Career Guidance with P.O.T.S

Aspiring doctor Joanne read my UMS posting and exclaimed:

Oh my god! I have just made my application to UMS! Can i know how long is the study duration fot medicine? How many years do i need to endure? XD

This is my humble reply.


Dear Joanne,

Thank you for reading and inspiring this post.

I apologise sincerely if I have inadvertently created a negative impression even before you are in University Malaysia Sabah (UMS).

The medical program in UMS is five years, just like all other local public universities.

The process of learning and training to be a medical doctor in UMS have gotten more difficult in the last one year due to the closure of the Queen Elizabeth Hospital.

I was told that medical students are now dispatched to Sandakan, Tawau and Kota Belud since some disciplines have shifted their services to the hospitals there.

Anyway, I think your best source of information should not be a socio-political blogger but someone who has gone through the UMS medical program.

Instead of enlightening you about the life of a medical student and doctor, I would instead advise you to think carefully before jumping into the medical bandwagon.

Be a doctor only if you are really interested in medicine and not because your parents are.

Asian families are still very stuck in the conventional thinking of going for professional careers if their children do well academically.

In all honesty, I think we need more smart and creative people outside the circle of medicine.

I might not have said this years ago when I just completed my STPM, but the truth is this – there’s a whole lot of interesting careers out there apart from medicine.

If you are artistic with an imaginative mind, you can always go into filmmaking and wildlife photography. You can produce photo essays for Time magazine or capture scenes of a honey bear enjoying a sunbath for the National Geographic Society. After all, we need to immortalize all these wonderful creatures of God in digital media before the China Chinese devour them all.

If you are into music, do consider a career in the genre of trance. You just might taste worldwide fame not unlike prominent deejays such as Chicane, Darude and Fatboy Slim. Stay out of jazz though. I find it super gay.

Medicine should very much be left to boring and bored souls like myself. Or maybe medicine turned me into a boring and bored person.

Shrug…

Oh yeah, don’t forget sports and athletics. I doubt Datuk Lee Chong Wei and Datuk Nicol David ever regretted choosing their career paths. Just don’t choose football and lawn bowling though. The first is reserved for mentally-challenged intravenous drug users while the second is just plain lame.

Just between you and me, I am constantly dreaming of the life that could have been if I were a professional skateboarder.

The food business is always lucrative and rewarding, even in times of economic crisis. I have already garnered enough capital to open up my very own aquaculture farm. I am still on the lookout for a potential UMNO crony since land is increasingly scarce and in high demand. Do consider the vegetarian food sector. You will be amazed how some people are willing to fork out ridiculous cash just to bite into a shrimp-looking tofu that tastes like, well, tofu.

Money is also abundant in share and currency trading. My cousins are driving fancy cars and feasting in vegetarian outlets way beyond my salary as a doctor, and they are not even vegetarians.

Of course, it’s not all about the money.

Sometimes it’s about the karma and divine retribution.

One can serve the church and God too. You would need a certain degree of vocal prowess and eloquence to thrive in the ministry. Success will come soon enough and it ain’t only in the form of heavenly treasures. Just don’t molest the altar boys and get caught doing so.

When all else fails, you can always go into Malaysian politics. If someone like Muhammad I-Speak-No-English Taib can amass millions without a useful academic qualification, so can you. There might be a window of opportunity in Bukit Lanjan soon. There, you can’t say I didn’t tell you so.

After this long winded reply, if you are still keen to do per rectal examinations for life as a medical doctor, I will still cheer you on and welcome you on board.

Rest assured if you are somehow not up to the mark in clinical practice, you can always join Dr. Rikki in the logistics of quality healthcare.

All the best.
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Four Braindrains And A Rotting Driftwood

Farewell, my dear friends. I know you will excel as immigrants once again...



SMS message from POTS:
So how are your Lion City plans? Any progress?

Reply from Dr. Bee:
On-going. Now waiting for contract n registration with Singapore Medical Council. Most likely will leave by end of June. Join us.

Come July, Malaysia will lose four very capable, talented and diligent doctors.

Dr. Aye, Dr. Bee, Dr. See and Dr. Dee are four medical officers who have served the people of Sabah to the best of their ability.

Despite proving their worth and passing the preliminary stages of their external exams, they have been denied an opportunity to pursue further training in the specialty of their interest.

“Be patient,” Dr. Aye and Dr. See were told.

With the sudden extension of housemanship to two years, there was seemingly nobody to replace them in the districts of Sabah till 2010 and even then, there is no assurance that they will be transferred to a proper training center.

“Be understanding,” Dr. Dee was told.

Despite fulfilling his years of service in Sabah, Dr. Dee was denied a transfer back to his hometown in Peninsular Malaysia. The state of Sabah is supposedly facing a healthcare crisis of immeasurable severity and all transfers back to Peninsular Malaysia are frozen indefinitely.

Strangely though, the local and national news agencies are virtually hushed on this matter of political interest. As the saying goes, their silence is deafening.

“We will not stop you from resigning,” Dr Bee was told.

The Malaysian Ministry of Health demonstrates its stupidity and ignorance with words such as these.

It goes to great length to preserve rotting driftwoods like Dr. Rikki but has no qualms practically pushing astute clinicians across the Tebrau straits.

Our bright and enlightened neighbours at the south cannot be faulted for jumping at the opportunity to welcome and receive these four Malaysian ‘rejects’.

The unwanted citizens of one racist nation become the priceless assets of a capitalist city.

They are not the first and certainly won’t be the last.

My four dear friends, I wish you all the utmost and the best in your future undertakings.

I know you will all excel in all that you pursue.

And yes, I do envy your freedom and liberation from idiocracy like the SKT and SLAB programs.
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House Officers: A Rose By Any Other Name....

We can call these medical graduates housemen, interns or by the acronym H.O. One lady surgeon even calls them slaves. The fact is, house officers are indispensable in Malaysian healthcare.

The day house officers in government hospitals go on strike is the day Malaysian healthcare collapses and comes to a total halt.

There is...a dire need for a system that places an emphasis on accountability and meritocracy. The lying house officer must be brought to book, the incompetent house officer sent back to his books, and the outstanding house officer written in the good books.


