is it really the house officer’s life so stressful?
few months ago i sent a message to our beloved Health Minister Datok Seri Liow Tiong Lai..
i told him “i think Malaysia should limit the number of medical schools, i’m very surprised that the surgical house officers do not know how to insert a branula”..
he didn’t reply my message.. but few days later in a press conference, he said “the Ministry of Health will look into the issue of the quality of house officers”..
and recently, the Ministry of Higher Education announced “no more new medical schools in the next 5 years”..
to me, this is a great news.. hahaha.. 
but to those businessmen and money-orientated academicians, this is a shocking news coz they are losing their opportunity to earn easy money…
well, is the quality of the house officers (HO or commonly known as houseman) in our country really that bad..?? emmmm, i think those who are working in the hospital definitely know the answer..
there are few factors contribute to the poor quality of the house officers, one of them is the business-orientated money-digging poor medical education system, both local and abroad; other factors include poor attitude from the house officers themselves, as well as lack of support from the senior staffs (MO and specialists)..
let me draw an analogy how is a doctor being produced in this morden day..
first, you must know the concept of instant noodle..
you can choose vegetarian flavour, or spicy ramen flavour.. similarly you can choose to study medicine in local or abroad..
open up the cap, throw all the seasoning into the cup.. similarly, you attend the medical school and the lecturers throw all the textbooks on you.. (it is very sad to say that when the students approach the lecturers for any doubt in their study, the lecturers most of the time and most likely will answer like this “go back and read your books, come back and tell me the answers tomorrow”.. so basically the doctors nowadays are produced by medical textbooks and not by medical schools.. and this also means that most of the medical lecturers nowadays are makan gaji buta (earning easy money).. surprisingly, some of these lecturers even do not know their subjects well and do not know how to perform a clinical examination in a proper way..!!!!!
then, pour in some boiled water.. similarlly, the students are “floating” in the medical schools.. study just because of assignments, tests, examinations.. but do not know how to link the basic sciences with the clinical problems, do not appreciate the progress of a disease, everything also main hentam and tembak (shooting the answers all around)..
and finally, you get your instant noodle, and instant stethoscope.. :p
so how can we expect these instant noodle doctors to perform their tasks competently and to function as a house officer confidently..?????
here are few examples of the instant noodle house officers that i have met..
# case 1
patient in hypovolemia with hypotension..
MO: pls do fluid resuscitation..
HO doesn’t know what fluid resuscitation is, and malu (shy shy la) to ask the MO.. but he remembers resuscitation is something to do with CPR (cadiopulmonary resuscitation).. so he performs chest compression in a CONSCIOUS patient, causing respiratory distress to the patient, and the patient is looking at him in one kind.. and the smokes come out from the MO’s head..
deserved for HO paling tukul award.. (this HO graduated from Russia, recipient of scholarship from a famous local body)..
# case 2
vital signs stable on a dead body..
the HO did his evening round in the acute bay.. one of the patients was intubated due to head injury.. the family members told him the body became stiff 2 hours ago.. but the monitor still showing pulse rate (patient on ionotropes).. so he documented “patient GCS remains poor, vital signs stable, continue the same management”.. huh..????? how to become a doctor even he/she can’t even differentiate between LIFE and DEATH..????? why do they want to spend the parents and tax payers money to study medicine but the medical knowledge is lousier than a layman..?????
deserved for HO otak ketam award.. (again, this is another HO graduated from Russia)..
# case 3
for MO to resus patient..
i was attending a patient in the female surgical ward..
suddenly another patient in the same ward collapsed and desaturated.. the nurses were shouting and called the surgical house officer who was sitting at the counter doing nothing at that time to attend the patient.. he walked slowly to the bed of that patient but did not examine the patient, he just pointed his finger toward me “neh, doktor dekat sana”.. huh????? what type of houseman is this..????? asking a MO to attend a collapsed patient without examining and doing the initial resuscitation works..?????
deserved for HO ubi kentang award.. (this HO graduated from a local public university, one of the three oldest medical schools in this country)..
# case 4
for MO to insert branula..
during my housemanship time in 2006, when we have problem in inserting a branula, we NEVER called our MO for help (except for neonates).. we would call our senior houseman (most of the time, the captain) to help us to insert the branula.. during my second housemanship posting, i started to insert the femoral line and i did my toes amputation for diabetic patients ALONE while my MO was sleeping the whole night.. i did my first peritoneal dialysis together with my houseman friends without the presence of our MO when i was in the medical posting.. but now, what types of procedures that a houseman can perform..???
recently, during my busy oncall day, suddenly the nurse called me up “doktor, tolong insert branula, houseman dah cuba 2 kali tapi tak dapat”.. huh??? why can’t the houseman call me directly if he/she cannot get the line?? just left the patient and ordered the nurse to call me..?? what tpye of attitude is this..?? no responsibility at all.. when i went to see the patient, i found the vein of the patient was BIGGER than the vein on the manikin..!!!!! how could the HO fail to insert a line into such a huge vein..?????
deserved for HO kurang asam garam award.. (this HO also graduated from a local public university)..
