HO HO HO...Housemen Housemen Housemen

3:57 AM

HO...HO...HO....looks like Santa Clause dropped by a week earlier this year!

The HO I am referring to is H-dot-O...Housemen. Last week might as well have been Housemen Week. A time when everyone in the medical field take some time to appreciate the contributions of Housemen. Without them the whole hospital would cease to function.

Who will trace lab results in the morning before rounds? Who will draw blood of in ward patients in the morning? Who will clerk new admissions to the ward? Who will run to the radiology department to get an early appointment for CT scan? Who would be called up at 3 am in the morning to set a new IV access?

Who else will do ALL these without housemen?!

Well, in another dimension called district hospital and even some clinics, MOs have to do it all by themselves. Its mind boggling how 3 to 4 MOs can manage a hospital all by themselves. Review patients in the ward, attend to new cases in the emergency room and then see patients in the outpatient department. To all MOs in district hospitals out there....I salute you!

All these 'hoo-haa' about housemen started with a letter from a disgruntled parent Disgusted Malaysian.



Two main issues were brought up in this letter to The Star;
1. Long working hours without rest.
2. Maltreatment by senior doctors.




Long working hour

It is undeniable that the work hours during housemanship is long (not so sure about the shift system in place now). During the HO on call days, new HOs in each department would have to go through between one to two weeks of tagging. The purpose of tagging is for HOs to familiarize themselves with the workload in each department. 'Taggers' are expected to clerk ALL new admission during tagging hours. Tagging can sometimes last until 10 pm or midnight (on top of the normal working hours).

I personally feel that this tagging period is essential to prepare HO to work faster and more efficiently. It worked for me. Usually, by the time I finish tagging my 'Sacred Book of Houseman Stuff' would be filled with the basic management of common cases. It helps a lot when I go on call (post tagging). During those days, a HO will have to be in charge of one ward all ALONE. In medical, I was in charge of TWO. HOs are expected to call up the MO on call regarding any new cases or any important updates.



Usually, there is one MO in charge of ONE department (2nd MO call receives referrals while 3rd call MO will be in the operation theater). That is one reason why MOs need to make sure HOs in the ward are competent enough to manage patients. Thus, HOs are sometimes given homeworks to brush up on their knowledge.

As for "no time to eat or go to the toilet", I have the same problem when I work at Klinik Kesihatan and ED as well. Patients would grumble and make a ruckus if I see patients too slowly. Now, do I have to write a letter to newspaper and say patients are bullying me?

There is no PROPER time to eat or go the toilet. That's more like it. When you become a doctor jangan harap la you want to have lunch at 1pm sharp or punch out exactly at 5pm. Everything is in a rush. You have to adapt yourself. You just eat whenever you have the time. Try and eat some extra food in the pantry. Tak sedap pun takpa, janji makan!


Maltreatment by Senior Doctors

Mr G was a ruthless orthopedic surgeon. Housemen and even medical officers get goosebumps with the mention of his name. He would scold HOs and MOs anywhere and whenever he wants. His favorite sentences are:

"You all are carrying bags of sins everyday from work"; referring to the disappointing level of knowledge HOs and MOs had.

"Monkey see, monkey do"; referring to how HOs work like monkeys. Doing things without knowing its principles.

Sekadar gambar hiasan. Its Mr G, NOT Ali G

During morning pass overs, he would go through every detail of a patient's diagnosis and management presented by a HO. If he catches something wrong in the presentation, HOs are penalized with a homework on that topic.

"Write it on the board!" ; The SACRED BOARD OF HOUSEMAN HOMEWORKS!

If a HO does not complete all the listed homeworks and present them to Mr G, that's an EXTENSION UNTIL PROVEN OTHERWISE.

Some, if not most HOs will call Mr G a big bully. Saja je nak extend orang. But with all these homeworks and discussions, HOs are forced to read up. He forced us to read up on orthopedic knowledge. And if you think you can goreng this surgeon about drugs and internal medicine; you are digging your own grave.

