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Sunday, December 11, 2011

open letter to people up there

A doctor must work eighteen hours a day and seven days a week.  If you cannot console yourself to this, get out of the profession.  ~Martin H. Fischer

before i start my blabbering
i know i may not be the first doctor who is going to write about this
there were already so many open letter , articles 
written by medical officers, specialist 
regarding the current issue of the houseman'
also know as the internship .. or new doctors

the new rules implemented by the government says that houseman must not be overwork
they must not work more than 12 hour per day and must have 2 days off every week
no oncall for houseman

then , they also must not be scolded and must be pampered ( occay , i added this part )

well , good for them.
when i was a houseman not long ago , i work every day  .... maybe 4 days off in a month at most ,
everyday we work more than 12 hours ... if we were to be on call.. we work 36 hours non stop

yes .... if u compared the condition during my time and current condition ... it's a lot of different
in a way , it's an improvement

in a lot of way , it's bull shit and  a lot of crap
like the proverb above said.. doctor must work more than the current houseman rate
i dont know who decided to give this houseman such a ridiculous schedule
but in the end of the day , it is not a way to teach houseman to be a good doctor

to be a good doctor , we need a lot of training
to have a lot of training ... we need to spend a lot of time treating patient
to spend a lot of time treating patient
we need to stay extra hours at the hospital
12 hours per day is not enough

currently the houseman works in shift system , am is 8 am to 8 pm... pm is 8pm to 8am...

sound very systematic right...
yes ... if u work in the office dealing with document it's fine
but not for doctors

we doctors have CME everyday , a place and time where we learn new things every morning .. so , those who come in PM shift.. they will miss the CME... how do u expect houseman to learn?

then , for those AM shift houseman ... they supposed to work from 8 am , to 8 pm... but 
generally in hospital ( unless in the emergency department ) 
from 5 pm to 7 pm is visiting hours and during that time , doctors dont do round's time for rest...  hence the houseman end up doing nothing from 5 pm till 8 pm....
might as well allow them to go back by 5 pm right?
this is logic thinking

then.. for those who work from 8 pm to 8 am...
they actually work from 8pm till 11 or 12 at most...
by midnite.. everyone fall asleep ...
eventually learn nothing for the rest of the shift

i wonder those who suggested the shift system ever work in the ward :p
i'm sorry to say  , but i strongly disagree with the shift system
it's such an disadvantage for those houseman who wants to learn more
for those who want to relax , it's a golden opportunity
with this kind of system.... anybody could be a bloody doctor nowdays

dear people out there...
do u want to be treated by doctor whom did not have a proper training during their houseman period ..
imagine ur family member being treated by these unskilled doctors?

back in my time ... we got scolded by medical officer and specialist badly if we made mistake and being screw upside down if we do wrongly..
we learned for our mistake 
and came to work very early in the next morning to do better
it was a good way to teach as we will always be reminded of the consequences...
and eventually make us good and capable doctors...

nowadays... if u scold a blood houseman ...
the houseman wont even bother to turn up to work the next day
and u ll get a letter from the people up there

crap isnt  it?
but this is the fact
wondering ...


Anna Mohamed Amin said...

I believe learning is a lifetime process. It doesn't need JUST the 2 years of housemanship to learn everything. I'm sure you're still learning too Dr. Hannan.

Even with the shift system, I still see my friends who just graduated feeling tired with the workload. I can't imagine during your time. I can't deny about some of our attitudes, but I'm sure during your time, your seniors complained about the same things.

Just because you used to had it hard, means we had to get it hard too. People used to walk to work, doesn't mean we have to walk too.

If you compare it with Moscow, doctors never seen tired and overworked, and yet we see them diagnosing patients well. In Australia, doctors are not allowed to work overtime, but if they do they have get OT payment. That's just how I see it.

But about the scolding thing, I do agree with you. We do need the scolding to get things right. :)


Dr Hannan said...

Anna - u have a very good point there.
But as I said... With this current system.. Houseman is not spending enough time at work.
Frankly... U learn most thing during houseman ship...
Once u r a medical officer... People expected u to know everything and u have to be the leader of the team already .
During pm shift , nobody will bother to teach u anything coz all the mo are already tired... So it is pretty much pointless to have houseman comes at 8 pm and to start sleeping in the room by 11 pm.
It is a true situation.
Anna... When u work long enough.. U will understand what I am trying to prove here

ahkialuzinamsa said...

I'm medical student..InsyaAllah,I will be HO next 6 years.For me,housemanship phase is very important so that all medical student can practizing their knowledge and increasing their skills to treat patient.I think,maybe because the increasing of number of medical student nowadays make people up there make a shift for the HO.But,honestly,I hope during my housemanship,I've to work not in shift because we'll not learn a lot..


