Would there be an excess of medical doctors in this country in the future?

[orthopod]

Originally Posted by Young

Here's my take on this issue:

I believe that there IS an excess of regular doctors with only an MBBS/MD as their sole qualification. As mentioned in the previous posts, the ease at which private institutions are able to set up medical schools is appalling. The number of Malaysians who opt for medical education overseas (mostly in Indonesia, India, Russia, etc) has also increased dramatically. I have an uncle who graduated 20 odd years ago and started his own clinic. During those days, business was excellent; he saw a good 100 patients a day. Today, he tells me that he's lucky to treat 15-20 daily; a testament to the oversupply of doctors.

However, I think Malaysia will still be suffering from a lack of medical specialists in many years to come. Entry into such training programs is extremely competitive, with only the best and most competent graduates admitted into such fellowships. Furthermore, the increase in fellowship positions isn't as stark as the production of fresh doctors.

well fellowships are for subspeciality training.Its quite easy to get a fellowship (locally or abroad) but gotta be a specialist first...welll yeah medicine in Malaysia is going down the drain...really badly and rapidly at that...cant imagine what is going to happen with the influx of all the ukrainian russian doctors..(well lets leave india out of the equation okay?,i do think their doctors are pretty decent..so many of them in the Uk and US serving as physicians..in fact the USMLE pass mark has been inflated by the sheer number of Indian Graduates who ace the exam..)

Anyway we'll leave the gov to figure out its problems.Personally I have a few cousins who are on JPA scholarship to read medicine abroad(UK,NZ)..therefore the more doctors in Malaysia ,the better it is for them..lol

[youngyew]

I am not sure how accurate USMLE score reflects one's true clinical competence. I have heard that there is now a flourishing USMLE "intensive course" industry that kind of serve the same purpose as the tuition centres in our country. I can't deny that there are bound to be many who are excellent both in exams and real practice, but I am interested to know how many people are exam experts but aren't as good in practice.

[Miracle_seed]

Originally Posted by Young

Here's my take on this issue:

I believe that there IS an excess of regular doctors with only an MBBS/MD as their sole qualification. As mentioned in the previous posts, the ease at which private institutions are able to set up medical schools is appalling. The number of Malaysians who opt for medical education overseas (mostly in Indonesia, India, Russia, etc) has also increased dramatically. I have an uncle who graduated 20 odd years ago and started his own clinic. During those days, business was excellent; he saw a good 100 patients a day. Today, he tells me that he's lucky to treat 15-20 daily; a testament to the oversupply of doctors.

However, I think Malaysia will still be suffering from a lack of medical specialists in many years to come. Entry into such training programs is extremely competitive, with only the best and most competent graduates admitted into such fellowships. Furthermore, the increase in fellowship positions isn't as stark as the production of fresh doctors.

If there is really an excess of doctors, why public still have to wait for hours just for consultation in government hospital? Sort of imbalance, huh?

Originally Posted by eve88

Well, its not very likely this will happen, because most of the ones who have the choice (mmm... well, leaning towards the better qualified/motivated ones i guess) will look at the situation [oversupply --> low pay --> low further training prospects] and decide to leave. Singapore *is* just right next door. Or the overseas grads wont bother coming back.

On the other hand... those that have the ability to stay away are probably on average "better" than the ones who can't stay away....... thus maybe leading to a decline in quality.

Hopefully this will be offset by the numbers coming in, there's sure to be good ones that will stay in Malaysia.



Todays MO and HOs are tomorrows specialists... so oversupply will probably spillover into the tertiary care sector. Particularly if training slots are based on seniority, if you stay in the system long enough....

Also, how long will it be until the increased number of docs clamor for increased training spots?

I think it should be [oversupply --> decreased pay in private sector (more specific, less income from own clinic)]. There will still be shortage of doctors in government sector, if the working condition does not improve.

By the way, instead of overproduction of MBBS/MD, more money should be spent to train more specialists, or even sub-specialists. There are still limited fields of specialty available in the country.

[supergoh]

If there is really an excess of doctors, why public still have to wait for hours just for consultation in government hospital? Sort of imbalance, huh?

Dear Miracle_Seed, an excess of doctors would happen in the near future, not now.

In my opinion, the government should reserve vacancies in government hospitals for JPA scholars(both local and overseas),followed by those graduated from public medical schools.

[Young]

Originally Posted by supergoh

In my opinion, the government should reserve vacancies in government hospitals for JPA scholars(both local and overseas),followed by those graduated from public medical schools.

That's a very interesting suggestion. I assume that would be a move in response to the growing number of medical graduates? If so, I humbly disagree.

Although such an act is common in countries like the UK and Australia, it cannot be implemented as smoothly in Malaysia because we have a very ingrained culture of privately sending students to medical schools overseas. Such a mentality is hard to change and you can imagine the public outcry when graduates from top medical schools worldwide are denied places in our local hospitals.

