Wednesday, April 15, 2009

Ukrainian CPR, Russian Life Support and the Boris Yeltsin Classification of Heart Failure IV: Pak Abu Dies

Pak Abu passed on today.

Take a guess why.

It’s all in the ABCs of basic resuscitation.

Someone did not ask for senior assistance when Pak Abu went into distress.

Someone forgot to clear the bloody secretions.

Someone did cardiopulmonary resuscitation on her own without addressing the ‘P’ of CPR.

Pak Abu survived open heart surgery.

Pak Abu pulled through a major abdominal surgery.

Pak Abu cheated death twice, the second time just barely.

Pak Abu worked hard his entire life to send his eldest son to study medicine in Monash, Australia.

His son will now graduate without a father by his side on graduation day.

Pak Abu was a great man in his own right but not great enough to survive that someone from CSMU.

That someone could have called for help but she didn’t.

Perhaps that is why there would be a funeral for Pak Abu tomorrow.

Rest in peace, Pak Abu.

See you at the crossroads.

To my dear readers from the Russian and Ukrainian medical schools, this short article would have served its purpose if you are outraged after reading it. May your anger and rage be translated into a greater determination for self improvement as opposed to running down the critics and skeptics around you. I am speaking to myself as I write so.

God bless.


spinosum said...

I think it will be fairer to all CSMU students and graduates, by addressing directly who that "SHE" you are referring to.

I believe not all CSMU grads are that incompetent. Some local grads are as bad too!

In fact, I am really interested to know who that "CSMU culprit" is! ;)

Anonymous said...

may Allah bless pak Abu ...

Anonymous said...

it is not fair for u to be putting such blame on the ho. ppl mess up at times, its only humane, we make mistakes. im sure she didnt 'kill' him as u proposed indirectly. the patient died becos it was his time, be it at a mall or the highest peak, when u got to go u just got to go. yes she messed up, but the way u made it sound, seems like a murder. shame on u la, u so perfect a? how u know ? u sure aint no angel, just a pathetic low life indeed.

Anonymous said...

hihi unwanted citizen, i fr russia uni, mb wil go sabah hosp. i realy got interested wana do summer postings under u. can tell ur name & dept u workin? hope to learn fr u... thx!

Anonymous said...

well said.
there is nothing better from learning for own's fault (or other's)

Product of the System said...



No one should be stigmatized because of one's university.

Local grads are bad too, but a local grad would most likely have called for help.



Product of the System said...

Anonymous who called me a low life,

All hail to you the last surviving prophet of God almighty.

You must be the prophet Isaiah reincarnated cos you sound so sure that "it was his time" for Pak Abu.

Tell me, will i die tomorrow from a Russian assault or the day after from stupid anonymous comments like yours?

God bless.

Product of the System said...

Anonymous who wants to work in Sabah,

It doesn't matter that much who you work under or where you are working, you will learn if you have genuine interest.

Once more, I am speaking to myself as I write.

Anonymous said...

I wouldn't say you CSMU HO is arrogant POTS. Most probably you have tortured her to the extend she was terrified to ask for help. Your earlier posts are a prove of that.It seems that you enjoy making fun of those poor HO's,and by painting a bull's eye on other Russian and Ukrainian students you seem to enjoy the attention you are getting aren't you??

ps: this is not a message of hatred, i m concerned about a deranged gov doctor. You should get help POTS, seriously. You are very bipolar & most probably you are suffering from ACD too.

spinosum said...

It is partly the mistake of that HO; but to some extent, i believe (not inferring anyone here) some of the seniors are just too "fierce" at times, therfore some HOs choose rather to "do everything themselves"... until really cannot only they will choose the last resort - calling seniors in. Sure they know they get bloody fired and humiliated; whats more if it was at the wee hours like 4am during on call days!

Not everyone can stand the humiliations and nasty statements from seniors - i do have frens who went into asthmatic attack or seizure when the specialists started bombarding at them!

Every human is created differently. Not all doctors, are created equally too. Some are dare-devils, some are arrogant b*tches, some are soft-spoken, some are cunning, some are lazy....

No matter what, as u go along, u will see a whole spectrum of doctors. Some specialists made wrong decisions too, and some specialists can't even set a good IV line (always ask senior MOs for help)...

All in all, the bottomline is - u r just being unlucky to have such a HO under u during this period. Just teach her whatever u can, in a nice way - who knows she will be enlightened some day and she will always remember u as the great teacher! :)

cllee said...

i cannot agree more with POTS - being ignorant and not asking for help is a big mistake.

to anonymous no2 "it is not fair for u to be putting such blame on the ho." ---
being a junior in this field, one must know his/her own limitation. arrogance/ know-it-all attitude can kill

DrLImTS said...

`I think that russian/ukrainian medical schools should be derecognized.
This will force half past six doctor apirants to work harder rather than just enrolling in a bogus degree mill at a bargain price.
Lets theorise hypothetically-the best medical aspirants who are financially less well off get straight As in STPM and enter UM/USM/UKM.Their richer counterparts do A Levels or the equivalent and get ABB to get into a decent but expensive medical school in UK/Canada/Ireland/Australia.
The less academically inclined end up in India.
However those who fail to even enter India opt for Indonesia or worse bogus schools in Russia/Ukraine.
Many come from the Arts Stream and have no aptitude for sciences.With a poor grounding/foundation and even poorer teaching/training with almost non existant assessment in russia,it is little wonder why these graduates are having problems at work.

sisofk said...

After reading so many comments, I still think that it's better you refer to the person herself than having a title like "Ukrainian CPR, Russian Life Support and the Boris Yeltsin Classification of Heart Failure IV: Pak Abu Dies".

What's wrong with Ukrainian CPR, or Russian Life Support? For your information, when I was studying in Ukraine, we learnt the same CPR or ALS as those taught in American medical schools. And most of our lecturers, (I say most, because, yes, not all) are trained in the USA, Germany, Canada, although having their first degree from a Ukrainian medical school.

And many of us worked very hard to learn everything we could while in Uni. So please, don't use such degrading title, when you want to talk of 1 bad 'apple'. Not all apples are bad. Just refer to that 1 particular 'apple', ok? That particular 'apple' was the one who was arrogant enough not to call in the seniors and not all Ukrainian or Russian grads are like that.

Please be fair to us.