# case 5
in the past, we houseman worked like lembu and donkey.. there was no time for us to sit and rest.. the MO just sat over the counter and monitored what we were doing.. we used to offer ourselves to assist the MO in doing any bedside procedures..
nowadays, the house officers are sitting over the counter and “observing” the MO doing their job.. no greetings, no offer, no initiative to learn..
deserved for HO kurang upaya fizikal award..
# case 6
houseman manja..
a female houseman is a little bit slow in doing her job and her medical knowledge is very poor.. but she likes to come to work late, and goes back home early.. every morning during the ward round, one of the surgeons likes to ask her a lot of questions to test her medical knowlege.. and most of the time she can’t answer.. one day, suddenly the surgeon receives a phone call when he is doing surgery “i’m the mother of @#$%, please stop asking my daughter any questions, or i will make a complain to the state health director..” huh?? like this also can arr..???
deserved for HO lampin pasti tak bocor award.. (this HO graduated from a local private medical school)..
so, is it really a houseman’s life so stressful..?? to me, YES in the past few years.. but NO in these days.. i don’t understand why the HO nowadays like to complain, small small things also complain, even language barrier with patients also become an issue to them.. in my opinion, these HO are too pampered by parents, not competent in clinical skills, too ego, and not taking positive attitude and initiative to improve themselves.. today, there are so many house officers in the ward compared to few years back, the workloads are markedly reduced.. so what are they complaining about..??? the stressfulness is mainly due to their incompetency to function as a house officer.. (of course there are still a lot of hard working, capable and reliable house officers around, but the numbers are not many now)..
as a trainee lecturer, i’m willing to teach and guide the house officers in any aspect, but only if they are really interested to learn.. my advice: don’t become a doctor just because of the title “doctor”, or one may end up like them..
hahaha i like ur examples /stories of the incompetency of HOs, they simply have no insight and kurang ajar, if the parents behave such a way, not surprisingly children will act the similar way. u are future lecturer, u don have a choice but not to give up and teach and guide them. u have to do ur part, is up to them to realize and change.
just like a school teacher, u cannot save everyone just them who are willing to learn and change, just hope that many many years later they are not the one who is treating us….. haha omitofour…………….
hehe.. true, true.. :p
This is usual way of ppl like sim/simon to present themselves. They do this for publicity. Not for the sake of betterment and needing for an improvement. They usually start like this ” oh, when i was an HO there was no room for me to sleep, my MOs were lazy and sit around making us do all the work”. We are used to this type of crap. Dude, you have been an HO, and only your MO knows what you have been. You might not be as lame as others. But you sure are nothing better than them. AND its your freaking job to train, and teach you juniors. That is what your seniors did to you hoping that you would do the same.
hahaha.. finally i found the candidate for the “siapa makan chili dia terasa pedas” award.. :p
thank you very much for your comment, you have just given us the “real example” of how’s a typical potato HO looks like: weak but yet cannot take any advice (tidak boleh ditegur walaupun lembik).. to the prospect medical students, now you know that the examples in my article are all real.. as i said before these potatoes are ego, poor attitude and no initiative to learn.. just like “tin kosong berlagak sombong”.. hahaha..
since you are so used to those “crap” that you mentioned, then why are you still so stubborn..??? why can’t you take initiative to improve yourself..??
it was clearly written in the last paragraph of my article “i’m willing to teach and guide the house officers in any aspect, but only if they are really interested to learn”.. you can drag a donkey to the river, but it is up to the donkey if it wants to open the mouth to drink and swallow.. if the HO is having attitude problems and lazy to learn, then how to teach..???
i also clearly mentioned that “of course there are still a lot of hard working, capable and reliable house officers around, but the numbers are not many now”.. if you think you are supposed to be in this group, then just prove to us that you are good enough.. no need to perasan and bising so much..
you as a House Officer (a so-called adult) but behave such immaturely really giving us an impression that you are one of the potatoes in the examples given..
please read the article from top line until the bottom line, and read all the comments from other readers.. none of us were saying that we are better than anyone.. we all took the Hippocrates Oath (i supposed you did, unless you are playing fool around during the oath taking ceremony, or your medical school is so lousy enough and didn’t organise one).. we must know our own limitation.. we don’t say “i’m good in doing this, i’m good in doing that”, this will lead you to become an ego doctor.. we should say “i want to know how much that i don’t know, so i can learn and improve myself”..
