MAKTAB RENDAH SAINS MARA KEPALA BATAS

LOT8781, JALAN BERTAM

13200 KEPALA BATAS

PULAU PINANG

FOLIO KERJAYA:

DOCTOR

NAMA : MAWARDI BIN MD ALI

No i/c : 951211-01-5215

KELAS : 501

NO. MAKTAB : 11373

GURU :

CONTENTS

No.

Title Page

1. W - Work Condition

2. I - Implications For Lifestyle.

3. N - Nature Of Work

4. N - Need By Society And Community

5. E - Entry, Training And Prospects

6. R - Related Occupations

7. S - Succesful Personal Attributes

INTRODUCTION TO DOCTOR

A career in Medicine involves the care of the ill, infirm and injured. It is a human profession and the only one classified as a 'noble' profession. The practice of medicine is a lifetime commitment to the study and delivery of healthcare. The medical graduate is not only trained in the basic sciences, clinical medicine but also taught other subjects necessary for medical practice including medical ethics, legal medicine, disease prevention, healthcare delivery, communicating skills and research methodology. The doctor always tries to maintain a fine balance between the scientific principles of

medicine and the art of healing when dealing with patients. A doctor's work though challenging and often satisfying is also physically and mentally taxing.

WHO IS A DOCTOR?

A doctor is a medically qualified person whose work is to prevent diseases, relieve suffering and to treat the sick, while providing care and support for their families. As an important member of the healthcare team, a doctor is knowledgeable in medicine and is primarily responsible for community healthcare and patient management in a hospital. A doctor also plays a crucial role in public medical education, medical research, planning and implementation of local and national health programmes.

W-work conditionsLet’s start with the workplace. Doctors usually work in a hospital. The work condition of a doctor should be spotless. If not, it can give patients other illness. Hospitals can be shut down for not being properly clean. Alert and knowledgeable is the work condition. Doctors help people on a daily basis, some of which are really ill and need serious help. Different doctors have varying responsibilities regarding to their line of work.

Then about the physical aspects that must have to be a doctor. Becoming a doctor requires more training than most other jobs. It usually takes at least 11 years to become a doctor: 4 years of college, 4 years of medical school, and 3 years working in a hospital. For some specialties, doctors may have to work in a hospital for up to 8 years before they are fully trained. To become a doctor, you should study biology, chemistry, physics, math, and English. It is not easy to get into medical school. You have to do very well in college and on medical school entrance tests. Students spend most of the first 2 years of medical school in labs and classrooms. They take lots of science courses. They also learn to ask patients the right questions and how to examine them. They learn how to tell what sickness a patient has. In the last 2 years, students work with patients and doctors in hospitals and clinics. After medical school, doctors go to work in a hospital for a few years. They are called residents. To be a resident, you must pass a test. If you want to be a doctor, you should like to help people. You should also be willing to study a lot. You have to know how to talk to sick people. And you should be able to make decisions and handle emergencies.

I- Implications For Lifestyle

DOCTOR LIFESTYLE is very variable as the field is divided into specialties as dissimilar as the eye is from the big toe. The environment practiced in also is highly variable e.g. Military versus commercial versus public. Some doctors practice from home, others from small clinics, others in huge hospitals, and some work in research or administration and never see real patients.For family doctors, hours of work are similar to regular offices with some taking night calls or day house calls from their patients. Clinics also run regular hours but some offer extended hours by having their doctors work a rotating shift. In a hospital, care must be provided around the clock. So specialists work on an on-call system: every four days work a regular work day, through the night, and then through the next day again with two or three hours sleep, then resuming work the next morning for a half to full day and regular working hours the next two days and repeat. This of course is very taxing on the lifestyles of these doctors and can result in social and home issues.

For all doctors, after the 'trauma' of medical school, a period of internship is required. This a time of supervised clinical training with a steep learning curve. Many clinical skills are developed for cases of future emergency, some of which a doctor may never use again but should know in case of disasters or freak accidents. Typically the degree of hands-on experience a doctor is involved in decreases as they get older, and more time is spent on direction of younger doctors. Unlike many other industries, doctors actually becomes more valuable the older they get as their experience and therefore clinical judgement becomes more refined.As many more physicians are needed in communities than are trained, doctors seldom experience the turbulence of market layoffs and unemployment.

