Since 23 August 2021, I have been working as a House Officer at Kluang hospital. So, why did I choose to do housemanship at Kluang hospital?
The UK General Medical Council (GMC) recognises 8 hospitals in Malaysia, which are University of Malaya Medical Centre (UMMC), Kluang hospital, Penang hospital, Hospital Sultan Ismail (HSI), Hospital Sultanah Aminah (HSA), Queen Elizabeth hospital, Kuching hospital and Sibu hospital. NUMed graduates who complete their housemanship at one of those hospitals will be able to gain Full Registration with the GMC. For a long time, I viewed GMC Full Registration as something nice to have, but I didn't think it's very important for me.
When I first started my MBBS course in 2014, Kulim hospital was my top choice for housemanship. While I was born in Subang Jaya, I grew up in Kulim and stayed there for 17 years. Kulim is a nice place and I had the feeling of attachment to it. I also heard that the work environment at Kulim hospital is rather relaxed. However, the issue was that none of my friends at NUMed were interested in doing their housemanship at Kulim hospital, which meant that I would be alone if I go there. Kulim hospital also doesn't have GMC recognition.
After I entered Stage 3 of MBBS, I became interested in doing housemanship at Batu Pahat hospital and Kluang hospital. When I was posted to Batu Pahat hospital and Kluang hospital, I could observe that the House Officers there seemed quite relaxed. Batu Pahat and Kluang are nice towns just like Kulim, although Kluang is a bit underdeveloped. I initially had the misconception that Batu Pahat hospital is recognised by GMC, but I later realised it's actually Kluang hospital that has GMC recognition. A few of my friends at NUMed were interested to do their housemanship in Batu Pahat or Kluang, which is a plus point over Kulim.
During Stage 4 of MBBS, I did my Student Selected Component in UK. From my observation, Foundation training in UK is well structured and Foundation doctors have a good work-life balance as there are safeguards against excessive workload, unlike housemanship in Malaysia. At that time, the UK Foundation Programme (UKFP) was open for NUMed graduates for the first time and I was interested in it. However, joining UKFP isn't an option for me for personal reasons.
During my initial year of Stage 5, I thought of doing my housemanship at Seremban hospital. One of my friend at that time was planning to go there and I wanted to be with her. I also briefly considered Queen Elizabeth hospital. It's a popular choice among the 2014-2019 batch for some reason, so I thought that I would have more friends with me by going there. However, a crisis with my group mates later put an end to my desires to go to Seremban hospital or Queen Elizabeth hospital.
During my repeat year of Stage 5, I became interested in Penang hospital as some of my friends in the 2015-2020 batch were considering it. I had previously heard that Penang hospital has a very stressful work environment, but one of my seniors working there told me that it isn't too bad. Later, my friend EL chose to do his housemanship at Penang hospital.
After having stayed in Johor Bahru for many years, I certainly like the place a lot and I have become quite attached to it. I wished I could have done my housemanship in Johor Bahru. However, HSA and HSI are the only hospitals available for housemanship in Johor Bahru. The work environment at HSA and HSI is very stressful, which I knew would be unbearable for me.
After completing my MBBS course, I started working as a Teaching Fellow at NUMed in October 2020. In November 2020, I heard from a senior lecturer about UMMC. According to him, the housemanship programme at UMMC is similar to UKFP, being well structured which ensures good work-life balance for House Officers. The uniqueness is due to UMMC being under the Ministry of Higher Education. I quickly became interested in UMMC. However, it's difficult to get a place at UMMC due to it being a very popular choice for housemanship.
In March 2021, the hospital selection for housemanship through e-Housemen was open for NUMed 2020 graduates. I chose to defer the start of my housemanship for 6 months as I wanted to complete my Teaching Fellow post first. A few of my friends decided to do their housemanship at Penang hospital. My love towards the 2015-2020 batch made me want to go to Penang hospital as well. EL advised me against that, giving the reason that the work environment at Penang hospital is very stressful. However, I had also been hearing that housemanship is going to be stressful regardless of the hospital, so I thought I might as well go to Penang hospital and be with my friends.
However in early May 2021, I made the firm decision to pursue Medical Education. For that, I have to complete housemanship and gain Full Registration with the Malaysian Medical Council (MMC). With a long-term goal in mind, I felt that it's important to maximise my chances of completing housemanship successfully. Therefore, I decided that I must not go to hospitals with stressful work environment such as Penang hospital, instead I would choose UMMC or Kulim hospital.