I just quit from medical school because of this problem.The problems start when some student who do not able to cope with the situation but yet still want to be a doctor.most of them come from spoon fed family.alast,they complain it to their parents because of the workloads.i'm saying this because i be friend with them.

This comment has been removed by the author.
Dr Hannan said...

ahkialuzinamsa - good luck occay and be a good doctor in the future :)

God has better plan for u

Anna Mohamed Amin said...

Some MOs will teach I'm sure, but from what I heard most junior HO learns from senior HO during night shifts. If they want to learn, they want to learn. They'll do whatever it takes. The ones that don't, maybe they didn't even want to be a doctor in the first place. Maybe they needed a pep talk. Not scolding.

If the MOs care about the future of medicine and patients, they should not let 'tired' be their reasoning not to teach the HOs.

That's what you get for being a doctor I supposed. Tired. Just saying.

Still, I have 6 more months to go till graduation. Like you said, maybe I'll understand once I work long enough.. ;)

woolang said...

Well said Anna Mohamed Amin.

I'm agreed that almost all the HO's know nothing 'bout how to treat patient, but that's why they are called Junior doctors.
It's the elder's responsibility to teach and guide them what to do.

One more thing, I really hate this kind of mentality, "Back in my time I used to.." or "I used to get treated harder and harsher when it's my time back then...".
What's wrong with you people? Why don't you cycle or walk to your workplace instead of buying a good car coz our ancestors used to walk to their workplace. Ridiculous isn't it?
People keeps moving forward and lifestyle improves. So as the system.
Whoever uses the excuse, "Back in my time bla bla..." rather to be said, as a Bully. Harsh, but it's the reality.

For the time being, instead of complaining and blaming each other, why not every single person in the Health System figure something out to lessen the workload and help HOs to learn efficiently.
Help them to help you.
Complaining won't get us anywhere, and sometimes it makes things worse. Nuff said.
Peace 'yo.

Dr Hannan said...

anna n woolang

when i was a medical student ;
i made a comment regarding doctor's workload back then..
and one of the specialist told me to shut up and try to finish my degree first before i jumped in the conversation

now only after 4 years of working i understand what he meant

even the housemen themselves are complaining about the shift issue anna
in kb GH , the housemen wrote to the DG asking to return back to old working hours schedule

last time ,
housemanship is only a year long
when i started working,
the increase to 2 year housemanship
everyone hated it
but after 2 years of hard work,
we understood the reason why

sometimes , u need to work hard and work long hours to get better and be a good doctor

when u finished ur housmanship
u might be send to work at the klinik kesihatan..
where u will work alone..
no one to help u
then and there , u will hope u have had enough training and knowledge

Dr Hannan said...

to both of u...
when u finished ur study
and when u finished ur housemenship

come back to this post and tell me am i right, or i was dead wrong

Anna Mohamed Amin said...

I'm not saying that you're wrong Dr. Hannan. Not saying that we don't need all the practice that we need. As a doctor, we need to practice all the time. Just saying even with the shift system, these things can be overcome. But I'll shut up now.

Chill lah Doc. It's just our opinion. I'm sure you're a great teacher Dr! ;))

Anna Mohamed Amin said...

I'm sure some doctors will prove that this system works, just like you proved that not all Russian grads are incompatible.

Anything is possible with hard work. ;)

devil said...

conclusion is it younger generation now work smart n no need work hard? does this mean u're any better than ur senior in time to come? hm......... honestly i still think HO nowadays damn cocky and if datuk datin kids make it even worse. But like i feel dr. It's their life so let them be =) u just do what u have to do and if they left ear in left ear out so be it. Cos if they dun learn they will never learn and so it's their life and hey maybe their parents are even proud of them cos being a dr that is so free to spend time with them more than patient? :P and sadly this is our FUTURE younger generation whom i dont' even bother to comment much =)so be cool and ya it's for their own good but at times it's better to mind our own biz aje. Make life simpler and nah i'm not in medical field but i do have friends in this line and everyday complaint about HO hahahahaa so i sort of know their attitude. It's just like our current education canning system. if u pukul anak aku mati u besok cikgu! hahahaha so just do ur work get salary and feel great at the end of the day =) cheers!

BayuTimur said...

dr i strongly agree with u.not so many people like u nowadays, it just same goes to education field as devil stated there, but if we just simply ignore (make life simpler as said by devil)just hoping for monthly salary, in future, education as well as other field will be even worsen,Dr u are the greatest!keep up your good work