Too many medical grads, too few housemanship spots

There are 43 government hospitals, three of which are university hospitals, providing housemenship. But demand has outstripped supply, leading to long waits for medical graduates. – The Malaysian Insider file pic, July 18, 2015.The future is uncertain for Ashraf who has already waited for six months since graduating from a foreign medical school but has been unable to find a houseman placement in any of the country's public hospitals.

The 25-year-old Public Service Department (JPA) scholar, who graduated from Egypt's University of Mansoura, is among many medical graduates who have been waiting three to six months for housemanship placements, a situation caused by the high number of medical graduates.

Director-general of Health Datuk Dr Noor Hisham Abdullah said there has been a significant increase in the number of graduates reporting for housemanship training in the last few years.

According to Health Ministry records, there were 3,564 medical graduates reporting for duty as housemen in 2011, and in 2012 (3,743), in 2013 (4,991) and last year (3,860).

Many graduates held qualifications from medical schools overseas and their number has increased from 877 in 2008 to 1,600 in 2011.

In 2012, there were 1,563 graduates from foreign medical schools and this grew to 2,403 in 2013, Noor Hisham said.

“Although there are 32 institutions offering medical programmes in Malaysia, their intake is smaller in numbers compared with universities overseas,” he told The Malaysian Insider.

Of the 32 local institutions of higher education with medical programmes, 11 are government-run institutions and 21 are private.

Malaysians can also opt to study medicine in 36 countries which offer 360 foreign medical programmes approved by the Malaysian government.

To stabilise the number of medical graduates which has outstripped the number of housemanship placements available, the Health Ministry in 2011 imposed a moratorium on new local medical programmes and institutions of higher education offering such courses, Dr Noor Hisham said.

But there are still other reasons for the long waiting period, such as the availability of positions and the location of hospitals.

Additionally, 30% of housemen do not finish their training in the stipulated period.

Dr Noor Hisham said placements were easier to get in hospitals in Sabah and Sarawak, for which the wait was about one to two months. But housemen applications at hospitals in Kuala Lumpur usually had to wait for six months.

Medical graduates have the freedom to choose the hospital they want to do their housemanship.

“The problem is 30% of those who do housemanship need to extend their training, so they will take up the posts for new intake,” he said.

Such delays, he added, could be due to housemen failing their training, resulting in extended training of between three and six months, depending on the hospital.

“That’s why we have delays (in housemanship placements) as we cannot simply add new training sites.”

There are 43 government hospitals, three of which are university hospitals, providing housemanship.

Better planning is needed to remedy the situation and to prevent unemployment among trained medical personnel, former Malaysian Medical Association (MMA) president Dr H. Krishna Kumar said.

Also, Malaysia has not met the desired doctor-to-population ratio of 1:400, despite having so many medical graduates. As of last year, the ratio was 1:633 among registered doctors in Malaysia.

He said foreign medical programmes had contributed to the competition between local and overseas graduates.

“Local and overseas graduates want to work here and they have to compete with each other, it is a matter of first come, first serve at the moment.”

He said joblessness among medical graduates was a worrying trend that could lead to medical practitioners setting up unregulated practices.

He said it was important for the government to have a proper planning to address the issue, despite there already being a moratorium on new medical programmes.

“We already met the government and we want them to reduce the number of universities or reduce the intake.”

It did not help, he added, that people tended to view the medical profession as one where big money could be made straight away. – July 18, 2015.