House Officers: The Backbone of Malaysian Health

Hypocalcemia in Pregnancy

It was 3am in the morning. A lady at 32-weeks of pregnancy came to the hospital complaining of numbness and very mild weakness over her right hand that was limited to a few fingers. The first house officer who attended to her, Dr. Gua, had no definite diagnosis in mind. She took the routine blood investigations anyhow which included a calcium level. Her calcium level came back as 1.9 which was low. Alarmed and concerned, Dr Gua referred the patient to her obstetric medical officer who was similarly troubled. She too had no inkling of the underlying cause and in turn referred the patient to a fellow medical officer from the department of internal medicine. The trainee physician arrived dutifully in a short while, attended to the patient, asked a few questions and ordered a truckload of blood investigations. The barrage of blood tests included a thyroid function test, liver function test, serum phosphate, serum magnesium, renal function test, serum and urine cortisol amongst others. She was worried over the unexplained severely low calcium level and decided to admit the patient for intravenous calcium gluconate.

Once in the ward, a second house officer reviewed the patient. Dr. Ahmad read through the notes and asked some basic questions. He too, was increasingly worried, but for different reasons.

Here’s why.

The initial blood was taken with a tourniquet that was applied for a pretty long time. Such a method of blood sampling may result in an artificially low calcium level due to physiological changes around the area where the tourniquet was applied. In other words, the pregnant mother did not have low calcium to begin with. Intravenous calcium gluconate is dangerous and could have killed her instantly.

The story does not end here though.

Dr. Ahmad repeated the blood sampling without a tourniquet. The result of the second calcium level was 2.2, which was acceptable in pregnancy due to physiological changes in the blood constituents. His medical officer however, did not think so and again referred to the medical team for further advice. It was decided that the plan to give intravenous calcium gluconate should go on. The mother was started on calcium tablets thereafter. Dr. Ahmad remained unconvinced and suspicious of his superiors’ management throughout. He complied nevertheless.

In retrospect, the pregnant mother presented with symptoms very typical of carpal tunnel syndrome. It was the right timing at 3am, the exact symptoms and in the ideal patient. There was no need for any blood investigations or any possibilities of an impending stroke whatsoever.

House officers and the Quality of Malaysian Healthcare

The public healthcare of Malaysia will rise and fall with the services of the house officers. I do not know about the rest of the world but this is fact for Malaysia.

The first personnel to attend to a newly admitted patient in the ward is usually the house officer. The ill patient who suddenly takes a turn for the worse is usually referred to the house officer on-call. Blood investigations, applications for radiological procedures, referral letters and discharges, and basic clinical procedures are all carried out by the house officers.

Without house officers, much work will not be carried out or would have to fall upon the shoulders of the medical officers.

We can call these medical graduates housemen, interns or by the acronym H.O. One lady surgeon even calls them slaves. The fact is, house officers are indispensable in Malaysian healthcare.

The day house officers in government hospitals go on strike is the day Malaysian healthcare collapses and comes to a total halt.

The Malaysian Medical Association (MMA), when they are not boozing away in the MMA house, has been fighting for the rights and welfare of house officers for decades now. I say aye to more rights and welfare and renumeration for house officers, yet I also know pretty well that we have a very variable and colorful population of house officers in the civil service. Not all of them deserve their basic salary of RM 2137.70 much less their much acclaimed right to greater benefits, higher allowances, more oncall claims and automatic promotion to a U44 grade officer.

I only have the experience to compare Malaysian graduates from local universities to Malaysians who graduated from foreign institutions.

Truth be told, despite all that they say about the low standards of our medical schools, the majority of our local medical graduates fit in fairly well into the local healthcare system. Fitting in is not synonymous with competency and excellence but most of our local graduates nonetheless are able to function in a system they are familiar with.

Granted a chance to work with foreign graduates in a foreign land, I just might be singing a very different tune. However, I am not even for a moment under the delusion that other nations naturally produce more ethical and more knowledgeable medical graduates.

I do know however that in most developed nations, there is a prevailing sense of responsibility and a emphasis on a culture of accountability.

That is something that is sorely lacking in our healthcare services.

The ‘Don’t Know’ House Officer

All doctors do not know something to certain extent. In fact, all doctors will not know anything about something if you prod them hard enough. Personally, I studied pharmacology rigorously like a mad man in medical school and naturally, I take pride in knowing something about drugs and toxins. If someone asked me something about the histological variants of ovarian tumors however, I will reply with nothing less than a stupid blank stare and declare with no shame that gynaecology is not my forte.

There are many house officers who however, seem to know nothing about all things. It’s really anyone’s guess whether this has always been the trend even in the good old days of Tanah Melayu or whether such a dunno tak tau culture is the result of half a century of race-based intake into local medical schools. The NEP policies have given rise to a complacent lifestyle among both Malay and non-Malays students. Why study hard when one has been having things served on a silver platter one’s whole life? Why study hard when one can pass an exam because the marking standards have been lowered to cater to the ‘special children’ with special rights?

House officers from foreign universities are not naturally better though.

The most reasonable and objective statement is to evaluate each house officer as an individual and not from the university one graduates from. We have a great number of lousy, undeserving students entering local universities both public and private institutions and they are not restricted to any particular race. We also have an abundance of mentally-challenged personalities graduating from India, Ukraine, Ireland, Indonesia and China. No doctor should be identified or stigmatized by the university one graduated from. The final competency of any medical student is really all about the person’s own initiative.

Unlike graduates from computer science and social arts and food technology, medical graduates upon completion of their studies are never ready to get up and work. A ‘don’t know anything’ house officer is terrible, but not beyond help. A conducive training environment made up of willing teachers, understanding superiors, supportive nurses and adequate facilities will make a world of a difference.

The ‘Don’t Know, Don’t Care’ House Officer

A forty-something man was admitted for hemorrhagic stroke. After a few days in the ward, he developed pneumonia and required mechanical ventilation. The house officer on-call whom I’ll just name Dr. Chong was entrusted with the task of sampling the patient’s arterial blood gases. He did so, but did not know how to interpret the results. Even so, he did not seek help. At 8 a.m six hours later, the patient died. Postmortem, the notes were reviewed and the results of the blood gases taken before the patient’s death were nothing less than shocking. It showed severe combined respiratory and metabolic acidosis.

Dr Chong is the kind of house officer I categorize as the ‘don’t know, don’t care’ type. These are characters that never fail to baffle me. I wonder what these clowns are doing in the profession of medicine in the first place.

They don’t know, not because they have cerebral palsy or severe mental retardation.

They don’t care, not because it’s not their business, but because they are callous, indifferent or simply uninterested. They appear to hold firm to the belief that ignorance is bliss. No matter what is happening, what instructions were given and how these house officers are reprimanded, their response is always along the policies of ‘don’t know, don’t care’.

“Doctor, patient is in pain…” – Don’t know, don’t care.

“Doctor, patient’s potassium is only 2.6…” – Don’t know, don’t care.

“Doctor, how is my surgery going to be like tomorrow?” – Don’t know, don’t care.

