For Future Doctors: Is this a Tragedy or a Comedy……….Since my last article in June 2019, there has been a lot of happenings in our country, as well as in other parts of the world. Is it for better or worst, only time will tell. The tragedy that is affecting our young graduates is something I predicted almost 15 years ago. As usual, our […]
Since my last article in June 2019, there has been a lot of happenings in our country, as well as in other parts of the world. Is it for better or worst, only time will tell. The tragedy that is affecting our young graduates is something I predicted almost 15 years ago. As usual, our suggestions and warning to MOH was just for filing purposes with no definitive action or plan. It was all about money and how much you can make out of our society’s ignorance and demand. Over the last few months, I have been watching and reading numerous articles in the newspaper in regards to housemanship waiting period and what is happening to those who have completed housemanship and floating around while waiting for MOH/SPA to make a decision whether, you are going to be absorbed permanently into civil service or just an extension of the contract. The frustration among the doctors is palpable but trust me, it will not just end there!
Early this month, there was a circular from MOH:
I find this circular very interesting. As I wrote in my article dated 15/04/2019, the first batch which started their contract housemanship in December 2016, most completed their housemanship end of last year and eligible to apply for a permanent post. Unfortunately, they were waiting for months. While they were waiting, they were kept in the same hospital as a floating medical officer with the same salary as a housemen. As long as the contract is not renewed, they will not receive the U44 promotion. They will remain in U41 as per the earlier contract. The first contract was for 3 years, to cater for any extension of housemanship. That’s the reason the contract has to be renewed after you receive the full registration as only then you can receive a U44 salary. Fortunately, the bright side is the fact that you still have a job till the contract expires.
In June 2019, I was informed that almost 500 of them were absorbed into permanent civil service and only about 50 were given extended contract to complete their compulsory service. Those who were given permanent post were mostly transferred out to where the post is available. A lot of them ended up in Sabah and Sarawak. Either you take it or leave it! There were actually more than 1000 doctors who had applied, following completion of housemanship, end of 2018. What happened to the rest? From my understanding, till September 2019, there were no news about the rest. While waiting, the number of applicants has been increasing as subsequent batches of contract officers began to complete their housemanship. What a mess we are in!
Then, out of no where, the circular above was issued by MOH, dated 30/09/2019. The circular basically says that while waiting for the decision, you can now be transferred to another hospital, klinik kesihatan aka anywhere!. You will not be in the same hospital as a floating officer. It also says that you will be notified of the decision of your application 3 months before your 1st contract ends (which is 3 years from your date of starting housemanship). Basically it just confirms that you will remain a floating medical officer till about 9 months after completing your housemanship (assuming you complete in 2 years on the dot) but in a different location!
The most interesting part of the letter is the fact that, if you manage to secure a permanent post, you will likely be transferred yet again to another location depending on availability of the vacant post that you are being given! Basically means, you will be transferred again within a year to another location! Is this a tragedy or a comedy? The best is yet to come: those who receive extension of contract can remain at the same place where they were transferred as a floating officer! In another word (the way I interpret this), your life in civil service ends there within another year aka completing 4 years of compulsory service. It’s just a diplomatic way of putting it !
All these just points to a simple fact: medicine is not a guaranteed job anymore. The market will be flooded with doctors and no one is going to be bothered whether you have a job or not. How many of them, who did not get a permanent post (can be about 2-3000/year) going to end up opening a clinic? As per my last article in June 2019, the GPs are already struggling to survive!
This is not something that is happening in Malaysia alone. In August 2019, Singapore Medical Council  announced that the number of recognised medical schools will be reduced from 160 to 103, effective January 2020. Many universities in Australia, India, Ireland and Canada were de-recognised. Singapore believes that they are now producing enough graduates of their own to fill the vacancies. Only UM and UKM degrees are recognised in Singapore and I heard that many who applied for a job in Singapore are not receiving favourable response compared to 10 years ago.
Similarly, as I have written in April 2019, Australia is also reducing their dependency on foreign doctors. In April 2019, I wrote that effective March 2019, Australia has introduced a new rule for employers who are recruiting foreign doctors to be a GP in Australia. They must first apply and receive a certification from Rural Work force agency confirming a genuine need to fill the position. In July 2019, Department of Health has reclassified areas which can recruit an International Medical Graduate (IMG). What use to be known as DWS (District of workforce shortage) area is now being replaced by DPA (Distribution Priority Area). These are the areas where an employer can recruit an IMG as you will not be given a medicare provider number(for medicare billing) if you are not working in these areas. Interestingly, many of the areas which use to be DWS areas till June 2019 are now non-DPA areas. DPA now only covers rural and remote areas. For example, in Western Australia, the entire Perth up to Mandurah and even small suburbs like Bunbury and Geraldton are considered non-DPA areas. And you have to work in DPA area for at-least 10 years (the 10 year moratorium) even if you become a PR. The whole idea is to cut down the number of foreign doctors. Furthermore, you can only work in Australia after passing both your AMC Part 1 &2 exams (except Monash Malaysia), where the passing rate is as low as below 20%. As for FRACGP, as mentioned in my April article, those who enter the program in Malaysia from January 2019 will not be receiving FRACGP and will not be able to work in Australia directly. Everyone works under contract in Australia and there are many specialist in Australia who can’t find a full time job. Many work on part-time or sessional basis. There is no such thing as automatic job for a specialist in Australia, upon completing their fellowship. So, don’t assume that doctors are guaranteed a job anywhere in this world!
This interesting letter from a doctor is worth reading, ” Medical Profession is no longer lucrative”. It is well written, not to mention the increasing litigation and patient demands. Do medicine only if you are determined to overcome all the obstacles. Reading my blog/books will inform you the real life of a doctor and not what the public wants you to believe. It is never as simple and cosy as what the public tells you. Till today, when I look at the comments in social media, the public still believe that doctors can work anywhere in the world. They got NO idea that a doctor cannot work in another country unless his/her degree is recognised in that particular country. They got NO idea that you need to sit and pass an entrance exam which can cost thousands of ringgit without a guarantee of a job! They got NO idea that there are jobless doctors in many countries, Malaysia is on the way to join those countries………
Happy Delayed Deepavali 2019 greetings.
IS THIS A TRAGEDY OR A COMEDY…………………..
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For Future Doctors: Is this a Tragedy or a Comedy……….