as you said, this is our freaking job to train and teach you guys.. but the problem is, you yourself are in poor insight, you don’t see your own weakness, even worse you cannot take advice.. then how to teach..?? you yourself know how to say it, but surprisingly you yourself cannot do it – what a big joke.. hahaha..!!!
i remember my professor told us before “speak out like a man with balls, or speak out like a woman with boobs” i know this statement is a bit 18sx.. but basically the professor was trying to say, if you want to be heard, than you must speak with your own identity and your own heart.. it is very shameful for you as a so-called doctor to use a fake name and post up a comment without using your brain.. just like a dirty rat shouting in a smelly drain (bagai tikus kotor menjerit di dalam longkang busuk).. we are all educated, and this blog is open for all, i welcome all comments.. there is no comment moderation in this blog.. (i don’t delete any comments so the other readers can read and judge how a commenter is..) you type, you click, and all your comments will appear in just a second.. but please try to learn to give a negative comment in an educated way (since you are using a “Dr” in front of your fake name)..
the way how you talk will reflect what type of character you are..
whether is it for the sake of betterment and needing for an improvement, it is all depend on individual.. if you can take criticism with an open heart and improve yourself, you will succeed.. but you feel uneasy with criticism and showing all your frontal lobe syndrome (like what you did), then you are a failure..
yes, when i was the HO, not only the MO knew who i am, but i’m proudly to tell you that even the specialists, consultants and patients also knew who i am..!!! now, asking back yourself, how many MO knows who you are..??? or, should ask in this way, how many peoples in your hospital aware of your existence..???
take this advice (if you think you are not a doctor potato): as a junior doctor, always be humble, humble and humble.. take your own initiative and a positive attitude to learn new things rather than waiting for your MO or specialist to spoon feed you.. i supposed you have learned all the basic stuff after soaking for 5 years in your medical school.. you paid money to the medical school and the professors, thus it is their responsibility to teach you, unless you were just paying them to pass you in exam and buy your medical degree.. the specialist and MO are not paid by KKM to spoon feed you all the basic stuff.. remember, please do not become the black sheep and spoil the good name of our profession..
also, thanks for calling me dude, it really makes me feel younger like you (as you know, it is very hard to get people to call an uncle like me a “dude”).. hahaha.. :p
i wish you good luck and success in your career..
dr sim, i truly agree wv u. until now, im stil studying everyday, med is a continuation process, when u learn more, u will notice dat actually u noe only a little bit. yes, its true we ‘ve been HO b4, we did angry at sum of mo for scolding nonsense previously but we prove to them we can be better and we thank them for dat. and dear dr muhammad, its the same mos’ who judge us b4 and judge the current HO attitude and performance then tel me dat- most of the HO are only 1 % of our previous at same stage of posting. im not saying dat we ar gud, but so far we nvr blame our mo like dat
hi Koayfami.. that joker is really having poor insight.. the main problem of the young generation of HO nowadays is the ATTITUDE problem.. but unfortunately most of them do not aware of their own attitude problems.. their nose is always pointing up to the ceiling just because having the title “Dr”.. but what the title “Dr” will do if these potatoes are just another tin kosong..?? what is the point to soak in the medical schools for 5 years but at the end of the days they even don’t know the basic stuff and still need the MO / Specialist to spoon feed them..?? how to teach if the HOs are lazy, always missing in action, copy and paste in the ward round, going back home earlier without complete the ward works, poor doctor-patient relationship, blame and shout at the patients when having language barrier, give the unresponsible answer such as “i don’t know, that is not my patient, i only take care of bed 1 to bed 3″, push all the works to the oncall person, frequent EL and ask other peoples to take their call and do their job, need to put a red carpet and give an invitation card for them to come to see a gasping patient..??? how would they expect the seniors to teach them if they never introduce themselves to the MO, never greet the MO, even worse they disappear when the MO is doing round or doing bedside procedure, ..?? these are all ATTITUDE problems.. aiiiiii, joker is always a joker…
Mohamed, I think you are not just lame, but childish secondary to hydrocephalus as well.. Do you think last time our MOs were so keen to teach us? Do you know that the MOs last time were much more malignant than the current MOs? We all learned by our own initiative..!! We approached our MOs for any procedures..!! Sometimes we were bombarded by the MOs without any reasons, but once we proved to them our capability, then they would be OK with us after that.. I agreed with what Dr. Simon said, the current HOs are too pampered and incompetent..!! Do you want us to teach you to come to work on time? To teach you not to be lazy? To teach you how to be more responsible? To teach you how to insert branula? Tell me which medical school you’re from, I would like to write a feedback to your Dean..!!
hi CKLee.. thanks for sharing..