“Doctor, I am having a cough and a fever…” – Don’t know, don’t care.

These house officers are beyond help. As the person battling at the frontline, they do not seem to realize that the things they do and do not do at a certain time can make a big difference to a patient’s outcome. Perhaps they are not truly beyond salvation. Perhaps when one of their own family members die or fall ill, they might turn over a new leave and change for the better.

The ‘Don’t Know, Don’t Care, Bullshit Non-stop’ House Officer

These are the most dangerous and perhaps the most difficult to see through. Some people are born to talk, and then there are those that are born to bullshit. They are not necessarily smart. In fact, those who knew them well and long enough might even suspect them of having mild dyslexia. They are not caring, far from it in fact.

They are however very capable of putting up a face as though they are sweet, empathic and all that’s noble in a doctor’s holy heart.

They slither out of troubles and crises, and I use the word ‘slither’ because these doctors are serpents. Deceitful and cunning, eloquent and loud, these doctors will do anything to save themselves from trouble.

Outright lies, dubious documentation and clinical sandiwara are their practice of the day.

I’m reminded of someone I’ll call Dr. Marvin each time I come across such deceitful doctors.

Dr. Marvin was a graduate from a local private university in Melaka. He’d disappear for hours to have his cigarette session. When confronted about his disappearance from the ward, he would feigned that wide-eyed innocent look, stare you back in the eye like Shrek’s Puss in Boots and exclaimed regretfully that he came across some frail old osteoporotic lady on his way back from the busy clinic who required his assistance climbing the stairs to the second floor. When he failed to turn up for work or oncalls, he would swear on his mother’s grave that his father had a heart attack at home at 6 am in the morning. His father must be a very blessed person, because the senior Marlin has had twelve supposed heart attacks in the preceding two weeks and is still mysteriously alive with no symptoms of heart failure.

Unsurprisingly, these are the house officers most liked and favored by their superiors.

Unlike the don’t know, don’t care house officer, the ‘don’t know, don’t care, bullshit non-stop’ house officer are truly beyond redemption.

The ‘Know Something, Can’t Do Anything’ House Officer

House officers have for far too long been erroneously labeled as being a homogenous group. They might be the lowest in the hierarchy of the administration but they are never all equal and same. Similarly, just because one is a medical officer, specialist or consultant does not mean that the person possesses greater knowledge and more astute clinical acumen.

A young lady at 18 weeks of pregnancy was admitted to the High Dependency Unit for “UTI sepsis”. She was experiencing high fever with shortness of breath. Urine tests showed an ongoing urinary tract infection (UTI). She was treated with antibiotics and hydrated vigorously. Upon completion of the antibiotics, she was swollen all over the body. Her feet were both so puffed up that she couldn’t even wear her own sandals. Fluids were accumulating in her lungs, her abdominal cavity and even around her genitalia.

The consultant obstetrician came and ordered for a full workout to exclude tuberculosis and HIV.

The specialist in turn thought the source of the infection was from her genitalia. The so-called specialist refused to listen to the house officer’s objection and ordered an emergency surgery to incise and drain the ‘labia majora abscess’.

The medical officer complied.

The patient complied too and went under the knife.

There was no abscess.

In the midst of all this stupidity and narrow-mindedness was a house officer name Dr. Mel. Unknown to and unlike the consultant and his team of esteemed specialists and honorable residents, Dr. Mel had sat down and taken a full medical history and performed a complete and thorough physical examination. Dr. Mel had done something none of the obstetricians did. He listened to the young mother’s heart and detected a murmur. Dr. Mel put it all together and opined that the patient’s fever was because of infective endocarditis that had set upon a heart that was defective to begin with. The ongoing generalised edema was the result of heart failure.

He was sure that the obstetricians were wrong. He was sure that the patient had no supposed ‘labia majora abscess’. He was sure that sending the patient for surgery was a dumb and lousy idea. His hands were tight though. In a feudalistic system however, who will listen to a lowly house officer?

His conscience got the better of him in the end. Dr. Mel secretly arranged an echocardiogram for the patient. It showed a mitral valve prolapse with calcified valve leaflets. He restricted the patient’s fluid intake to 500 cc per day. Within a week, the patient was fit to go home. The last I heard, both mother and child were safe.

Summary

No doctors can fully rid themselves of the humbling title of house officer.

At best, every doctor is an ex-house officer whether one is now a consultant, a specialist or a private practitioner. Not all competent house officer ends up as a specialist and similarly, not all specialist was once a competent house office.

The specialist of one discipline may very well be as competent and knowledgeable as a house officer in another discipline. The obstetrician will fumble around when faced with an orthopaedic patient.

Thus, there is no need for arrogance and unnecessary show-off.

There is however, a dire need for a system that places an emphasis on accountability and meritocracy. The lying house officer must be brought to book, the incompetent house officer sent back to his books, and the outstanding house officer written in the good books.

This article was about house officers – their quality and qualities, their ethics regardless of ethnicity.

The contents of this article can easily be extrapolated to medical officers and specialists and consultants in fact.

After all, the consultants of today were the house officers of yesteryears.

For example, the ‘don’t know, don’t care, bullshit non-stop’ HO of 1980 is a neurosurgeon today.

Sigh…..











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Dr. Rikki

Not a word came from him. Not a movement did he make. The fringes of his blood-stained white coat fluttered in a mini-frenzy as the squeaking, jaded ceiling fans blew his way. Against the sun, his tiny frame casted a long and forceful shadow.


Dr. Rikki

Marked furrows were forming between his tired-looking eyes, his expression slowly transforming into a frown. The teeny hazel eyes strained against the scorching afternoon sun, consigning eventually into a vague squint. In the cramped and crowded medical ward, a neck and white coat was not exactly the ideal outfit. Sweat trickled slowly down his temples, coalescing finally into a pool that drenched his short-sleeved turquoise shirt. His black neck tie was oversized in proportion to his tiny frame, hanging a few inches after his rusted belt buckle.

I stood an arm’s length away, keeping mum, observing this senior doctor in deep, concerted attention. There was no smile upon his pimple-scarred face. He had sparse graying hair that was otherwise trimmed neatly to an inch’s length. This great man must be at least forty years old but it was also possible that years of striving and struggling to be the knowledgeable man he is today have aged him beyond his time.

Scrawny and thin, his hands stayed put in the side pockets of his black pants hanging a distance above his ankle, revealing a pair of holed black socks wretched from years of repetitive wear, wash and tear. There was no definite expression upon this overworked and underpaid Dusun doctor. His bent and hunched posture bore evidence to the years he must have spent silently and lonesomely burning the midnight oil in the noble hope of serving his community one day.

