Khamis, 28 Oktober 2010

4 just nice but 21 is messy

Almost everyday my specialists will tell me about how terrible the HOs nowadays. Previously we have only 10 HOs at one time to torture us but currently we have sudden influx of them. 50% of them are first poster, freshly from medical school. I have 2 general paediatric wards and one NICU, such a small unit. I am scared that soon the number of HOs will out number the patients. I keep telling our hospital director that we can't really teach the HOs properly because we don't have enough patients for them to learn. They are suppose to do minimum 8 calls by regulation but they only did 4 or five calls the most per month. Each HOs will be in-charge of the most 4 patients. Well, with that number of patients that they have to look after, they still can't even remember or know what's going on with the patients. The antibiotics the patient is on and the number of days that the patient already in the ward. Worst still, they don't even examine the patient to know the patient's progress. Don't ask about disease, forget about it because the normal values also they don't know. There are so many protocols and informations available in the ward for their day to day work but they hardly used it. Basically, they know nothing. Very poor basic medical knowledge, bad attitude, no pro-activeness, lazy and some of them worst, beyond economic repair. We do have the numbers but where is the quality. We really have a tough time teaching them. You ask questions, never get any answer. Silent or you have to answer yourself. Fine, probably, we need to teach them and show them the way. Yes, we did that with difficulties. We have to teach even the basic medical knowledge such as how to differentiate between stridor and wheezing, petechiae and purpura, pallor and jaundice, crepitations and rhonchi and many others. Showed them how to take good relevant clinical history and to do proper physical examination in which all these should have been taught in the medical school. By right, my job is to teach and guide them in applying their knowledge to the real patients. But the situation is so different because there is no knowledge or skill to apply. Whether we like it or not we still have to teach them otherwise the patients will be in danger. We can't be there to hold their hand forever. After 2 months, probably 1 or 2 will improve but the rest remained the same. DG advice us to treat them nicely and give them TLC. Yes, we did that as well but nothing happen. If we increase a bit of our voice, because one or twice or sometimes you lost your patience, the eyes start to turn red and some of them will just cry out loud. Every day during the rounds, my specialists and I keep on repeating again and again but it doesn't seem to get into their grey matter. I really don't know who to blame. The HOs themselves or the universities or the new medical curriculum? For how long that we specialists have to go through this?. Looking after 4 patients they said too busy and tiring. 4 calls is too many until they don't have a social life. Give them more, the parents will come and threaten you that they will make a police report for torturing their children. Teaching was taken as torturing. Nothing seems right. I continue to encourage my specialists and medical officers not to give up on the HOs. Keep reminding them that it is our duty and responsibilities to train and teach them but I don't know for how long. I am so scared to think about the future generation of doctors that will treat me when I get old or treating my grandchildren when they are sick. I wonder how they pass their exam in the first place. No doubt, as a lecturer or teacher, we want all our students to pass the exam but we shouldn't compromise on the quality. Recently, I was one of the examiner in the final medical professional exam of one of the university. During the examination, the external examiner from oversea whispered to me commenting on the students performance during the exam. He was shaking his head. My colleagues failed few of the students during the exam but to our surprise, all of them pass their exam. This is just because their continuous assessments are good and the final exam only carries 20% mark. It is not that I don't want them to pass their exam but we should have some standards for our future doctors. I wonder why in the first place we need to carry out the final exam if we already know that the students are already pass their exam prior to sitting it. Are we doing it just for the sake of fulfilling the requirement by the board. May God bless our children.

2 ulasan:

  1. Salam Dr Norra..we missed you..;)..i missed your Grand Round...actually our Final Pro carries 60% (20% Long Case + 40% OSCE)and Continuous Assessment carries 40%..the exam was tough...we also thought that many will fail, but Alhamdulillah..all of us passed. The lowest, passed for 0.2 from failing point. He scored 50.2%. The exam was tough..but i could say it was fair. Some of us failed miserably in the Long Case, but scored superbly in OSCE and vice versa...So the marks were compensating each other..;) thanks for the 'kind' system. I still remember in the OSCE (14 stations alltogether + 3 rest stations, some of us burst into tears station by stations... It was 6 minutes for each stations in the OSCE. For example one station we have to run cardiac resusc (patient presented with VF, with presence of nurses, MA and we have to instruct them to set the line etc, the next Primary Survey for MVA case, the next, patient with acute urinary retention have to insert CBD, and the next perform Pap Smear...I must thanks all of our lecturer for giving us this kind of exam experience..because to me, the Final Pro was not only assessing our knowledge but meant to assess our resilience..if we were not up to the marks..it was our fault...in the stress mode, anything could happen and no wonder some of us left the speculum in the vagina after Pap Smear and rush to the next station..so funny..but we learnt a lot the 'lesson behind' that our teachers trying to tell us from the exam itself...

    BalasPadam
  2. Well, I guess being a doctor you have to be good in both skill and knowledge. They go hand in hand. Good attitude is another important thing for us to have towards our responsibility as a doctor. I am happy for all of you who pass your exam and I hope that all of you will become a safe and successful doctors in the future.

    BalasPadam