Interesting…..you are right, our country is getting more and more “doctor” , whether they can do their job well or not are different story. As long as your family got money, you can study Medical. LIke you said, there are so many colleges local and abroad which offer medical course. One of my cousin was studied in one of the famous private university in Bukit Jalil. The school purposely take in a lots of students, fees is sky high, any subject if you need to re-sit got to pay 1000, to re-marked your paper- RM5000, you not even get to know what are your mistakes in your exam…..they want to fail you , you failed!! The college just earning like crazy..
the business peoples are just thinking about money.. they don’t bother about the quality of education and the quality of future doctors.. :/
Dr sim, sgt best entry blog kali ni. siap ada award lagi. hehe. should publish this blog dlm MOH website
hehe.. sokong, sokong.. :p
This is why I pay shiteloads of money even w a flu to see old, established doctors. They may be expensive but at least I know they won’t give me something I’m allergic to.. And ppl who x afford them are stuck w those asses? Shame on them! How did they graduate at all?? Tsktsk
pass with luck lor.. hafal, hafal, hafal lor.. :/
There is also the question of selection. They should just choose the best and not consider race, place of origin, state… I know they’re trying to be fair but not for this profession.
yup.. agree, agree..
Heya, Dr Sim. Thanks for advice
hi.. u r welcome..
It is so true, nowadays the lecturers especially those young one with lack of clinical experience, whenever they teach, they will ask any questions? When we tell our questions, they will reply: it is a very good questions, very good that you have questions to ask, why not u go back and find out and tell me tomorrow? it is a very typical answer from one of the lecturers.
And then tomorrow, we found the answer from books, but still not really understand the explanation, hoping the lecturers will clear the doubt, before we even could tell the full answers, just the beginning structures sentences from textbook, they will reply, good good, you got the answer, okay next move on.
So pathetic!
hi Rei.. ya, some of the lecturers, including both in private and public med schools r just makan gaji buta.. they become lecturers not because they r interested in teaching, but just wan to avoid busy works in the hospitals.. wat a sad story.. :/
i hv medical student directly coming into my room asking my nurse for cases w/o introducing themselves and even looking at me for permission. i hv oso med student 3rd yrs claim that we senior mo nvr provide them opportunities to learn as they ar stil in learning process and treat them not according to their level and claim we also like dat last time. even med student oso such attitude and so arrogant wat more when he graduated?plus i hv HO call bc to enquire ragd cases in a sarcastic manners as well. yea, im very headache wv them …:p
hi Koayfami.. ya, i agree with u.. not only the HOs, the med students now r also having atitude problems.. they thought dat they r so smart can enter med schools.. but they don’t know if they r really the right candidate to become a good doc..?? these younger generation.. aiiii.. no eyes to see.. :p
Great similes and comparisons for the examples!! Thank you for sharing!!
thanks YM.. wish u success in ur study.. be a good doc in future k..
Dr Sim, interesting post,. Just curious, which medical school did you graduate from?
hi Crus..
i studied at RCMP..
nice to hear from u
very well said! (: love ur “award” section.. LMAO! (:
hi Grace.. thanks for visiting my blog..
simon.. you’re the man lah.. you should work in our ministry of health maa.. i had 13 lovely years in government hospital… houseman in 1998 in the busiest hospital in our country.. HSA JB.. Man… you can imagine how much i cried after every grand rounds but i keep coming back.. never let the stress things got in my way.. then i became an MO, later master students and currently an O&G specialist.. and guess what.. to my disbelieve, there are so many them Ho’s.. till i can’t keep track with their names.. so many attitude problems.. and none of them would actually passed my end of posting assessment.. but then, beaurocracy.. they in fact made it through to another department.. and guess what, most of them failures were from russian university.. coincidence???.. keeps up the good work bro… i am in private now.. doing what i do best and give my best service to the people.. sometimes it better this way.. take care…
dear Dr Md Adhanizam.. thanks for your comment
i agreed with you.. the stress of HO nowadays is nothing if compared to the stress that you and other specialists had gone through last time.. for the past 4 years, i onli can remember 3 of my HO’s name, who’re really reliable and responsible in their works.. the quality of HOs graduated from Russia are really doubtful.. i love teaching, so i quit KKM and join university.. i am doing my master now, currently doing my rotation in HSAJB :p
Dr. Sim
i do agree with you that many med students are not up to the mark,
i remember doing round for 50 patients a day and we would still be able to remember all cases. but now if u ask a HO another patient instead of the ones he/she takes care of, they would proudly say, that is not my patient.
how blunt can they get?
i just started my masters. and i am an ukrainian graduate.
it is not fair to state that all russian graduates are horrible, i would agree that there are a few who are the black sheeps but not all are unreliable.
hi Dr Raj.. thanks for your comment and sharing
ya, i agree with you.. i have met some russian graduates who are hard working and very keen to learn..
some of the local public university graduates are also having problems as well..
medicine is not meant for “A” star students.. i myself is not an “A” star student..
anyone can become a good doctor as long as he / she is having a caring heart, a good listener to the patients, has a strong desire to learn new stuff and keen to improve him / herself from time to time in the clinical matters..
wishing you all the best in your master study..
