Wednesday, December 1, 2010

Doctor too many, Part 5

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A doctor too many — 5

The problem of too many medical schools being set up in too short a period, which I have raised repeatedly many months ago, is finally being acknowledged by the authority.

On Saturday, Star carried a story on its first page prominently about too many housemen in our hospitals.

Then yesterday, Minister of Health was quoted in the Star, while acknowledging there are too many doctors, as saying that the two ministries (ministry of Health and Ministry of higher education) were working together to ensure a “satisfactory quality” of medical students graduating from abroad”.

I have written in MalaysianInsider about the problem of having too many medical schools, and in May this year, I have written a press statement as well as called a press conference on this issue. It was carried by Sun, as well as Nanyang.

The problem of too many medical schools being set up in too short a time–over the last 10 years, 21 medical schools were set up – inevitably resulted in a shortage of good and experienced medical teachers. It has also resulted in the training facilities unable to grow fast enough to cater for all the medical graduates, resulting in one housemen to 3 or 4 patients ratio, instead of the ideal of 1 to 15 patients.

When there is not enough patients to learn from, the houseman would have very limited hand-on experience to deal with illnesses later on, because after all, medicine is apprenticeship. We learn from looking after patients. The more patients under our care, the more variety of cases we will see, the more experience we gain and the more competent we become.

There are now 3500 housemen being churned out a year. The figure is to hit 4500 soon when all the local medical schools become fully functional. The problem is not with the foreign graduates. The crux of the problem is that we are simply producing too many local doctors without facilities and manpower to adequately train them.

As regards to the standard of foreign graduates, what we have to do is much simpler. Do not simply give recognition to any overseas Medical colleges, especially those from under developed countries. We need to vet them thoroughly before recognition can be considered. There is really nothing wrong with those graduating from UK, US, Canada, AUstralia or NZ. Their medical schools are of world class. Not so with some of the universities of our Big Neighbour down South. Some of the universities have not even been heard of, but they are either producing doctors for us directly or are in partnership with some of our medical schools to provide twinning courses and indirectly producing doctors for us.

Nowadays, it is easy to set up medical schools. You dont even need to have hospitals to back you up. Just pull your string to get a license, and the rest is easy. Set up a pre-clinical school where medical sciences like biochemistry anatomy and physiology are taught and this part is easy and will be like setting up any science colleges. . Once you have a pre-clinical school, the clinical training part can be arranged with some of the unknown universities down south, and there you go, you have a full university churning out doctors. Parents are paying through their nose to put their children in these so-called twinning program. Nevermind the university is unheard of, as long as our Health Ministry recognises it, and as long as the title Dr can be awarded to the graduate.. This is unhealthy.

There cannot be double standard in the vetting of medical colleges overseas, just as we cannot allow any Tom Dick and Harry to set up medical schools locally to make money.

Otherwise, we are going to face with the problem of doctors unable to diagnose simple cases. There is really no point pouring billions into our health system when our doctors in future cannot even treat simple cases correctly or undertake simple procedures competently.

There are already anecdotes of doctors unable to take blood from patients, or of doctors watching movies in cinema during office hours, or doctors loitering in canteens simply because there are too many of them in a ward. These doctors are going to be the very ones that will tend to our healthcare, you and me included. Our lives will be literally be in the hands of these people.

If the situation does not improve, all I can say to you is that ” May God Bless you” the next time you need to see a doctor.

Related readings:

A doctor too many

A doctor too many 2

A doctor too many 3

A doctor too many 4

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