Personally, there are pros and cons to each, thats why deaneries in foundation years do 1 year in DGHs and 1 year in main uni hospitals to give you different range of exposures.

DGH-wise, you play a bigger role and you have more responsibilities with patients overall. In general, You can be the only junior doc in charge of 4-5 bays of patients. You are also responsible in making more management plans which you can discuss with your reg/cons. You also could even lead the ward round some days when there are no seniors around (especially like ortho)! In a nutshell, you get alot of experience doing things and also familiarise yourself with the ward work in a smaller scale with less workload in comparison to main hosps.
You also have more chance to pursue your interest since you have more time. (so like assisting in surgery and etc)
the main cons is that you often feel the lack of support and find it hard to cope with the workload if youre the only one available. (especially when youre on call at night or on weekends! its can be quite dreadful)

Main hospital wise, youre very well supported and there are plenty of helpful hands around (if youre nice). and plenty of exposure to tertiary, more specialised conditions and management, like neuro surgery or major trauma surgery for example. You also have more opportunities to develop a professional network with doctors to do research projects and be the front of upcoming technology or breakthrough research.
Cons wise can be hectic workload since you handle more patients and cases. the pressure of beds really hits as well and the turnover can be really fast and drastic. (DGHs too but not as bad imo). ALOT of your work early on is admin work and doing TTOs/discharge summaries with tons of other jobs. So you could turn into a machine after awhile.

(this is just my opinion as a med student observing and listening to junior docs)

This post has been edited by Jckc: Apr 21 2017, 11:04 PM

@jckc, thanks for the input! So I guess it very much depends on where one's interests lie, when applying/ranking hopistals. Relative just watched "confessions" and said Northampton does look "quite bad".

Hey guys 4th year med student here. Anyone here from public university? (i.e USM, UKM,UM) What are your plans after graduating? Anyone here planning to do masters overseas?

Don't you need to complete your housemanship first?

Well, yea that's obvious I just inquiring what are your plans after housemanship whether you guys planning to do masters overseas or local. It's never too early to ask hahaha

what do you mean by "masters overseas"?....

You have to ask yourself what are your interest before you choose which field you wanted to specialize in.
Then, you ask yourself where you want to work: in Malaysia or overseas. If overseas, you may have to go through the country's medical exam. There's no guarantee that you can get a place of training even though you successfully registered under the medical council.
Then, you need hands-on i.e. housemanship training.
Then, you need to ask yourself again, "do I really want such life in the future?"
Then only you plan for masters.

There are basically 2 main ways to become a specialist:
External exams e.g. MRCP, MRCPCH, MRCOG. There're rules and regulations of registering as a specialist under such way. However, MRCS is not recognized (means to become a surgeon, the only path is to do masters).
Masters: You will need to have 3 good SKTs before you are entitled to apply for master. You may have to pay using your own money as the govt has no money to give you HLP. The exams are tough; passing rates are low.

Yes, it is too early for you to ask.
Please study hard, ensure you have strong basics before you start your housemanship training.
Things have changed and you are not guaranteed a permanent MO post anymore.
Please focus on your finals for now and stop daydreaming.

i would suggest that all medical students survive and complete the housemanship first, before talking about anything further into the future...current statistics show 30% cannot complete housemanship on time (ie retained in one of more postings)....and 5-10% actually failed to complete...ie dropped out....

This post has been edited by limeuu: Apr 23 2017, 01:34 PM

30% is alot..
i wonder what is the main reason for this.
I have not heard of doctors in the UK being retained or delayed in their foundation years unless personal issues.

The situation is different in the UK.
They really choose ppl who really want to pursue medical career.
They really choose ppl who are competent. Those incompetents will either be expelled from the uni level itself or being refused to be registered by the GMC (especially foreign graduates)
They compete for jobs (FYI, they are under contract. Those found incompetent during their training may have to drop out.)
Thought they are busy, they are guaranteed ceiling working hours.
They have good superior-subordinate relationship. They do really monitor your progress, make sure you learn.

Things are really different here.
We take every sorts of students here: those who really want to become a doctor, those who only wants the prefix, those who are being forced by their parents.
We take all competent and incompetent medical graduates.
We are (used to) confirmed a permanent medical officer post (not anymore now). You progress or not, still get the stainless steel rice bowl job (permanent government servant job: easy earning money directly goes into your pocket irrespective you do your work or not.
There is no ceiling working hours here. You work until death, perhaps there is some condolence initially, but later it'll be like nothing have ever happened before.
Your superior may be a nice person, a fierce person, a nasty person, or a super-OCD person who wants the result to be immediate. As long as you finish your job in time, they don't really bother. The rest is on your own. You want to learn? In most of the time, eat yourself la...

The statistics translate into millions of ringgit putting them through medical school and resources used at undergraduate level, AND during housemanship training, all down the drain.

