforward cases.
Legal aid is available even to those who can't afford it. The Bar council runs
Legal Aid Centres
Bird flu: be prepared
Well I am glad we are taking steps and getting prepared for what may be inevitablei n the Year of the Rooster - an Avian Flu pandemic.
The Star Reports on what the MOH is doing in
Preparing for an avian flu pandemic As for Malaysia, Dr Ramlee Rahmat, director of the Disease Control Division of the Health Ministry, said that the nation’s human influenza preparedness plan is being worked out with the WHO and local experts and should be ready in a couple of months.
“Stockpiling of vaccines and anti-viral drugs is part of the preparedness plan that is currently being discussed at ministerial level,” he said.
Dr Ramlee said the United States and Britain have stockpiled antiviral drugs because they assume that the drugs will slow down infection in the event of a pandemic. However, he cautioned that while the anti-viral drug has its role, it only reduces the viral load and virulence but does not kill the virus.
“There is no cure for a viral infection,” he said.
He said the most important thing from the public health point of view is to be sure of the mode of spread for it will determine the sort of intervention plans needed.
Malaysia has a surveillance system for influenza-like illness (ILI) that is adopted from the WHO ILI system. Currently, all outpatient clinics in government hospitals will have to report cases of atypical pneumonia and influenza to the Health Ministry.
From outpatient records in government hospitals, less than 1% of patients suffer from flu each year and the Ministry is planning on putting 1% as the threshold.
“If the number of influenza cases increases (beyond what is) normal, we will investigate,” said Dr Ramlee.
The flu surveillance will be similar to that of Severe Acute Respiratory Syndrome (SARS): when there are confirmed cases, the Ministry will carry out active detection by looking for those who are infected through health screenings and patient isolation, he said. |
Human-human transmission may have occured already as a result of viral mutation. What we need now is to be prepared and maintain constant vigilance.
Buai danger
buai: cradle; swing; seat slung by ropes or chains for swinging in.
The "buai" is a traditional baby's hammock used in this part of the world. Sometimes made out of sarong. Anyone still using these?
The Malaysian Paediattric Association President, Dr. Zulkifli says that the buai could be a source of head injuries for babies.
From the
Malay MailWith the heatwave that we have been experiencing, stringing a hammock for a bed seems a cool alternative. That was what many of us had as infants – swaying to the breeze in our sarong cradles. However, paediatricians like Dr Zulkifli Ismail are now advising parents not to use these sarong cradles, or “buai”, as they can cause brain damage to our infants.
Dr Zulkifli, who is the President of the Malaysian Paediatric Association (MPA), says they have found that most cases of sub-dural haemorrhage (bleeding beneath the skull) in babies that are not directly related to non-accidental injuries, such as child abuse, to be associated with the use of the buai. He adds that they have also documented cases where the buai was pushed, hitting the baby's head against the wall.
In one case, the infant's two-year old sibling loved to swing the buai, not realising the baby's head was hitting the wall. The baby's head was resting on a pillow inside the buai and there were no obvious signs of bleeding and, as is so often the case, the injury went undetected until much later. Dr Zulkifli says that internal bleeding is not visible but is found during a medical examination. Such an injury is referred to as a "contra coup", a French word for an injury caused when the brain moves within the skull, tearing blood vessels that join the surface of the brain to the skull causing sub-dural haemorrhage. The up-and-down movement of the sarong cradle can cause the same kind of injury, as it is almost like shaking the baby vigorously in your hands. Zulkifli explains that the brain of the baby is actually floating within the skull and when you move the baby vigorously, the brain moves in the opposite direction of the head, resulting in brain damage "If it is done gently, that is fine, but the bouncing movement of a sarong cradle with a spring is enough to injure your baby. There have been cases where the buai with the metal stand fell over and the stand hit the baby. This is why the MPA says it is not safe to put your baby in it." The best bed for the baby is a baby cot, not a sarong cradle or your bed. |
There you have it. Use a proper cradle not the buai.
Pensioners' woes
Times are tough for Senior citizens - inflation and rising costs of food, fuel and health expenditure coupled with low bank interest rates (and FD returns) makes it very difficult for the retiree to make ends meet. With the breakdown of the extended family system, there is a real danger of
senior citizens becoming marginalisedTo rub salt in the wound, pensioners who have served their entire working life with the Government are now asked to
Appeal for medicineHealth Minister Datuk Dr Chua Soi Lek has advised pensioners who cannot get medicine from government hospitals to appeal to the ministry.
