jckc said hands on experiences as a student is more important, and you seem to disagree with him, as if implying jckc was referring to after graduation...

jckc is right, one of the reasons, and there are many, why so many housemans are incompetent, is simply they have little or no clinical experience...

in some overseas med schools, going to wards and seeing patients is "optional", and some may have ever clerked one or two patient only in their entire med school life...how can one, for example, explore a case in depth, with a russian patient, with a shallow level of russian language?....

so "No. just study hard, bring your brain and heart...." is not enough...this is not a theoretical course where you just study knowledge...

the same problem exists for students in ipts and some ipta...as they do not have their own teaching hospitals...many just leave the students in the crowded wards, with no guidance...and many have very few lecturers, and some of these lecturers are foreigners, most who not actively practicing medicine in msia, sometimes already for years....they are just teaching facts (which you can get from any text books), not the PRACTICE of medicine...

This post has been edited by limeuu: Apr 25 2017, 08:36 PM

which is why many of those who went to places with little clinical training, do learn quickly and eventually become competent...

but a combination of poor intellect, lack of interest, bad training, lazyness and low personal drive will result in grief....

4 out of the 5 can be picked up with reasonable accuracy BEFORE entering med school....

This post has been edited by limeuu: Apr 25 2017, 09:34 PM

the training of a doctor in the old days was an apprenticeship...that is time tested, and it should still be...unfortunately, modern education, especially many "money making degree mills" have converted it into an academic exercise....

in good medical schools in well managed health care systems, it still is, and the process of transition from student to doctor blurs as they involve students early in the management of patients....

as an example, in australia, final year medical students are assigned to a firm/team, and in effect function like junior housemans...they clerk in the patients, and initiate investigations and treatment plans...all on the actual case notes...but of course, they are not registered practitioners, so all these will have to be vetted and countersigned by usually a registrar grade doctor.....the transition to an intern ( as they call houseman) is thus seamless...they just continue doing what they have been doing...

that is why, choosing a good medical school, in a good health care delivery system, is important...but then, the majority of msian med students will not qualify to enter these med schools in developed economies like uk/oz/spore anyway....even if money is not a problem...simply because they will not pass the stringent selection process these med schools practice....

procedures are not important....in any case, other than venesection, there isn't any other procedure students will be allowed to do....most places will not allow catheterisation even...

a lack of apprenticeship denotes a poor medical school....apprenticeship is the close observation of how senior doctors think, behave, interact, manage, communicate, mentor etc...and the close observation of how patients progress through the entire encounter with the health delivery team....

factual knowledge is NOT important...

because it is a given in good med schools with carefully selected students, that they WILL have acquired all the necessarily theoretical knowledge freely available in text books and online...because if that is even a problem, you have chosen the WRONG student...

hence in uk, many junior doctors will have already obtained their mrcp part 1 easily within the fy years...with some completing paces in pgy3....

the pass rate of any exam depends on several factors....perhaps summarised into 3 main ones...

1. the knowledge/ability of the candidates
2. the familiarity with the format of the exam
3. the familiarity with the common questions asked

the test attempts to test 1....but 2 can cause lower assessment of 1 due to silly mistakes related to lack of familiarity, improper time allocation etc...3 skews the result up due to foreknowledge...

the mrcp pass rate statistics show that overall uk trainees pass rates are lower then uk graduates...note that uk trainees include significant numbers of non uk graduates working in the uk, including from eu, as well as​ imgs from the subcontinent, africa and the Caribbean....these uk traniees should have the same factors 2 and 3.....therefore, it must generally be a reflection of factor 1....

and that is not surprising, considering how med students are chosen in different countries...

for the all candidates pass rates, this includes exams conducted for non uk trainees, in uk itself, or at several centres in several countries, including msia...and the lower overall pass rates reflect the low rates from that group...this lower pass rate may be influenced by factors 2 and maybe lack of 3....and to some extend, by the additional factor of not being familiar with uk disease patterns and practices...but also likely reflect the poorer quality of the candidates...

hope that explains the statistics....

This post has been edited by limeuu: Apr 28 2017, 12:41 PM

this is at proposal stage but will likely go through....a few observations...

1. Interesting uk finally decided to adopt the North american nomenclature of calling gen med "internal medicine"...

2. But they are NOT adopting the american (and some european) system of residency training...but retains the tried and tested general->specific pathway...ie, they expect all physicians to be a competent generalist first...in fact the proposed 3+4 system devotes 4 years to gen med training...

3. this makes the training long...9 years...longer than the american system's 4-6 years...but have shorten the process from the past (12-15 years) and more in line with european standards, and they are still quoting european guidelines, despite brexit...