Graduation from medical school does not guarantee lifetime practice. To protect the public, medical cases with unusual or unexpectedly poor outcomes are reviewed by medical boards. If the attending physician is repeatedly found erring s/he is deemed unfit to practice and their license is revoked. For a few of the oldest physicians today, there were no CT scans, MRI, computers and many common drugs around when they graduated. So part of a doctors lifestyle is keeping up with changes in the field.The day to day experience of a doctor at work is typically spent hurriedly, with a high degree of concentration and rapid decision making based on their lifetime of experience. It is generally a stressful but morally rewarding lifestyle.

Becoming a doctor requires more training than most other jobs. It usually takes at least 11 years to become a doctor: 4 years of college, 4 years of medical school, and 3 years working in a hospital. For some specialties, doctors may have to work in a hospital for up to 8 years before they are fully trained. To become a doctor, you should study biology, chemistry, physics, math, and English. It is not easy to get into medical school. You have to do very well in college and on medical school entrance tests. Students spend most of the first 2 years of medical school in labs and classrooms. They take lots of science courses. They also learn to ask patients the right questions and how to examine them. They learn how to tell what sickness a patient has. In the last 2 years, students work with patients and doctors in hospitals and clinics. After medical school, doctors go to work in a hospital for a few years. They are called residents. To be a resident, you must pass a test. If you want to be a doctor, you should like to help people. You should also be willing to study a lot. You have to know how to talk to sick people. And you should be able to make decisions and handle emergencies.

N-Nature Of Work

The nature of work for a doctor are vary depends on their expertise. The nature of

work also bring the same meaning with task or work activities. Generally, work as a doctor

is quite tough and sophisticated. Typical work activities vary according to the role and

employer, with most doctors specialising in a specific area. Within each specialism, tasks

typically involve humans.

After providing diagnoses, a doctor treats patients who are suffering from diseases and

injuries. A doctor is also called a physician and may be either an M.D. (medical doctor) or

D.O. (doctor of osteopathic medicine). M.D.s and D.O.s both use traditional treatment

methods such as drugs and surgery, but D.O.s emphasize the body's musculoskeletal system,

preventive medicine and holistic patient care. Doctors can be primary care physicians or they

may specialize in a particular area of medicine such as obstetrics, pediatrics, psychiatry or

anesthesiology.

WHAT DO DOCTORS GENERARLLY DO?

Doctors are involved in all aspects of healthcare delivery and the related fields. The

most important ones being :

1. Examination, diagnosis and treatment of illnesses in patients.

2. Alleviation of pain and suffering in patients.

3. Administration and prescription of medication.

4. Performing procedures and surgery.

5. Counseling of patients and their families on health matters.

6. Implementation of Family Planning Programmes.

7. Prevention and control of communicable diseases.

8. Dissemination of Public Medical Education.9. Planning and implementation of health programmes.

10. Developing new modes of treatment through medical research.

E-Entry, Training and Prospects

Entry requirements :

The minimum requirements for students to pursue any programmes except Medicine

and Dentistry at first degree levels both locally or overseas is two (2) Principal E in the

STPM examination or any equivalent qualification that is recognized by the government.

As for the examination system that utilizes the Cumulative Grade Point Average

(CGPA), the minimum qualification grade required is 2.00. The minimum qualification for

critical areas of study such as Medicine and Dentistry is three (3) Principal C in the

STPM examination or any equivalent qualifications that is acknowledged by the

Malaysian government or at least a CPGA of 3.00.

In this regard, the Ministry of Education Malaysia has agreed that the minimum

qualification requirements for admission into first-degree programmes in higher

institutions of learning both locally and overseas are as follows :

i) Two (2) Principal E at STPM level or any equivalent qualification that is

acknowledge by the Malaysian government, or a CGPA of 2.00 for all courses

except Medicine and Dentistry.

ii) Three (3) Principal C at the STPM level or any equivalent qualification that is

acknowledged by the Malaysian government or a CGPA of 3.00 for Medicine

and Dentistry.

iii) SPM school leavers who wish to pursue their studies at first degree levels in

areas except Medicine and Dentistry through a foundation or matriculation

programme must have a minimum requirements of five (5) credits. Students who

wish to pursue their studies through this channel in the field of Medicine and

Dentistry must have a minimum qualification of five (5) credits with at least 4B in

their Science and Mathematics.

