The seemingly stuck-in-time villages of Kampung Baru nestled among the skyscrapers of Kuala Lumpur have long been viewed as a symbol ...
With long hours and huge responsibilities, being a doctor can be mentally and emotionally challenging. These three doctors get by on their desire to help people.
Aizat Zahari is a 27-year-old house officer at Hospital Kuala Lumpur (HKL). To be a registered doctor, house officers (or housemen) need to complete their housemanship plus one year as a medical officer. The housemanship training covers six disciplines: internal medicine, paediatrics, obstetrics and gynaecology, orthopaedics, surgery and emergency medicine. Each posting lasts for at least four months and a houseman can only move on to the next posting once they pass an assessment.
When we met, Aizat had just completed his tagging session in orthopaedics – his fourth posting – working from 7 AM to10 PM daily without a break for the past week. A term used to describe the beginning stages of entering a new department, tagging ends with an off-tag assessment to ensure that the houseman is ready to tend to patients independently.
Despite having worked for over 100 hours the week before, Aizat doesn’t seem at all tired on his first day off in a week, nor does he discuss his long hours with a hint of a grumble.
“As you go on, you realise that this job isn’t that bad,” says Aizat of his first year of housemanship. “Most of the time I get satisfied when a patient I took care of gets discharged and he or she will say ‘thank you doctor.’ Another satisfaction is when you work in a department long enough, you know how to do things and you get praised by your medical officer. As a junior doctor that’s what we want – to be appreciated.”
“Maybe sometimes you get depressed from being scolded by superiors. But at the end of the day it’s about you, how you want to learn, how you want to practise in future. If you get scolded, you have to be positive about it,” he muses, admitting that he gets scolded “almost every day.”
A typical day for Aizat involves working from 7 AM to 5 PM, although it’s common to stay until 6 PM or 7 PM. For on-call days, each department employs a different system depending on the number of housemen.
In 2011, the Ministry of Health (MOH) implemented flexi hours for housemen (which later became the Modified Flexi System), where traditional on-call hours (around 34 hours) were replaced with a shift system.
However, Aizat says the hospital can’t drop the old system completely as the number of housemen is limited, usually resulting in two or three on-call days a week instead of one. If they’re really short-staffed, Aizat may not even get his weekly day off.
Over the years, the topic of overworked housemen has been a hotly discussed issue, but overworked medical officers and specialists are rarely mentioned. In fact, the flexi hours only apply to housemen – medical officers and above still observe traditional on-call hours.
Hana Azhari, 28, has been a paediatric surgical medical officer at UKM Medical Centre for three years. Her usual working hours are from 8am to 5pm with around two on-call days a week, during which she’ll be working for almost 36 hours straight with no rest day before or after. However, Hana points out that the hospital’s paediatric surgery department isn’t “terribly busy” during on-call hours, unlike in general surgery or general paediatrics.
“Being a doctor can get overwhelming because you have to make sure you’re in top form for every patient you see. You can’t just do a shoddy job if you’re not really feeling up to it. [But] every day you see you’re making a difference in people’s lives – there aren’t many jobs where you can come away feeling like that every day,” says Hana, who’s generally satisfied with her job, although feeling exhausted can reduce it somewhat.
It’s a sentiment shared by Fawwaz Qisti, 30, a paediatric medical officer in his fifth year at Universiti Malaya Medical Centre. Like Hana, he relates the best part of his job to being able to treat children, but he does feel he doesn’t get paid as well as he should for what he does.
“I’m definitely not doing this for myself – or I’d be a banker or something and earn crazy money!” laughs Fawwaz. “[The pay is] comfortable but it could be better. Patients treat us well so that gets me through, but it’s tough balancing a family, work and stress of exams.”
On top of having four or five on-call days a month and working around ten hours a day, Fawwaz is also doing his master’s, which medical officers can do to become a specialist. He’s also a new father. Hence, Fawwaz admits he hardly has time to meet up with people.
“After doing three on-calls in a week, I calculated that 60 percent of my time was spent in the hospital, 15 percent sleeping, and the rest devoted to everything else.”
A common grievance shared by these doctors – and perhaps many others in their situation – is work-life balance. Besides MOH’s Modified Flexi System for housemen, there’s currently no system in place that caps the number of working hours per week for medical officers and above. Hana believes that having a limit will make a huge difference in doctors’ lives – they’ll be less exhausted that way.
“Other than that, there should be better planning in terms of the number of doctors required per speciality so that you’re not under or overworked. You’ll have the right number of people per department,” she adds.
In Malaysia, the word “doctor” may carry a certain air of prestige associated with a good life and good income, but in reality, long shifts, tough working conditions and an average income would paint a better picture of a career in medicine. Good grades may get you past medical school but, as these doctors prove, it’s one’s passion to help others that will get you through the next ten years of your career.
"We have a long way to go in developing healthcare in this country, but thinking about being a part of how healthcare moves forward for children is something that really interests me to stay in this country as opposed to leaving,” concludes Hana. “Quality of life, work-life balance and pay are better in other countries but knowing that I’m doing something for my own country – that keeps me going."
By Syarifah Syazana
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