I had read this.. i’ll remember this for a long time.. post it at my fb.. continuing my studies soon. n hopefully i’ll get lecturers like you, with passion. When you have the passion, i’ll definitely study with passion.. its hard to say now but i’ll i’ll try hard..
dun want to be like a HO wif gembing award = sissy and lembik.. always cry..
or HO wif hidung tinggi award.. hehe
anyway thanks for putting up this.. great help.. pengajaran untuk budak2 banyak lemak..
hi Khaldoun.. thanks for sharing.. wishing u all the best in ur study and future career..
nice one… how have u been friend?
hi Joe.. nice to hear from u..
me fine..
Hi, I enjoy reading your blog very much, Dr. Sim. These are all the truth that happened in our medical field now. I agree with you that this newer generation of HO are not reliable as our time. A lot of them are having attitute problems. Not because they are stupid, but they are just not keen to learn and want only easy life. Some of them even don’t respect MOs and specialists at all. I like your “award” part. They deserved for the “kurang upaya fizikal” and “kurang asam garam” award. Keep your hard work and do write more these articles.
hi S Mey.. thanks for ur comment.. i think the medical schools should add in “moral” classes in their syllabus.. :p
hello dr.sim. thank u for such article. it’s very inspiring not to be like any of the mentioned above… by the way i just graduated from a Russian university, at first seeing the first few award going to a russian grad r quite upsetting.. but that the ugly truth.. somehow, i m gratitude over ur clear judgement toward both local n private med school. at the end of the day, its an instant noodle made of… still long way to go…. but i really hope not to get any award that u put out earlier..?hehehehe.. by the way, thanks again..
hi Miguel.. nice to hear from u, and thanks for sharing..
the article was written mainly to remind ourself, as a doctor, we need to keep learning and update our knowledge no matter at which level we are in, and the importance of the positive attitude of “keen to learn” and “humble” in seeking knowledge and self-improvement for the benefits of patients..
hope u success in ur lifelong career..
Hi Dr. Simon Sim,
I’m a houseman from Seremban. At first, after reading your article I felt very sad, just because I’m a houseman too. But after I read it for few times, I totally agreed what you said are true. Many specialists and MO from my hospital also saying that the standard of current houseman has dropped. Actually there are many houseman in my department are having attitude problems, some are exactly the same like the examples you gave. Some of us are trying our best to complete the ward works asap, but some are just missing in action. There are just too many lazy houseman in the hospital. And these black sheeps have spoilt all the good name of the other hard working houseman.
Dr. Simon, can you give me some advice how to remember the cases in the ward well? I’ve tried my best to know all the cases but just very forgetful. Also, i’m interested in paediatric, how can I do my postgraduate study later?
I will remember all your advice, and hopefully I myself won’t be the recipient of any awards above :p
I also like your blog very much, especially articles related to nice food
Thank you Dr. Simon.
From,
A little HO
hi little HO, im a mo fr wm. as long as u hv gud attitute, u wont be affected by thos black sheeps as ur mo and specialists deinitely wil noe ur hardwork. i noe that nowadays the HO qualities ar at 2 extreme end, thos who ar very gud and thos whom i think shouldnt pass at all and worse part they do not want to becum better.plus,it depends on experience to rem cases. as long as u ar the 1 who owez take care of pt,like taking his blood, get urgent scan , or carry out some procedure on them,definitely u will rem the patients progress. anyway, hop u maintain the gud job. gud luck
hi koayfami.. nice to hear from u again.. and thanks for sharing..
hi little HO..
how r u? there r 2 possibility to pursue ur postgraduate study in paediatric.. 1st, applying for the 4 years master program in local universities (UM, UKM , USM). after completion of ur housemanship and done ur district MO posting, try to attach to a paediatric department in any kkm hospital.. experience in paediatric department prior to application will be an advantage.. 2nd, applying for external exam MRCPCH, which u can try to study now and sit for the part 1 exam if u have d time, usually it takes 3-4 years to get ur full MRCPCH.. u can contact paediatric department hospital Ipoh coz they r organizing preparation/revision course from time to time. the 2nd pathway may be a faster route but with expensive examination fee.. but master program may be a more secure route, once u r in the program, as long as u r doing well and with good performance consistently, u r almost a paediatrician after 4 years time.. whereas the MRCPCH mainly depends on luck.. there r good and hard-working candidates but just unable to get through their final part of MRCPCH exam after few attempts.. exam depends on luck.. and money wasted for repeating the exam..