However, he pointed out that the ministry spends some RM7bil a year to provide healthcare services but the returns were only RM128mil.
“The people must realise that this is a heavy burden for the Government,” he said.
He was responding to complaints that some pensioners had been told to buy medicine from private pharmacies. |
So what's this? Is the Health Minister asking Pensioners to go
beg for what is rightly due to them? Why should Pensioners be given the run around to hunt down for the medicines they need? I can tell you the scenario where "pensioners had been told to buy medicine from private pharmacies" is not an uncommon one where Government pharmacies run out of stock or do not stock the medications in the first place, requiring a "local purchase order" which takes time or gets buried in the bureaucratic paperwork process.
If the medications are expensive, there is no way Pensioners should be asked to "pay first" then claim later from the Pensions Department. Obviously the system stinks.
I can tell of one instance when a retired teacher was given the run around between the Ministry of Education and the Pensions Department,when she needed an expensive medication for her leukaemia and the hospital did not have the budget for it.
I am also sick and tired of the Health Minister constantly whining that the money spent on Healthcare is a "heavy burden for the Government". This is bullshit. Healthcare expenditure by the Malaysian Government is only a small % of the GDP and below what the WHO recommends. The Government is in fact
underspending on healthcare for its citizens. In fact when you think of everything we require - the water we drink, the toilet waste we flush, the electricity and telephone services all being Privatised now, one wonders what we actually pay taxes for?
So does anyone out there have any Pensioner tales of woe to tell, expecially related to healthcare?
Health warning
Imagine this scenario. A drug pusher sells a packet of heroin powder/cocaine powder/ecstacy pills/syabu/[insert addictiv drug here] to an addict. However this is s drug pusher with a difference. The packets come with a "health warning" with a message like "heroin addiction can be seriously damaging to your health" or words with similar effect. Does this sort of warning mitigate the pusher's actions?
Switch back to this Malay Mail
reportCigarette firm sends out strong message on health hazards
Every Marlboro cigarette pack of 20 now comes with a leaflet warning smokers of the health hazards.
The folded leaflet can be found inserted behind every pack as part of the company’s third phase communication programme to warn that smoking is an addictive and dangerous habit.
It also explains the meaning of the various terms, such as light, mild and ultralight, of its cigarettes.
Philip Morris (Malaysia) Sdn Bhd communications and public affairs manager Eliza Mohamed said adult smokers should not assume that lower tar cigarettes are safer or better. |
So what's the difference?
IMO health warnings are useless. What has been shown to work is increasing the price of cigarettes and I'm glad that the
Ministry wants a stop to sale of small-pack cigarettesThere are too many youngsters messing around with drugs thinking "they know better". Some even dare to
Blog about it (WARNING: this Blog is NOT for the consumption of minors; Rated PG).
Cigarettes are addictive drugs. The public must be told so.
MMA's stand on tobacco
Quit griping
"A Poor Doctor" has written a letter to Malaysiakini - he/she is of the opinion that
Doctors should quit griping and get on with job The MOH introduced the extra fourth and fifth postings because the one-year housemanship period was deemed inadequate. Previously, even if you had completed the basic postings of medical, surgical and obstetrics and gynecology (O&G), you would still lack of orthopaedic and pediatric experience.
All these postings are important as many doctors choose to become general practioners (GPs). Doctor need to undergo all these five essential postings for without them they would be inadequately trained.
The MOH seems to have learned from its mistakes over the years and that’s why these postings are compulsory for all doctors now.
Thus, it is not to be argued that a certain doctor should be treated as a HO, junior MO or MO after the first year of housemanship training. If you’re doing the fourth posting in pediatric and you are fresh, obviously, you will be treated as a HO until you are adequately trained.
Obviously, when the doctor is new, they will be treated as such and thus the need to start from the bottom and be upgraded through the posting accordingly. No one would allow them to carry out MO responsibilities if they haven’t acquired the skills needed.
It is amazing that many doctors complain of long hours and the need to work on weekends and so on. But the fact is, this is the nature of the job. This is where I feel that many medical students are not counseled well regarding a doctor’s life before they take up their course.
Many of them think that they can make big money as doctors (of course, if you ask them, they will deny this saying they just want to help people). But while they will complain of long hours on the job, they will have no qualms doing locum, even overnight as the money is good (up to RM720 a day). |
All valid points if I may add.
But Poor Doctor goes on to say:
I have seen doctors taking leave to do locum. I have seen doctors doing seven days locum continuously. So the root of the problem is not the long hours but the remuneration. The MOH does not pay us well at this moment but this should not be used as a reason to complain as we owe ourselves to our patients the moment we choose this profession.