The Ministry of Education Malaysia has the right to amend the minimum qualification

requirements whenever necessary.

The Cabinet has decided that students who do not meet the minimum requirements but

are still continuing their studies in institutions of higher learning both locally or overseas

will not receive any recognition from all Professional Bodies/Associations in the country

upon completion despite getting their degrees from a university which is recognized by

the Malaysian government. Hence, the students may not be able to practice in this

country.The conditions mentioned above were enforced effective from the academic session

2003/2004. Students who are already registered and are currently pursuing

programmes at any institutions of higher learning locally and overseas are exempted

from the requirements. However, Professional Bodies and the Public Service

Department (JPA) has the authority to impose traditional requirement before recognizing

a degree that is acquired by a student who does not possess the sufficient entrance

requirements.

Several foreign countries require the Certificate of Overseas Support that is being issued

by the Ministry of Education Malaysia for the purpose of getting their students' visa. In

this case, the Certificate will only be issued to students who have met all minimum entry

requirements as mentioned above.

Training

Malaysia has a huge responsibility in maintaining a healthy nation and since

Independence, the entire burden in terms of cost and manpower was paid by the

government. In view of this, it is a social responsibility of health care providers especially

Doctors, Dentists and Pharmacists, whereby a term of 3-year compulsory service is

required towards the government. This is not subjected to any earlier agreement or bond

with the government or their agencies. A scholar with or without any kind of financial aid

from the government would have to undergo this 3-year compulsory service.

Internship or Housemanship would be another extra year prior to the commencement of

the compulsory service. Housemanship or Internship is stipulated in the Medical Act

1971 whereby a qualified doctor would undergo a rotation posting in Medicine,

Obstetrics & Gynaecology and Surgery of 4 months each. However, in the last 3 years,

another 2 postings have been added; Paediatrics and Orthopaedics and this would be in

the second year of service after completing the Housemanship.

During the period of compulsory service, the Medical Officers would have to comply with

all transfer orders by the Ministry of Health. It would be desirable to serve in rural and

small towns throughout the country whereby the need for medical expertise is required.

The learning opportunities are often better in smaller towns, as the exposure is wider.

Besides that, in these towns, there would be less competition to perform procedures and

better prospects to gain hands-on experience.

On completion of compulsory service, the Doctor could continue to serve as a Medical

Officer or opt to pursue a postgraduate course locally or abroad. There are many

courses available in the local universities, such as University of Malaya, Universiti

Kebangsaan Malaysia and Universiti Sains Malaysia. Avenues to acquire postgraduate

qualification from overseas are available but tougher, as it requires attachment postings

overseas in some courses.

Prospects

Over the last few months, many budding doctors have contacted me to ask about the future prospects of doing medicine. Of course I gave them a depressing night after informing them of the current and future prospects of doctors in Malaysia. During these discussions I realise that many of these people do not understand a lot of issues surrounding the field of medicine. Thus I was obliged to write this article to wake up these people from their dream of “guaranteed” life if you were to become a doctor!

1)      Guaranteed Job and Good salary/can make money

 Many parents still believe that being a doctor guarantee their children’s future. Well, it may be so before but not in another 5-10 years time. You can read about these issues in my MMA articles column. 20 years ago we only had 3 medical schools producing about 400 doctors a year but now we have almost 30 medical schools in the country (the highest per capita population in the world). Last year alone, almost 4000 new doctors started housemanship in Ministry of Health (MOH). The number will further increase in coming years when all the medical schools start to produce their graduates. I believe it will reach a figure of 6000/year by 2015.

This is where issues arise. Even now, the MOH is struggling to place these doctors in various hospitals in the country. We have almost 30-40 houseofficers in each department now not knowing what to do every day. Their training is compromised and they are being released after that without proper training with license to kill! I may sound negative but this is the reality. Even district hospitals are being used to train houseofficers now, starting 2010. As you would have read in the papers recently of parents complaining that their child has been transferred to East Malaysia after completing housemanship, it is a known fact that the shortage of doctors at this point of time is in East Malaysia. As our MOH Director General had said, most doctors will be sent to Sabah and Sarawak from this year on wards.