Thank you.

Anonymous said...

To anonymous who said that 'it's pak abu's time',

If you are a doctor, please quit before more die in your hands and you could just say, it's his or her time.

If you are a medical student, please quit too, before they give you the license to kill.

To say it's a patient's time to die is a big bullsh*t. I know POTS blow up the scenario but the essence is there. ASK FOR HELP if you can't handle it or don't know anything about it. Rule number one of medicine: DO NO HARM!

How do you weight being scolded to a patient's life? It can't be compared. It's life we are talking about. Yes, some MOs or specialists are nasty but I believe after scolding the HO, they will come in the end as it's their duty. Failing which, they are the one who will be responsible since the HO has already informed them. So what, if you are being scold? You will only be depressed for a few days but if someone dies, the impact will be there forever for the family.

Imagine one of your relative(I'm not cursing you but just giving you an example!) has problem and the HO didn't want to call for help. How would you feel? Or how would you feel if the mortality board told you that the HO did nothing wrong by not asking for help but it's just your relative time to go? Remember, you were the one saying that 'it's his time'. So do you accept it?

sisofk said...

I also agree with cllee.

HO's, please know your limitations and don't act smart if you don't know something. Please ask, there's no harm in asking, and call for help when help is REALLY needed!!!! If not, another family will lose a loved one. If it can happen to Pak Abu's, it could happen to anyone's family.

I always ask my seniors and consultants, and they are very willing to teach me. I can't say for all seniors and consultants, of course.

However, if you cannot stand all the scoldings from seniors or specialists, then don't be a doctor!

Anonymous said...

To drlimts,

Mind u.I am one of the students who scored all A1s in spm. i chose to study in russia over d stpm->ipta pathway.

Dr.SIN said...

Good idea Dr.Lim Ts, derecognize russian & ukrainian U's just because of a few rotten apples. Bogus med school's u say?How do you know that?Perhaps u should come to these bogus med schools and see it for yourself..Dr.Ismail Merican sure did, and he was more than satisfied.Russia's health system is way2 better compared to Malaysia's. It has given birth to lots of nobel price winners.Medicine is individual effort,judge the H0's individually not by their U's. Terrible student+ Good U= Bad HO no matter wat..
Sadly some rotten apple's do get their way around med school,it happens so deal with it, try to inspire them not torment them into quitting. I rest my case.

Product of the System said...


Saying that one will become a great clinician because one's lecturers are from great foreign institutions simply does not hold water.

It's like saying Najib Razak is an upright Muslim because he goes to a mosque where the imam trained in Al-Azhar University.

Dr LimTS said...

Just a note,DrSin.
While I agree every doctor should be judged individually,my personal experience with HO/MO from Russia begs me to differ.
Maybe we are "classically conditioned" like Pavlov the dog,which was in irony Russian.
I acknowledge some of the great doctors are from Russia.How about Ilizarov,a self taught orthopedic surgeon who created the Ilizarov method of bone lengthening via external fixation.
I am by no means degrading the REAL Russian Medical schools.
But what is happening is with the fall of the Soviet Union,many medical schools in Russia want hard cash and they do this by sacrificing quality-they enroll students regardless of academic achievements nor inclination.
While they maintain better standards and training for their local doctors,they couldn't really give a hoot about the foreign students in the "English medium" program.After all these "doctors" will return to their own country to "practise".
Now you can deny this if you want.Just ask yourself,would you trust lifes of your loved ones under the care of these products?
Before you even begin-lets just say we have a hospital entirely staffed by MOs from russia versus a hospital staffed entirely by MOs from say UM/UKM/USM/UK/Ire/US/Aus?
Which would be your pick?
May your conscience be clear.
And thank you POTS for bringing up a very important topic in our healthcare system.

MUAR said...

First of all, I would like to offer my condolences on the death of Pak Abu.

It will not be the end of the story. As long as we are keeping these CSMU grads in the hospitals as doctors, there will be a lot more 'Pak Abu'

Let me share my experience with CSMU grad doctor with u all:

One day, i was seeing a patient in the ward, who was admitted for uncont DM / HPT. That patient was clerked by a houseman (CSMU grad). Let's introduce to you this great great houseman. She is "Legend" in my hospital. She stays in Medical department as a houseman for more than 4 months already (2 months tagging, currently allowed to start on call but with supervision by another H.O). Well, she had written down on the clerking sheath "Fundus examination -- no papilloedema, no haemorrhage". I was so 'impressed' that she was able to see the fundus of a patient with bilateral immature cataract. So the next step, i called her to come, and tested her about fundoscopy, and few more simple questions. I was tottaly speechless after I got the answers form her
1) Did not know how to use opthalmoscope, did not even know how to switch on the light
2) Papilloedema is "swelling of the whitish part (she pointed to her sclera) of the eye"
3) Normal SBP = 110 to 130 mmHg
4) Normal DBP = 100-110 mmHg
5) Normal PR = 90 - 110 bpm
6) Normal Spo2 = 90-95%
7) Paroxysmal Nocturnal Dyspnoea = patient feel SOB at night only, not during daytime
8) Orthopnoea = patient feel SOB on sitting up position
9) ECG --> "mute"

Imagine, she is the first doctor who attends all the patients admitted for U.A., Decomp. CCF, AECOAD, AEBA, etc.... and yet she doesn't even know the normal range of all the vital signs, simple ECG interpretation, and some simple basic knowledge!
She is not the only one among CSMU grads. 9 out of 10 of them have the similar quality. Imagine how tension our MO here are to oncall with them, and how unsafe patient is to be handled by them!

I still remember when i first joined surgical department as a houseman, on that very first day i met the head of department -- the best surgeon, and the most dedicated doctor i have ever met, he showed me the House-Officer's Protocol and asked me to read it out one by one. 2 things i still remmeber by hard till now:

(1) Housemanship is a period during which you will undergo a lot of Special High Intensity Training (S.H.I.T).

(2) Patients who come to you, trust their lives in your hands...DO NOT BETRAY THIS TRUST...there can be no greater sin.

Well, I woudn't say that i was a good or the best houseman. But i can say it out confidently that i have equiped myself with basic medical knwoledge during my medical students life, to allow me to practice clinical skill and management of common diseases during my housemanship.

CSMU grads, generally, well-known as poor knowledge, attitude suck, arrogant, tin-tin kosong berbunyi!

