Catch-22: The predicament of junior doctors today


KUALA LUMPUR: The number of new doctors facing unemployment in Malaysia continues to soar yearly due to the limited training spots available at government and university hospitals.

Malaysian Pre-Houseman Joint (MPHJ) spokesman Dr Muhammad Firdaus Syukri Zubaidi said in order to be recognised to practice in a country, a medical graduate must obtain a full medical license, which they receive upon completion of housemanship training.

However, he said housemanship training is only provided by accredited government and university hospitals; and junior doctors were solely dependent on these limited training posts to continue their career in medicine.

“Yet, as the number of graduates has increased in the past five years, the number of training centres and houseman post has remained relatively static.

“The private sector is not willing to employ a doctor without a full medical license, whilst other countries have laid out strict entrance and linguistic examinations for foreign doctors.

“Thus, neither the private sector nor working abroad are viable options for the junior doctor – public service is the only option.

“We are beholden to the mercy of the Public Services Department (PSD) and the Health Ministry. In the final analysis, medical graduates are worst off compared to other graduates.

“Junior doctors are trapped in a Catch-22 predicament, not entirely of their making but bearing the brunt of the policies of the PSD and healthcare systems,” he said in a statement today.

Dr Firdaus said since the landscape of the medical field has changed dramatically since the olden days, society needs to revise their perspective on the medical profession.

Those intent on a career in medicine and surgery, he said, must be made cognisant of the damning changes currently at play and not be misled by false societal perceptions of this once noble vocation.

With promises of guaranteed employment, Dr Firdaus said more and more people have ventured into the medical field, which has led to a disproportionate mismatch between the number of graduates produced and the places for their training.

“With limited posts available, graduates would now have to wait many more months before it is finally their turn to enrol into housemanship.

“And as the number of medical graduates increase year by year, so does the waiting period for housemanship, extended longer and longer.

“Medical graduates of 2013 waited for an average of three months before starting housemanship, while graduates of 2016 have yet to be employed after eight months of waiting. The promise of a secure career in medicine is now a thing of the past.”

Dr Firdaus said the long waiting period takes a toll on the new doctors, as graduates were unable to put their knowledge into practice, their medical knowledge becomes rusty and wither by the day.

The skills learned in medical school; such as the art of communicating with patients and carrying out procedures such as drawing blood; will surely be lost without constant practice, he said.

“This is probably the major cause of the ever-growing complaints of poorly performing house officers, less the “failures” of medical school programmes to nurture the passion to care and heal.

“Is it any wonder that the rate of depressive illnesses is high among the junior doctors in training? “This further leads to poor learning and poorer performances, aggravating a vicious cycle.

“Poorly performing house officers would be further extended in their training, taking up posts designated for new house officer intakes, further escalating the problem of limited posts.

“As house officers are the first line of doctors serving in tertiary government facilities, at the end of the day it is the people who bear the brunt of the housemanship crisis.”

According to an online survey conducted by MPHJ, a whopping 80 per cent of graduates remain unemployed during this waiting period.

The remaining 20 per cent are mostly employed in part time jobs such as tutoring, sales and marketing, driving for ride hailing services or as research assistants.