IN recent months, the working conditions and long wait for posting for the young houseman have been highlighted in the newspapers.
In my opinion, the 12-hour shift that is required during the housemanship is a major cause of their stress and probably the main reason why up to 20% of newly-graduated doctors quit.
One way to understand this 12-hour shift is to see the life of the general workers and security guards, many of whom work from 7am to 7pm. There is no life for them as they shuttle between their workplace and quarters. But these workers are at least able to get off work as soon as their shift ends.
Not so for the trainee doctor. He or she needs to arrive usually an hour earlier to receive reports, and often leaves a couple of hours after. As a daily routine, especially during the tagging, the doctor is up as early as 5am and is on his feet until as late as 11pm, leaving barely a six-hour window to sleep.
It has been reported that as many as 25% of junior doctors are involved in road traffic accidents due to fatigue and sleep deprivation. As there is often not enough on-site quarters available, trainee doctors have to return to their premises and risk accidents during their travel to and from work.
Proponents of hard work and long hours as a component of good training will insist that this is the way it has to be done. Citing hospitals in the United States, some will insist that this is the way to sift the good doctors from the lazy ones.
But the reality is that some junior and trainee doctors are married and have babies and families to take care of. Not all spouses and family members understand that the profession demands total commitment to serve under harsh and strict conditions for two years.
The working environment needs to be “good” too. Are there rooms for trainee doctors to shower, rest and sleep before returning home? The answer is “No”, as they are on shift and not on call and hence not entitled to rest during the shift.
Are the bosses understanding, considerate and helpful? This depends on the situation because of the multiple hierarchy of bosses, beginning from senior house officers to medical officers, to specialists and consultants. Along the way, junior trainee doctors are bound to meet some difficult and unreasonable bosses who will threaten and frighten them over the slightest mistake.
I have been told that being late by a few minutes may result in a show cause letter, despite having put in many hours extra for the week. Some seniors, whether medical officers or specialists, insist that trainee doctors follow their night rounds even though it could be past their 10pm shift. The stress is not just physical but also mental and emotional. The smart doctor then learns to survive and bites the bullet through each posting, hoping that they would ride through without any issues. Invariably, some are faulted, delayed and extended, and the misery and agony is prolonged.
As a parent, I see the agony and stress my son is going through but he has little room to complain.
One consolation that is often heard is that it will soon be over. Sadly, though, for 20% of them, their career and profession as a doctor is over.
I know the medical fraternity does not like parents to interfere with its “job” of training doctors. May I urge the senior members of the profession to show more compassion and understanding.
Apparently, some major hospitals do not follow the double-shift system which was introduced because the number of trainee doctors was too large. For the benefit of the newer doctors, I urge the Health Ministry to review the two-shift system, or modify it so that the trainee doctor does not feel he is undergoing military training.