But the MOH is not entirely without blame. HOs are paid RM25 per call which is for 16.5 hours for weekdays and 24 hours for weekends. This rate is worse than what Mcdonalds or KFC pays their worker.
The MOs and specialists are no better of for they are being paid RM75 or RM113 for similar time durations. The MOH never seems to appreciate its human capital assets especially experienced doctors or lecturers or professors in universities. |
All points again which I agree 100% with.
And he hits home with this point about promotions:
The ministry seems to be more interested in numbers and not quality. They have even required doctors to take the Peperiksaan Tahap Kecekapan (PTK) competency evaluation test for promotion. Apparently the MBBS and various stringent specialist qualifications are now deemed useless.
You may be the most experienced and dedicated doctor with great qualification and able to do the most advanced surgery but if you don't clear this ridiculous exam, you are considered incompetent and should not be promoted. |
I would say it is Management which is incompetent. If you cannot value highly trained professionals then these people will not stay long with you. Promotions and assessment of doctors must not be lumped together with the rest of the civil service.
Take away the stupid PTK evaluation NOW or you will see further brain drain. In the end all you will have left are the junior and the mediocre.
Poor doctor concludes thus:
In conclusion, my opinion is that you need to have a certain degree of passion in this profession. Difficult working conditions are to expected but our patients’ welfare must be our top priority. We should still fight for our welfare and this can be done through the Malaysian Medical Association, the Malaysian Medical Council and other relevant bodies.
For the youngsters out there who want easy working conditions and good money, my advice to them is this - don't become doctors. A good doctor is one who has passion the job and that's why there are still many left in our public hospitals despite the poor terms offered by our MOH. |
Amen to that.
Poor Doctor sounds like someone quite senior in Government service who has seen it all. Kudos to him for writing the letter. Even more Kudos to him for not leaving the MOH!
Feedback: Backache association?
Edmund wrote in to enquire about a "Backache association of Malaysia".
Sorry Edmund, I am not aware of such an association. If anyone does, please post a comment here.
Generally, medical and health related associations would be based on disease entities rather than symptoms so I doubt if there is one or if there ever will be one.
Site update: NAM & MA
Added the
Neurosurgical Association of Malaysia to the MMR's list of
Professional Societies and Associations' websites.
The Neurosurgical Association of Malaysia (NAM) was formed on 26 April 2001. I was not aware they had a website until recently. It appears to be freshly updated - the last being on 21 February 2005. Let's hope they keep it up.
I also changed the
Medic Alert Foundation's link to the currently only working one hosted on UMMC in the MMR's list of
Public Societies and Associations.
Bird Flu Watch : Improving public health response
From Medical News Today,
Nurse who attended bird flu patient now has bird flu, Vietnam
07 Mar 2005
A male nurse who had been caring for a patient who had bird flu now also has bird flu, say authorities in Vietnam. Officials from the Thai Binh province, Northern Vietnam, cannot yet be sure of how the nurse caught the bird flu (from the patient or elsewhere).
The nurse has been taken to a Hanoi hospital.
The nurse had been looking after a man who had caught bird flu - the man's sister also had bird flu.
This is not the first case of bird flu in the Thai Binh province. Earlier on this year another man died of bird flu - his two brothers, who also caught the virus, recovered.
Health experts worry that the bird flu virus could mutate and pass from human to human. This could lead to a serious pandemic (on a world scale) that could kill millions of people. |
The bird flu saga in Vietnam has certainly not abated. It appears that this virus has now possibly attained the ability for human to human transmission. Such airborne transmission is always the toughest to control and requires the strictest and most efficient of public health responses. It can potentially be the new "tuberculosis" of yesteryears. The difference is that we are practically defenseless against this new strain of deadly virus.
Malaysia needs to be on its toes. It has to be prepared for the eventual emergence of this virus on Malaysian soil. We need to ensure that our public health machinery is well oiled and up to the task. We should not let unpreparedness and inefficiency cripple our public health. Special drills should take place to identify weaknesses and flaws in multiple scenarios. We need to get our act together and learn from our errors during the latest dengue epidemic.
The Americans are coming!
We are about to be invaded. And no, don't worry the US Army isn't coming, but it's US Medical Tourists.