In early June 2021, I met up with a senior lecturer for career advice. I was hoping that he might know an alternative pathway to pursuing Medical Education that wouldn't require completing housemanship. However, instead of getting good news from him, he told me some very bad news:
- The MMC has decided such that starting from 2023, only doctors who are on the National Specialist Register (NSR) can practise as Medical Specialists or Medical Lecturers.
- Having the full MRCP(UK) or equivalent qualifications isn't sufficient for a doctor to be on the NSR. The doctor will still have to complete gazettement process which would take years.
- Only permanent MOs will be able to complete the gazettement process. Contract MOs don't get the opportunity.
- Only about 10% of House Officers will eventually be offered permanent MO posts. The remaining will only get contract MO posts.
By implication, this means I would have no more than 10% chance of achieving my dream! The news definitely came as a bombshell to me and I was devastated. Worse still, that was right after I rejected my UKFP 2021 offer.
After giving some thoughts about it, I decided that I must do housemanship at a hospital that is recognised by GMC. This is so that in the very likely event where I don't get a permanent MO post, I will be able to do my specialty training in UK. I will eventually return to Malaysia as a specialist where I will get to enter the NSR. GMC Full Registration is no longer just something nice to have, but an absolute necessity for me, without which I will have a bleak future ahead.
Among the 8 hospitals recognised by GMC, I felt that I won't be able to survive housemanship at HSI, HSA, Penang hospital, Queen Elizabeth hospital, Kuching hospital and Sibu hospital due to their very stressful work environment. Therefore, UMMC and Kluang hospital are the only viable options for me.
However, Kluang hospital had been designated a Covid-19 hospital since March 2020, so it probably hadn't been taking in new House Officers. Meanwhile, the Covid-19 situation in Klang Valley was getting very bad at that time, so it was quite likely that UMMC wouldn't be recruiting new House Officers either. I was clueless on what my next steps should be and I felt quite depressed.
Then one day, my friend and Teaching Fellow colleague LG told me that he intended to do his housemanship at Kluang hospital. He clarified that Kluang hospital was actually still taking in new House Officers despite it being a Covid-19 hospital. I gave Kluang hospital a serious consideration and concluded that there would be many advantages doing my housemanship there:
- Kluang hospital is recognised by the UK GMC.
- The work environment at Kluang hospital is relatively relaxing.
- Kluang hospital looks quite nice and I am rather familiar with it, having been posted there previously.
- I will have LG and possibly other friends from NUMed as company.
- Kluang has a lot of nice people.
- The living cost in Kluang is quite low.
- Unlike Klang Valley, Kluang doesn't have major water supply issues and the Covid-19 situation in Kluang isn't too bad.
- Kluang isn't too far away from Johor Bahru so I can return to Johor Bahru regularly.
- As Kluang hospital is a teaching hospital for NUMed and IMU, I will have the opportunity to deliver some teaching, enabling me to gain further teaching experience.
The drawback of doing housemanship at Kluang hospital is that Kluang is quite far away from my hometown. Being a bit underdeveloped, it may also be a bit difficult for me to adapt to living in Kluang, after living in Johor Bahru for 7 years. I felt that the pros of choosing Kluang hospital greatly outweigh the cons.
In mid July 2021, e-Housemen hospital selection was open for LG and he chose Kluang hospital as planned. According to him, there were no vacancies at any of the Klang Valley hospitals including UMMC due to the Covid-19 situation. I expected that it would be the same for the next e-Housemen as well, so Kluang hospital would be the one and only option for me.
The e-Housemen hospital selection was supposed to be open for me in late September 2021. However, it unexpectedly got brought forward to 5 August 2021. As I had already deferred once, there was no option to defer once more if I fail to get a place at Kluang hospital, making me really nervous. I nearly got a panic attack when I saw that there were only 5 vacancies at Kluang hospital. Thankfully though, I successfully chose Kluang hospital.
After that, I found out from one of my friend that there were actually more than 140 vacancies at UMMC, which was totally unexpected. I hadn't bothered to check if UMMC had vacancies available as I didn't expect there to be any. Despite that, I didn't regret choosing Kluang hospital, as it still has certain advantages over UMMC.
Now, I can say that I made the right decision to choose Kluang hospital. While I had to face quite a lot of challenges with housemanship especially in the beginning, the situation has become much better as I gain more clinical experience and skills over time.
In October 2023, MMC decided to abolish the requirement that only doctors who are on the NSR can practise as Medical Lecturers. This means I will be able to pursue Medical Education without having to complete specialty training or gazettement. In spite of that, it's still advantageous for me to have GMC Full Registration, as it gives me a backup plan if things don't go as planned.
https://daniellimjj.blogspot.com/2024/02/my-house-officer-training-at-kluang.html
