Medicine: A Calling

Ask most Malaysian parents what they want their children to become, a substantial majority will want them to become doctors. To quote a prominent Indian lawyer-politician in a forum which I attended last year, "every Indian wants a family of doctors".

However, wanting to be a doctor, having "rights" to pursue an education in medicine is absolutely different from being qualified to become a doctor. Sometimes, as reported in the Star, "students apply for medicine not because they truly want to join the profession, but due to parental pressure or the thought that doctors make pots of money."

As highlighted in my earlier posts, "What's Up Doc?" and "No Cure for Medical Schools?", I've been wanting to write about this topic for the longest time. My best friend and best man is a specialist pediatrician based in Singapore (who is a Malaysian from Johor Bahru, by the way). He has served more than his full term with the Ministry of Heath in Singapore and will be out in private practice starting next month. I am certain that after years and years of hardwork, it will finally pay off financially for him.

Having seen him perform his service with the amount of dedication, and the number of regular long and difficult hours, I can say with certainty that being a doctor is one mean task. Hence when I read in the papers that the number of doctor wannabes who went for the career talk on medicine at the Star Education Fair had increased four-fold, almost causing a pandemonium at the venue, I thought - do they really know what they were getting into?

The Star reported that more than 2,000 students and their parents turned up for the session, with hundreds queuing outside the conference hall an hour before the 4.30pm talk!

Top students, who have the right foundation and quality should be given every opportunity to pursue a career in medicine. However, I worry when many third and fourth rate students seek to pursue a career in medicine at all cost. The demand from such candidates is so strong and lucrative that there are many profit oriented agencies which were set up solely to help these less qualified candidates gain entry into any institution which will accept them as students. These institutions are usually located in Indonesia, Turkey, India and Russia.

To a certain extent, these overwhelming demand for an education in medicine has encouraged the mushrooming of private medical colleges in Malaysia in the late 1990s and early 2000s. Today, when the pioneering batches of students are graduating from these private institutions, we find that many of them are not qualified to become doctors - for they are either half-baked or have received a half-baked education!

To me, what the point? Why do students whose results for STPM don't cut it "die-die-also" want to be a doctor? Some of you might remember the controversy over the recognition of students from Crimea Medical State University (CMSU) whereby certain Arts students with average results and no foundation in Biology or other sciences have been accepted to pursue medicine. The fact that these students are accepted immediately tells you the probable quality (or lack of) in these "universities".

Do these students actually know how much medical officers are paid and how long it takes before one will finally have the opportunity to come out into private practice? Even in Singapore, I know that my friend was underpaid for years, earning income significantly below that of all our peers (particularly those from the legal profession, by the way). And I know that the situation is worse in Malaysia.

The same lawyer-politician I referred to earlier argued that every student should have a "right" to pursue a degree in medicine. I completely disagree. With obvious scarcity of resources to conduct the medicine course with sufficient quality, places must be reserved only to candidates with the necessary foundation for their secondary education as well as qualifications in terms of their performance. In fact I'd go so far as to argue a case that students who don't meet the minimum subject and performance requirements to pursue a degree in medicine should be "banned" from taking up the occupation, at least in Malaysia anyway. If not, are we not just taking a huge risk and endangering the future generation of Malaysian patients who may come under their care?

Being a doctor is an extremely honourable profession. But the same honour should apply when one should know the limits of one's own academic and intellectual capabilities. The same honour will be smeared, if one actually "qualifies" to be a doctor and is unable to carry out the job functions in a competent fashion - which in this case, may threaten the lives of individuals out there.

Hence, when it was raised by Datuk Dr Shafie Salleh, the previous Minister of Higher Education, that an additional "Medical School Admission Test" be conducted before students are admitted, I thought it was a good idea (given the circumstances). The test which was to include videos "on the life of a medical student and doctor", attitude tests as well as a written examination should hopefully act as a better filter on the right quality of students as well as the right motivations. To a certain extent it might resolve the annual controversy over the admission criteria for matriculation vs STPM students with the common entrance examination.

However, typical of the civil service response time, "the test has yet to be implemented due to a lack of time". I do hope that this test can be carried out soonest by the new administration for the next batch of graduates, in a fair and equitable manner. In addition, I hope that the examiners for these tests are not officials from the Ministry of Higher Education but practising doctors and academics in our hospitals.

So for students aspiring to be doctors out there - think twice, think thrice, think very very hard. And if your grades just don't cut it (anything less than 2 or 3 'A's for your STPM with the required subjects), seek out a new career which you might excel better in. Medicine is not the end of the world.