Housemanship is not for you to learn basic medical knowledge. You are supposed to undergo S.H.I.T, and polish up your clinical knowledge and skills. Please, stop torturing your MOs and patients! Do watever you want, but not a doctor please.

p/s: Hi, POTS, that Pak Abu is not our 6th college Pak Abu, right?

Product of the System said...


Well, Pak Abu is a convenient pseudonym...

Anonymous said...

Dear anonymous who scored many A1s in SPM but choose to study Russia,

So what if you scored billions of A1s in SPM? Anything to brag about? What are you implying? Let me tell you this. SPM is a joke. Any tom, dick and harry can score if you 'swallow' the books! Look at the trend in the newspaper. People are scoring like cats and dogs here.

If you bragged about scoring in A-level or SAM, then I will show you some respect. But to bragged about SPM, which is incomparable to any other international papers, this just shows that you are those typical 'Jaguh Kampung' kind! Just remember, there are many medical students and doctors here in this comment page. As if we didn't score well in our SPM.

spinosum said...

There is one solution to this:

To those MOs and specialists who are "extra-cautious" over those Russian grads, probably u all should stay in or stay by your houseman. Clerk all the cases, see all the cases, and do all the procedures - with ur HOs tagging along.

Stop those hierarchical sh*t, eg. going out of hospital, staying home during on calls etc. Just becoz u r an MO or specialist! ;)
Most MOs and specialists will ask the juniors to "call them when any problem" or "reluctant to come in during emergencies" - only give phone consultations and orders, plus some scoldings (thinking its a way to teach the juniors).

If u really really care for the patients, u should be staying by the patient or carry out duty just like an HO - rather than thinking u have already "gone thru the torture years" and now u must "have more freedom and higher hierarchiecal privileges"!

Its a norm in govt hospital nowadays. No one can denies it. Even I do that too sometimes to my juniors! ;P

So if u r just being unlucky to have such a "moronic" HO under u, u just have to buck up a little. Order the nurses to inform u of unstable cases every instance, and not just the HO! That way, u will get first hand info from the ward situation, and u will rush in to give early aid! Afterall, we love our patients, dont we?

It is bad to blame the HO after Pak Abu died... and blame Russian grads for that.

I choose to be a fair person, and critical one. No doubt the Russian grad HO has done a terrible mistake this time by not calling. But just frankly asking "where were the senior docs at that time?"

U can extend the HOship of this lady doc. But the same time, u must also from now on, make sure that u stay in all time, and order the nurses to inform u of EVERY case so that u will anticipate any danger!

I speak from experience, and this is what my well-respected boss did the last time whenever the HO or MO is incapable! He stays in!

Anonymous said...

POTS, I think you're very brave to write what most people (including me) do not dare to. I believe there are many who religiously follow your blog if only to read about something that they themselves think true but dare not voice out.

I would like to believe that the CSMU graduates are competent, however the CSMU graduates that are competent are rare indeed. (I know that most start out as good SPM scorers and end up being taught by *great* teachers)

for MUAR who posted about the HO who tagged for 2 months, I know of one that stayed on for even longer (close to 1 year- by is not a CMSU graduate) who, IMHO, in retrospect, I would trust better than some/most CMSU graduates.

for what it's worth. I think I know who Pak Abu might be. and I think that he's a strong person to have undergone such an ordeal, and perhaps what happened would be a better thing for him, and at that whoever did whatever might have done better for him than the great doctors that had the competence to keep him alive. (but how would you justify allowing a guy to die of UGIB due to overwarfarinization when the warfarin indication was for a prosthetic heart valve) then again, pak abu could be someone else...

Anonymous said...

Pots why dont you just stop fighting online cowardly n go teach ur stupid HO making sure that the pt doesnt die is ur job as well.what good does it make if the MO was busy blaming others while the stupid HO was at least trying to save. your sequel is getting disgusting.

Anonymous said...

All I can say from my experience was ALL CSMU HOs are useless. They don't even know what they don't know.

Anonymous said...

this is anonymous 2

- hmm.. by saying it was 'his time' it only comes into meaning after the person has died, to explain, death is already written for all of us, the exact time, date, place, even how. even the way somone 'cheated death' so u say is already written, whether he comes through it or not. i am a medical student, of course i would give my best to save another's life, but the final result is only God's call, for it is written. its a way of consoling another, ie- blabla 'died' of heart attack - 'it is ok, his time has come'. not that 'hey he's having a heart attack la, nvm babe its his time let him be.. r u really that silly? gosh..

- about the ho thingy, again, everybody makes mistakes, could u read right after u were born? fine la u graduated and had above par skills, when look around you. everyone has their weakness, everyone has their strength, let it be this small mishap grants a longing triumph in future. impossible? how u know? think ppl think. the idea is to never give up. again, only insecured low life ppl look down upon others. well the best part is, every human is equal, plus minus here and there same summation.

oh my name is kamal btw, from manipal.

Anonymous said...

Dear Kamal,

Dude, have you ever talked to a family with member that has died? Or do they teach you counseling in your school? "It's his time" shouldn't be coming out from your mouth. It should be from the family members who would have used that, knowing that you have tried your best. This is medicine. It's science. Although they say treat everything including spiritual, but it doesn't say explain yourself spiritually! Gosh, you sounded just like some 'bomoh' or something!

ccc said...

I've no comment on CSMU grads... after meeting their equivalents from Pakistan and Bangladesh and Indonesia... (hmm... why is the hospital suddenly filled with HOs from exotic schools?) one who would think potassium level of 10 is normal (can't he read the normal range given in bracket?), or a dead body is merely sleeping (You mean he just couldn't wake up from deep sleep? My dear HO, he isn't breathing at all!)

I'm working in the government hospital.. Those days, when we were HOs, we used to be the first line, the first person to see and manage patients until the specialist and MO come for wardround. But now, it has changed. We, as MOs see patients, stabilize them and plan all management from the casualty itself if they are to be admitted into general wards. My HOs will see only the stable patients (those unstable one would have been died or sent to intensive care units).

Spinosum, here, we certainly do not go back home on our oncall days. And we do not have next day off or whatsoever pm off. (I wonder why the MOH has suggested pm off for HOs but not MOs?). Anyway, I guess I'm more comfortable working this way, knowing that most if not all of the patients in general wards are the stable ones.

