HOUSEMANSHIP PROGRAMME IN MALAYSIA: PERFORMANCE, ISSUES & WAY FORWARD

E-Housemen (e-HO) Intake HOs, every 2 months since August 2014 - according to availability of posts Implementation of e-HO since March 2015 e-HO is a online system that which allows HO (which have been appointed by SPA) to choose the hospital, depends to the availability of posts Only hospitals with available posts are displayed in e-HO. – If HO doesn’t agree with the available training centre, HO may postpone the training for 2, 4 & 6 months. e-HO opens for 1 week: 6 times / year ( Jan, March, May, July, Sept, Nov )

Disciplines offered 2008: 6 postings 2015: 9 postings Minimum: 4 months each posting Medical Surgical O & G Paediatric Ortopaedic Emergency Medicine Medical Surgical O & G Paediatric Ortopaedic Emergency Medicine Anaesthesia Psichiatry Primary Health Maximum: 1 year each posting Choose 6 postings

STRUKTUR LATIHAN PEGAWAI PERUBATAN SISWAZAH Tempuh latihan PPS tidak kurang dari dua tahun maksima LIMA tahun (+ 4 bulan obligatory posting). Penempatan maksima dalam satu-satu disiplin hanya dibenarkan selama satu tahun. Terputus /‘Gap’ latihan melebihi 4 bulan - mengulang semula keseluruhan latihan pegawai perubatan siswazah.

44 public hospitals accredited as HO Training Centres 14 H.SA. Johor Bahru H B. Pahat H.S. Ismail Johor H. Kuantan H. Temerloh H. K Trengganu H. K. Bharu H.U. Sarawak H. Sibu H. Miri H. Q. Elizabeth H. Tawau H. Sandakan UMMC* UKMMC* HUSM* H Kemaman H Kuala Krai H Tanah Merah H. Segamat H KLUANG H. Bintulu H. Kangar H. A. Star H. Sg. Petani H. Kulim H. P. Pinang H. S. Jaya H. Taiping H. Ipoh H. T. Intan H. S. Manjung H. K. Lumpur* H. Putrajaya* H.T.R. Klang* H. Selayang* H. Kajang* H. Serdang* H. Ampang* H. S. Buloh* H. Seremban H. K. Pilah H. Melaka H. Muar 44 public hospitals accredited as HO Training Centres FUTURE - Keningau, Sarikei, L Datu, K Lipis)

ISU & CABARAN:ADUAN Tidak sempat makan dan minum Waktu bekerja yang lama Waktu bekerja fleksi Tidak dapat pergi CME/ Buat prosedur. Buli – MO/Pakar • • minta belikan makanan, Ugutan extension untuk kesalahan Menjerit dengan menggunakan bahasa yang kasar Pilih kasih (favouritism) Ditegur kesalahan depan pesakit

NUMBER OF NEW HOUSE OFFICERS APPOINTED (1998 – 2014) 6000 5000 4000 3000 2000 1000 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Local Universities Overseas Universities Total Year 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Local Universities 360 372 477 519 830 850 907 945 993 1,104 1,449 1,726 1,864 1,964 2,180 2,588 2370 Overseas Universities 619 433 345 241 167 109 129 104 66 186 877 1,332 1,388 1,600 1,563 2,403 1490 Total 979 805 822 760 997 959 1,036 1,049 1,059 1,290 2,326 3,058 3,252 3,564 3,743 4,991 3860

Intakes of House Officers vs Availability of Posts Increasing numbers of house officers: - HO appointed in 2014: 3860 -Total HOs (2 years- 2013 & 2014): 8851 • 31.1.2015 UD41/HO posts : 10, 805 - Filled : 10,190 (94.3%) - Vacancies : 615

GENERIC FLEXI SYSTEM FRAMEWORK: MODIFICATION Duration: 65-75 hours per week To implement Modified Flexi System 3 sessions – for ward based disciplines Modified session - for ED & Anaesthesiology Shall not work continuously for more than 16 hours per session (without breaks) All days are considered as working days inclusive of Public Holidays & weekends (as HO is undergoing training) Entitled for replacement day off if working on Public Holidays (as it was earlier given) - only 1 day given if PH fall on weekend HO shall be given 1 full day off per week – can fall on any day Post-night duty off (afternoon off) – counted as 1 day off even if less than 24 hours Protected time for CME must be provided & HO expected to attend at least 75% of department’s CME sessions 23 16 Nov 2013

EXAMPLE OF MODIFIED FLEXI SYSTEM 7am-12pm 12pm-4pm 4pm-10pm 10pm-7am 5 hrs 3 hrs (-1 hr lunch) 6 hrs 9 hrs - - - - - - - - - - Table HO 1 - - - - - - - - - - hrs/day MON TUE WED THU FRI SAT SUN MF2 (NORMAL + EVENING) 14 MF1 8 14 17 MF2 (NORMAL + EVENING) MF3 MF3 (NIGHT) Post-night duty till 12pm OFF 5 14 OFF MF3 MF3 (NIGHT) Cumulative hours for week 72 Refined schedule to enable more time to be spent during day time/office hours – to maximise attendance to ward rounds, OT, Day Care/OPD, procedures, CMEs, hand-over, etc.

ISU & CABARAN: PERLANJUTAN PERTAMA & TERAKHIR Masalah cuti berlebihan/ sikap/ buku log tidak lengkap Tidak kompeten Tempoh: Minimal 2 bulan maksimal 4 bulan di hospital yang sama. Perlanjutan di hospital yang sama dan tempoh bergantung pada sebab perlanjutan. Sekiranya masih tidak kompeten maka untuk penilaian terakhir selama 3 bulan di hospital lain. Sekiranya masih tidak kompeten maka bawa kes untuk diputuskan Samada di beri peluang lagi atau ditamatkan dalam Mesyuarat MQB

LEMBAGA KELAYAKAN PERUBATAN (LKP)

Distribution by Universities Overseas Universities: 79% FINAL ASSESSMENT OF HOUSEMEN IN 2014 Distribution by Universities Local Universities: 21% Overseas Universities: 79%

Termination of PPS via MQB (2010-2014): Distribution of universities

SUGGESTIONS Choose the right type of hospitals Make good friends with the team esp Nurses Learn what your seniours prefer and plan to follow their pattern Plan your week and anticipate. Do not get too many surprises Withstand all the emotional challenge Remember that it will only be for 2 years Try to sit for membership exams if you can Must always remember the long term niat and rely on our remembrance of Allah and His Pleasure. Make good Do’a always