A better suggestion to solve the problem would be to simply limit the supply of medical graduates. How? Just slash off a few dodgy medical schools from the charter of recognized institutions. For heavens sake, we recognize 2X the number of medical schools Singapore does..

Or, we could follow Singapore's method of extending the period of conditional registration for overseas trained doctors.

We could also do with a standardized exam where every medical graduate, regardless of institution, has to sit for before being allocated a seat for housemanship. That way, only the best graduates will make it into practice. However, I admit, the last suggestion would probably end up doing more harm than good if it became a political too.. Just look at that law exam Malaysia used to have.

[vseehua]

Originally Posted by Miracle_seed

If there is really an excess of doctors, why public still have to wait for hours just for consultation in government hospital? Sort of imbalance, huh?

People will have to wait for hours just for consultation in the government hospital, no matter how many doctors are working there. There are many more limiting factors besides the numbers of doctors present. As present, the doctors to patient ratio in current government hospitals are way lower than many of the private hospitals. But facilities can only support so much before space, and facilities in a hospital runs out.

In Germany and the UK, a national health policy is implemented where people can always get inexpensive treatment in every health care facility, government or not. If a condition is covered under the scheme, people can opt to get compensated for their treatment. This helps to spread the health resources far and wide, instead of it concentrating at any one place like in the hospitals in Malaysia. I think the situation in Malaysia can be much better if such a policy is implemented here as well.

[supergoh]

Originally Posted by Young

That's a very interesting suggestion. I assume that would be a move in response to the growing number of medical graduates? If so, I humbly disagree.

Although such an act is common in countries like the UK and Australia, it cannot be implemented as smoothly in Malaysia because we have a very ingrained culture of privately sending students to medical schools overseas. Such a mentality is hard to change and you can imagine the public outcry when graduates from top medical schools worldwide are denied places in our local hospitals.

A better suggestion to solve the problem would be to simply limit the supply of medical graduates. How? Just slash off a few dodgy medical schools from the charter of recognized institutions. For heavens sake, we recognize 2X the number of medical schools Singapore does..

Or, we could follow Singapore's method of extending the period of conditional registration for overseas trained doctors.

We could also do with a standardized exam where every medical graduate, regardless of institution, has to sit for before being allocated a seat for housemanship. That way, only the best graduates will make it into practice. However, I admit, the last suggestion would probably end up doing more harm than good if it became a political too.. Just look at that law exam Malaysia used to have.

Dear Young , you are right.

I just simply considered taxpayers's money spent to sponsor JPA scholars and to subsidize tuition fee in public medical schools.And I now know that suggestion is not viable.

Malaysians deserve the best healthcare service.Hence, medical students from top medical schools should always be welcomed to come back to serve the country.In fact, medical students from top medical schools have the luxury or privilege to work in foreign countries.

However, some medical students,especially those studying in Russia are not so fortunate.I believe they cannot work in countries other than Malaysia .Even Russians would hesitate to allow those Malaysians to work in Russia.These medical students as well as the government is to blame .In their(or sometimes their parents' )craze for a doctor title,these medical students do not care about the quality of medical schools.They just want to become doctors by hook or by crook.They simply believe any medical degree recognized by the government.

In the world,Malaysian government may be the only and only country which highly recognizes Russian and Indonesian medical degrees to the extent of sponsoring students to study there.

[supergoh]

Dear Miracle Seed,

Maybe you are still not fully convinced that there would be an excess of doctors in Malaysia in the future.

Are you an IMU student?

There is a paper published by Medical Teacher
Medical Education in Malaysia
2008, Vol. 30, No. 2, Pages 119-123
Dr.Victor K. E. Lim.

[tehjiao]

I believe that in future there will be excess of doctors in Malaysia, however i doubt those excess in amount wouldn't mean improvement of the quality. My hospital recruit more than 20 houseman (graduated from Russia/Ukrane) in a month and they were just terrible. Poor knowledge(1 HO claim that Pyridoxine is a type of antibiotic as he always observe this drug is prescribed for TB patient while my Nurse can answer that this is a vitamin, So ?Doctor worse than a Nurse)), NO clinical skill (as they are not allow to touch any Rusian Patient during training, OMG),what they've done during the 5 years training? God only know and our government still recognize their degree, OMG ...... It's our government policy fault if there is excess of mediocre/incapable doctors in futre as our politician/ministry officer don't really care about Quality Control of doctors. In future, those incapable doctors may only can survive in government hospital as they are not competent enough to work in private sector, I'm really worry about our GH patients in future. Sadly, i don think our politician care for the time being, do u agree, my MOH Minister, Mr Liow?

[orthopod]

i feel scared for my relatives who were ex civil servants who seek treatment at gov hospitals