Interesting articles to read..to friends or Doctor to be. should read this article..because it is reality that happen and still happen even today and maybe longer..it does not mean to discourage someone's ambition to become a Doctor, but the reality that they will face when they hold title Doctor soon..
Why we left and why we will continue to leave...
Posted by: MS Mohamad
I
 read an interesting article today about a few prominent figures 
addressing their concern over the increasing UKM and UM medical 
graduates who have left the country to continue their medical practice 
overseas.
After reading the news for 3 times, I called a 
very close friend, an MD (UKM) graduate to ask his opinion on how the 
news might have affected him. He has been working in Singapore for more 
than a decade as a Consultant Surgeon with a certain sub-specialty
"Why be a slave in your own country, when you are a king in another?" He replied.
Indeed,
 if anybody would want to find a reason why all of us left, either after
 housemanship, after being a specialist, or even after sub specializing,
 and now, even prior to doing housemanship, they need not look at our 
payslip, or the wealth that we have gained overseas, but only to the 
Medical System that has been rotting in the ignorance and politic-based 
stupidity that Malaysia has been well-known for (in the medical field).
I
 have served the system for nearly 2 decades of my career, waiting for 
it to improve for so long, and only finding myself in despair, quitting 
with a 24-hour notice and serving abroad. The system is, in my opinion, 
keeping doctors, since the beginning of their career as House Officers 
to the end of it, in the lowermost priority. When I was working there, 
doctors are so ill-treated, while the nurses and the medical assistants 
are overpowering us.
I still remember the days when I was 
doing seeing patients and rounds as an MO, while the staff nurses would 
mind their own business, having breakfast in the pantry, or having 
gossip chats at their own leisure. My House Officers would then have to 
do merely all the labour-work, up to the extent of setting intravenous 
drips, and serving medications. If I am to expect the nurses, my 
patients would have been dead, or the work would have been too slowly or
 incompletely done.
When I was a House Officer, I had to run down 
4-5 floors just to review a blood investigation of a dying dengue 
patient. The ward staff would either be nowhere around, or will say that
 he is busy (busier than the doctor?) or the answer I got at that time:
"Doktor nak cepat, doktor turun sendirilah, gaji doktor lagi banyak dari saya"
Even
 when I was a Specialist, the staff nurses had to be called again and 
again just to make sure the management plan for the patient would be 
done. I was already used to answers from them:
“I’m busy with something else"
“My shift is already over"
...it was routine for me.
The
 Medical Assistants were worse. They would hide behind their so-called 
boss, the Head of Medical Assistant. They feel hiding behind him would 
make them not under our jurisdiction, that we have no power to instruct 
them in managing the patient, that they have power to manage own their 
own. I've seen them giving medications not as we prescribed, performing 
procedures without our knowledge, as if they are the actual "Doctors". 
They are in their own world, and we have to do their job, taking blood, 
labelling samples, and even cleaning gadgets from the procedures that we
 have done.
Oh, but the ministry loves this group. They 
even let them run a clinic now, instead of upgrading the clinics already
 run by doctors. The government feels that the MAs are very important 
and should never be ill-treated by those big bad doctors. One time when I
 was a District Hospital Medical Officer, I was conducting a delivery of
 a baby. An MA insisted that I remove my car which was block-parking his
 car. I answered through the phone that I was busy.
He came to the labor room and yelled "Semua orang pun sibuk jugak, macamlah doktor seorang yang sibuk!” 
It
 is insulting that an MA or a staff nurse claims that they are BUSY, as 
busy as a doctor? As a Malaysian Doctor, I have even worked for 72 hours
 straight. I have experienced working until my 6 month old daughter did 
not recognize me at the end of the week.
Is that how busy 
they are? I am very sure that they are so busy, that they can only spend
 2 hours at the nearby Mamak stall, or can only leave at 5:10 PM instead
 of 5, or can only have 1 hour of lunch.
The management 
staffs are worse. I have to beg and plead so that I can get my on-call 
claims, of RM25 per 48 hours of work. While sitting in an 
air-conditioned office, they will at their own leisure, process my call 
claims so that I will receive them by the next decade.
The
 state health or Hospital Director would just give another inspirational
 talk (of bollocks) on team effort and beauty of teamwork.
That
 is how Malaysian doctors are treated in the government sector: without 
respect, without dignity and without significance. Why?
It
 is because we are bound by ethics to try our best to save lives, 
despite how ill-treated we are. We hardly have time to complaint because
 we are too busy or tired, and we would rather spend the precious time 
resting or seeing our loved ones. The burden of trying to save lives is 
on our shoulders alone. No MAs or Staff nurses would shoulder it with 
us. They have their own bosses: the Sisters, Matrons, or Head of MAs, 
which job description is to ensure that the big bad doctors will not ask
 their underlings to do extra work.
This is how the 
Malaysian Ministry of Health have treated their doctors. I am very sure 
that in each and every doctor, there is a slowly-burning patience in 
serving the Malaysian people, which will eventually fade and cause them 
to surrender to serving a place that treats them better.
A few colleagues who graduated from UK choose to serve there:
"The pay is more, and we get the respect we deserve"
Another works in Brunei:
“Here the staff nurses respect Malaysian doctors, and they are very co-operative" (He ended up marrying one)
A few are consultants in Singapore (working with me):
"Here we are treated well, we spearhead the management, and every else do their work to the best of their capabilities".
A few even enjoys working in Indonesia:
“The
 work-load is horrible since there are a lot of patients, but we are 
well respected by every hospital personnel" (They have migrated there 
for nearly a decade)
I am sure that people will see 
doctors as power-hungry individuals who want to be the boss in the 
hospital. Trust me, after having graduated 6-7 years of medical school, 
earning a DEGREE, and subsequently MASTERS, and SUBSPECIALITY, you would
 expect a degree of respect and being considered important. We are 
trying our best to improve patient's quality of life, or making sure he 
lives another day. Is it too much to ask from the system that we are 
important?
I find that Malaysia is the only country that 
is making doctors' lives miserable and treated like rubbish. It was 
never about the pay in the first place. It is about the treatment we are
 getting and the false political-based promises. Do you know that the 
so-called circular about doctors can have the day off after working 24 
hours straight released JULY 2009 is not yet implemented? Do you know 
that the raise of UD 41 to 44 does not involve every doctor in the 
government service?
We are waiting for improvement. We 
have waited a long time when we were working in the system. Somewhere 
along the line we decided to leave and wait outside the system. Until 
the system changes, we will continue to work overseas, in countries 
which are appreciative of us. Trust me, Malaysian-graduate doctors are 
considered highly skilful and competent in neighbouring countries, and 
the 15 % brain drain is more significant than you think.
We will return when the system prioritize us and gives us the quality of life we deserve.
If
 it stays the same, Malaysian Hospitals would end up having Staff nurses
 and Medical Assistants as "Doctors", and we would have to send patients
 to Indonesia for an appendicectomy.
Hear our voice. We hardly speak, but will usually fade away from conflict (and fly to another place).