My only concern and worry is: What if this batch of incompetant HOs eventually become MOs? Should the specialist oncall start running to the casualty and the wards? What about having them in the district hospitals and health clinic?

What's next?

Product of the System said...

Chubby Penguin,

You find my blog disgusting, yet you religiously follow my Russian series up till the latest instalment.

You are either lying about my blog or simply have a fetish about disgusting things, on par with faecophilia and UMNO Youth.

Product of the System said...

Anonymous who lambasted Kamal,

Please show some respect for the reincarnated holy prophet of the God of Death.

And please do not insult Kamal's mouth for he did not use that part of his body to utter "it's his time".

He used his ass.

Anonymous said...

my good, this is getting very out of hand isn't? ok dear POTS your HO sucks. Why dont you try to help other medical students who are really interested in medicine.Try to help them sharpen up their clinical skills in accordcance to malaysian hospitals in your blog.I m sure they will appreciate it POTS.God bless u

Anonymous said...

My deepest condolences to pak Abu's family. May his soul rest in peace. I totally agree that the grads from CSMU and Russia are not fit to practice medicine. It is unfair for the MMC to require grads from China (who are really good) to sit for the local exams before starting housemanship and yet let these people just start straight away. They are really 'makan gaji buta" and totally dysfunctional.

I am now in a position to ensure that the incompetent doctors from russia/ukraine keep getting extended and eventually (hopefully) deregistered! it is nothing personal but patients come first and incompetent doctors should be allowed to practice.

in their defence, there was one house officer so far from Russia/ukraine who came to us with very little knowledge and minimal clinical skills but with the right attitude and passion and the willingness to learn and do good and by the end of his posting, was one of the best house officers i have had and i was sorry to see him leave to another posting. I do hope that more like this come along.
Pots- great job you're doing here. i just hope that the powers that be are reading your blog too...

Anonymous said...


Stop watching House, Scrubs or Grace Anatomy. Those doctor's life does not apply here.
Here in Malaysia. Everyone is busy. Medicine is about continuous learning and self learning. Ask if you don't know. Learn when you assist or see something.
I believe when POTS has resuscitated Pak Abu a few times, the HO might have seen what has been done properly, which might be just enough to save a person. Isn't that teaching?
I believe Russia Uni also needs you all to do elective. Why not choose one of the busiest hospital, eg. where POTS work, and you will know how is it like.

ys said...

i echoed ccc.
i have been telling other MOs that, by the rate these incompetent housemen are coming, and nobody taking any action (eg extend them till they are competent, deregister them etc), they soon will be dysfunctioning MOs who will be working with us...
perhaps when indicators like perinatal mortality, maternal mortality etc start to rise back worse than a third world country only people will realise it is too late.

and thats a huge price to pay.

please, immediate action is in need.

cllee said...

ccc who wrote: "My only concern and worry is: What if this batch of incompetant HOs eventually become MOs? What about having them in the district hospitals and health clinic?
What's next?"

this unfortunately is already happening....(not aiming at any grads in particular- all uni local or international grad has been implicated).....

to CSMU grads/any HOs who feel that they've been misunderstood: take all this verbal lashings in a positive note...prove us wrong, buck up, work hard and above all 'DO NO HARM'
there's nothing more depressing than being a senior who has to sweep the skeletons into the closet/ undo mistakes by mistakes. don't treat us as your countercheck mechanism - start growing up and take responsibility!

i'm sure all the 'seniors' in this field have
all at one point or another in this medical field been degraded and feel completedly demoralised from medical blunders . the difference between a good doctor and a lousy one is that a good one will realise a mistake, and improve; while a lousy one will not acknowledge a mistake, and move on repeating the same mistakes on other patients.
about being criticised repeatedly - it's not the end of the world, stop blaming POTS for bringing up the obvious and make a change, starting with oneself
.......GROW UP!

Anonymous said...

a hate post and a hate speech.

tbt said...

The mentality of 'ppl mess up at times, its only humane, we make mistakes' is a big no-no in medical field. Why shouldn't we blame ourselves if we make a mistake? If your loved one died because a doctor messed up unintentionally, what would you feel? I found that those who have no gut to admit their mistakes would never improve. They are all ignorant and lousy in their clinical practice. Please quit if you can't take the responsibility.

To anonymous who thinks POTS is a deranged gov dr, you are wrong. He/ she was very enthusiastic HO when we worked together. He/ she always taught UMS medical students and incompetent HOs with patience.
POTS, continue your great job!

moja said...

i wonder who the hell in the first place recognised Ukrainian and russian med degree!
it's not our fault tht we ended up in these lousy system.
blame the Gov bodies who didn't thoroughly surveyed the true conditions for learning in those uni before recognizing them.
you can't make a conclusion about an education system fortnightly. you must talk to the lecturers, see for yourself their english competency, go to class wit the students for at least a week for every subject, compare for yourself whether these students are clinically and practically exposed adequately etc.
i doubt these steps are carried out by the Gov bodies before giving out the green light.
doctors are supposed to help each other in all ways.
so instead of spending your time criticizing us, why not help us in every way you could?
leaving them to rot on their own wouldn't make things better.
i hv worked wit some local students too during my elective training and pardon me i must say tht there are some local students who are also very incompetent.
they are lucky coz there ain't any stigma on local grads yet but trust me if nothing is to be done wit the education system in malaysia, the future students wil b juz a bunch of spoon-fed-couldn't-think-out-of-the-box people.

Anonymous said...

Dear POTS,

A panel of MMC people came to visit recognized Russian medical universities in November 2008 and they told us they were quite impressed with the system here. I was quite confused, because I am not impressed at all. It doesnt matter what I think, but my point is derecognition of Russian medical universities is not going to be anytime soon.

With all due respect, there's nothing much you can do about the recognition status.

You can elaborate much on how incompetent they are. You can continue demonizing as you wish. But let's face it, they're going to be doctors and penetrate Malaysian healthcare system once they graduate.

In your earlier post, I disagree with the notion "they were made instant doctors". Before one can become a registered physician, one has to pass the 2-year housemanship. That's 2 years of very tight supervision. If one's performance is unsatisfactory during housemanship, the duration should be extended.

Thus it is your job to evaluate your HOs, whether they need extension on their housemanship or otherwise.

