Housemanship

Local graduates get posted soon after graduation. Overseas graduates have to wait about 8 months (September 2015 - May 2016 ) before they are called for an interview and then wait another month (29 May 2016) before they get a letter telling them where they have to undergo housemanship.

BTN for east coast graduates

The letter also specifies where they must do a BTN course (eg for east coast graduates, they have to report at BTN Besut). The BTN course is 5 days (Monday, 2 pm - Friday, 1 pm). Brothers are best to send and pick up for the BTN course as Monday is a work day and Friday is for Solat Jumaat. Can stop at any masjid along the way. Planning is necessary. Besut is 2 hours drive from P. Chepa airport. Going to BTN Besut is easy, but graduates may need to hitch a ride with friends from BTN Besut to the airport in P. Chepa.

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Housemanship Guide 2016-2018

Housemanship is done immediately after graduation and lasts 2 years. It involves attachment to a few select hospitals which have vacancies for house officers (HO). Not all hospitals have the necessary expertise and facilities for housemanship training. Learning during this time is by tagging - follow other doctors and the team. The working hours are long, tiring and heart-wrenching.

A houseman has to try and meet set targets (eg handle 10 deliveries in 2 weeks at O&G).
A warning letter comes if targets are not met ... can either remedy or get kicked out for good.

This is roughly what daily life is like as a houseman:

Night before: charge handphone and powerbank.

5:00 am: Get up. Wash and have breakfast (instant oats) and drink something (eg Milo).
6:00 am: Pray solat Subuh. Bathe, iron clothes and get dressed. Pakai tudung and kasut.
6:30 am: Drive/chauffeured to hospital (fathers are best drivers at this early hour).
7: 00 am: Clock-in at O&G section (or whichever you are assigned to during prior orientation).

8: 00 am: Start work by tagging other doctors and the team.
2:00 pm : Solat Zohor. Light lunch.
5:00 pm: End of day job. Clock-out. Solat Asar.

5:00 pm: Start of on-call job. Clock-in.
8:00 pm: Solat Maghrib.
11: 00 pm: End of on-call job. Clock-out. Go home before midnight.

11:00 pm: Pick up at O&G department (fathers are best to pick up their daughters at this hour).
11:30 pm: Reach home, bathe and have dinner/supper. Solat Isya'. Write short notes in logbook.
12:00 am: Sleep. Totally knocked-out.

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“Housemanship provides an opportunity for new graduates to be further trained, supervised and guided so that they can become safe and competent doctors. On top of the four monthly rotations in six major clinical dis­ciplines – general medicine, paediatrics, general surgery, orthopaedics, obstetrics and gynaecology – one obligatory posting in emergency medicine, anaesthesiology, psychiatry or primary care is also a must under the two-year housemanship training,” explains Dr Noor Hisham.

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Are there problems with Housemanship?
Yes and No.

Some doctors think good of Housemanship, some think otherwise.
Many doctors give up on their Housemanship and move to other areas of work.
Many persevere and make it successfully through their Housemanship.
Many leave medical practice by doing a postgraduate degree (eg Master of Medicine, MMed) and enter teaching at the university.
Many still engage in surgery and run clinics at university hospitals.

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What is Housemanship?
The Housemanship is necessary after completing the undergraduate medical degree (MBBS/MD).

There is an interview to evaluate the students 8 months after graduation.
The graduate is asked where she/he wants to do Housemanship.
A letter is issued from the Ministry of Health, MoH (Kementerian Kesihatan Malaysia, KKM).

The Housemanship is for 2 years at an appointed hospital.
Can't switch hospitals unless for valid reasons - anak premature masuk NICU etc.
Can't take leave unless for valid reasons - anak sakit dan kena jaga di NICU/ICU, ibu sakit dan meninggal, urusan nak kahwin etc (2 weeks leave allowed at most).

Can only do Housemanship at appointed hospitals as not all hospitals have the necessary depts, expertise, and capacity to take in Houseman to train them for 2 years.

There are 6 postings at 6 depts, for 4 months each posting, plus 1 month extension if necessary.

There is viva/written exam at the end of each posting.
If pass can continue to next posting.
If fail, must repeat another 1 month of the failed posting, and then proceed if pass.