New Age Media reports an
Inside Look at Medical Tourism in Malaysia; American Reporter to be Given Unprecedented AccessWriter and Journalist Eric Erickson will be travelling to Malaysia for a series of articles on medical tourism. He will be given unprecedented access to hospital facilities in the country as he follows two American women as they undergo procedures. The articles will take much of the mystery out of medical tourism, a multi billion dolalr industry that can save Americans 70 percent off their health care costs.
The United States has the dubious distinction of having the highest healthcare costs in the world, by some accounts twice as high as those in other comparable nations. In fact, over the last five years healthcare costs in America have risen an average of $2,500 per family.
Following in the footsteps of their European cousins, a growing number of Americans are turning to medical tourism for their surgical procedures. Every year more and more people travel to countries such as Malaysia, Thailand and India, where they can save up to 70% off their surgical procedures. Simple cosmetic surgery costing over $8,000 in the United States can be as low as $3,000 in other countries, for exactly the same procedures and often with better service and care.
This March, writer and journalist Eric Paul Erickson will depart on an unparalleled journey with two American women who are traveling to Malaysia for surgical procedures. Erickson has been granted unprecedented access to not only document the experiences of these two women, but the inner workings of the country’s medical tourism industry.
Erickson will also be keeping a blog at www.medicaltourmalaysia.com which will go live March 11 |
At the moment, checking out the above blog link, the reporter hasn't posted anything yet but March 11 is only this weekend so lets see if it goes "live".
I am not so sure if it is such a good thing to over-emphasizse medical tourism. Sure it brings in the foreign exchange but we need to develop many other aspects of medicine in Malaysia. No point boasting about cheap cosmetic surgery available in Malaysia when patients are dying on the cardiac surgery waiting list.
The cost of private medical studies
Private medical schools are not subsidised by the government and are therefore very expensive – tuition fees alone cost RM250,000 or more.
Well, think about it. How much will the medical degree ultimate cost you (or your parents rather, if you are taking up a parental scholarship). RM500,000?
The Star has an article in today's Education section on
High fees hinder private medical pursuit.
| In total, 99 seats were offered by private medical colleges – 34 at IMU, 10 Perak Medical College and five Aimst. However, because of the high fees, (even with the government's offer of convertible loans) only 33 of the 99 seats offered were taken up. |
Is it worth it? Well it is worth it only if you are truly interested in pursuing medicine.
But therein lies the obstacle. Money. If you are truly motivated but not born into a well off family then you have to fight for the places in the public medical schools. Will we see a repeat performance this year where
128 top scorers failed to enter medical school?
There were a couple more interesting articles in The Star along the lines of Medical Education worth checking out:
-
Good grades and aptitude- The
Heart of Medicine
Another grading system for doctors?
From The Star,
Move to upgrade government doctors
KUALA LUMPUR: Doctors in government service will soon have to attend continuous medical education to help them stay abreast with new developments in medicine.
Health Minister Datuk Dr Chua Soi Lek said the programme would be linked to the Government Efficiency Level Assessment Test.
“Those who do not attend the course will lose some marks in the test. Taking it will enable doctors to continue upgrading themselves with information on the latest technologies and treatment procedures.
“If a doctor does not attend the course, I am afraid he will just be a doctor who cannot give the best to patients,” he told reporters after launching the Living Skills Pillar under the MCA Lifelong Learning Campaign at Wisma MCA here yesterday.
He said Deputy Health Director-General Datuk Dr Mohd Ismail Merican had been directed to work out the course details. |
Now it appears government doctors have to contend with another grading system in a test that has largely been redundant to doctors. Even the course details have not been worked out and thoroughly tested. It is a case of putting the cart before the horse by making policy statements before drawing up any concrete plans.
Doctors are not a homogenous population. There are many sub specialties and diciplines. Planning a course to suit all doctors will probably not work favourable in the long run. There has to be some sort of flexibility. There are many programmes already in place and any new programmes should incorporate current measures so as not to cause duplication of work.
The Health Minister also needs to seek views of government doctors concerned. Such ruling cannot be seen to be autocratic and must ultimately benefit the doctors concerned and not further increase the burden on them. If any programme is to be a success, it has to have the support of all those concerned.
The idea of continuing medical education is essential and important. Doctors should equip themselves with up-to-date information and any programmes that promote that is most welcomed. However, such programmes should ultimately have the doctors in mind and not some agenda of a group of select individuals. This mistake has been made with the current PTK examinations where questions are highly biased.
Doctors are trained even in medical schools to cultivate the habit of continuous medical education. My concern does not lie with doctors but politicians, policy makers and top managerial staff that may themselves be lackadaisical in their pursuit of knowledge and up to date practices that may result in implementation of archaic policies.