I do not know how it really works in your hospital, but if you can turn them incompetent to competent with your own harsh teaching style, then you're the better teacher than their teachers in alma mater.

Housemanship is crucial time for all housemen. Even the unteachable can be taught with some use of force and power.

ex HUSM HO said...

there are many local products that are incompetent too esp from USM, i did my housemanship there.a lot of my colleagues from USM(fresh HO)do not know many basic skills-how to draw blood, how to insert branula, and so O&G department,there were many times that when i offered med students to do epi repair,learn how to do vacuum/manouver, internal CTG etc. they refused to do it.i ask why, and they say bcoz they are only allowed to conduct normal SVD (i.e no medical prob,not multipara,primipara bla2).i said, u want to be a doctor or midwife?
and most of the time they just smirked.(haiyyaa,even midwives/SN at district hosp do all the things that i just mentioned above laa exc. caesar)
However,I think the best local produts are from UM,and i can testify for that, all my colleagues from UM are very smart and highly capable HO.other than UM-UKM/UIA/UNIMAS/UPM, only some of them are above average

sbmma said...

I'm a medical student in Russia and I think there is no prob with the universities. The only problem is the mindset of students..Yes..I'm saying u, moja! You should expect Russians speak russian before you came here isnt it?

Perhaps you should try to go classes with non-malaysians or try to fight the front row seats with russian students in their lecture. There are alot of malaysians like you. They blame the university and professors because they themselves cannot accept the fact that russians speak russian. If you are looking for a english speaking country then please go to australia, uk or us. Why russia?

Alot of malaysians rush to go home everyday and forget about seeing patients. Have you ever talked to your tutor here? Or sit in the class and wait for he/she to teach u everything? Do you read textbooks and reference books instead of seniors notes with russian translations? Alot of ppl said they speak russian but how fluent you can speak and how much you can understand?

Unfortunately we have too many graduates and graduates-to-ne who actually donno how is the hospital's system here. Where is our passion towards medicine? Even other foreigners are looking down at us. Wake up please russian-malaysian students! Dont rush to go home everyday after class. Try to speak more with patients. Do not blame! We can be as good as well!

DrK said...

All those who are reading,

Scenario nowadays has changed so much.

I was a HO 10 years ago:

1. Started taking blood before 7am.
2. Seen 5-10 patients before my MO came at 8am.
3. Do all the ward procedures, it was a "see one, do one and teach one" thing.
4. Worked through lunch and rushed to the medical clinic to see patients.
5. Stayed back after work, to do all the summaries and had dinner plus supper together.

HO nowadays:
1. At 7.50am, slowly shaking the big bum on the way to the hospital.
2. By 9am, still has not finished taking the blood.
3. Follow round as if like a medical student (no writing, no participation).
4. Barred from doing certain procedure, just because of iatrogenic injury to patients are too rampant.
5. Not even required to go to medical follow clinic.
6. By 5pm, bye-bye.

vagus said...

complicated subject with a lot of generalizations and no simple answer, i'm sure.
I do however agree with sbmma. i think a lot of it comes down to attitude. if one has the right attitude to learn then i think it's difficult to become that incompetent.
Even here in the USA, with plenty of teaching faculty and support systems, i have had some medical student whose attitudes suck more than a Hoover vacuum.
I had one recently who told me she didn't have time to study because 'it was Mardi Gras'!! Thankfullly most aren't like that.
But everywhere you go, you're gonna find rotten apples, as well as good ones.

Anonymous said...

first of all...dun get me wrong...i'm not from csmu this more like personal attack...seems like there were no deaths occuring b4 csmu grads arrived which i beleive isnt point is that there were flaws in the intake of students to csmu...the tuition fee,the strict supervision of the uni,but u cant blame the consumer entirely...i knew grads from india who stayed there 12 yrs jus to obtain a degree which takes 5 yrs...i guess the extra years were not sufficient enuf as he was only capable of prescribing panadol and so nicknamed dr.panadol and this was yrs back...the mentioned person even owns a clinic now...beat another case which occured during my 4th year practicals was a final year student from rcs ireland cudnt answer to how muscle contraction works...a jpa scholer to ad in.i wud like to be straight forward here....u seem like a highly intelectual person in accordance to ur IT savvy'ness' but u seem like a bully or jus plain picky...i'm sure ur the type that can 'please'ur superiors...let the poor gal alone and u shudnt blame the whole lot for the mistakes of a handful...

Anonymous said...

we cannot judge the HO just by which medical they have graduated from. I have few HO from russia whom done very well during their HOship, even though they dun have lots of knowledge but most of them are safe doctors.
The only thing to blame is the attitude of the HO. If they not willing to learn, no matter how good the uni they came from, they wont become a good doctor

Anonymous said...

i want to tell everyone here....
on 25th of april 2009,we are having sport games for whole msian students,VOlgames...
we now focus on the games.
we have no time for studying any subjects..
we,4th year,almost 3 mths,we couldn't study properly just to prepare well for ths opening ceremony...
i wont judge,u guys judge for ths...
we are still medical what?
pls...start comment again...POTS!!!!
frm VSMU.

Product of the System said...

Anonymous with the sports announcement,

do enjoy your years in university.

Study hard, play hard and pray hard.

i'm sad said...

haih. oh my God. what have i put myself into. i come from a poor family, stuck here in russia, not because my dad robbed a bank or what not, but i was presented with a JPA scholarship to study medicine oversea. well that's what the offer letter mentioned years back. was so happy. i mean, even to get to matriculation dady has to work so hard to buy me my ticket! aduiiiii.. felt like crying. omg2. i am never a pessimist, but now i feel like killing myself to spare the embarrasement. help me dear God. POTS, do give me advice wat to do. i am in deepshit. if russia(MMA to be specific) is so bad.. as bad as it gets, as shitty as it can be, do give me some hope to continue my studies. might as well flunk all my tests and majukan tanah kat kampong! omg!!!!! i'm so depressed. bloody shit! fuck shit! shit face! not to u POTS but to everyone else who made MMA looks bad!! the bad apples!! go fuck ur self!!!! please approve my comment! i am in great need of support here:'(

Anonymous said...

To the anonymous who says that im bragging abt my results,

Im referring to Dr LimTS post.Pls read his post before u leave a comment.

