A little Guidance, Perhaps

I seldom talk about my medical life. With good reason, too, as people have twisted my words and accused me of malpractice and murder. Haters are gonna hate, I'll give you that. As usual, I have to write a disclaimer. To quote Baz Luhrmann, "the long term benefits of sunscreen have been proved by scientists whereas the rest of my advice has no basis more reliable than my own meandering experience." I do not represent Neurosurgery or Hospital Kuala Lumpur. I do not represent the doctors of Malaysia, or post-graduate residents. This is all me.

Savvy?

I often hear complaints about house officers--newly graduated doctors who have to undergo compulsory rotations for 2 years before they are eligible for a permanent practicing certificate. Though house officers are as varied as monkeys in the jungle, the complaints are almost invariably the same: they're useless. They're spoiled brats who cannot do anything right. These statements are more often than not followed by lamentations on the death of good freshly-graduated doctors, or how things were not like this when the complaining senior doctors were house officers.

Let me be honest with you guys. The first few days of starting my housemanship, a specialist humiliated me in front of medical students when I could not answer his question. One of the students answered right, and the specialist scoffed at me and commented that I should not have graduated in the first place. In front of the students, in front of a perfectly coherent patient. My first month at O&G? Hated the department. Hated everyone in the department. Nothing I did was correct. I had to juggle between 4 teams, and I got the heat for forgetting something.

When I left, however, the specialist in charge of house officers in each department I worked for, when finding out a new batch of house officers were from USM, would ask them whether they knew me, and that they had big shoes to fit in.

While not the best in terms of knowledge, I was a proficient house officer. But I did not start off an excellent specimen. I had good teachers: senior nurses, senior house officers, medical officers and specialists. They spent time to teach me. In the span of a year, I learned so much more than I did the five years I spent as an undergraduate. I gained valueable knowledge that made me a safe medical officer.

So. Enough about me. For the moment.

We do not have house officers in my department. The first time I had house officers was when I did a 6-month rotation in General Surgery at Hospital Selayang. Suddenly I had this group of doe-eyed youngsters who kept referring me as "Dr Fadz/Fadzli". Just like in any other groups, be them humans or animals, there were those who stood out, whether from excellence or from sheer incompetence. Most of them were of average qualities, but hey, that's normal distribution curve for you. Sure, the number of these house officers is mind-boggling. When I was one, we had a maximum of 30 house officers throughout the whole hospital. When I went to Selayang, there were almost 20 of them per ward.

So yeah. When I was a house officer, there were so few of us that we had to make up for the slackers lest we would face the wrath of medical officers and specialists. Nowadays there are so many of them that they assume someone else would and should get the job done, and nothing gets done instead. The large number also reduces the chance for them to learn essential skills.

Is this their fault? I don't know. The country needs more doctors, so the government is churning out new doctors to meet the need. When you mass-produce something, the quality is bound to decline. But come on, to have newly-appointed medical officers complain about house officers, when they themselves had just been raised not too long ago?

Something's not right somewhere.

Let me ask you this: for those who complain about how house officers are made of suck, have you spent time teaching them, guiding them?

When I worked at Selayang, the specialists and medical officers organize classes for house officers on a weekly basis. During rounds they asked house officers about patient management. These youngsters were treated with respect. They were nurtured. There were several hopeless cases, but they were closely monitored.

Sadly, when I worked in another hospital (which shall remain nameless, but I'm sure you can venture a guess), there were plenty of house officer-bashing but an alarmingly lack of guidance. House officers who had almost completed their surgical rotation had never been taught about short central lines, ABG interpretation, even fluid balance. Sure, there were compulsory CMEs, but that was for the whole hospital and lacked individual touch.

I took some of them under my wings and did my best to guide them to the best of my knowledge and experience. Those who were interested to learn, anyway. My colleagues were surprised that house officers were willing to help me with inserting IV lines and getting blood for investigations, when they had to do those things themselves. They teased me when they found out I was teaching these house officers.

But someone's got to do it.

It's easy to give up on people. It's easy to complain about others on Twitter and Facebook. It's easy to create a group just to bash house officers. Sometimes people are made of suck, be them house officers, medical officers, and even specialists. I'm not judging anyone.

When I was a house officer, I was raised with love and respect. I was given the freedom to grow, to learn, to prosper. As a medical officer, I afford house officers the same love and respect. Imagine, then, when new house officers are treated with scorn and derision, how they'll treat their house officers in a few years' time.

They end up complaining about house officers when they're posted at another hospital as medical officers.

Break the cycle. Spend the same amount of time complaining about house officers to teach them instead. Treat them as friends instead of merely subordinates. Show a little love.

And a little guidance, perhaps.

Comments

[Account Deleted]

mo kena ajar jgk houseman mcmana nak isi borang hpe.dah byk kali aku tegur mo,specialist aku tegur surgeon.by rite operating surgeon yg kena isi borang tu sbb dia yg tau intraop finding ngan sutures yg diorang buh utk orientation marking.proper relevant history and investigations done.be it blood ix or radiology.houseman mostly tau retract je.kalau nak jgk ho yg tulis,mesti countersigned by operating surgeon.kalau isi form request blood for transfusion bole buat betul2,borang hpe lg kena buat betul2.sample darah bole amik byk kali.sample tisu??
so, kpd kwn2 mo sekalian..tolonglah ajar isi borang hpe.tqia :)