Sunday, April 13, 2008

Shouldn't They Return Home To Serve..... our hospitals?

I'm talking about our medical graduates who were on government scholarships.

This is not a new problem and one that has never been easy to overcome.

One overriding factor for their reluctance to return home to serve in our hospitals, is, of course, money. Another is the terms and conditions of service, I reckon.

That is, if things have not changed for our government doctors and specialists.

Years ago, my colleague (at the NST), Sulochini Nair, wrote about the brain-drain in the country, in particular, among doctors.

She discovered that among Malaysian public servants, doctors practising in hospitals, were the worst off.

Surprising, because medical students were (still are) the creme de la creme of our school-leavers and would have spent more number of years at university (than other undergrads) but were not being given due recognition in service.

This was in comparison with other sectors in the civil service.

I'm not sure if medical officers still have horrendous working hours -- like working 48 hours non-stop (quick meal breaks in between).

However, doctors in public health (not practising in hospitals) were better off in terms of salaries and conditions of service including prospects of promotion.

Now, this was in the 80s. I'm not sure if the situation has improved for them.

I was prompted to write about this after reading a report here.


Anonymous said...

Puan Nuraina,

My daughter is a doctor graduated from Manchester U in 1999. She spent altogether 7 years in UK including 2 years doing A level.

She has served the government for almost 8 years now and only paid around rm 3000. She had cleared her part I on her Masters in anaesthetist and hope to complete her final by this May. Now they call her “registrar”, I believe there is no pay increases.

She is doing her Master on off campus basis, meaning she has to work as normal doctor.

Why cant she opt for full time basis with full pay in pursuing her master?

Because the eligibility for a doctor in the government to do a Master is after one has completed 5 years in service by month of June of the year of submitting the application. My daughter was short by 3 months then, because, as graduates from UK,they would only can come back serving the government by month of September , unlike local graduates who can join in June!

That means to say overseas graduates can only eligible for Master after 6 years in service?

My daughter do not wish to waste time so she opted for off campus.

When she opt for off campus, she is actually working as normal doctor with on- calls duty at least 2 times per week. Unfortunately her yearly increment was frozen. The department concerned is “tidor just like their punya tuan Tidowi” thinking my daughter, and (others too), are on study leave, therefore not eligible for increment.

I just wondering, why they still insisting doctors to be on calls?
People generally thought on call meant; when they really in need the service of a doctor only then they call the doctor.

But in this case, it is not. In fact the doctors work without sleep more than 24 hours. Normally on calls starts at 7.00 am and finished at to on next day.How much is the allowance?
After that they come back to rest (post calls) and come back to work again on next day!

What type of rest is that?
So what is to expect? We had a real doctor as Minister before, still he could do much. Except he managed to get the government to increase the pay of houseman ( HO) .This happened that her daughter just being appointed as houseman, about last year I think.

Anonymous said...

Our civil service system does not appreciate doctors and police officers.

Anonymous said...

Kak Nuraina,
I believe you're right. I was surprised at the numbers when I read the article as well. But judging from the comment left by anon12.09, it is probably still the low pay and terrible working conditions, compared to overseas.
Although I can't speak for all of them, I'm sure that most of them would love to return to Malaysia, after all, this is where their families are.
Maybe the govt might like to take another look at the conditions being offered to these top-of-the-crop med students?

Anonymous said...

they are more interested to make dollars and pounds than serve their country. Sad!

Anonymous said...

Why did they choose the medical profession in the first place?

To make money or serve the people?

busymum100 said...

It's only common sense for them (the young doctors) not to come back, when there is no enforcement to do so. Even if they have to pay back, they would. But in many cases, esp among the MARA sponsored students, they need not pay back, esp when they did very well in the exams.

Maybe MARA can something about these students? If they get harsh penalties, then hopefully they would come back.

Having said all these, if i have a child who is on MARA scholarship, and can get a job there, why hurry to come home when you can get a better working environment there (and better pay too) over there?

I was told that MARA was lenient because it wants to help more bumis to get better education and become highly qualified professionals (when they stay on to work and work and continue to study for their specialist qualification). But I want to ask again, does the country benefit from this?