there r normally 2 categories of patients in the ward every day.. 1) new admission, 2) patients that already in ward.. for new admission, when i was d houseman, d 1st thing i came to d ward in d early morning was looking for “new faces”.. i would then quickly go through the case note, tried to ask additional questions where appropriate, then quickly looked at d clinical examination findings documented, and repeated myself for confirmation and at d same time did some other additional examination which were missed out by d oncall HO/MO.. by doing so, when ur bosses come, u r not only know d new cases well but also can pick up new relevant history and signs which may impress ur bosses.. for patients already in d ward, usually before i went back home in the evening, i would go through all the case notes of every patients to find out d latest progress (and because of this, most of d time i would end up going back hostel quite late, furthermore, i might need to trace some investigation results for some patients which were forgotten to be traced by some “lazy” HO).. but i learned a lot by doing so, and easy for me to correlate d patient’s problems with d relevant management (u will see d flow of d management of a specific disease).. on d next day, i could do my morning round very fast, and also picked up any new symptoms/signs of patients easily.. i know it is really taking up ur time.. but don’t worry, just make it as a learning process.. u will learn more than d others.. even until now as a MO, i also review my patients every evening before i go back home.. d next morning i will present d cases to my boss easily without looking at d case notes (i don’t rely on my HO for d ward round)..
what dr koayfami said is right.. d MO and specialists will know which HO is hard working, which HO is king of snake.. to me, it is ok if d HO is weak in knowledge coz we are still learning, we can improve with time, as long as d HO is trying his/her best to learn and do d ward works properly and promptly.. personally i don’t like d “tin kosong berlagak sombong” type of HO, knowledge kosong but still want to behave like consultant, cannot take advice from seniors, or “poor insight” (never know that they r doing wrong), or like to blame d patients or other staff.. for these type of “HO istimewa”(aka HO cacat) i usually don’t bother about them, they will get into trouble in one day later.. i only help and guide d HO who r keen to learn with good attitude, coz i know that he/she will become a good doctor with good character in future..
hope these help u.. feel free to drop any questions if u need further opinion/assistance..
I’m going to begin my medical studies on scholarship in Cuba. Thanks for the article! It is sad to see that so may doctors nowadays behave so apathetically and don’t have a desire to learn. I would think that they would be rushing to help to get the most experience possible. How else would you be able to develop your confidence in diagnosing and treating patients in the future?Thanks for highlighting these cases. It serves as a reminder of how not to BEHAVE!
hi Marlene, thanks for sharing. wishing u all the best in ur study in Cuba
hahaha.. totally agreed! not all of them but most of them!! one of my exp wit them …few months ago.. i got referal frm HO for anaest to r/w .. he informed me pt GCS dropped,spo2 unrecordable but HR n BP stable.. looks comfortable.. not tachypnoeic.. when i went to that ward.. no HO around, no nurses around that pt.. only unrecordable spo2 machine that giving an alarm!! tet tet tet.. when i looks at the pt ..yeah he looks sooo comfortable in weird position.. rigor mortis alredi maa… owh my god.. that sooo bad… keluar asap alredi my ears… i call the HO and ask him to come… rupa rupanya.. the HO didnt r/w the pt at all.. retrospectively…’while he was sleeping with sweet dream , sn call him and told him that she cannot get pt spo2 reading.. and the clever HO terus call anaest oncall…and referring the case…. masatu i rasa mcm nak makan that ho..
hi Ida.. it is quite common nowadays d HO don’t actually examine d patients.. during d round, they don’t see patient, they don’t touch patient, and they don’t talk to patient.. but just copy and paste from d previous review, and everything also “con’t the same management”.. :/ when d nurses inform them any thing, they would just take up d phone and call d MO asking for help without examine d patients first.. 2 days ago i received a call from a HO saying a patient in d ward with EVD is having vomiting, when i asked him is d EVD function or draining, he said he doesn’t know how to check d EVD, so i went to see d patient myself, but there is no any single tube or drain on d patient’s head..!! i’m really thought of putting 24 EVD on d HO’s head..!!!