''The less academically inclined end up in India.
However those who fail to even enter India opt for Indonesia or worse bogus schools in Russia/Ukraine.
Many come from the Arts Stream and have no aptitude for sciences.''

Quoted from Dr LimTS

And im not bragging.Sickening.

Anonymous said...

Anonymous with the sports announcement,

Its all about time management.

I am sure that is part of your university training too.

Anonymous said...

WAKE UP LA!! Whoever you are.. Do you think Ukranie and Russia University is that lousy?? If we dserved to be dereconized.. the university in our country should CLOSE DOWN!

Who are you to call us incompetent?? WHO YOU THINK YOU ARE?? You should really watch you mouth and keep a sane mind before making some rubbish statements like you did.. Yes.. YOU!! POTS!!

Having said that, I agree with 3 words in all your post.. "God Bless You!" I hope He have mercy on your soul and mind.. It is clear you have it all queered up..

Let this be a wake up call to all of you that think, We, Ukranie & Russian Students and Grads, are incompetent. Look at yourself first.. Look at what the so call BEST university are prodcing before even trying to doubt our (Ukrane and Russian) standrads..!!

To those that are on the sam boat with me.. Let's prove them wrong! They are just JEALOUS! YES!! JEALOUS!! of the quality of education we get..

May God grant peace to Pak Abu.. God Bless all of us!

stopitalready said...

actions speak louder than words.
buck up, take the initiative to learn and be serious. there's no other way.
be brave enough to face the criticism and maybe one day, things would turn around for us.
learn NOT to kill patients now, in med school.
stop fooling around. have the gall to own up to your own weakness.
criticism is tough, but most of the time, constructive.
you don't get to be good in anything without a jab in the arse every now and then.

Aleckii said...

I don't believe in anonymous post, anybody can do that. People who have balls, leave their names and contacts behind, even if it is at the risk of being hackled. So I really will just skip through all the anonymous, gall-less posts and jump straight to the point.

I can understand your frustration. And I understand your critique. What I fail to understand is your necessity to spew out such a frivolous hate speeches on Russian and Ukrainian graduate. The last thing any struggling resident need, is a senior who not only hammers her constantly, but goes back, logs online and BLOGS about her shortcomings. Shoot, even Gandhi would crack under that sort of pressure.

Just don't insult our intelligence by grouping a whole group of students into one term- incompetent. Because speaking for myself- I know I am not one of them.

To all you haters- Screw you guys, dude. Your holier-than-thou attitudes will honestly get you nowhere. Why is there a need to trample on others to make yourselves feel better? All that amounts to is zilch. Na-da! Kapisch?

Anonymous said...

hi POTS! You know what, I'm another of your dreaded russian medic student (ooh!) but I just gotta say something...

thank you! your blog posts about the suckiness of russian medic graduates and students, they totally inspired and motivated me to study harder and be more proactive in my medical education. i'm not sure about other russian uni but the one that i'm studying at, we don't get a lot of clinical exposure because well, we're foreigners and basically, we're just a "money-tree" to the admin, shake us up and they get a few thousand dollars. ;) but i'm going to start being more responsible for my own education now, because I do not want to cause the death of Pak Ali or Auntie Gan. So err, thanks...

Product of the System said...

Anonymous just above this comment,

Perhaps that's the whole purpose of all these damning articles...

Study hard and do your best.

You'll go far, if not already. :)


Anonymous said...

To anonymous who wants to derecognize local Uni,

Nothing to brag about but if you were that good, you would have join us already. Why choose Russia then? If you were that rich and smart, why not choose India, UK or Australia?
But wait, maybe you aren't that smart or inspired to be a doc. So you choose an easy university where 'bits' culture and 'crocodile tears' apply. Maybe the entry exams for India, UK and Australia are too hard for you. :p In the end, why local uni have to be derecognised, which you didn't elaborate much about it...

Anonymous said...

Condolences to " Pak Abu's" family.

I agree with POTS saying that a local grad would SURELY call for help. Its what the med student's here were trained and taught to do.

Try to do, if cant or dont know at all, call senior or boss.

I dont know whether this was taught in RUssia or Ukraine so I cant say the same for Ruskie's or Ukrainians meds though.

Anonymous said...

Probably the main reason why medical graduates from certain universities has negative image is due to general assessment & observation by senior doctors.

If they see always the same doctors from the same University which is causing problems, then they start making bad assumption.

Personally, a newly graduated doctors should at least has adequate clinical knowledge to practice medicine & know common things first & not something rare.That is much more important than doing procedure during med school.

Example is knowing normal pulse rate. One HO on call considered a PR of 150 is 'normal' in a patient who had op.The patient in fact developed SVT throughout the night & luckily she survived.

Anonymous said...

Some of us end up in Russia / Ukraine not because we choose to. Some of us are just not as wealthy or smart or even a bumiputra to score a place in a local U, or even study in the UK or Australia. We choose Russia/Ukraine not because medicine is easier here, or not because we know that we can get thru medicine the easier way. Its really disappointing to know that, we russian graduates will be treated 2nd class, even before we start working. Senior doctors in Msia are already stereotyping us without giving us a chance. THANKS to POTS, u really inspire me to study harder to prove you wrong!!~

Mckloud said...

Anonymous Anonymous said...

To anonymous who wants to derecognize local Uni,

Nothing to brag about but if you were that good, you would have join us already. Why choose Russia then? If you were that rich and smart, why not choose India, UK or Australia?
But wait, maybe you aren't that smart or inspired to be a doc. So you choose an easy university where 'bits' culture and 'crocodile tears' apply. Maybe the entry exams for India, UK and Australia are too hard for you. :p In the end, why local uni have to be derecognised, which you didn't elaborate much about it...

Do u want me to remind you about the "QUOTA" system which our local universities are practicing? You can use both your eyes and read the news report about how many PERFECT scorers were neglected. I am sure most of the csmu/russian students do not lost to u in term of qualification to enter local universities.

Those students studying in russia/csmu are not all brainless and retards. TO study in Aus/US/UK, it does not only take brain,inspiration, but MONEY also matters. Maybe you are rich, but not all Malaysians can afford to send their children to study medicine in those 3 countries. So russia/csmu is an alternative to them.

And 1 more thing, please do not group all csmu/russian medical graduates as useless. I admit there are some individuals who slack at their studies but I am pretty sure some local & other foreign graduates aint that great either.

