Lily says she decided to quit when she started becoming more afraid to get scolded than she was afraid of her patients dying. — Posed photo/123rf
TO Hisham*, medicine represented years of sacrifice and sleepless nights in pursuit of his dream of becoming a doctor.
So when he suddenly decided to quit his housemanship training, everyone in his life, especially his parents, was confused.
“‘How could you throw all that away?’ they’d say.”
If he had to choose any particular incident that made him “throw it all away”, Hisham says he would probably point to the time he reported a “particularly traumatic” case of bullying to his superiors and the management dismissed the incident entirely.
“How can you continue in a system where even management enables abuse?” he wonders.
But the hospital management’s response was just the straw that broke the camel’s back.
“What made me leave wasn’t just one incident. It was the weight of countless moments that broke something inside me, piece by piece.
“The environment was deeply toxic. Public humiliation in the ward happened so casually that it became a routine. If a senior felt like shouting at you across the ward, they simply would. No hesitation, no regard for dignity,” says Hisham.
The junior doctors not only had to deal with public humiliation, but no real mentorship or counselling was being provided to them at the time, he adds.
“Help was rare and precious. Many of us were treated less like junior doctors and more like burdens to be endured.
“If you wanted help, you had to take the initiative to seek a psychiatrist on your own, knowing full well you’d risk being labelled as 'not strong enough'. That stigma stuck like a mark on your back.”
Now 35, Hisham has since pivoted to auditing and has no regrets about leaving the field of medicine. Auditing was his “second chance at life”, he says.
“I don’t regret it, not one bit. I finally feel like I’m growing again – as a professional and as a human being. There’s grief, yes, for the dreams I once had, but there’s also relief and gratitude.
“I got out before I lost myself completely. But without a change in the system, we’ll keep producing doctors who are broken before they even begin,” he warns.
Hisham’s housemanship happened many years ago, but to this day, junior doctors are still experiencing similar issues.
Lily* recently quit her housemanship training in March, after one week on her first posting. Her stories sound familiar; constant verbal humiliation, lack of guidance and a toxic work environment. She recounts her first day when she asked someone where the toilet was and got shouted at.
“They pointed at the patients’ toilet but I was told in university that it is not ethical to use the patients’ toilet, so I didn’t know we were allowed to use it.
“And then the person started saying things like ‘Oh were we supposed to build a toilet for you?’ and ‘She thinks she’s a doctor now.’”
“That was a constant in the work environment and it makes you not really want to ask people anything anymore, but then when you make a slight mistake because no one taught you how to do it properly, then you get really, really badly chewed out for it.”
Within one week of her housemanship training, Lily says she lost a lot of weight and hair due to the long hours and stress, sometimes only eating her first meal of the day at 11pm.
“But the main reason I quit was that I started becoming more afraid to get scolded than I was afraid of my patients dying,” she says.
That was not the kind of doctor she envisioned herself becoming, so she left.
The Malaysian Medical Association (MMA) president Datuk Dr Kalwinder Singh Khaira acknowledges that there are some “bad apples” among the medical fraternity who apply undue pressure and stress on junior doctors.
“But at the same time, what is the reason? Because we are dealing with life and death, sometimes expectations are high.
“So when expectations are not met and it affects the patient care, maybe some take it out on them (the junior doctors),” he says.
Then there is the issue of resilience and how different personalities deal with such challenges, he says.
But he attributes the hair-trigger tempers of some doctors to the insufficiency of medical professionals in the system and the massive workload government doctors have to deal with – something which Lily agrees with.
Older doctors who have been in government service for a long time have probably suffered through the staff shortage for a while and thus become more irritable, with Lily recounting senior doctors blowing up at her over simple questions, such as where the toilet is.
It wasn’t all uncaring and abusive seniors, as she says some medical officers tried to help the housemen.
“But they were also really, really overloaded themselves so they couldn’t always be there,” she says.
Hisham may have found his new calling in life, but Lily is still trying to figure out potential new careers, including perhaps in pharmaceuticals.
But she wants people to know, “When someone quits their housemanship, it’s not because they don’t want to be a doctor anymore, it’s because the environment is so unsuitable for them to be a good doctor that they just feel the need to leave.”
* Not real name