This was a day like any other. A young lady laid in her bed, breathless and exhausted from whatever was rocking her frail, ailing physical body. At the end of her bed stood the pensive doctor, deep in thought and away in a restricted zone of his own.

Not a word came from him. Not a movement did he make. The fringes of his blood-stained white coat fluttered in a mini-frenzy as the squeaking, jaded ceiling fans blew his way. Against the sun, his tiny frame casted a long and forceful shadow.

It is true then, what we medical students were taught in medical school. So much information could be gathered from a mere general inspection of a patient lying before us without the need of touching, pricking or prodding a distressed soul. I wondered what was going through his mind. If only I could get a sneak peak at the long list of probable diagnoses he was conceiving all by himself.

A few other doctors gathered nearby, around the patient, beside her but not at the bed’s end. They were young and well-built, both cheerful and nerdy, talkative and restless. How unbecoming of these junior doctors to be distracted and uninterested even as their consultant physician remained focused and unrelenting over the pitiable young lady.

The consultant brushed aside an irritating sweat droplet that had made its way into his left eye.

It was then that I saw his name: Dr. Rikki, a name that I will remember forevermore. The sound of cymbals and drum roll played ceremoniously in the back of my mind. Behold Dr. Rikki – the first consultant physician of this house officer’s budding career.

It was then that Dr. Sam broke the mellowed ambience. He was one of the three younger doctors surrounding the patient.

“So what do you think Dr. Rikki? Do you think the sodium level in this patient is normal?”

?????

Now, wait a minute. Did that medical officer just posed a daring challenge to his consultant specialist, in a very rude manner nonetheless?

Dr. Rikki remained silent, his authority and wisdom under siege from a subordinate unaware of his rightful position.

“Dr. Rikki, if you don’t know the normal sodium levels, you can refer to the reference figures attached with the blood results,” Dr. Sam persisted, handling Dr. Rikki the patient’s charts.

I almost fell back to the ground in shock. Like a fool, I’ve been looking up to the wrong figure among the crowd. I have mistaken a fellow house officer for a consultant specialist.

The drumroll in my mind ceased abruptly, the cymbals came to a crashing halt.

Dr. Rikki (not his true name) remained interesting and enigmatic though, but mostly for very different reasons. As I worked with him or rather worked him out, I discovered a wealth of incredulous enlightenment, if I were right to deem it as such.

Dr. Rikki was indeed forty something years old. An indigenous local Sabahan, he was sent on MARA scholarship to Indonesia to study medicine, in spite of the fact that he never did apply for medicine or was ever interested in medicine in the first place. He went anyhow, and stayed a duration exceeding twenty years. He failed his first medical school, attempted to return but was pushed by MARA to complete his medical degree in another Indonesian medical school. It was then that he fell in love and married an Indonesian Chinese. The couple would go on to have four children – in Indonesia. As the responsibilities of fatherhood mounted, the then MARA scholar Rikki took an extended break from medical school to raise his brood. A man’s gotta do what a man’s gotta do, even if it was at the expense of Malaysian taxpayers’ money. He remained under MARA scholarship until the day he finally graduated with a medical degree from Indonesia – fifteen years later. He did not immediately return to Sabah though. The newly bestowed Dr. Rikki stayed behind in Indonesia for another few years. Only God Almighty will know what he was doing there.

Over the next few months of working with Dr. Rikki, it was obvious that he was pursuing all things but medicine all those years in Indonesia.

He made ridiculous clinical errors that will go down in hospital records as urban legends.

He discharged a patient with intravenous medications. The bent old lady came back to me with two boxes of bottles and drips but no tablets or pills.

He sent a patient with active tuberculosis home with all the goodies of vitamins, iron and double calcium supplements, but no anti-TB medication.

He started a drip regime for a patient in sepsis: three pints of normal saline and two pints of ceftazidime. What was he thinking, a life-long prevention of melliodosis infection?

A stroke patient was started on tube feeding. Most doctors will start slow say, at 500mls/day. Dr. Rikki started slow too, at 2mls/day.

His English was incredible, in a very absurd manner. Like advance kindergarten teachers, we taught him how to spell A-O-R-T-A and A-S-T-H-M-A, dictating each alphabet to him. Our blood pressure was rising faster the price of oil per barrel in USD.

When a lactating mother assured us she was breastfeeding well, Dr. Rikki scribbled in the notes: Mother says breast is well.

We all need amusement in our daily work, but not when it’s dangerously funny. I thank Dr. Rikki for all that and more.

I do not have any idea where Dr. Rikki is now. It would be interesting to know though. He’s definitely not in the hospital anymore. Rumors are that he left to pursue farming in Papar. Others say he was sent back to medical school (again!).

I may sound judgmental and holier-than-thou in writing the truth about him. Seriously, I don’t blame him for being slow, I blame him for wasting my father’s taxes and for being unwilling to improve and learn on the job despite the repeated chances.

What’s my point in writing this article?

Amongst others, some of which are stating the obvious:

• First impressions are deceiving. I felt like a fool after that first meeting in the ward.

• The BN government has wasted enough of our money handling out scholarships by ethnicity.

• Sabahans won’t necessarily treat Sabahans better. So stop this crap about work permits for Peninsular Malaysians when Filipinos are entering the state in sampan-loads every day.

• Tertiary education is not in the best interest of every person. Some are better off owning a farm in Papar, to sell papayas and become rich.

• Our Ministry of Health is full of hot air each time it speaks about quality control. Dr. Rikki worked for 18 months before the Ministry decided to take remedial action. If he saw just three patients per day, he would have endangered the lives of 3X30X18 = 1620 patients. Any one of them could have been your father and my grandmother.

• Possessing a medical degree is not reflective of anyone’s grey matter. It is true that empty vessels make the most noise, but not always. It is also true that diam-diam ubi berisi, but not always too.

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SLAI or SLY?

A popular Malaysian blogger, Ong Kian Ming (soon to be Dr. Ong Kian Ming) who writes regularly for Malaysiakini and educationmalaysia.blogspot.com enquired about the SLAB/SLAI programs. This was my reply to him, which i will share with you all.

SLAB/SLAI: A World Of A Difference


Dear Kian Ming,

Sorry for the late reply.

The link that you attached was not accessible.

Nevertheless, the SLAI program is something recent. UM did not have such a program, at least not when I left UM in 2005. In theory, the SLAI and SLAB programs are both equal and identical.

In practice however, there are marked differences between the two.