And stop being an arrogant local graduate and look down on csmu/russian graduates. If you are really that great, i am sure you are sharing your knowledge with them, instead of complaining.

MMA Medstudent said...

Dear POTS,

Undoubtedly, it all boils down to the individual. Some just lack the common sense that others have. One could come from a family of geniuses and still be literally stupid. Like what most have pointed out:

Good university/lecturer + unwiling student = ignorant professional(on a separate note, there as just as many ignorant lawyers, engineers, etc out there)

And for those who actually gave excuses for the HO, shame on you guys!! You guys are indirectly saying that fear of asking for help actually substantiates the death of a patient!

Why are Malaysians so averse to criticism? Is it so hard to just suck it up, admit to the mistakes and learn from them instead of blaming the situation, circumstance and others for these shortcomings?

In response to all who study in Russia and think that the Russian education is sub-par. I suggest you re-evaluate the situation and ask yourselves how much effort did you put in to warrant so many complaints. Most of you study only for the exams and not for the actual knowledge that's essential for future HO life. Most of you can't even speak or understand Russian in order to communicate with the patients. Look back and ask yourselves - Who's to blame?

We live in an imperfect world. If one constantly blames everything around him for his own imperfection, what can we make of the future?

Anonymous said...

Dear DrLimTS,

With all due respect, you forgot to consider about the quota system in your differentials. You MAY(let me repeat may) have the brains but when color matters....

min said...
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min said...
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Anonymous said...


Ronald Tan said...

I disagree with whoever that said the HO is new, hence mistakes are make etc...

Because we have to realise that it is precisely this kind of mistake that the patient did not make it. If the consequences of a mistake is minor, then perhaps we can close 1 eye about it and hope that we have learned from that experienced. However, if the mistake is going to cost a great deal to the patient, eg. patient's life, patient's leg etc, then claiming that we are inexperienced is clearly an unacceptable excuse, if you cannot handle the situation, you better bloody well ASK FOR HELP!!

In this case, irregardless whether this HO is from Russia, Malaysia or even Australia, calling for help is paramount. No CPR drill is ever a 1-man show, resuscitation is a team effort and the biggest mistake this HO has made is that this HO has failed to call for help when it is of the foremost importance.

You owe it to the patient to give your best. If your attitude is such that you do not bloody care, please move onto a different career. It pains me to read some of the replies in this post as it clearly reflects the above.


Ronald Tan

Old Guard from Penang said...

Lets me intro myself first, I'm 40 years old GP practising in Penang and I was with Penang GH from 1995 till 2000 mainly in intensive care unit.
I just go through some of the comments and i feel that those from CSMU feel insulted.I think we should target all those incompetent HO instead of focus on CSMU student only.

I think those department heads/consultant/Senior MO should not "pass" the incompetent HO (regardless of his/her university)to fully registered as MO. At lest when this incompetent HO remain as HO, he/she still under closed supervision and will not done as irreversible damage.

Thus, ALL CONSULTANT/HEAD of DEPARTMENT, please be sympathy with your patient/general public. You are not cruel if you "keep" incompete HO as many months/years as needed because at least you prevent general public from unneccessary harm.

Later, MOH can compile a data from the "Fallout" rate and may be , with a solid evident, certain measure can be taken to remedy current situation.

As such, for Product of The System, your outburst will be fruitful - will bring certain changes that benefit everyone -medical field and general public.

Anonymous said...

dah bosan dah...

Anonymous said...

hhurrrmmm..i x know what to say. i graduated from csmu. at first, i was terrified of working cause there are people who like to penalised others from crimes which we dont commit. people simply bashing the grads from csmu for a reason i dont understand...
i started out as a surgical intern. it taught me discipline and hard work and responsibilities. i admit, i lack of knowledge compared to my other colleagues. but, my colleagues, mo's and specialists are not the type to put people down. yeah, they screamed and shout..but they dont humiliate us. they teach us what we dont know.
soon, i proceeded to a medical intern. during the first few days, i was lost. but then, i look up to my mo's and specialists for guidance and they taught me a lot. now, im longer scared of being oncalls in the busies medical ward. just bring it on.
it's not the university that shaped us.. it's our own attitude and determination.
no point in criticising and scrutinising about others. lend a hand when someone in need.
oh yeah.. i arrive to work by 5.30am, have sandwiches for lunch and stayed till 7-8pm after work.

Ashnya said...

Dear POTS, Im a medical student studying in Russia, n i sincerely think it unfair of u to label ALL CSMU students as incompetent whn I'm sure that there are those who rnt. Second, to those of u who keep urging to derecognise Russian unis saying that those who come to Russia are merely students who have no qualifications (eg:Arts stream etc etc), I sincerely ask u to once again like POTS, DO NOT GENERALISE!! Maybe u know of some students who are studying in Russian unis who r 'unqualified' but do u also know of the other students studying here with excellent SPM results (straight A's n not offered scholarships), excellent A-levels scorers, and such??Most of us here, it is not because we don't have the qualifications, it is because we are not rich...just from average families, our parents have more than one child to support, n in some cases siblings are studying medicine. Just so you know, medical courses nowadays in UK/AUS/USA etc, cost at least 400000 nt including cost of living etc. Yes we have the QUALIFICATIONS to get into these (UK/AUS/USA ETC)but not necessarily the MONEY. Pls do not group everybody into one group n like DRLIMTS make a HYPOTHESIS with no supported facts. If Dr Limts is making his HYPOTHESIS based on FACTS or CASES which he knows of, thn clearly state that in your comment. I may have the sense to see the word THEORETICALLY HYPOTHESIZE but nt everybody might, n let me tell u that in that case everybody reading this blog would have again GENERALISED that ALL russian graduates are 'less academically inclined'. However I do agree that we should all (not only Russian graduates, but generally medical students) learn a GOOD LESSON from this post n study harder to prove these flamers wrong.

frustrated ukrainian said...

you totally forgot INDONESIAN students. they are bribing through their NOSE, they know NOTHING and they talk BIG. what the fuck are you so disgusted with us ukrainians and russians when you have the INDONESIANS medical students who are equally incompetent too?

