Doctors LUCKY to get housemanship???

NEW STRAITS TIMES
Experience at what cost?
04 Dec 2006
PROF DR RAYMOND AZMAN ALI, Medical Faculty, Universiti Kebangsaan Malaysia

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IT is my duty and social obligation to address the issues raised in the statement by the Malaysian Medical Association president ("MMA: Doctors lucky to get housemanship" - NST, Nov 30).

As someone who has been in service for 20 years, and worked as a house officer abroad and resident medical officer in the Kuala Lumpur Hospital, I think it is time I stood up for doctors.

Yes, house officers and resident medical officers gain "valuable hands-on experience" by working long hours in government hospitals, but at what expense?

It is not wise and counterproductive for us, the seniors, to say "I did it before, why can't you?" to our juniors.

In Australia, no doctor is allowed to work continuously beyond 12 hours.

It is dangerous and unethical to make the brain, mind and body work beyond 12 hours as a doctor. It is unthinkable to make any doctor work 34 hours continuously.

On returning to Malaysia to work as a resident medical officer in the Kuala Lumpur Hospital, that is what I was made to do.

So, these long working hours are not confined to house officers. As a specialist who deals with the organ that thinks, I can say that sleep deprivation causes irritability, irrationality, poor concentration and poor judgment.

Does the public want doctors to treat patients when they are tired, irrational and lacking judgment?

Could some of the deaths and mishaps that have occurred in government hospitals been avoided if doctors were more rational and able to make reasonable judgments?

And, this could also explain why some medical officers get upset and temperamental with their junior house officers.

Sleep deprivation may cause migraine attacks and cause daytime sleepiness.

What is the point of producing more modal insan (human capital) for the nation (in the form of doctors) when excessive daytime sleepiness makes them less productive or unproductive during normal working hours?

It is time government and university hospitals reviewed the working hours of house officers and resident medical officers. This can be done. It does not require parliamentary policies. YEAY! (I just added the yeay part!)

It is a matter of hospital administrators thinking of ways to shorten the working hours with the limited number of doctors.

Some may argue that developed countries, like Australia, have more doctors, but they also have more hospitals.

At the hospital I worked at in Australia, the doctor-patient ratio was the same as any government hospital in Malaysia.

I know that the medical officers in anaesthesiology in most hospitals in Malaysia have started practising new improved working hours.

Doctors who work nights should only work nights, and then go home in the daytime and get the weekends off. Doctors restored to work days should go home at night, but also work on weekends (which are normally less busy and have no clinics anyway).

Of course, there must be adjustments to call allowances and teaching hours if medical officers are in a master's program.

The improvement of working hours for doctors can and must be carried out by stakeholders.

P/S: Good news to will-be doctors huh :P