A reasonable analogy will be like how the Ministry of Higher Education claims to practise meritocracy in theory but puts in place a very devious mechanism to ensure the continued dominance of the bumiputra Malays.

By its name, it may appear that SLAB is a program that caters to all bumiputras – both Muslims and non-Muslims, Malay and non-Malay bumiputras. A close friend of mine, a Kadazan bumiputra once met up with a senior professor of Universiti Malaya to enquire about her eligibility for the SLAB program and how she can go about applying for the scheme. The senior professor of Public Health, who was also the then Deputy Dean of the Medical Faculty gave a very nebulous answer but essentially told this friend of mine that non-Muslim bumiputras are basically not eligible for the trainee lecturers’ program. I was there personally so my eye-witness account is essentially all I can offer you as solid evidence that the SLAB program itself is a mere smokescreen to ensure Malay supremacy among the academic ranks.

The SLAI program is really something else. It stands for Skim Latihan Akademic IPTA (Institut Pengajian Tinggi Awam). There are no ethnic criteria attached to it but in view that the bumiputras already have SLAB to cater to them, you are very correct to assume that SLAI is therefore in existence to cater for the non-bumiputras.

If at all the SLAI and SLAB programs can ever be comparable to each other, I can only say that both does not emphasize on meritocracy. The few non-bumiputras I know who are currently in the SLAI program were not among the top students in their classes. Apart from that, the terms and conditions after one successfully completes one’s studies under the SLAB/SLAI programs are similar.

This is perhaps where their similarity ends. On closer scrutiny , one can see great discriminative practices between the two programs.

I am only covering the medical fraternity as I do not want to make any misleading statements that may not be true for other fields of knowledge.

For starters, the SLAI program for non-bumiputras or rather non-Malays, are open to all specialties in theory but greatly constrictive in practice. Competitive disciplines and specialties in high demand are very much closed to non-Malays. These include opthalmology, otorhinolaryngology, orthopaedics, general surgery, anaesthesiology, radiology, obstetrics and gynaecology. Non-Malays keen to pursue SLAI training will have to contend with non-clinical fields like the basic sciences (physiology, biochemistry, anatomy), public health, or less competitive clinical disciplines like internal medicine. This is in stark contrast to the overwhelming presence of bumiputra Malays in the SLAB programs for the aforementioned hugely popular surgical disciplines.

The number of successful SLAI candidates pale in comparison to the number of SLAB trainees. If you are interested, you can view the individual departments’ academic staff and compare the number of SLAB to SLAI lecturers currently in the Faculty of Medicine, University of Malaya. This is the link. Assuming the website is updated (it is not!), there are only three non-bumis currently pursuing an academic program under SLAI. The ratio of SLAI:SLAB candidates is therefore easily 1:10. As such, I can’t see how anyone can portray the SLAI program as equal and equivalent to SLAB.

The process of applying for SLAI is also more rigid and stringent. Conversely, there have been many instances where the bumiputra doctors who never even applied for a SLAB placement were simply given an offer to pursue SLAB. More often than not in fact, the bumiputra Malays are given the luxury to take their pick from a few disciplines. One Malay colleague of mine wsa invited to choose between internal medicine, orthopaedics and obstetrics and gynaecology! Such privileges are of course not accorded to the SLAI candidates, who must decide on what they want to pursue when applying for the training program.

As with most other government schemes in Malaysia, the process of entering these academic programs is littered with political elements. Once again, I’m using Universiti Malaya as an example. There is an uncanny overwhelming presence of royalties among the SLAB lecturers and trainee lecturers. We can see this clearly in the departments of orthopaedics, otorhinolaryngology and ophthalmology. The number of academics with preceding Tengku-s is really a cause for suspicion. In addition, there is a great element of family business as well. The daughter and son-in-law of UM’s ex-vice chancellor, Professor Annuar Zaini are both in the SLAB programs of paediatrics and general surgery respectively. As far as the academic records are concerned, they were both merely average students while they were pursuing their basic degrees in UM. A father and daughter team is also currently in the Department of Social and Preventive Medicine. There is nothing improper about any father-daughter team except for the fact that the Professor himself was also the person who processed his daughter's application papers. It is not unlike the corrupt practices of late Zakaria Mat Deros. Sons and daughters of Datuks and other UMNO cronies are also abundant in the SLAB program. The SLAB program is thus one that is lacking in transparency.

I am not sure if there is any solid method to substantiate these allegations except through my personal daily observations and ground knowledge.

A great number of SLAB graduates are currently holding influential positions within the faculty. Generally, their privileges extend beyond the completion of the SLAB program. Some have been promoted to head of departments and professorships, bypassing more experienced and competent lecturers. Most of these SLAB graduates went on to pursue further training overseas on a university scholarship, at the expense of other non-bumi lecturers that joined the academic ranks by merit. This is also the major factor behind the resignation of many non-Malay academics from the university. It remains to be seen whether the privileges of further training and education will be accorded to the SLAI candidates.

My personal opinion about the SLAI program is that it is in reality a sly move by the Higher Education Ministry to appear meritocratic while resuming their racist means of managing Malaysian tertiary education.

I hope I have shed some light on your enquiries about the SLAB/SLAI programs.

Regards.

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The Reward For Dilligence

Very upset. Worked so hard as houseman only got 76 for my 2007 SKT. Wanna leave this stupid country.

That was the SMS I received from my colleague Dr. Bee, medical officer of Kinbatangan on my back from Kota Marudu today.

I was driving at 80km/hr along the treacherous Kota Marudu-Kota Belud ‘highway’ then, but could not help but feel angry over the news.

Dr. Bee like myself, graduated from UM and assumed housemanship in the state of Sabah by choice.

Doctors come to Sabah for many different reasons. The kiasu ones are here under the impression that a working stint in Sabah will earn them extra points in their pursuit of the local Masters specialty training. Some are here because they were told that the training and working experience here in Sabah are much better and wider compared to Peninsular Malaysia. I can’t comment on that, because I have never truly worked with the Ministry of Health in Peninsular Malaysia. My short attachments in the Klang, Banting and Tanjung Karang hospitals are not sufficient for me to make a proper comparison. Of course, there are always the jerk doctors who come to Sabah preying on the gullible local ladies. You can read my other posting for real-life stories.

Dr. Bee however, came to Sabah with nothing to gain and everything to lose – her spouse, her family, her friends, the comfort of home. I believe she came to serve the community of Sabah and verily I say, she has lived up to her personal pledges.

In the eighteen months of my working experience with Dr. Bee, I only have words of praise for her. She was among the top graduates in my class but unlike many other brainy doctors, Dr. Bee was competent and well-balanced in knowledge, work and character. She came to work early, examined patients thoroughly and demonstrated sincerity in her dealings with patients. She was so dilligent and motivated that other doctors took her for granted and pushed her around.

