From Malaysia: Too Many New Doctors and Too Few Hospitals to Train them

I was reading The Star, one of Malaysia leading English newspapers. One of the articles attracted my attention because it was related to one of the most talked current medical issues which is the excess medical workforce (medical housemen) in Malaysia. It was interesting because as I will graduate in about 2 years time, so I hope by the time I go back, the problem will be solved. So, today I would like to share about this issue.

According to the Ministry of Health, the number of medical housemen undergoing clinical training in most government hospitals has increased. There were 38 hospitals providing training to more than 3,058 housemen last year but the number has since increased to 6,253. Based on the statistic 5 years ago, one houseman looked after 10 patients in hospital wards but now it’s reduced to one to every 4 patients.

Besides that, in the past, there were 5 housemen in each department but now it could be 20 to 30 for each department. These lead to the situation where there were more housemen than patients in the training hospitals, including in Sabah and Sarawak. Each specialist was supervising four times as many housemen compared to a decade ago.

There are few reasons why overcrowding of interns in hospital can happen. With new medical schools opening up locally and lower fees being offered at new institutions aboard, a steady number of 4,000 Malaysian medical students are expected to graduate annually. Besides that, the action taken by the Health Ministry to increase the duration of housemanship from one year to two to overcome the lack of experience among housemen worsens the situation.

Actually, what is the impact of excessive medical housemen to the health care? Why the government and Health Ministry are concern about this issue? One of the reasons is they afraid that medical housemen may not get sufficient experience. The interns are seeing fewer patients and hence, have fewer opportunities to carry out adequate procedures.

Apart from that, excessive interns indirectly affect their attitude. They became less competitive and less responsible towards their patients. The Health Ministry stated that there were also interns who failed to give accurate diagnosis and relied too much in investigation tools. Thus, the quality of future doctors is affected.

So, I think few steps can be taken to overcome this problem. First, there is a need to increase the number of training hospitals. (You can read my previous post about requirement to implement a hospital ) J

Second, we can increase the number of specialist to train the interns. For example, the Health Ministry is recruiting 58 contract specialists from Egypt, India and Pakistan to help supervise housemen and reduce the burden of the specialists.

In conclusion, I believe housemanship is the time where the medical students practice what they learned theoretically. Therefore, I hope the current situation will improve so that we can learn more and be more prepared to care for our patients.

References:

1. Too many new doctors and too few hospitals to train them, The Star