IT takes five years to be a medical graduate and another three of compulsory housemanship at a government hospital to finally be a doctor.

For some 1,200 medical graduates in Malaysia, their wait to be fully fledged doctors could be longer due to a combination of budget cuts, a scarcity of posts and an oversupply of graduates.

Some end up working as baristas or Grab drivers to earn a living while waiting for news on postings to government hospitals nationwide.

Government sources said Pakatan Harapan inherited the problem – due to bad planning and the large number of recognised universities that offer medical courses – from the previous government.

Malaysia recognises 346 such universities, including 34 local ones.

“There has been a mismatch for a while now. Too many take up medical courses, but there are not enough hospitals for them, or even posts, due to budget cuts over the years,” a source told The Malaysian Insight.

The sources added that the Health Ministry has no budget for housemanship placements, and it is uncertain when a budget would be allocated.

“Until the budget is allocated, the 1,200 graduates on the placement list will just have to wait. And, there will be no screening for new placements,” said another source.

“That means medical graduates waiting to be added to the placement list will just have to wait until the new screening is done. It could be a long wait.”

The sources said the government is not keen to transfer doctors after their housemanship, so as to save on transfer costs.

“Transfers are only for priority, or to fill vacancies. Otherwise, not at all,” said one source.

This sticky situation comes at a time when the ministry has said it will implement plans announced six months ago to resolve the housemanship placement issue.

A graduate, who wanted to be known only as Ahmad, said he applied to the Public Service Department (PSD) for housemanship in June last year, and is still waiting for a reply.

The 24-year-old said he is aware that the number of graduates like him far exceeds the number of slots available.

“A new intake opens up every two months, and that’s when 1,000 graduates are supposed to be taken in – this is what previous batches told us.

“But (in reality), only 400 graduates were taken in.”

Now working at a bakery in Kuala Lumpur, Ahmad said he is worried that as more time passes by, medical graduates would start losing their skills and knowledge.

The Mara scholar, who studied at the Perak Royal College of Medicine, said he faces another problem: servicing his student loan.

“No matter what, I still have to service the loan. I hope to get a placement soon.”

Ahmad said it is frustrating to hear about the “success stories” of his seniors, who were able to secure housemanship placements within eight months of graduating.

“Some of us graduated eight months ago, but there’s still no sign of our placements.”

 Results will take time

Among the steps that Health Minister Dr Dzulkefly Ahmad last June promised will be taken to resolve the glut of graduates issue is having shorter placement periods – from two years down to 18 months – for those who perform well, so that those waiting can enter the training system sooner.

He said the move is expected to commence this year, involving at least 10% of the total number of housemen undergoing training.

Medical graduates are also waiting to see the impact of another move announced by the minister: extending the moratorium on new medical programmes at the degree level for local institutions up to April 30, 2021.

This should limit the number of graduates, although Dr Dzulkefly said the ministry cannot control the numbers graduating from schools overseas.

Another measure announced is increasing the number of training slots from 10,835 to 11,706 through additional graduate-training hospitals.

Last June, Dr Dzulkefly said there were 47 such hospitals, not 38, in 2009. They comprised 44 under the ministry, plus three teaching hospitals, namely Universiti Sains Malaysia Hospital, Universiti Kebangsaan Malaysia Medical Centre and University Malaya Medical Centre.

He also said new posts will be introduced gradually in anaesthetics, emergency services, psychiatry and premier health departments to channel medical graduates to specific areas.

Malaysian Medical Association president Dr Mohamed Namazie Ibrahim welcomed the moves, but said it will take time to see results.

While increasing the number of training hospitals is a good step, he said, the hospitals must first acquire “adequate senior staff and facilities to ensure the housemen are trained well”.

He presented the other side of the coin: graduates can sometimes be fussy, wanting to be posted at particular hospitals.

“The vacancies at hospitals are advertised online, but some graduates delay their applications as they want to work only at certain hospitals, which may have no vacancies.

“If they are not particular about the location, and go where there are vacancies, they need not wait long. They shouldn’t be choosy.”

Graduates still waiting

The long waiting period is nothing new to medical graduates, who have been forewarned by their seniors.

Penangite Choi Lai Yee, who graduated from Universiti Malaya, said it is, nevertheless, tough after the fourth month.

“The long waiting period has been going on for years. We are hoping that the new government can address this issue,” said the PSD scholar.

“Three to four months is alright. But the longer we wait… our medical knowledge will deteriorate,” said the 24-year-old, who has taken up a temporary job in Kuala Lumpur, earning just enough to cover food and rent a room in Petaling Jaya.

Housemanship placements are held in three batches every year, and a total of 5,000 graduates are given slots annually.

But one graduate, who wanted to be known only as Arun, is worried after finding out that earlier batches still have not received placements.

He graduated from Charles University in the Czech Republic last July, and applied to PSD in August.

“I checked with PSD in September, and they said the filtering process will begin in December. But now, we’ve heard that it has been postpone to February, because they still haven’t given placements to the previous batches.

“We also heard that those (who applied) in June are still waiting to be filtered before getting places.

“If they haven’t gotten in, then when are we going to get in? We hope the new government can standardise the waiting time,” said Arun, who now works as a telemarketer. – January 1, 2019.