It’s really hard to figure out how the current situation of housemen in hospitals has reached such a disgusting level. I say disgusting because the stories that have been coming out are about events that are downright inhumane.

If medical professionals have strayed from practising human values while dealing with doctors under their supervision, we can see an ominous sign of what is to come if left unchecked; it could snowball and lead to a collapse of our health system.

Of course we have heard from the doctors of old that they too were subjected to harsh treatment during their internship. I guess some hard knocks are needed to produce doctors who are tough enough to face a profession that decides life and death.

But should we get violent, practise racism or indulge in using uncouth language on them? It will be good to remember that these young ones were subjected to a rigorous five-year training with a few years of clinical experience before being appointed housemen.

One doctor who did his houseman training in the ’70s said the senior medical officers and specialists who supervised them were “super tough” but it was very clear then the sole aim was to make them face the morbid reality of the profession.

“We took it well as most of them were really good at their job and knew what they were saying or doing. The sole aim was to make us good doctors. We didn’t hear of any physical abuse,” he said.

But he swore there was no element of racism, with no one being told to go back to rubber tapping like their parents or to work in padi fields as alleged by some housemen at the Penang Hospital.

Another junior doctor was told to “go up to the top floor and jump down from the building”. Others, including some of my close relatives, were either kicked on their legs and knocked on their heads. Some were so humiliated that they lost their self-esteem, with a few undergoing psychological problems.

The current media furore started after the death of a houseman three weeks after reporting for work. He was reported to have fallen off the Penang Hospital building on April 17.

In December 2020, a trainee doctor there also fell to his death, three weeks after quitting his job.

Verbal abuse in front of patients

What’s more shocking are claims that during some rounds in Penang Hospital, some specialists and seniors even break into Mandarin when asking questions or answering queries. Many housemen are shouted at in an unpleasant language, vulgar at times, right in front of the patients.

Yes, most of them know that the supervisors need to be tough on the young doctors to bring out the best in them, so that they pick up the right skills to become medical officers who are capable of facing emergency situations.

But, as rightly pointed out by many, do the seniors and specialists need to resort to uncouth language and blatant insults which can break some doctors? Should there be a more polished way of teaching the trainee doctors whose future is at the mercy of the seniors?

Of course there is, and there ought to be. I had a long chat with a relative in an Australian public hospital where she underwent her houseman training. It was for a year, compared to the two in Malaysia.

She had been following the unfortunate debate on the sad state of junior doctors in Malaysia and spoke to many of her course mates who concurred about what has been alleged.

The Australian experience

She said housemen in Australia are closely supervised by senior specialists whose sole aim is to ensure they are competent before being issued with a full practising certificate. Racism is minimal, if any, while bullying is virtually absent.

“No one gets kicked or knocked on their head, let alone told to jump off a building. Special attention is given to some who are slower than the rest. But no one dares to bully as there are strict guidelines on dealing with trainees,” she said.

“The supervisors take the trouble to speak to housemen and even have coffee with them to discuss any problem.”

She said health ministry regulations stipulate that housemen must not work for more than a total of 80 hours in two weeks. If they are forced to do so, they are encouraged to put in their claims for extra hours.

While some say this is a luxury, shouldn’t this be the ultimate work culture and environment in any hospital? We are dealing with fresh medical graduates who are just starting to build their careers. Obviously, they need a lot of encouragement to be part of a system that is crucial to all Malaysians.

Long working hours

Malaysian working hours for housemen – a minimum of 72 hours a week – are nearly double that of Australia. This is definitely too taxing and can have huge repercussions on their mental health.

In addition, when they are posted to a new department, they undergo “tagging,” which means they have to follow a senior from 7am to 10pm, six days a week for 10 to 14 days, depending on the posting. They have to be attached to six departments in their two years of houseman training.

Some of the factors that have led to the current problems could have been caused by a total disconnect between the health ministry and those on the ground. Obviously, those in Putrajaya appear to be in a state of denial.

Hospitals are the cornerstone of the survival of a nation and its community. Only the best should be appointed to run these institutions: no compromise can be accepted here. We have to be colour blind and beat any form of racism.

Must we wait for more deaths before we correct the many wrongs in our hospitals?

The views expressed are those of the writer and do not necessarily reflect those of FMT.