One year training proposed in only six departments for trainee doctors in Malaysia

PETALING JAYA – A housemanship of one year instead of two, and restricting the rotation of trainee doctors to six departments – these are among the proposals made by the recently formed Medical Advisory and Action Council (MAAC) to the Health Ministry.

According to a ministry circular, the MAAC proposed that the training period be reverted to a year as the Medical Act 1971 outlines that a doctor with provisional regis­tration will require at least one year of training.

The training period was increased to two years in 2007.

If the proposals are accepted, the rotation of house officers to anaesthesiology, psychiatric and primary care units would be stopped temporarily.

House officers would instead be rotated to six departments, namely surgery, ­general medicine, obstetrics and gynaecology, orthopaedics, paediatrics and emergency medicine.

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The ministry and the Malaysian Medical Council are looking into the implementation of this proposal.

The MAAC was formed in January last year and comprises clinical specialists working at the front lines of MOH hospitals.

Some experts, however, questioned the proposals.

Hartal Doktor Kontrak spokesperson Dr Muhammad Yassin said the move only raises more questions.

“We feel it’s more of a knee-jerk reaction due to the shortage of medical officers, and is not trying to deal with the root cause of the problem, that is poor remuneration, workplace bullying and stress, too many patients and too little doctors or healthcare ­workers,” he said.

The one-year training, he said, was extended to two years as there were complaints that the medical officers were not well equipped to handle a variety of cases once they are posted to districts.

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“It was a wise move, and backtracking to one year raises questions. Will the medical officers now be ready to handle cases once they are posted to district hospitals?

“What will happen if they have to handle cases involving anaesthesia or psychiatry? How will they deal with issues if they are not exposed to these patient groups?” he asked.

Retired Health Ministry official Datuk Dr Zainal Ariffin Omar said reverting to the previous practice of one year would allow trainee doctors to have a “socially productive life” and reduce their burden.

However, he said it would need proper planning.

“The supervisors and specialists at the training centres should be thorough in their training, observation and evaluation.

“Extension of a house officer’s term at a department or discipline should be enforced to ensure the quality and competence of the house officers before they are allowed to become medical officers,” he added.

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Malaysian Medical Association president Datuk Dr Kalwinder Singh Khaira said the association is waiting for more details on the proposal.

“We need more details on the reasons behind the proposal. It is important that all housemen are adequately trained to function independently and safely before becoming medical officers in districts,” he said.

“We believe this is the streamlining of the housemen postings so the training programme will be more structured,” he added.

Dr Kalwinder felt the adjustments would not affect the current training of housemen.

“Under the current programme, the housemen’s competency will still be assessed by senior doctors and specialists. They will only be allowed to become medical officers after completing the required training,” he said.