So at the end of the day, kita nak blame siapa? I'd blame the sponsor!

Anonymous said...

Hi there Kak Ena,

I chance upon a wonderful malaysian doctor while my premature baby was treated in a hospital here in Perth.

We spoke at length while i was visiting my baby everyday. Yes, he was a goverment sponsored student and i believe he has been a doctor for the past 10 years or so. I have never met a doctor like him before. He is so refreshing, enthusiastic, and passionate about his work and life. I can just tell by the conversations we had and also from feedbacks from the nurses.

At first i thought, so sayang that a person of his skills and passion is not serving kat Malaysia. But after talking to him and listening to his reasons, i can empathise with him. And it's not totally about the money. This doctor is working in a public hospital.

Well, apa nak buat? If our government can match or even come close to the working conditions and recognise these doctors as how they should be, we'll have more dedicated doctors serving our country. Come on la....these people help us to get better when we are sick. They save lives! What else can be more noble than being a doctor?

doc said...

these so-called scholars are pathetic renegades.

they know the terms of the contract, ie. govt gives you money to study, you come back to serve.

they know the working conditions in govt hospitals, ie. work your butt off & get paid peanuts.

everything is laid out before they accept the deal. so if they are not prepared to fulfill their responsibilities, why take it & deprived other genuine students of their life ambitions??

to the parent who's daughter is doing masters, anaesthesia is a clinical discipline. you can't learn it just from books. doing clinical duties, including ward rounds & on-calls, is part of the learning process.

i've been through the mill & i know the system works. oh, BTW, those days we do on-calls without extra allowances, ie. we get nothing extra for doing 24-hour shifts.

so, i say, just grit your teeth & get on with the job.

Anonymous said...

If they are sponsored by government money, return or pay up! They signed a contract knowingly, and without any coercion, the working condition that they are going to face.

Not only they have the legal obligation to serve but a moral obligation!

Anonymous said...

I guess it's ok for the medic overseas grads to refuse to return to malaysia, it's their choice but they should remember that the have social obligations towards the other citizens of malaysia. So pay back if you refuse to come back, of course with some penalties to be imposed. Do not deprive others from the funding facilities, don't be selfish. You wouldn't obtain your overseas degrees if not because of the rakyat's money. So give back, don't be a thief. The government should do more in ensuring that these doctors come back to serve the nation, or the scholar automatically becomes loan/debt once the condition is not met. And stop sending them to expensive and developed countries (with an exception to matured students/postgrads) as there are more opportunities to practice in these countries.

Hi&Lo said...

Anon 8.55 am, so easy to say they are more interested in dollar and pound than to serve the country.

Each of them have their own reasons from returning home to serve.

Anon 12.09 am gave a true picture of the work of a medical officer pursuing higher studies.

Does Anon 8.55 know what is like working round the clock for 48 hours (in Sabah/Sarawak probably 72 hours) when on call? And the next day they are expected to report to work at 8 am sharp without fail to attend to outpatients.

For the kind of work load their pay is peanuts.

In other industries, this would be called exploitation.

Are doctors not human?

Money is not everything. Job satisfaction is the primary motivation. With the pittance and having to put up with demanding patients, do you think it is worth it?

tarings said...

It's a thankless job this, a doctor. You reneged on your contract, you're labeled a freeloader, a traitor. Worse, your uncles or cousins who stood as guarantors might be blacklisted and their off-springs be denied of future scholarships.

Should you dutifully return to serve the Motherland, you're swallowed by the system and hence the horrendous(maybe that's too harsh a word) working conditions and the RM3,000 pay cheque.

So is it worth it? Straight A's from kiddie school up to STPM and through the rigours of medical school, which cost more than RM1 million, and earning RM3,000 for the first 10 years or so? How many did a Sufiah or Sufian along the way?

The best bet is, chills some. Tell your children to chill some too. Let them enjoy their childhood. Study, yes. But other EQ increasing activities should also be pursued. Then pursue political or social sciences. Reckon the pay is way better.

Especially when the other side come knocking.

