What To Do After Housemanship? This Is The 5 Ohsem Answer!

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Artikel INI mendapat keizinan daripada penulis asal iaitu Dr. Aimir Ma’rof. Boleh ikuti pautan artikel asal beliau DI SINI

Sometimes I ask this question to my house officers and occasionally they asked me. To be honest, it is a difficult and at the same time, an easy question to answer. The answer will never be the same for each person.

In the course of our profession, I am sure someone will throw this statement to our face. “You have the looks of a physician / surgeon / psychiatrist / GPs / lecturer / hospital pengarah / wakil rakyat.” And for some of us, the harsh words of “You are not cut out to be a doctor, you might as well quit and become housewife/househusband!”

Tell you the truth, there will be times that I think of quitting this profession and sell pisang goreng at hospital lobby. I will be my own boss, work hard for my own self, have control of my own times, and most importantly, not trying to please anyone all the times. Well, the thought comes quite often this past couple of years but as usual, life goes on.

Anyway, this is about answering the above question so the answers to it are actually with questions.

1. DO YOU WANT TO CONTINUE WORKING AS DOCTOR?

There is no shame in quitting this profession. Don’t worry about people judging you. It is your life, not them. I only have 2 advices though. First, do it professionally and through proper channel. Second, plan ahead your life after you quit. Sell pisang goreng or something. Don’t just quit with no backup plan. Don’t just quit and be a couch potato stay-at-home troublesome headache to your parents.

The other issue is the timing. I know many house officers who think of quitting out of frustration and exhaustion. Like I said, plan ahead. Your housemanship training is to obtain the full MMC registration. Without it, you can never work as a practicing doctor. Yes, you have the degree but practicing as clinician is another issue. I know of few who quit too early and had to do housemanship again at the age of 30+ just to get the license to practice. At least, quitting as MO with MMC registration, you can still apply for APC and earn from doing work at private clinic.

The other thing is don’t quit half-heartedly, thinking that you can simply re-apply for your job back anytime you feel like it. With current contract-based employment, maybe it won’t affect that much. But for some, especially if you quit after you get “pengesahan pelantikan tetap”, good luck in applying to work with Ministry of Health again in the future when suddenly you decide to come back.

Also, please think of other prior contract like JPA scholarship or PTPTN. Unless of course, your spouse is a multi-millionaire or you really don’t know what to do with your money.

2. DO YOU WANT TO DO CLINICAL OR NON-CLINICAL WORK?

Becoming an administrator is another option if you don’t think you can continue doing clinical work. It is actually better for a doctor to govern doctors’ administration stuff, don’t you think so? It takes a doctor to understand another doctor’s plight. Be thankful for your administrator at the office. You might think that they just sit in the office and attend meetings, but try do their work if you think you can do better.

And most importantly, don’t worry. People will still call you doctor.

3. DO YOU PREFER OFFICE HOURS OR YOU DON’T MIND DOING ON-CALL WORK?

Different department comes with different way of working. I am sure you all know this. For some of us, family is the priority and for others, “Work is my life and please bury me in the hospital when I die!” Think of the future because no matter how unattractive you think you are, you may get hitched one fine day. Will your spouse understand the requirement of your work (read: bosses)? Will your kid understand? Think.

4. DO YOU WANT TO SPECIALIZE OR YOU DON’T MIND BEING A CHRONIC MEDICAL OFFICER?

There is nothing wrong being a chronic MO. I know many who are happy as chronic MO. You will be the most senior and respected in your department. You have more times for yourself and for your family. You have less responsibility and the difficult questions can be answered with “I’ll discuss with boss later” or “Let boss decide”.

You will enjoy the benefit of the time-based promotion with no added pressure of passing your exams. You go to UD44 once you complete housemanship, UD48 3 years after that and then UD52 another 4 years later. And who knows, by luck with vacant position, you get promoted to UD54 after another 3 years.

However, to stay as chronic MO in one place is another issue. You either create a strong relationship with your boss or you work at places where no one is willing to go. Forget big major tertiary hospital because people come and go. The places are limited for training purposes and most of the times, you need credentials to enter any department and with the intent to specialize. I know of few department HOD in Klang Valley who kicked out their MOs if they don’t progress in 3 years.

So, if you plan to be a chronic MO, plan well and pick a spot where you think your family can settle in. I suggest KK Song or KK Belaga.

5. DO YOU PREFER MEDICAL OR SURGICAL BASED FIELD?

For most of us who aspire to become a specialist, this is the big question. Equip yourself with the knowledge of how to enter the postgraduate programme. Learn about the parallel pathway. Know that some paper qualifications are recognized and some are not.

I have my views on the medical based field but I don’t think it is my place to talk about it in this public platform. I also don’t think I am qualified to give my opinions on that since I am in surgical field. Maybe if you approach me personally, I can. Suffice to say that there are considerable options to be a specialist in medical field.

To those who are interested in surgical field, be it surgery, orthopaedics, obstetrics & gynaecology, otorhinolaryngology, ophthalmology, etc., my advice is only this. Decide early and fight for your place.

For many of us who wants to pursue on this field, we all know that it is a difficult task with long arduous journey ahead. We also know that for many of these courses, the only way is through Masters or postgraduate training programme. The places are limited each year and you are competing with your seniors and juniors. For those interested in surgery, know that there are now a direct programme for neurosurgery, paediatrics surgery, plastic & reconstructive surgery, urology and cardiothoracic surgery.

Know the requirement for entering, write papers and posters, and prepare to spend a lot of money (really, i mean a lot!) sitting for exams and attending established courses. Apparently doing (and paying for) all these is a show of true commitment that you really want to do surgery.

Trust me. Take it from someone who was told this straight to his face during Masters interview. “2 years as surgical MO, no MRCS and no publication at all? Might as well I take the candidate before you. Only one year as surgical MO with already 2 publications to his name.”

Of which I replied, “Can that guy do craniectomy or scopes?” Just that the words did not come out of my mouth, hahaha…

In surgical field, seniority is important. With seniority, comes experience and skills. Years of service matters, to a certain extent. I have friends who after housemanship, were instructed to serve in a “real” district hospital (because few HO from Semenanjung think SGH is a district posting). They eventually came back to secondary/tertiary hospital and department of their choosing, unfortunately as a junior MO to some of their previous HOs.

Imagine doing tagging work with your ‘juniors’. Learning how to cut from your ‘juniors’. And personally to me, it is sad to see they entered postgraduate training programme also later than their ‘juniors’, when it is not solely due to their own fault in the first place.

I know some people say time and age means nothing, and everyone is in their own race, and we should not compare, and seniority is nothing. Well, tell that to the people who applied for three-four times (read: three-four years) before entering the programme. Tell that to the people who now have to call people younger than them as “boss”.

Alas, it is true that we are in our own race. So, live within your own timeline and savour the experience and the journey. Most importantly, Allah is the best planner of all. But we still have to make plans and pray that Allah ease our journey to get there.

Life after housemanship is just a beginning. Ok, maybe a middle. Just make sure that we do it on our terms. Or else, we may be unhappy for the rest of our lives.

Thank you for reading. Jom balik Raya!

Owh crap, 2 more on-calls to do before Raya!

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IKRAM Health merupakan sebuah NGO dibawah Pertubuhan IKRAM Malaysia (IKRAM) yang ahlinya terdiri daripada mereka yang terlibat dalam industri kesihatan.

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