For Future Doctors: Finally, the Hurricane is leading to a Hartal……… Part 2It has been 4 weeks since my last post on the Black Monday campaign by SCHOMOS and the hartal that is being organised by a separate group of junior doctors. I had received a lot of feedbacks for my previous post personally and via my blog. In the background, SCHOMOS/MMA has been working with MOH […]
It has been 4 weeks since my last post on the Black Monday campaign by SCHOMOS and the hartal that is being organised by a separate group of junior doctors. I had received a lot of feedbacks for my previous post personally and via my blog. In the background, SCHOMOS/MMA has been working with MOH and finally had a direct meeting with PM on 23/07/2021. On the very same day, the PM’s office issued the following circular:
As I mentioned in my previous post, absorbing all graduates into a permanent position is NOT a long term solution. I had explained the reasons for this very clearly. It is almost impossible for the government to do this looking at the number of graduates being produced. My recommendation is for all doctors who are into post graduate training should have their contract renewed till they complete their training and get gazetted. The postgraduate training should be standardised. I also said that the permanent government positions is not sustainable anymore and all positions should be changed to contract from now onwards but they need equal opportunities etc, similar to other developed countries.
The circular above basically agrees to what I have been saying all this while. The government has guaranteed that they will provide a minimum of 6 years contract (4+2), increase from 5 years (3+2) currently. During the last 2 years extension, if you are enrolled into a post graduate training program, the contract will be extended to a maximum of 4 years. I presume this 4 years comes about due to the 4 years Master’s program. Those who are already in parallel pathway, they should be in their specialist training by the time the 6 years is done, especially for MRCP, MRCPCH and MRCOG. This 4 years extension hopefully will support their subspeciality training programme. So, overall, if you are in specialist training program, you will be guaranteed a job and training for at least 10 years. The government has also agreed to provide Cuti Belajar Bergaji Penuh and HLP if you are enrolled into the Master’s program. The only problem I foresee are for those who are dependent on local Master’s program which predominantly will be the surgical fields.
With large number of graduates applying for local Master’s program, the waiting period is going to get longer. I did mention this many years ago. The number of slots for Masters program is only about 1000 per year for all speciality included. My question is whether these doctors would even be able to get into the Master’s program within 4 years after housemanship. If they don’t , would their contract be not extended? What if they do not complete the training within 4 years, like they get extended etc? What if they do complete their training but wants to do subspeciality training? Would the contract be extended further? There are many unanswered questions but at least this circular clarifies some of the urgent matters and hopefully, further improvement could be made in the future.
However I noticed that the letter did mention about amending the Medical Act which I find it puzzling. The medical act has nothing to do with employment EXCEPT in regards to the compulsory service. Are we looking at an official reduction in the compulsory service in the future? Currently MMC (since Oct 2020) do allow junior doctors to leave the service 18 months after completing housemanship, pending Minister’s approval individually. Would this be lowered further, permanently? Or are we looking at a common licensing exam applicable for all graduates? It will be interesting to watch but again, it is all a political ball game!
Unfortunately, the above circular and reassurance did not seem to satisfy the group of doctors who were organising the Hartal. Yesterday, they issued the following circular, insisting that the hartal will go ahead today:
I also understood that many warnings have been issued to the junior doctors by the hospital Pengarahs and DG himself has issued a reminder on his FB post as below:
Interestingly, the DG has said that the Pension Act will be amended. This again goes back to my last post where I said, permanent post with pension is not sustainable anymore and all government positions should be changed to contract basis with continuous extension as long as the post is needed and for post graduate training. The hospital should be given the right to choose their own doctors based on need. I feel this is how this scenario is heading into the future. In fact, if the pension act is going to be amended, it may affect all other civil service jobs as well.
The world is changing. Jobs are changing as well. Unemployment of doctors is also a norm in many countries. Consultant without full time job is also common in developed countries but at least they get to complete their training. We need to change. We can’t keep on harping on the same benefits and perks as the baby boomers generation where the world population was a third of what they are now!
I will stick to what I have said in my previous blog post. The era of guaranteed job and permanent pensionable job in civil service is over. Every job is the same and will be treated as the same based on need. Doctors are not an exemption. Everything should be based on merit. I hope the selection of doctors into postgraduate training will be done on merit and be transparent. I also hope that a single post graduate training system will be implemented rather than 2 separate system. I might be dreaming but it is the only way forward. A total revamp of the healthcare system will be needed. A National Health financing scheme is needed to sustain at least the GP practise. A Restructured healthcare system is needed to move away from tertiary health care to primary based healthcare!
The question is , are the politicians ready to make this unpopular decisions? Looking at the current scenario, I don’t see it coming anytime soon!
At the time of me writing this piece, this is happening :
Source:
For Future Doctors: Finally, the Hurricane is leading to a Hartal……… Part 2