What’s going to happen in the next few years? Again, my prediction is, there will be surplus of doctors by 2015. There will more bodies than post in MOH by 2015. Doctors most likely will need to queue up to be posted in government service.  You will be sent to rural and East Malaysia to serve. Any appeal will not be entertained. If you think this would not happen, please look at the nurses! 5 years ago, the government began to approve numerous nursing colleges due to shortage of nurses. Now, we have surplus of nurses without any jobs. I know of nurses who are currently working in petrol stations! BTW, the MOH is currently considering introducing common entry exams for all medical graduates. Only those who pass this exam will be given housemanship post. This will happen soon.

Furthermore there may be a pay cut for doctors when all the post are filled. One of the allowance known as critical allowance of RM 750 will be removed once all the posts are filled. Critical allowance is never a fixed allowance and is usually reviewed every 3 years. As you know, the pharmacist’s critical allowance is going to be removed if not already. 

I had one budding doctor who said that the reason she wanted to do medicine is because it is the only field where you have a guaranteed job and a starting salary of RM 6000. Well, I have talked about guaranteed job issue above but she is definitely wrong in stating that the starting salary. The starting salary of HO has gone up over the last 5 years; no doubt about it (please read my MMA article). However, the starting salary of HO currently is about RM 3500 to about RM4000 after including the on-call allowance. Remember, your salary only increases about RM 70/year. You will only reach a salary of RM 6000 after 7 years of service as a medical officer, when you are promoted to U48 according to current promotional prospect in civil service introduced end of last year! BTW, other than the difference of critical allowance, a doctor’s salary is only RM 200 more than a pharmacist in civil service!

 2)      Medical degree recognition

 If I can’t work in Malaysia, I can go to Singapore or Australia to work, right?

Again, another misconception. Many do not know that medicine is a very peculiar field and cannot be compared to any other profession. In order for you to work in another country, your degree needs to be recognised by the Medical Council of the other country. If it is not recognised, you would not be able to work there. For your information, only UKM and UM degrees are recognised in Singapore.

Almost all medical degrees from Malaysia are NOT recognised elsewhere.Malaysia Boleh mah! Only Monash University Malaysia’s medical degree is recognised by Australian Medical Council and thus you would be able to work in Australia/New Zealand. Some of the private medical colleges do twinning programmes with external universities from Ireland/UK/India etc. These may be recognised depending on which degree and where you graduate from. 

3)      Housemanship & Compulsory service

I have mentioned a little about housemanship above. As you know the housemanship has been extended to 2 years since 2008. Even though it is good for your own training but it does prolong your future postgraduate training. After Housemanship you have to undergo another 2 years of compulsory service before you decide to resign for private practise or pursue your postgraduate degree. It is during this compulsory service that you will be posted to anywhere in the country.

 Furthermore, housemanship is not an easy posting. Even though the numbers of HOs have increased tremendously over the last 2 years, it is still a very exhausting job. Many have had a mental breakdown during housemanship. I just heard of a houseman who is on psychiatric MC for the last 2 months! It seems she thought that being a doctor is just like sitting in a clinic and seeing cold cases (probably she thought she can become a GP immediately!)

4)      Hard work and post graduate training

 20-30 years ago, being an MBBS holder itself is good enough. You can easily open a clinic and become a GP and well respected by the community. But things are changing. Even GP

practise is a speciality by itself in many countries (Master in Family Medicine/FRACGP etc). Malaysia is also moving towards that. Many patients are demanding and would prefer to see a specialist directly nowadays.

 Thus it is important that when you join medicine undergraduate degree, please be prepared to continue your education for another 10 years after graduation! In order for you to complete your postgraduate education, it will easily take another 10 years, assuming you pass all your exams in one try! So, don’t assume your education is only 5 years! MBBS do not mean anything now, in fact it is only considered as a diploma!

 Getting into postgraduate training is also becoming increasing difficult. The number of places for Master’s programme is very much limited in local universities. The demand is greater than supply and of course don’ forget the quota system as well! Other than MRCP (UK) – internal medicine, MRCPCH (UK) – paediatric and MRCOG - Obstetric, you have to depend on local master’s programme for your speciality. Thus, you have a very limited option. With such a big number of doctors coming into the market now, I can assure you that getting a place for post graduate education is going to be a major problem in 2-3 years time! Be prepared.

