AS a junior medical officer, I started my housemanship in Queen Elizabeth Hospital, Kota Kinabalu, in July 2013 and completed in July 2015.
We went through the shift system. All of us went through tagging whenever we started in new departments, working more than 16 hours per day for at least 14 consecutive days with or without a day off in between.
If one’s performance was deemed subpar at the end-of-tagging assessment, the tagging period could be extended up to four weeks.
For example, during our Obstetrician and Gynaecologist tagging in 2014 — it was 14 consecutive days without any day off in between. We started before 6am and ended after 10pm, easily more than 16 hours per day. On top of the usual ward duties, there were certain logbook procedural requirements before one could even go for the end-of-tagging assessment.
Each of us had to perform 10 deliveries, five episiotomy repairs, assisted in at least three Caesarean sections and also other gynaecological procedures in operation theatres during the two weeks of tagging.
All of us stayed well beyond 10pm to perform and assist in those procedures. Some even camped overnight in the hospital.
Once house officers pass the tagging assessment, they are expected to function independently. However, the normal working shift is not eight hours as reported. Our usual daily shift 2-4 years ago lasted for at least 12 hours each.
Currently, house officers in Kuala Lumpur Hospital work at least 10 hours per shift (7am- 5pm). These 10-12 hours are the minimum length specified on paper, but the actual working hours are always longer.
The long hours during tagging can be challenging indeed. However, bear in mind that once house officers complete their training, they will become medical officers and will have to be on call, working for more than 24 hours continuously with heavier burden and higher stress level.
Housemanship is similar to apprenticeship — an on-the-job learning. Reflecting on what we have learnt and done for the day is much encouraged. It can be done at any time and whenever necessary throughout the day. Six hours of sleep per day during tagging is challenging, but not impossible.
If we use those time spent on whining and complaining on social media to sleep, we can easily get five to six hours of sleep on most days. Some may argue that we do not have the time to study. Be proactive, make time to study, take control and dictate our own learning.
House officers are never treated like lesser beings. By default, all senior doctors (consultants, specialists, medical officers) treat junior doctors with respect, dignity and professionalism. Credit will be given where it’s due. Capable, responsible house officers will always be appreciated. Better still, junior doctors get to befriend these senior doctors who will provide guidance.
It was pointed out by some junior doctors that coming up with shorter tagging sessions will result in a lower failure rate, while shaping better functioning, thinking and rested house officers. I beg to differ.
The on-the-job learning process does not happen at home, nor in front of laptops, smart phones, tablets, etc., but only in hospitals. Furthermore, we choose to be doctors not to be well rested, but to make a difference in every patient’s life.
Sir William Osler, the “Father of Modern Medicine”, said: “Live neither in the past nor in the future, but let each day’s work absorb our entire energies and satisfy our widest ambitions.”
Looking back, all those training and hardship made us better doctors. We were able to be functional in the shortest possible time. Whenever we work, lives are at stake.
As junior doctors, we should dedicate to improve ourselves constantly, not just to pass the housemanship assessments or exams, but to prepare for those moments when we are the only ones standing between a patient and death.
The quality and quantity of training can never be compromised. Embrace the challenges along the path of this fulfilling career and we can achieve greater heights.
Medicine is indeed only for the creme de la creme; housemanship is the easiest phase of the whole career. If one can’t endure this initial phase, then one needs to rethink his future and choice of career.
DR SCHEE JIE PING
Medical officer, Kuala Lumpur