4. finally, looks like gen med as a specialty is dead...they are not running a pure gen med programme anymore...

2nd last paragraph, page 5 states: "We do not envisage any enthusiasm or role for single specialty accreditation in Internal Medicine alone. A curriculum for training in General Internal Medicine (GIM) alone as opposed to specialty with GIM was not utilised."

actually, a strong foundation in factual knowledge, especially the basic sciences like biochemistry, physiology, pathology etc is crucial in the competent practice of medicine, the basic skeleton upon which is built wisdom from experiences...(there is some debate about anatomy, but that is another matter)...

basic knowledge is always emphasied in all good med schools...but is not normally a matter of concern, and in the past, and still is in countries with well run doctor training systems, it is ASSUMED that all med students WILL have a strong foundation in "factual knowledge"....and indeed, these students are the creme-de-la-creme and have no problem absorbing such knowledge like a sponge...hard work and attitude just add on that strength....

msia (as well as some other mostly 3rd world countries) is unique that this becomes a matter of concern, and this is purely due to the way students are selected...

why is it surprising that mediocre students, who already have problems coping with the generally easy spm exams, until they get b's and c's, should have problems coping with medical studies?....and that they eventually cannot cope with work in real life?....

and needs "hard work" and "working attitude" to COMPENSATE for this lack of knowledge?...

no need...

the shadowing varies, some 2 weeks, and some don't have at all....

Based on projections, all applicants will get a fy job this year....not sure if there was even a second round...

There will be loadings on top of base pay, for working​ out of hours....that used to add 50% on top....not sure how the new contract will have changed that....

P/s only 26 on the reserve list....compared to 500 in 2013....

This post has been edited by limeuu: May 25 2017, 04:04 PM

In 2013, it took 4 rounds to place everybody, although all got jobs....

Oz still managed to place all internationals who applied this year, but I think few from Monash Malaysia got jobs, if any...next year will be worse....and they have already removed the 457 visa used by internationals to work....and may remove doctors from the shortage list completely, which will mean ALL internationals will need to leave on graduation....

There will not be time for locum work, except for the occasional covering of colleagues who call in sick at the last moment....

Previous to the NHS doctors contract revision in England, housemans will usually be in a rotation which will be rated with a 50 or 45% loading depending on the banding of that particular job...that is an averaging calculation to account for the portion of the standard 75hrs/fortnight worked outside 'normal" hours....

Ewtd does not allow for longer work time....but the job requirement mandates doctors to work long hours for stretches....this is even out by mandating time off outside annual leaves...so you will have situations where you work long hours for a 3 week stretch, then given 10 days off the roster to keep within the ewtd....

There is 5 weeks annual leave, or more accurately, 25 working days....what I mentioned is over and above annual leaves....when your will have exceeded statutory working hours limits and need to stop work for a while...

It can stretch up to 2 weeks at times including weekends, and people have been known to go to Europe for holidays during such breaks....the problem is, rotas only get set few weeks in advance, so such trips tend to be impromptu....

This post has been edited by limeuu: May 26 2017, 12:40 AM

Each job is different, depending on the departments rotated through....those with mostly office hours will have lower banding but more civil hours....

Unlike Msia, each job in fy1 (you get to choose from a list) is fixed before hand.... although the exact rota will not be known till just before starting the rotation...

Sounds like relative starting with an easy office hr rotation...

Doctoring is no more the glamorous profession it was....

And now that everybody can buy a medical degree, it is no more exclusive either....

We joked in the past how some countries doctors drive taxis....now they drive Uber here....

The BBB grade is only because of the 2011 mmc minimum qualification guidelines... otherwise they will accept lower to fill places....

In Russia Indonesia Egypt, d and e also can.... otherwise do a "Foundation" and miraculously get a and b.....

there is nothing to defend...anyone worth his salt will have done a proper pre u....if they want it fast, do the ausmat/sam lah.....same 1 year....

mmc should have followed the bar council's action, restricting only those with a proper pre-u to sit for the clp....

the problem is, many "foundations" are sham courses to enable students to get into medicine....d and e students in spm miraculously become a students in these foundations, some of which are as short as 5 months....

it is for this reason that the mmc guidelines specifically include spm results for those doing foundation....5b in maths and sciences being the minimum....

there are many graduating students now, who enrolled in 2011 and after the guidelines was introduced....

there are also students enrolled in recent years in ipts who also do not meet the minimum....

in spite of the guidelines being known by all, students and med schools...

This post has been edited by limeuu: Aug 16 2017, 12:02 AM