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An example of Housemanship at HRPZ II in Kota Bharu, Kelantan:

1. Posting O&G, 6 June 2016 - 28 Sept 2016 (4 months)

2. Posting Surgery, 29 Sept 2016 - 28 Feb 2017 (4 + 1 months)

3. Posting Medicine, 1 March 2017 - June 2017

4. Posting July-Oct 2017

5. Posting Nov 2017 - Feb 2018

6. Posting March - June 2018

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Some issues:

The major issues before/during Housemanship for female doctors are:

1. Bila boleh kahwin? Preferably after successfully completing Housemanship.

2. Bila boleh beranak? Preferably after successfully completing Housemanship.

3. Bila boleh independent? After first pay, first month of Housemanship.

4. Bila mampu berdikari? After first pay, first month of Housemanship.

Since the Housemanship is a very trying period, the houseman can start live alone at nearby rented places or Houseman quarters at the appointed hospital.

For most unmarried women, the Housemanship is very trying and leaves no time and energy for a good life. It drains the person, and worse still is she has her menses. If in this poor unmanageable state, it is not advisable to live apart or alone, but to continue to live with one's family while highly dependent. Only decide to get married when things have stabilized and life is manageable. Otherwise family problems will crop in and the marriage will tend to fail.

Some ladies have managed to get married soon after arrival from overseas after their MBBS/MD or during their undergraduate days. However, they still have to depend o others to look after their babies or children - usually their aged mothers or childcare centres. Most mothers prefer to cook, send and care for their married daughters who are undergoing Housemanship. They also do babysitting.

Most unmarried ladies dread and cannot cope with Housemanship. Their personal problems, attitudes, mood swings and menses add to their difficulties. They cannot adjust to Housemanship life. They make life difficult for themselves and others around them. They threaten to give up and scare their parents and siblings.

A few unmarried ladies are wonderful and can manage well and have no fuss about Housemanship - they can even drive daily to work and back, and back to their homes in the villages far away during weekends or off days.

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What is possible after Housemanship?

Graduate doctors can pursue further studies or specialise after successful completion of their compulsory 2-year Housemanship.

They can go for either a Master of Medicine (MMed), Master of Science (MSc) or Doctor of Philosophy (PhD).

MMed is 4 years.
MSc is 1-2 years.
PhD is 3-6 years.


1. Master of Medicine (MMed)

If doctors go for MMed, they become specialists in a special area of expertise (eg Gynaecologist, Orthopedic surgeon, Gastroenterologist, Pathologist, Pediatrician, Medicine specialist - Endocrinologist/Diabetes specialist etc). Without a further degree, the doctor is just a general physician (medical officer, MO) and can do private general practice (GP, doktor private) or locum.

The MMed program can only be taken up by medical graduates who have completed 2 years Housemanship at a Govt hospital. The MMed program is four years at a public university - USM, UM or UKM. After MMed, the graduate is an expert (pakar perubatan) in his/her area of specialization.

As a medical specialist later on after graduation from MMed, doctors who work in medical/surgical dept get a Clinical Allowance (about RM3k) on top of their monthly salary.

If they are a specialist after MMed, but do not run clinics or see patients daily (eg posted to non clinical/surgical/medical dept), they get a Critical Allowance on top of their monthly allowance. Critical Allowance is 3/4 of Clinical Allowance. Doctors in a Lab-based dept get a Critical Allowance.


2. Master of Science (MSc)

This is not wroth doing for a graduate doctor. The MSc will not make them a specialist but just an expert (with extra knowledge) in a specific related research area, not a clinical practice area or specialization. They can only get a Critical Allowance after graduation and if they work at a Govt hospital.


3. Doctor of Philosophy (PhD)

The MMed degree is not a match for a PhD. The MMed degree is a coursework plus research beginning in year 2. The PhD is an entirely research program from year 1 and lasts many years. They can never be one and the same. They just don't match at all.

It is not worth doing a PhD as the medical graduate only gets a Critical Allowance after all. It is better for the medical graduate to do Housemanship and then MMed, become a specialist and then go for PhD.

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External links:
http://successful-housemanship.blogspot.my/2013_12_01_archive.html?m=1

http://lifenotless.blogspot.my/2013/02/housemanship-where-and-which-is-best.html?m=1

https://forum.lowyat.net/topic/1238484/all