Anonymous said...

hey frustrated ukrainian,why the fuck you have to get the indonesions into this too. wipe your own ass and there's no need to get your shit splatterd all aorund.
oh yeah, then after this you want to drag along all he pakistani, bangladeshi, egyptian and everyone is it? do you know that you are just adding more dirt to your kind?
indonesians graduates could be worse, but one thing for sure we dont give a shit at what people think bout us and just carry foward. coz in the end its the individual that makes the difference, not the university they went.
next time, please kindly talk using your brain, not your ass..

zyryx said...

1. i hate people being labelled into stereotypes
2. i personally know HOs who are LOCAL grads who are just as arrogant and didnt call for help - i was their senior..i could have tortured them but i kept helping them from making those mistakes..if they didnt inform, i did, but i made sure they knew
3. i was lucky i started work as soon as i got my degree from russia..i never got harassed from the "senior"s who came 2 months earlier and became mean to my friends who came later
4.pak Abu's story was's something all should learn from
5. after 3 postings, i still ask for help if i was fact, informing is what a HO is supposed to do even if he/she thinks they know what to do..
6. the 25 fellas who came with me all had either straight As or one 3B in a minor did the other hundred sent throughout Russia, and are senior Hos by now.this well known fact is a truth you can check with MARA or JPA, not some rumours some people think is real.
7.incompetency is not what they taught at Russia, ukraine, or anywhere...there were incompetent housemen even before there were graduates from russia,indonesia,india, or even local Us...every 1st batch from any university will have their own story to tell about just how open/close minded people are..

Anonymous said...

as far as russian degree is concerned it is recognised in EU union so fuck MCI who really wants work for peanuts??? 200usd??? if r ussian graduates work in russia they are paid more than 2000 usd ... and bout smartness u aint gettin netin for tat u just another cmon man !!! tink b4 u say netin POTS

Anonymous said...

I am a Russian grad.All I can say say is that I am competent.
I wanna do surgery but my MO always asks me questions that do not reflect practise like what class of antibiotic is this and this?Who cares?just give the god damn antibiotic-the patient needs it.
And then asking me about ABG interpretation.hey-just give some oxygen,why the fuss on ABG?
When I transfused a patient with 13.0 level of HB-my MO went mad-im like huh?the normal level is 15-so i topped him up.
in short-I think we can learn more if these MOs let us do more and stop asking irrelevant questions.
they wont even let me insert a central line-so how am i gonna learn???
instead of teaching me-they ask me about anatomy.
I am so sick of this -why must russian grads be treated so bad?

Alan said...

To the above 2 anonymous Russian grads. The fact that you guys hide behind the shroud of anonymity already shows the inferiority complex in you.

Nobody is out there to nail the Russian grads. It seems that way because you guys have put the medical profession to shame.

The language used by you guys in your comments merely reflect the uncivilized beast in you, just waiting to devour the next person who speaks the truth about Russian grads. How despicable! Call yourselves shameless can doctors like you be...

Obviously if you don't know what class an antibiotic is, how to intepret an ABG, your anatomy or what the big fuss is all about transfusing a patient with Hb=13, you simply don't deserve to practise medicine. You are worse than a Form 5 student. Medicine is not a profession that you can do whatever you like with the patients, thinking that if you can operate on a patient you are a great doctor. If you still don't see my point, you are just too stupid to be a doctor.

Mind you, anonymous...I will say it again (and I don't regret it), you are just too stupid to be a doctor. Just go flush your face in the toilet bowl. If you guys don't know simple things like your anatomy after going through 5 years in medical school, there's essentially nothing more you guys can learn even if you were given the opportunity to learn.

-peacemaker05- said...

what a shock seeing doctors and doctors-to-be fighting like this.have you ever heard of different country different system.just one of the truth for senior doctors for guidance to help us Russian graduated medical in Russia the medical system are way too different from Russia especially for Russian medium student,after graduating they can straightly apply to study specialist.which mean from my opinion they develop their skills from there.even for those who want to be a cardiologist and pediatrics they start to attach to the department from 1st is far more different from Malaysia which we need to do the HO first.during HO also need to attach to all department which what i can see that is for us to develop our skills into different cases.which this will require a lot different skills and things to study.Also in Russia the technology is not up-to-date as in Malaysia as Russian always stick to their tradition but it has no problem because in Russian they are very particular about the basics.even the process how laser is produced,how ECG is forming,and even Latin language we all need to study.About Latin language,Russian used Latin language widely in their medical world.even when giving prescription they are using Latin language which is not being used in are we going to adapt to Malaysian system which is totally just to let you all know the truth.Russian system are totally different from Malaysia.some are talking about how bad the system without knowing the exact problem.also some defending by talking about those who have succeed which are from Ukrain and Russia medical schools.even if you the one who study in both country cannot accept about what this POTS so called talking about.just something to say,Russian and Ukrainian medic have even survive war and develop from it.even most of the term,the things you study in medicine are from more thing to say,government sent us to study abroad to bring good things from place we are studying and if the system in Malaysia don't want to accept what we are going to present please don't make things worst.or else,Malaysian medical system will lost something that really thing that i can see,those who have study to more up to standard country don't even want to put their foot back into our precious land MALAYSIA.this is because they think they are not welcome.not just because of the money but because what we need to overcome during HO.we Russian students can proudly say that we are not afraid to be scold because Russian are far more rude than Malaysia.sorry for my bad English:D


-peacemaker05- said...

instead of complaining why don't we altogether share our problem,search for the source and give some ideas so that we can develop more.not just for us also for our beloved profession and later for our nation thing to say,European always see us as hooligan people.just because we have black eyes they said we are aggressive.they said that we are bad tempered and so on and so POTS say u like justice more than other.why don't instead of complaining we brings people to act the correct way.if we think that we are right,so nothing to afraid.:D

Anonymous said...

no one else is in the ward is it? except the csmu HO? where is everyone else? nurses? seniors nurses? MOs? how come the MO doesnt know that there is a pak abu who needs constant supervision..someone shud standby there wht because HO is pegawai perubatan siswazah u shithead..they r dumb...maybe this one is extra dumb..but i can say the MO is extra lazy n dissapeared expecting the HO to be a person to call n call..n he shakes legs while geting paid..dont show off laa..the MO got blood on his hands too..due to pak abu's death..the MO maybe got screwed by the specialist, so in anger he going around bitching about someone he can transfer the blame too..