If I were to find any fault in her, it would be her uncanny fetish for all things afro. That's none of my business, though.

There have been a many emergencies and events whereby she was one of the few reliable hands around. There is no doubt in my mind that without her assistance and support during those times, a large number of patients would have had a very different and worse outcome.

She had had her share of frustrations and downcast while serving as a house officer. Sadly, this is the exactly the case with Malaysian healthcare. Lazy, moronic and irresponsible doctors get off scot-free while diligent, responsible and knowledgeable doctors like Dr. Bee get trashed. It’s a sickening system, to say the least. The hardworking doctors end up with more baggage and liability while doctors who go AWOL remain AWOL with no accountability.

Having studied real hard and basically smart to begin with, there were times where Dr. Bee just couldn’t reconcile with the occasional doubtful conclusions of some of the clinical specialists. In a feudalistic system like Malaysia’s, differing opinions are not tolerated well, much like the culture so rabid among our politicians.

Being pint-size and soft spoken, Dr. Bee was an easy target for the wicked bosses among us. It was really distressing to see her on the receiving end of verbal harassments from those racist, sexist, shit-full orthopaedic surgeons and NEP products.

While she was as frustrated with the system as I have been and still am, she remained ever enthusiastic and firmly focused on the big picture that is patient’s well-being and best interests.

We have gone separate ways and function independently as full-fledge medical officers now.

I have no doubt however, that Dr. Bee continues to maintain a self-imposed standard of excellence in her daily work in the interior of Sabah.

It was therefore remarkably upsetting that a doctor like her received a mere 76 marks for her annual work assessment called the Sasaran Kerja Tahunan (SKT).

Is this the reward for diligence in the civil service?

What the big deal about SKT, one might ask?

Sigh…

For non-bumiputera doctors like Dr. Bee and myself, the SKT points are very much a determining factor in our application for the local Masters program. The SKT points MUST NOT BE BELOW 88 FOR THREE CONSECUTIVE YEARS before we are eligible to APPLY for a specialty program.

Contrast the above criteria with the criteria set in place for Malay doctors who are accepted into the Skim Latihan Akademik Bumiputera (SLAB) program. Essentially, there are no specific criteria in place for the SLAB program. In fact, one may not even need to apply to join the SLAB program. I have had Malay colleagues who were simply offered to choose from a variety of SLAB specialty programs.

With an SKT of 76 points, the chances of Dr. Bee being eligible to apply for specialty training is practically nil.

Anyway, do we really seriously think that NEP products groomed in a racist system will be fair and considerate in their assessment of non-NEP products like Dr. Bee? Will they be able to empathize with the struggling non-Malay doctors striving for career advancement while juggling their daily work? Will they give a leg up and lend a helping hand the same way they were given crutches and wheelchairs to roll about?

To my dear friend Dr. Bee, take heart and don’t be discouraged. Study hard and kick their NEP asses. Above all, stay the same – a wonderful and dedicated clinician.

Now I wonder what my SKT is for 2007…..


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Higher Education in Malaysia: A Vicious Cycle

Do you know that Minister Nazri Aziz recently shouted the word “Racist!” 41 times in parliament?”

I received blank stares from the six Chinese-educated medical students.

“Do you who is Nazri Aziz?”

Blank stares again.

“Do you know what a ‘racist’ is?”

More blank stares.

“Go and ask your friends what a racist is,” I said.

“Sorry super senior, how to spell racist?” the Chinese guy closest to me asked.

“R-A-C-I-S-T – Racist.” I replied, in rather irritated and bewildered tone.

They went off in hurry and started asking the others what a racist is. A few metres away, I overheard their intellectual brainstorming session.

“Hey, what is racist ah?” one of them asked in fluent Mandarin.

His friend replied confidently, “STUPID, ‘RACIST’ also you don’t know ah? Like Michael Schumacher lah.. He drives the F1 car and race, he’s a RACIST la…..”


As funny as it was and still is, my short conversation with the few students was a rough but rather accurate representation of the current state of higher education in Malaysia.


Higher Education: A Vicious Cycle

By June or July, the local public universities will be welcoming their new intake of students. The routine hoo-ha will follow, with each ethnic group claiming that their community is under-represented in the institutions of higher learning.

I remember a conversation I had a few years ago with the first year medical students in University Malaya. As a final year senior, it was customary for us seniors to become acquainted with the freshmen. My conversation with a few freshmen somehow veered into the area of general knowledge and recent events.

“Do you know that Minister Nazri Aziz recently shouted the word “Racist!” 41 times in parliament?”

I received blank stares from the six Chinese-educated medical students.

“Do you who is Nazri Aziz?”

Blank stares again.

“Do you know what is a ‘racist’?”

More blank stares.

“Go and ask your friends what a ‘racist’ is,” I said.

“Sorry super senior, how to spell racist?” the Chinese guy closest to me asked.

“R-A-C-I-S-T – Racist.” I replied, in rather irritated and bewildered tone.

They went off in hurry and started asking the others what a racist is. A few metres away, I overheard their intellectual brainstorming session.

“Hey, what is racist ah?” one of them asked in fluent Mandarin.

His friend replied confidently, “STUPID, ‘RACIST also you don’t know ah? Like Michael Schumacher lah.. He drives the F1 car and race, he’s a RACIST la…..”

As funny as it was and still is, my short conversation with the few students was a rough but rather accurate representation of the current state of higher education in Malaysia.

It must be borne in mind that the few students I was talking to were supposed to be the cream of the crop in Malaysia – the top-scoring students among the sea of top-scorers. It was not acceptable that they were not aware of significant happenings in the country as Nazri Aziz is a pretty important character to know, for without him, it was highly unlikely the DAP could have fared so well in the recent elections. These students either read nothing except school books or they simply were not bothered about anything other than themselves. It was equally unpardonable that they did not know the term racist or even how to spell it. They were the generation that had to go through the so-called Malaysian University English Test (MUET) prior to entering university. It was appaling that these future doctors did not recognize an insult when they hear one. Imagine one being called a racist and receiving a dumb smile in reply.

Above all else, it was abysmal that the equally ignorant medical student proudly called the other stupid. It was the epitome of the popular Malays phrase ‘bodoh sombong’.

If I were to summarise all that is wrong with our local universities in one phrase, I will say that higher education in Malaysia is currently in a state of vicious and self-perpetuating cycle.