After I completed HO, I appreciate what he did. He prepared me for MOship. I feel confident in managing orthopedic cases. He taught me a lot. Thank you Mr G. You might probably know who you are. (P/S: yang kenal dia tak yah dok bagitau who I am).

The Extended Houseman 

During my HOship, I met a legend. He was extended in ONE posting for almost ONE year. When I first met him he told me the specialist just hated him for no apparent reason. ALL the MOs were against him. He even had his mother appeal to the HOD to let him off. But when I worked with him, I realized if I was the HOD I would kick him out of the service!

He never came to work on time. He would NEVER be in the ward to do ward work. He would take emergency leave as he pleases, especially during days when he is on call. He was a pain in the.....everywhere sakit!

Imagine if this guy becomes a medical officer in a clinic or a hospital. He would leave the clinic as he please. He would just let patients die in the middle of the night by not being there in the hospital.
If that happens, I am sure there will be more DISGUSTED MALAYSIANS.

HOUSEMEN. You might not realize it yet, but the things you might consider as 'unfair' and 'useless' may be a lifesaver. I was irritated with the long list of procedures in the log book as well but it has proven to be useful. Just be patient and things will get better. There are some snobby MOs and specialist out there. Just make sure you don't turn out to be the same as the MOs and specialist that you hate. As I said before, the better doctor is the humble doctor.


Other posts related to Housemanship:
Houseman
Bootcamp for Housemen
Supply and Demand
Why No HOfrust?
On Call Versus Shift System
Age of Ultraman Doctors
Housemanship: A Disgruntled Parent
Too Many Doctors

MOfrust

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8 comments

  1. Yup..practise make you a perfect mo n perfect specialist..

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  2. Exactly. Hit the nail on the head.

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  3. Funnily enough, I said the same thing to my houseman last night as we were having dinner. I told him about how I had stern MOs and Specialists and even when I cried or were upset at being shouted at, I didn't mind because I knew I was 'green' and stupid - and they were more experienced than I was.
    It doesn't matter if a houseman lacks knowledge because you can always read up on things you didn't know - but if your attitude is wrong, then, nothing will help you. Always be humble and realise that you can learn from anyone and everyone, even the PPK or staff nurse - and you'll be fine....

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  4. Monkey see monkey do... At least a functional HO.. Disgusted Malaysian = monkey see monkey squeak, non functional piece of rubbish = sampah masyarakat, won't know how to appreciate what senior taught.

    ReplyDelete
  5. Mencari Doktor Tetap bagi Kilnik Swasta...

    By way of introduction, my name is Aznial Rahmat. We are Owner and Operator a General Practice (GP) Clinic in Bandar Sungai Long, Bangi and Putrajaya (Presint Diplomatik - Klinik Pakar KASIH).

    We are looking for a dedicated Medical Officer Requirements at Bandar Sungai Long Clinic:-

    l Lady doctor
    l MBBS or equivalent from a recognized institution approved by Ministry of Health Malaysia
    l Possess valid Annual Practicing Certificate
    l Registered with Malaysia Medical Council - Minimum 2 years working experience in Obstetric & Gynecology
    l Attended an Obstetric Life Saving Skill
    l Attended A Neonatal Resuscitation Program
    l Working hours negotiable with minimum on-call
    l Very attractive salary RM7,000 (starting)

    Kindly please send to recommend CV to: aznial@gmail.com

    Clinic information:-

    PUSAT RAWATAN SUNGAI LONG
    NO. 12 JALAN SL 1/13
    BANDAR SUNGAI LONG
    43000 KAJANG
    SELANGOR
    TEL / FAX: 03-90114833


    Regards
    Ir. Aznial Rahmat
    Director
    Primary Wish Sdn Bhd (KASIH Group)
    012 312 9264
    aznial@gmail.com

    ReplyDelete
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