Just to share my experience during my last on call:
All the bloods results are delayed for at least 2 hours.
It wasn't because the delay in sending to the lab, or the lab delayed the process. The house officer on call delayed them.
The blood which was supposed to be taken at 10.45pm, was only received by the lab at 1am. Then another blood was ordered to be taken at 3am.
At 5am, I called the lab asking whether they have received the sample.
No, the sample was not received. I went back to the ward to check if the blood sample was lying on the counter.
To my surprise, The house officer was just about to take. She gave a lot of excuses there were many blood taking (there was only 5 patients whose blood need to be taken that night) and cannula settings.
The blood I was chasing was a coagulation profile.
Both patients had Lung Ca with SVCO, had stenting (Day 0 and Day 1). One recently had an UGIB due to anticoagulation. They were just started/restarted heparin infusion that day.

A significant portion of msian medical graduates lack the intellectual ability, the interest, the mental attitude, the mental fortitude etc to be doctors...Many are there for 3 simple reasons...Their parents want them to, they have the money, and it is easy to enter medical school....

Because this will be the natural course of events, if left to the free market, most countries regulate tightly at the most important step in the pathway: at entry into medical school....

Msian decided not to....For political reasons...

Hence you have the current situation.... Unfortunately, people have spend a lot of money already when they realise/decide they can't/don't want to do it....

But that's the whole point.... Someone made a lot of money....

Thanks for the insight.
Is there enough HO to cover wards or on call or isit really oversaturated as what has been mentioned.
(Or isit just due to limited post available )
I would have expect a lighter workload and hence, more time due to the number of HOs.

It's kinda sad when people spent 5 years and ended up even more miserable but that's the reality now in Msia.
Hopefully things will improve soon. (Or else I won't be returning anytime soon :/)

There is no political will to correct the problem at source...ie intake into​ med schools...

Actions taken are only at graduated doctors level...By removing all recognition of all overseas qualifications...And by employing housemans on contract...And only taking in selected doctors as mo after...So joblessness after housemanship is real now...

Market forces will also play a role...As the public realise there is no more guaranteed jobs, many will think twice...

That may mitigate the total numbers issue....But it does nothing to the quality issue....Ipta is cutting down on places, as ipts rams up their numbers...And the gov have stopped scholarships for medicine...

The nett effect is, many good suitable students will be discouraged from taking up the profession due to limited opportunities, cost, bad publicity....And replaced by basically rich students...Who will span the whole spectrum from excellent to the mediocre....

In simple terms, going forward, if no cohesive comprehensive action is taken, the next generation of doctors will be populated by either rich people, or very indebted people, or both....With high drop out rates....

In KKM hospitals, there isn't on call for HOs. Has are supposed to work in shift: you will have to complete your task before you leave the hospital. If you are slow, you might have to either come earlier or go home late.
Yes, it is overall oversaturated. But it also depends on how many HO posts a hospital can accommodate. If there are many HOs stuck in a posting (i.e. extension due to various reasons), then the other department will definitely be lack of HOs.
Workloads are overall heavy especially if you are working in a major hospital e.g. GHKL, Klang, HSAJB etc.
MOHE hospitals e.g. PPUM, PPUKM, HUSM still retain on call system. But the HO allocation for each hospital is very limited. You might end up with covering the whole ward of 28-54 patients.

Most of the House officers degrade themselves to a clerks. They do not have the initiative of clerking cases by themselves (ended up copying MO's clerking including spelling errors etc); some of them try to avoid doing morning round (they come at 7.30am start taking blood slightly earlier than 8am); they do not want to involve themselves in planning investigations and treatments (most of the time the only written plan was "awaiting MO/specialist to give plan" in contrast to many years ago you still can see some KIV this and KIV that in a HO's note).

If you have real passion (not those hangat2 tahi ayam) to become a doctor, then try to clerk case yourself, try to plan for relevant investigations and treatment (at least put a "KIV...." in front, or "to discuss with MO/Specialist regarding ...." if you are not confident of your plan), try to do start morning round (or at least follow round), try to ask question if you don't understand why such plan is made or such investigation is ordered (ask what to see when result is out). This is how ppl learn.
But if you are the other type, then just forget what I've said.

Just let's see how strictly they want to enforce on the rules on these contract HOs la...
Now the govt is reducing the HLPs. It means the specialist posts will be forever inadequate...

ho jobs are assured, as it is the statutory requirement for full registration, and this role is given to moh (and some mohe, and soon, mod as well)....so all msians WILL get to do the ho...on contract....

there are not enough mo posts for all the ho, so some kind of selection process will be required to select who gets mo jobs (likely compliance with the parallel moh pathway, ie some kind of part 1 under their belts)....but it means a significant number of hos completing their housemanship will not get full time jobs in moh....what will become of them?....time will tell....maybe drive uber?...

it is pertinent to note, what we see now, is the result of doctors who started their courses before the implementation of the mmc minimum qualification guideline....where people with c and d and even e in spm and pre-u get into med schools...particularly overseas...hence you will expect some of them will be, i will be completely blunt here, intellectually incapable of being a doctor to begin with...rubbish in, rubbish out...

the guideline was introduced in 2011.....and will likely mean those graduating from now, will be affected, although it is well known many students and med schools did NOT comply with the guidelines....so perhaps the quality will improve somewhat...although personally, i think 5b at spm and 3b/3.0/atar80 at pre-u is still way way too low...