When the intake of students is flawed to begin with, it is really a tall order trying to sigificantly improve the outcome of the final products. Worse, when the students come from mediocre primary, secondary and pre-university education, there is little we can do to improve the quality of students entering universities even with a transparent and objective intake system. The employment of academic staff is as flawed as the intake of undergraduate students. This is best characterized by the SLAB program. Further along, shady and dubious promotion criteria have pushed many talented teachers from pursuing a long-term career in higher education.

Essentially, we have ended up in a situation where mediocre teachers produce mediocre graduates who later on become mediocre teachers producing more mediocre graduates.

A constellation of factors have resulted in this vicious cycle.

Years of quota-based student intake in the past have denied thousands of competent students from pursuing their courses of choice here in Malaysia, forcing them to seek opportunities elsewhere. Simultaneously, the doors of our ivory towers were ushering in too many students who were never built to survive proper university education. This resulted in the ‘need’ to compromise the very basic standards of evaluating and passing an undergraduate candidate.

The situation has now improved with the current practice of intake by ‘meritocracy’. Much the opposite, in fact. In the past, UMNO had no choice but to follow a quota of 6:3:1 for Bumiputera, Chinese and Indian students, with all the non-bumis presumably being from STPM background. With the abolishment of such restrictions, UMNO had a free reign in the intake of Malay students. As a result, in many faculties Malay students can form as high as 80-90% of the student population. While the absolute number of non-bumis has increased tremendously, their percentage has decline in respect to the increased total intake.

In the last few years too, local universities have witnessed a different breed of Chinese and Indian students. These are the non-bumis who took matriculation for pre-university education, thanks to MCA’s intense lobbying for a 10% non-bumi representation in matriculation. As a result, faculties of local varsities have seen a peculiar trend emerging over the last few years – an increasing number of non-bumis failing their exams badly to the extent some are retained for their semesters. In my opinion, these non-bumi students would have fared differently if they had taken the STPM and would definitely have not attained the same excellent results as in matriculation. If I were a mere racist, I would thank MCA and MIC for bringing in more non-Malays. I will instead curse the MCA and MIC however, for they have now created a new pool of under-qualified undergraduates.

As always, the ubiquitous NEP plays its role too. Racial elements in the selection and promotion of academics staff have discouraged many talented and enthusiastic lecturers from pursuing a long term career in higher education. The Faculty of Medicine, University of Malaya has seen the resignation of so many senior clinicians in the last few decades, many of whom I can personally testify were great teachers and wonderful educators dispirited in a biased system. How many people can take it silently when one’s own ex-student end up being the head of department?

Restriction of academic thoughts by a communistic UMNO administration, as characterized by the cases of Terrence Gomez, Azly Rahman and Prof. P. Ramasamy has resulted in a pool of homogenous academics. They seem to sing the same tune, speak the same language and share the same thoughts on events and happenings around the country.

Under-qualified UMNO-appointed faculty deans and university vice chancellors completes the circle, ensuring a perpetual rot and putrefaction of Malaysian higher education. The current vice chancellor of UM typifies this.

Having said all that is so condemning of our local institutions, it is also undeniable that we are still producing many qualified and world-class graduates. These are the exception rather than the rule, and many of them were simply talented to begin with. The residual and shrinking pool of great academics in universities must also not be forgotten. These few teachers are creating an impact far greater than all the mediocre ones combined.

So yes, our varsities are still in a sad, sad state.

Is there a remedy for the rot in Malaysian higher education?

Yes, there is.

A total change of government with complete removal of all BN elements in local varsities.

Nothing less will suffice.














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Slapped, Pushed and Kicked Around.

I don’t feel an attraction or any strong pull towards Singapore or Australia or the USA. I owe my medical career to the rakyat of Malaysia who subsidized my university education. I repeat - I owe my current career to the citizens of Malaysia, not to the BN government. Out of honor, I serve the needy community in return. I do not see a life in another country any more comfortable or satisfying. There is no pull factor, no red carpet, no open arms, no welcome banner, no golden handshake, no personal invitation from any foreign land.

Yet, there is always this push factor from the country I was born in. It’s unspoken, unwritten, unannounced, unpublished. It’s felt and tangible so it must be real and existent.




The Push Factor

A friend of mine will be resigning from the Ministry of Health soon. No, she is not headed for the lucrative private sector. She is headed for university again, having been accepted into the Skim Latihan Akademik Bumiputera (SLAB).

Born of Pakistani father and Sabahan Chinese mother, she is somehow registered as a bumiputra. She entered medical school two years younger than us non-bumis. I don’t remember her as an outstanding medical student. In fact, if I don’t remember wrongly, she was almost retained in the first years for failing three consecutive semesters.

One week ago, she was still a humble house officer – taking blood in the wards, receiving orders from medical officers and specialists and running around frantically tracing investigation reports. She was not particularly outstanding as a house officer as well – not exceptionally knowledgeable or skilful, not noticeably more astute clinically than other doctors.

Next week, she will be a trainee lecturer-specialist in Universiti Malaya. In UM-land, she will join the hundreds of other SLAB beneficiaries and NEP products training to be a surgeon. She will be cradled like a precious stool sample, with extra care and guidance to ensure a smooth sailing over the next four years. Along the process of being spoon-fed, she would be lecturing medical students on how to study medicine and become community-oriented doctors. All tuition fees will be fully sponsored by the Ministry of Higher Education.

Four years from now, at the tender age of 30, she will be recognized as a full-fledged surgeon in Bolehland. She will be barking orders at the medical officers who once ordered her around - non-Malays like myself who are only eligible to begin applying for specialty after 4 years in Ministry of Health service, roughly around the age of 31.

I don’t feel an attraction or any strong pull towards Singapore or Australia or the USA. I owe my medical career to the rakyat of Malaysia who subsidized my university education. I repeat - I owe my current career to the citizens of Malaysia, not to the BN government. Out of honor, I serve the needy community in return. I do not see a life in another country any more comfortable or satisfying. There is no pull factor, no red carpet, no open arms, no welcome banner, no golden handshake, no personal invitation from any foreign land.

Yet, there is always this push factor from the country I was born in. It’s unspoken, unwritten, unannounced, unpublished. It’s felt and tangible so it must be real and existent.

The SLAB programs and its other NEP siblings all serve to inhibit and retard the achievements of non-bumiputeras across a wide range of disciplines and fields. With its strict and increasingly strict requirements on non-bumi doctors to pursue specialty training in Malaysia, it is the ultimate push factor that purges away people like me.

The push factor forces me to rethink the noble choice of serving a community that supported my education versus the obligation of prudent stewardship by looking towards seemingly greener pastures.

