Too many new doctors and too few hospitals to train them

Adopted from The Star online: Saturday November 27, 2010

Too many new doctors and too few hospitals to train them

The number of medical housemen undergoing clinical training in most government hospitals has increased and this has given rise to concern that they may not get sufficient experience.

With new medical schools opening up locally and lower fees being offered at new institutions abroad, around 4,000 Malaysian medical students are expected to graduate annually from 350 universities all over the world in the coming years.

Each specialist was supervising four times as many housemen compared to a decade ago.
Five years ago, one houseman looked after 10 patients in hospital wards at any one time but now it is one to four patients. The concern is that these interns are seeing fewer patients and hence, have fewer opportunities to carry out adequate procedures. In some hospitals, there are more housemen than patients. In the past, it was five housemen in each department but now it could be 20 to 30 for each department. Some specialists were overburdened by the workload. The ideal ratio should be one specialist supervising five housemen with one houseman taking care of 14 hospital beds depending on discipline. To help supervise housemen and reduce the burden of the specialists now, 58 contract specialists from Egypt, India and Pakistan will come soon.

Lack of experience and responsibilities may affect their attitude such as lack responsibility towards their patients,skills such as did not know how to give an accurate diagnosis and relied too much on investigative tools instead of clinical skills and getting the proper patient history.

The large numbers and training hospitals were finding it difficult to cope. There were 38 hospitals providing training to more than 3,058 housemen last year. The number increased to the current 6,253 housemen since the ministry increased the duration of housemanship from one year to two. This led to most hospitals, including those in Sabah and Sarawak, having an excess of housemen.

Hospitals that were chosen must be able to cater to six areas in which housemen need training – medical, surgical, paediatrics, obstetrics and gynaecology, orthopaedic and accident, and emergency.
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May be the private hospitals bills will reduce due to high competition OR the medicine prices will be increased. Patients also may have to choose right doctors so that they do not see the poor quality doctors. When I was in school my teacher use to tell me one day the doctor will cycle from house to house with ice cream bell. because too many doctors. we need more specialist and scientists.