R-Related Occupations

Medicine offers a wide variety of job opportunities. There is still a demand for doctors in

all fields especially in the smaller towns and rural areas. Medical graduates mostly go

on to work as clinicians in general practice and in the various specialties looking after the

health needs of the patients. A small number will pursue a career in non clinical work

like medical research, occupational health, medical journalism or administration.

Traditionally, clinicians are classified either as physicians or surgeons. This division has

now become blurred with the coming of many newer branches of medicine which do not

fit neatly into either of the above.GENERAL PRACTICE

A General Practitioner or GP must have a good working knowledge of common

conditions in all branches of medicine, to make the preliminary diagnosis and institute

treatment, as patients usually see them first. General Practice is also known as Family

Practice as the entire family not only gets treatment for their illnesses but also gets most

of their advice regarding all aspects of health from them.

GPs are used to working on their own, in single-handed practices, for long hours in

isolation with little time for either themselves or their families. Realizing this, many GPs

have now formed partnerships to work together in polyclinics and this will probably be

the trend in the future.

GENERAL MEDICINE

A doctor who works in General Medicine (also known as Internal Medicine) is called a

Physician. General Medicine encompasses a wide spectrum of diseases, which need

drug treatment as opposed to surgical treatment. In bigger hospitals, the Physicians

usually have a special interest and experience in a particular field or subspecialty. The

common subspecialties being Cardiology, Respiratory Medicine, Gastroenterology,

Neurology, Nephrology and Dermatology.

SURGERY

Surgeons are doctors who perform operations on patients to rectify a disability or cure

illnesses, as part of their treatment. Surgery has now become highly specialized and

Surgeons only deal with a particular kind of surgery, neuro surgery, orthoapaedic

surgery, eye surgery, ear, nose and throat surgeries or urological surgery.

OBSTETRICS AND GYNAECOLOGY

The Specialist in Obstetrics and Gynaecology looks after women in pregnancy and

diseases related to the female reproductive organs.

PAEDIATRICS

A Paediatrician provides medical care for children from birth till their early teens.

PSYCHIATRY

Psychiatrists treat the mentally ill and mentally handicapped with the use of medication,

behavioural and psychotherapy. The method of treatment is changing rapidly because

of new treatments, reducing the need for long hospital inpatient care.

ANAESTHESIA

Anaesthetists are primarily involved in providing pain relief or anaesthesia during

operations. They also look after the critically ill patients in intensive care work and are

involved in the treatment of chronic pain.RADIOLOGY

Radiologists perform investigations using many imaging techniques including X-rays,

ultrasound, Computed Tomography (CT) Scan, Magnetic Resonance Imaging (MRI) to

establish diagnosis and to document progress of treatment.

PATHOLOGY

The specialty of Pathology provides a wide range of laboratory diagnostic services and

includes the sub-specialties of clinical microbiology, pathology, bacteriology, virology

and haematology. The laboratory services help to confirm diagnosis and help in

choosing appropriate treatment.

PUBLIC HEALTH MEDICINE

Doctors working in public health are involved in health education, disease prevention,

planning and implementation of health programmes.

ACADEMIC MEDICINE

An academic career can be pursued in any of the above specialties in the universities.

Those working in academic medicine look after patients, doing research and teach

students.

OCCUPATIONAL MEDICINE

Doctors working in this specialty are involved in advising management and employees

on the prevention of medical hazards of occupation.

PHARMACEUTICAL INDUSTRY

The pharmaceutical industry employs doctors mainly in clinical research and sometimes

in advisor capacity.

The above list though not comprehensive indicates how medicine is highly diverse and

specialized. After finishing the undergraduate course and compulsory service, doctors

may often be unable to get a training post in the specialty of their choices and have to

take up training posts in specialties in which opportunities exists.

WHO ARE THE EMPLOYERS OF DOCTORS?

The government is the single largest employer of doctors. About half the doctors in

Malaysia are employed by the government and the other half work in the private sector.

GOVERNMENT DOCTORS ARE EMPLOYED TO WORK IN :

• Government hospitals

• Government polyclinics

• Health Departments

• AdministrationPRIVATE PRACTICE :

Most doctors in the private sector are self-employed while a few are salaried. They

normally work in :

• Private hospitals

• Private clinics

The remaining small numbers are employed by the :

• Armed Forces

• Universities

• Pharmaceutical Industries

S-Successful Personal Attributes