Anonymous said...

yes they should serve in our hospitals! but if only they can be grateful enough to realize that their 'high salary' was already paid in advance. how much do you think the MARA/JPA spent a year on each of them? RM3000? (only masscommers in ITM received that amount, right?) RM 15,000? i still don't think so! RM70k? or RM100k ++ maybe? and that was for each year of their minimum 5 years abroad!!!
if they want to make money out of health business, then they should start off on their own account, not on JPA or MARA. it's sick!

datuk said...

It is indeed sad that they are not keen to return home for whatever reason they may have. They forget that the money used to sent them overseas are the peoples money hence they should repay it.

With regards to the on/off campus masters training. Basically it is the same even if you are in campus or off. You still have to do calls (ie 24hours or more). So it should not matter much on or off. When someone is doing masters, their early increment is frozen if I am not mistaken. This is clearly stated before one takes up the masters program. There wouls be an increment (backdated I think) once the masters is completed.

Anonymous said...

i've a number of siblings and in laws working as doctors in malaysian hospital. they are all on gomen scholarship from undergraduate until specialist level. once they are on specialist level, their allowances are FAT. people will always complain, but then again, the gomen do spend a lot money on them - our tax payer money, esp if they are on scholars. so ... life is not bed of roses ... ingatlah pengorbanan rakyat pembayar cukai menyekolahkan mereka ... it's the whole nation sacrifice ... pandai-pandailah membalas jasa.

me said...

As I've posted on Malaysia-Today, the statistics does not necessarily show anything conclusive.

Among elements that should be taken into account is the actual proportions of non-returnees and not just the absolute figures and also the fact that the statistics released dated from 2003.

This means the longest stayers in those statistics have been there for 5 years, which many would still say is an acceptable period for gaining experience and not yet long enough to prove beyond doubt that these people don't intend to return some day.

There is also a lack of any statistics on the average length of how long people usually avoid returning, or whether many of those who did not return immediately since 2003 have already done so in the last 5 years.

Statistics are only numbers if they are not comprehensive or viewed critically.


Anonymous said...

if they go do their medical degree overseas, using THEIR own monies, who are we to critises?

They have the right to get RICH and earn more. After all, medical degree does not comes cheap.

However, if they use govt or govt agencies' scholarships, then come back and serve the time that stipulated in the contract.

That is Malaysian monies, monies contributed by people like me, and you people.

Yes I agree that the salary sucks. The packet are so small, it become unattractive anymore for doctors to serve in this country. For that govt needs to do something about it.

But again, Malaysians should not be deprived of good medical services just because some sponsored docs decided that they don't want to honour their part of the bargain.

hi$lo said this "Does Anon 8.55 know what is like working round the clock for 48 hours (in Sabah/Sarawak probably 72 hours) when on call? And the next day they are expected to report to work at 8 am sharp without fail to attend to outpatients.

For the kind of work load their pay is peanuts."

I do agree, but don't just blame it to the govt. blame it to those renegade docs too, who failed to come home to serve the vey country who paid for their degree overseas.

if you refuse to come back, pay up, so that we can get some overseas specialist to come and serve the people.

shame on those sponsored docs for not wanting to serve the poeple who sponsored them at the first place.

masa tak dapat bantuan, habis semua ADUN/EXCO/Menteri dia pergi cari nak dapat sokongan. BIla dah jadi doctor, tak mau balik bantu rakyat sendiri.

Anonymous said...

Nak belajar overseas saja....takde duit, mintak gomen....conditions? what is that? we're willing to do whatever it takes to become doctors and to serve the people...(padahal nak pergi berjalan overseas, for free, dapat tengok negara orang...kan cantik). Once they graduated (on our money), they think hey, why not we work and live in this beautiful, developed country, the pay back home is peanut, and we're the great minds, the overseas medical graduates ! Hey people, just because you're gifted with great brains does not means you're entitled to cheat on us, to steal our money. When u can't afford abroad studies, you ask from the gomen, you get good medical degrees and you come back, not to follow the footsteps of the rich men's sons...never mind them, it's their daddies' own sweat of the brow, not the people's hard work to educate you hoping that you'll come back and serve them. Inilah yang dikatakan tak sedar dek untung....the classic example of kacang lupakan kulit...what a shame.