Of course there are HOs who don’t deserve the title at all, but don’t forget the good ones as well. I am a HO graduated from a public university. Part of me want to laugh, and the other part want to cry.
hi Fiza, thanks for sharing.. the black sheep has spoilt the good name of the good HO.. but don’t worry, the good HO would normally get the awards from the patients themselves.. “ni doktor bagus punya, banyak tolong saya”.. this award is better than any award given by ur boss..
dear HO and drs..and to me as well..we must treat all pt like our family.. just imagine ur mum was admitted in the ward and being treated like that.. sure kita sedih …frustrated and angry.. i know.. time HO memang banyak blur.. but as long ur attitude are ok..willing to learn .. tak suka berkira.. dah kira ok..( common answer yg i dapat masa r/w pt kat ward..itu pt dr so n so …i tak incharge that bed.. i jaga pt bed ni saja.. so i tak tau pt tu case apa..) that answer really make me naik angin
yap.. agreed with u Ida.. attitude problems among d HOs are now getting worse and worsen.. and now MOs are transparent to them as well.. no more greetings to the seniors.. some of them not only not keen to learn, lazy to use their brain, but lagi teruk, hilang budaya sebagai seorang yang berpelajaran.. very sad :/
does anyone think ppl who havent gotten good results are eligible to become a doctor?
what are the options there if i didn’t score well in a levels?
hi Ro.. “medical profession” is not only meant for clever people or people with all As in their exam.. “medical profession” is open for those with brain to think, and with heart to care.. as long as u have a brain and a heart, there is still a chance for u to become a good doctor..
there r many examples of “excellent” or “best” students turned up to become “doktor ubi kentang”.. and there r also many examples of “so so” students become “responsible, caring and passionate” doctors.. so don’t give up, just try ur very best if u r really interested to study medicine.. to maintain d standard, one must archieves d minimum requirement as stated by d MMC to enter d medical schools.. if not doing well in d A levels, u can try for another attempt (A level, STPM, pre-u programme) at least to archieve d minimum entry requirement.. but if u r not sure u r really interested to study medicine or not, then probably u can proceed with any other bachelor degree first (if possible, health sciences related) and u can apply again to enter d medical schools with ur degree later.. for those who r really interested with strong desire and determination to become a doctor usually they can realize their dream by this route.. however, for those tahi ayam hangat-hangat 5 minit type of people, they will give up medicine and choose to work in other field after completion of their first degree.. cheers 
erm, totally agree with u.. don’t understand why need to complaints the small2 thing… huhu… why need our ministry start on shift system for HO… we cannot learn much….
how to become a competent Dr later on and become a good MO when u never do on call….
hehe.. because those policy makers themselves are not good doctors as well.. :p wishing you all the best in your career Syida..
yes , dr sim i agree wv u that policy makers ar not gud drs. some of them ar not ethical as well. they started the system now as a response to the public concern regarding sudden crowd of HO, the shift system does not solve the prob at all. this is like they like to transfer staff whom they thnk as problematic (som of them not really) here and there but never tk proper action. in my plc, they owez entertain pt wv complains wv is nonsense and not right even medically not ethical and gv pt wrong perception regarding the real situation. they dun care at all bt pt care or mx.
hi Koayfami.. what they did is just like sapu all the dirt and dust under the carpet.. outside looks clean.. but when remove the carpet, dirt and dust still there.. problems will never solve.. most of the time they just wan easy and quick job, but don’t really see the whole sequelae of the events.. sad story.. :/
aiyooo…don blame the shift system….take the advantages…less ho so more work to do………. u can learn more
hi Dr Tam.. thanks for dropping by.. the reaction regarding the shift system varies among the HOs.. some like it, some don’t like it.. let see how it works with time.. but not sure the following situation will happen..??
morning shift, HO 1: emmm, let’s go makan 1st.. all the tasks just push to afternoon shift people.. just say this morning i have too many things to do..
afternoon shift, HO2: wa lao er, i just punch in, but there are oredi so many things for me to do.. how to finish them.. celaka punya morning shift people..
night shift, HO3: hehe, not my problem.. now after office hour, the lab and radiology department are half dead, many things cannot be done.. tomolo only do la..
next day morning, back to HO 1: *^@#$&^, same shit same tasks again..
conclusion: patients are still the poor things again..
(p.s. i like ur email address.. i hope it does not reflect u.. hahaha)
haha dr sim true its so sad esp recently i felt very shocked and sad at the same time to know that my ”boss” been so unethical in handling patient’s issue.what to do? we ar in this country.:p
hi Koayfami.. yup, agreed with you.. we are just makan gaji only.. not much things that we can do or to change the “boss”.. as long as we take our own responsibility and complete our tasks well lor..