It pushes me to study hard so that in future, if and when I come across these NEP/SLAB products, I can confidently kick their ignorant spoon-fed asses.

When one is so slapped in the face by arrogant SLAB products, one is pushed and driven to gain new and marketable skills, to be globally useful and locally humble.

When one is pushed around and kicked about often enough, one learns to seek a place away from the abusive forces.


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My Take On Chinese Schools

National schools will always be in the core of my character. I’ve grown up with and among all races and fully understand that while some racial stereotypes are unfortunately true, most are erroneous. It was through a sekolah kebangsaan that I got to know so many machas. It was through an SMK that I saw Malaysia for what it really was rather than a Chinaman’s enclave.



A Banana's Thoughts on Vernacular Education.

I am what most Chinese-educated people will call a Banana – yellow on the outside, white on the inside. I studied in a missionary school all my life and never learnt a word of Mandarin until I went to University Malaya. My father did not encourage nor discourage me from learning Mandarin. My grandfather did pressure me to take up Chinese from a young age but being a pompous know-it-all and getting by so comfortably in the local dialect, I brushed off his suggestions and have regretted it ever since.

I stepped into UM knowing not a word of Mandarin. I couldn’t communicate with the Chinese who spoke Hokkien, Hakka, Foochow and yes, Mandarin. I was like a foreigner in the midst of a Chinaman community. In a Malay-extremist land like UM, solidarity in something, anything was of utmost importance. Gradually, I picked up Mandarin and over the years, slowly learnt more from whoever I could learn from. I am still unable to debate with anyone in Mandarin and probably never will be able to, but I get by fairly well and for now that’ll suffice.

I never regretted studying in a missionary school though. It did after all, make me who I am today. I can sit through a whole episode of South Park and fully appreciate its sarcasm and wicked humor. I doubt I’d be able to do that if I were educated in Chung Ling.

Bananas may not think in Chinese, express themselves in Chinese or even listen to Chinese songs, but that doesn’t make them any less Chinese. Like I’ve said before, Ling Liong Sik speaks Chinese, speaks like a Chinese and looks like a Chinese, but everything he’s done during his tenure was never in the interest of the Chinese community. He sold off the Chinese race to UMNO while declaring himself more Chinese than the DAP. That’s beside the point, however.

National schools will always be in the core of my character. I’ve grown up with and among all races and fully understand that while some racial stereotypes are unfortunately true, most are erroneous. It was through a sekolah kebangsaan that I got to know so many machas. It was through an SMK that I saw Malaysia for what it really was rather than a Chinaman’s enclave.

That is why I was initially indifferent over DAP’s gung ho debates and demands for more Chinese schools. I could totally identify with a close friend’s condemnation of the Chinese schools, deeming it racist and not fostering national unity.

Look at the state of our national schools, however. With increasing Islamization, even the missionary schools are fast losing their golden identities. My own school is a shame, and don’t you La Sallians think that your schools are any better. It’s only a matter of time before UMNO and NEP come for you, and by then you have no Catholic brothers to stand up for you.

The top scorers in STPM are always from the national-type school. Even among the national schools, the top students were those with a background of vernacular education. There must be a certain distinct environment in Chinese schools that breeds such talent and diligence, a competitive atmosphere that is rarely felt in national schools these days.

Language is one’s identity and identity should never be lost. Language makes one more confident, more prepared to meet anyone anywhere. As a product of a national school, I will never find a place anywhere in China, and China is the country to do business with these days. Not knowing proper Mandarin is costly, not just to Chinese people but to any races in Malaysia and beyond. Language unites, and not every Chinaman speaks Hokkien and swears in Cantonese but would very well understand basic Mandarin.

Most students from Chinese schools may not speak English or Bahasa Malaysia as well as their national school colleagues. This was blatantly true when I entered first year of medical school. Our banana gang used to laugh and giggle when the Chinese school kid said ‘cigalette, led blood cell, and electile dysfunction’. As a university student, some of them could hardly speak a sentence of English without obvious grammatical error. As they progressed in university however, they make marvelous progress in their vocabulary and proficiency in English, though mostly limited to technical terms and expressions. They’d still be unable to appreciate the beauty in Chicken Soup for the Soul or express their thoughts about Barrack Obama though.

It was admirable nonetheless, and that’s exactly what’s truly respectable about these guys. They recognize their weaknesses and are keen to improve themselves while my dear friend is still so reluctant to take up Mandarin for communication’s sake.

If I appear to be over-patronising to the Chinese schools, I am not apologetic. I am sincere in my praises for the Chinese schools and I also have my reservations.

I will always support the DAP in its fight for Chinese education, though I may not do so with the same intentions or with equal gung ho spirit. I only believe that each of us has a right to choose the form of education that is most appropriate to our supposed needs and preferred identity.

Diversity is strength, not a weakness. Not all Chinese should be reading Naruto, and not all of them should be watching South Park.


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A Cheeky Poem in 2004.....a Bitter Reality today.

“I Am A UM Student”

Haven’t read much of journals in recent,
Please pardon me – I am a UM student,
I don’t care much about disease aetiology,
All I worry is the Epidemiology,


I’d get stumped if you asked about M.I,
Better you ask me about Klang’s A.P.I,
Ain’t it scary I’m unclear ‘bout risk factors?
Yet without effort can control the Vectors?

I don’t know the symptoms, I can’t recall the signs,
But teach me Pollution, and about House Designs,
I know not management cos’ I know not my drugs,
But boy can I brief you in the treatment of Sludge,

What’s cinnarazine, and what’s loratidine?
I can’t really explain – some new Pit Latrine?
No, I haven’t heard of Prozac and Zocor,
It’s the Food Quality that we need to control,

Test me on ECGs, but I can hardly reply,
But show me the Water, and I’ll trace the Supply,
So the heck with CTs and X-Rays also,
The in-thing now is that of Waste Disposal

In less than 2 years, I would be a H.O,
I’ll impress my consultant with all that I know....

Epilogue:

The above poem was written back as a medical student as a silent objection to what i perceived as misplaced priorities in our medical syllabus. At a time when we were first exposed to clinical medicine, the Faculty was impressing upon us that Public Health was much more important. This was reflected in the undue weightage accorded to Public Health in our professional exams. There was little emphasis on practical medicine - clinical pharmacology, for example. As a result, I am now seeing house officers and fellow medical officers administering potent medications they have no inkling about.

Oh how the great have fallen. From a world-quality university in 1970s, Universiti Malaya is now but a pale shadow of her former self. Undone by the racist NEP and very much by its own vanity, Universiti Malaya is irreparable - at least not under a BN government.
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