Permanent residents : Should taxpayers be forking the bill?
The approval of the permanent resident(PR) status in Malaysia has always been controversial and shrouded in secrecy. There is no consistency in the criteria for awarding this PR status. It appears that the decision lies solely with certain individuals thus igniting the suspicion of corruption. Previously raised issues of much sought after medical professionals failing in their bid for a PR status remains unresolved. Yet many with no qualifications or experience important for the country's growth, are granted PR status without much hassle. This has raised several issues that need urgent attention.
Let me highlight one such case. A PR without a job is admitted to a local hospital. He claims that he has no money to foot the bill. Welfare officers are called in and miraculously agree to pay all his medical expenses. He comes in regularly and despite being fit for discharge refuses to go home on the pretense that he has no money and no where to go. There is no way of forcing him out of hospital but guess who is paying his bills? His condition unfortunately is chronic and his symptoms would fool any doctor obliviously to his modus operandi.
Should welfare be paying bills for individuals with a PR status? They are certainly not citizens in this country. Should they not be advised to return to their home country to seek further medical management? Failure to do so should result in repatriation to their homeland. These individuals are exploiting the weaknesses of our system and on occasions holding us at ransom.
There has to be a solution to this issue. Perhaps a lawyer could enlighten us further!
Feedback: Medic Alert Malaysia
Zainal Abidin writes:
| The link or websites cannot be used? need to know details about medic alert malaysia cause i was registered recently under my physicians. |
Thanks for writing in Zainal. Yes, the link to the former Medica Alert Foundation Malaysia's website (listed in the MMR's
Societies and Associations page) has been down for ages. Currently, the only link that I can find is a page of information from
UMMC on the Medic Alert Foundation.
Otherwise you can contact them directly here:
MedicAlert Foundation Malaysia c/o University Malaya Medical Centre, Jln Universiti, 59100 KL. Tel 03-7957 5111
I previously had a futile experience trying to contact Medic Alert's "24 hour hotline" and I blogged about it
here.
Good luck!
Blogroll update: Stand up
Added
Stand up! which seems to be a protest Blog or at least one to vent the frustrations of life as a HO/MO in the MOH?
Let's see how long this blog will stand up before it wilts ;)
Help for Thalassaemia soon?
The post on
Thalassaemia Tragedy is not an unsual occurence as there are many other economically deprived thalassaemia patients who are struggling to stay alive and unable to afford expensive iron chelating therapy.
The Star now reports there will be a
More than RM40m allocation for thalassaemia registry and treatment.
Good news I hope.
More than RM40mil will be allocated to provide treatment and start a registry for thalassaemia patients in the country, Health Minister Datuk Dr Chua Soi Lek said.
He said out of this amount, RM19.9mil would be provided to purchase equipment and other aids as a one-off allocation, adding that this was a Cabinet decision after its meeting on Wednesday.
"We will also start a census to register all patients in the country beginning with secondary school students this year.
"We will also prepare the logistics to allow couples to test for thalassaemia prior to getting married," he told reporters at the ministry on Thursday. |
Screening for carriers would be an important step too as carriers are asymptomatic and it is tragic for couples to be told their first child has Thalassaemia major and both parents had no inkling at all that they were carriers. It is even more tragic to see families where there are 2 or even 3 children with Thalassaemia major - one wonders what kind of genetic counselling they have received by their care givers.
Thalassaemia Association of Malaysia
Perak Medical College
The latest news is that the Perak Medical College has been bought by "University Kuala Lumpur" which is owned by Mara's Universiti Teknikal Mara Sdn Bhd.
Bernama reports:
The Perak government has agreed to sell a 75 per cent stake in its wholly owned Perak Royal College of Medicine (PCM) for RM60 million to Universiti Kuala Lumpur (UKL).
Menteri Besar Datuk Seri Tajol Rosli Ghazali said the PCM campus near Ipoh Hospital was priced at RM45 million while the shares in the college were valued at RM15 million in the deal.
"The state government through the State Secretary Incorporated will still retain a 25 per cent share in the college," he said after the Executive Council meeting, Wednesday.
UKL is owned by Mara's Universiti Teknikal Mara Sdn Bhd.
Tajol Rosli said the name of the college, which opened in 1999, would be maintained as that was one of the conditions for selling it to Mara.
"This is in recognition of the Sultan of Perak Sultan Azlan Shah's contribution towards the college's development. As the Chancellor of Universiti Malaya (UM), he had played a significant role in establishing a strategic alliance between the university and PCM," he added.