Hi Dr. Simon, your blog are very interesting
I am a 4th year medical student from UKM. Thanks for your guidance. I will always keep myself remember to be a good doctor in future.
thanks LKW
all the best to you..
i wanna share this article…can?
hi Azila.. ya, of course u can share this article..
this article was written to highlight the substandard quality provided by some of the medical schools as well as the attitude problems seen among some of the junior doctors nowadays, with a small hope to arise “self awareness” among the academicians, students and junior doctors in order to improve the current medical education, the medical services, and the quality of patients care.. it was not intended to put anyone down or any personal attack.. cheers
this is an interesting story, at least new ho can read n compare the real ho in the past compared to now, n made an improvement….After reading these, i realized that i may not work too hard or perhaprs being too pampered.
Anyway….i do have some sort of problem in communication with my mo. I really dunno how to treat my mo. If i remain just silent, they call me arrogant, if i treat them like friend, they call me kurang ajar…So i dont know how the proper way of establishing reliationship with senior doctor like mo n specialist
Second….there is 1 mo who keep shouting n scolding me, that made me feel so scare of her. To the extend, there are time, i dont report case to her n managed the case alonely. Not mean to be arrogant, but i admit that im still ignorance about many thing n how unfortunately such ignorant are not being toleratable by this mo. Everytime i ask question or thing to clarify, i would be shouted n been scolded
dear dr junior.. thanks for sharing..
i understand and know how you feel when somebody was shouting at you.. just be patience k.. some senior doctors like to shout, but this doesn’t mean that you are wrong. sometimes you are doing the correct thing, but just not in the preference way they like (bukan cita rasa mereka kononnya), and they start to shout.. personally i don’t like these type of “shouting” doctors, they just spoilt their own professional image.
don’t feel sad and don’t keep inside your heart k.. if this happen again, then just think carefully, why did she shout..?
1) is there anything that you have done wrong which can cause harm to the patients? if yes: then remind yourself not to repeat in future.. if no: then just don’t bother about her, just continue your work as usual..
2) is the thing you have done not according to her order/instructions? if yes: then just do according to her preference as long as not compromising the patient’s care.. if no: then likely she is just shouting for no reasons..
3) did you forget to carry out some of your task, which some of them are very important and urgent? if yes: then try to keep a small piece of paper with you and list all the tasks that you need to do.. if no: then likely she is just shouting for fun..
4) did you delay in carry out any order? if yes: then try to do thing faster.. also, always look at the list of tasks, which one is more urgent.. always prioritize the urgent things first.. what are the urgent things? things related to life-threatening cases, things that only can be done in the office hours, things that required for surgery, etc..
5) is she shouting at any HO..? if yes: then that is her character problem, you can’t do much about that, so don’t feel bad.. if no: then she is just shouts at you alone, may be she is “targeting” you and just want to give you the hard time.. but why she wants to “target” you..? probably the answers are in the above 1-4 statements..
you may try to ask your other HO friends for the things that you are not sure before you ask her..
regarding the communication problem with your MO/specialists.. very simple: just smile and greet them..
always introduce yourself to the senior doctors in your department, especially the 1st week when you join a new department.. if a HO is smiling to me, of coz i will giv him/her a smile as well.. but if a HO doesn’t greet me at all, of coz i won’t talk to him/her as well..
compared to the old days, most of the MOs and specialists now are “benign”.. we are not punishing or bullying the HOs like what the old days MOs did.. but, obviously we only talk to the HOs who are polite and friendly, who are keen to learn, who always do the works with “heart” (means buat kerja dengan teliti)..
housemanship is a training period.. try to get good impression from your senior doctors during this period.. this is very important for your future professional image and postgraduate training..
no doubt there are still some MOs who are very emphasizing on hierarchy, so they don’t want you to treat them like “friend”.. in such a case, then just treat them like a “colleague”..
talk to them in a nice, polite and “formal” way.. then everybody will feel comfortable.. when times go on, you will get their trust, and they will come back and treat you like friend..
tips: say hi whenever you meet your senior doctors.. approach and offer yourself when any MO is doing bedside procedures.. finish all the tasks before going back regardless the time.. avoid taking too long for doing things outside the ward (e.g. go makan, tracing results, run for blood, getting appointment etc..) becoz some may misunderstood you’re “missing in action”.. (if possible, always let your colleagues know where are you going to).. review and examine the patients yourself when doing round, and pick up any new signs.. when have any problem, try to investigate and discuss with your colleagues before you call your senior doctors (but need to act fast in life-threatening cases).. if you have done most of these, i’m sure you will be the most outstanding HO among your batch.. and your senior doctors will remember your name and trust you very much..
wishing you all the best and success in your medical career..
that was soo funny , wow the first time i heard about m.o being bullied by h.o
haha.. it is common nowadays.. :p