Junior doctors

My hospital started to receive HO for training about 2 years ago in 2008. For the last 2 years prior to that year, I was working with medical officers and 3 of my specialists. Well, even though we didn't have enough staffs but we managed any how to finish our work on time. We were able to go for lunch fairly consistently. Job was done perfectly well at the end of the day. I still feel that I have full of energy in the evening. However, the scenario has changed since the HO came to the hospital. We know that these junior doctors are supposed to learn and to be trained in order for them to survive out there as a safe doctor. As a senior doctors, our job is to teach and guide them. We also know that they are not extra pair of hand in the department. We understand that clearly. Nowadays, I feel that the job and responsibility in training the HO really drained my energy toward the end of the day. More than 50% of them have poor medical knowledge and skill. You really need to teach them from zero. You have to teach them again and again but nothing happened. You can't even raise your voice because they won't turn up for work the next day. Some of them required one to one coaching. On top of poor medical knowledge and skill, their attitude toward patients is also bad. My specialists are doing ward round at least twice a day. They continue to give them teaching and tutoring until one of them lost her voice. She was found to have four nodules on her vocal cord. The ENT surgeon said that she has over used her vocal cord and advice her stop talking or reduce it temporarily. You can imagine how much talking that she has to do everyday. I pity her and wonder how is she going to stop talking when you need your voice to teach the HO. Unless she decided to ignore them or don't teach at all. She told me one day that she just can't do it and kept quite. So, the solution was for me to do the talking and let her rest her vocal cord. I advice her to take it easy. You can only do that much but most of it up to the doctors themselves whether they want to learn or remain the same. If their knowledge and skills are not up to the requirement, they just get extended. No doubt, I have to do a lot of paper work but I don't want to get stress up unnecessarily. The amount of teachings and guidance given by my senior doctors are beyond description. Repeatedly telling the same facts again and again. Looking after 4-6 patients, already being considered as hard work and very busy. Some of them also commented that we are not suppose to compare the past and current. The ward round completed very late everyday. Because of these they end up having kuih or bread for lunch.

I am not saying all of them are bad but having bad HO today is not a rare species anymore. You are bound to have them in your department. Extension of posting sometimes doesn't make them better. Worst come to worst, the parents will come after you for extending their children. On top of having poor knowledge and skill, they have bad attitude. Many of them have to be referred to the psychiatrist for assessment. The common diagnosis is reactive depression or poor coping mechanism. As the head of department, now our duty is being channel to handle problems of poor coping mechanism in them and writing report for their poor progress. No PA to type letters make things worse. We have less time to do our clinical work. Hours and hours are spend to counsel them and give them encouragement. Sometimes we won and sometimes we failed. How long it will go on, only God knows unless certain measures need to be taken by the higher authority. Initially, the duration of housemanship training was one year but since 3 years ago it was increased to 2 years because one year is insufficient to train them. Are we going to increase further the training period to 3 or 4 years if these doctors are still have poor clinical skill at the end of their posting or akuna metata, no worries attitude. I guess, it is a serious problem that need urgent solution.