The Malaysian Insight

THE inability of the public health system to expand and keep up with the increasing number of medical graduates is putting Malaysians at risk, says Penang Institute senior analyst Lim Chee Han.

Lim said it is impossible to accommodate such demand at the current rate.

“The Health Ministry (MOH) takes years to build new hospitals and train new specialists, but more and more housemen are coming in year by year and the only logical move for a short term measure is to try its best to control the medical graduate numbers while expanding their capacity to cater for more,” he said.

Lim said MOH also has to guide underperformers reduce the possibility of them getting more extensions in future postings at the expense of new incoming housemen.

New medical graduates have to enrol in two year housemanship programmes where they would be exposed to five compulsory disciplines and four alternative disciplines before they obtain full license to operate as a doctor.

He said those who had to extend their housemanship due to incompetency and disciplinary problems were clogging up the programme.

Lim said this led to prolonged waiting period for getting a housemanship position and it would compromise training quality due to the enlarged mentor-mentee group.

He said healthcare services and quality of treatment in government hospitals would be compromised if the government failed to address the issue.

“If housemen do not undergo proper skills training and gain enough exposure to cases, and they go on to become our doctors, you can imagine how is the public healthcare service quality,” Lim said.

He said the fact that 2015 statistics show house officers and new medical officers comprise 28.9% of the total doctor population in the public sector underscores the need for the issue to be addressed.

“That means more than 1 in 4 doctors we encounter in public hospitals will inevitably be new doctors,” said Lim.

Malaysia only has 44 housemanship training hospitals out of 143 government hospitals.

He said building more specialist hospitals will not solve the problem when there were not enough specialists to conduct training.

Lim suggested that MOH train more specialists and retain them in the public sector instead.

“The ideal combination is 1 specialist to five houseman but right now the ratio is 1 specialist to 6-10 houseman,” said Lim.

He said MOH should revise the structure of housemanship programmes to be more effective in supporting and giving more incentives to specialist trainers.

Lim said MOH should also explore the possibility of forging ties with local private medical institutions and hospitals to provide training for housemen.

“The offer has to be attractive to get private hospitals to work with the government on this.  Incentives should be given and the cost burden of the training should be shared with willing participating hospitals and their consultants,” he said. – July 21, 2017.