He said when Britain's Sheffield University stopped issuing its degree to PCM students few years ago, UM stepped in to help the students.
Tajol Rosli said the college could take in 100 first-year students who each pay RM50,000 annually for the first two years and RM55,000 each year for the remaining three years.
"Mara actually saved the college by buying it. PCM was losing students, especially from overseas, when Sheffield stopped giving its degree," he said. |
Well I think UM saved PCM with the so-called "strategic alliance between the university and PCM". If I were still a faculty member of UMMC I would be upset that the faculty's limited staffing resources is forced to take on another medical school's student load. PCM could be seen as gaining a back door entrance to UM's medical school.
If Sheffield University had pulled out, it would have meant there wasn't enough faculty members to setup a proper medical school. PCM should have been put on hold IMO.
Now that "UKL" is taking over, is PCM still going to exploit UM's medical school or are they going to do it properly and not leech on another school's teaching resources? What is the current situation now, anyone knows?
Private medical schools are mushrooming all over the country. Yet isn't anyone crying out to examine the
quality of the teaching faculty? What about staff-student ratios? Isn't this important? What kind of medical students will be produced by understaffed medical schools?
Beware - even more suffering ahead
Dr. Lin claims in a letter to Malaysiakini that a recent
Health ministry circular for doctors is unhealthy Previously, graduate doctors were expected to undergo only one year of compulsory Housemanship which consisted of completing four-month durations in three different postings (General Medicine/Paediatrics, General Surgery/ Orthopaedics and Obstetrics & Gynaecology).
As HOs, we are expected to come in every single day including public holidays with a total of nine days allocated for leave. After completing this grueling one-year period, many can finally breathe again as they will now become Medical Officers (MO).
Being an MO is no easy feat either as they are held fully accountable for any problems that may arise. However, MOs are allowed certain benefits that are not bestowed on HOs, for example having your weekends/public holidays off if you’re not on-call.
However, all of these has changed in recent years. Our Ministry of Health (MOH) recently produced a circular addressing the need for doctors to now complete five separate postings in General Medicine, Paediatrics, General Surgery, Orthopaedics and Obstetrics & Gynaecology in that order.
Accordingly, another eight months have been added to the Housemanship period. On top of this, the circular states that doctors are no longer considered House Officers in their 4th and 5th postings but are now Junior Medical Officers (JMO).
Unfortunately, there is no proper implementation of this new rule and most government hospitals are applying it according to their whims and various needs. In most centres, doctors in their 4th/5th postings are asked to remain as HOs until informed otherwise.
This situation would be a common example. Dr K, in her fourth posting, and was asked to remain a HO for the first 2 months before being subsequently ‘upgraded’ to an MO for the remaining two months. She was then sent to her fifth and final posting where she is ‘downgraded’ to a HO for the first three months and later on ‘upgraded again to an MO until the posting is completed.
Is this not an absurdity? Perhaps most government doctors are just too tired, too over-worked to actually start complaining regarding this ridiculous maltreatment. Maybe these doctors know that complaining about it will not get us anywhere or achieve anything. |
What other Government Department has any employee expected to work "every single day including public holidays with a total of nine days allocated for leave"? Is this true? Is this the state of exploitation of HOs in the MOH today? I can sympathise and empathise if the suffering is going to be yet further prolonged in the guise of the dubious title "JMO" which is really an MO doing a HO's job.
Forced HIV testing policy untenable?
Azrul Mohd Khalib writes in Malaysiakini that he is of the opinion that
Forced HIV testing policy is untenableFour States have implemented or are considering implenting this policy (Johor, Perlis, Malacca and Perak) and yet the public remains strangely silent on this policy which will affect issues relating to privacy and human rights. Azrul points out "I must ask why are the HIV/Aids NGOs, community groups, People Living With HIV/Aids activists in Malaysia mostly quiet on this issue?"
Sad.
Hospis Malaysia
The NST has a nice write up on
Hospis Malaysia today in their article
Healing, in death While
Hospis Malaysia is doing a good job, there are still many parts of the country which are not covered by Hospis Malaysia. From their website, the limited coverage encompasses "homecare services for the community residing in the Klang Valley, namely those in Petaling Jaya, Subang Jaya, Shah Alam and Kuala Lumpur. Hospis Malaysia does not cover Klang, Rawang, Sg. Buloh, Ulu Langat, Kajang, Bangi and Putrajaya."
We need more people in Palliative care medicine.
