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.

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...

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.

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...

It's a bit too early to make any comments on how it will be 2 years later.

Talk about now...
New medical graduates now have to wait at least 10 months to get the HO job.
(during my days I only waited 4 months after graduate)
Even HO posts are inadequate now... What are they going to do during these 10 months? Grow mushroom perhaps....

The 1500 jobs can only fill some of those who graduated in 2016. What about the soon-graduating-2017 batch?


No woh... Last time I attended the interview 2-3 days after my final result came out. What's your time?
Or do you mean the induction/BTN?

My time was 2009 woh... The last batch who experiences only 6 HOs in a department, doing almost EOD on calls with NO post call off...

I don't know how I have survived.
I remembered, I used up all my 4 month on call money and half month salary to buy a RM6k iMac...

You must be from the era of shift system.
You have RM600 allowance what...

If you were from the era with no call allowance, then you must be old enough to be call consultant or the same age with consultants who are retired/retiring soon I supposed?

Before you think about your long term goal, just achieve your short term goal first i.e. pass your final exam.
It is useless to have fantastic long term goal ahead if you fail your exit exam.
Not to mention about completing housemanship (you haven't even exposed to the real life of the training, you are still not sure whether you are suitable with a doctor's life yet and whether your bosses are satisfied with your work)
Hey, that's Mars, please come back to the Earth....(;;)

I think for now the only appropriate slightly-longer-term plan after graduate to make is to think where you want to practise.
If you want to practise in overseas, you may have to study extra (probably double or triple) hard in order to prepare for their entrance exam (unless your degree is readily recognized by their medical councils).

No. just study hard, bring your brain and heart....

Errmm...
What I mean is what a 4th year medical student can do.

Erm, have I lose the whole picture?
I don't see anything wrong with both of our statements.

Sorry for my bad English (I've been like a china pek all this while). I don't really understand what you mean by "read"

I responded to Hunther's post

by saying


Then, Jckc quoted me by saying


I don't see any conflict in both of our statement, so I echoed like this:



I did not object to his statement nor did I commented further.
Perhaps you can enlighten me?

Oh... now I understood.
It depends on what you mean by "hands-on". If your "hands-on" means history taking, examining patients, getting physical signs, figuring out basic investigations and drafting treatment plans (perhaps a little difficult), yes, I agreed with that completely.
But if your "hands-on" means procedures, I think should leave that till housemanship training.

Study hard, gives you knowledge.
The eyes can't see what the brain doesn't know.
Without knowledge, even there is an gross sign staring in front of you, you may also miss it.

Bring your brain, asks you think.
Without thinking, that's just something like monkey see, monkey do.
You saw something, you followed, but you didn't think. Eventually, you didn't really learn anything.

Bring your heart, ask you to have passion in this medical career, be both physical and mentally present.
Get your own initiative to see more patients, not to avoid difficult cases, that's how you learn.
The same applies to during housemanship, after becoming MOs or even speciality training. (sounds like cari pasal masa kerja)

I'm not sure how medical school teaches a medical student drafting a management plan nowadays.
And I couldn't figuring it how - as almost none of house officers draft any management in their admission clerking.
I've seen one house officer's clerking, she wrote an excellent history, and some simple examination findings. But when come to the plan, she wrote just a simple phrase, "awaiting MO/specialist to give plan." Patient has anemia, she don't even bother to write for transfusion, of KIV transfusion.


From my past experience being a medical student, my lecturer did not bother to guide me much about management. The whole management idea was vague, and a little specific to the disease not patient's condition. I could only pick some, thanks to our Sarawak Handbook. To be exact, I learned how to come out with al management plan by reading our Sarawak Handbook.


People do struggle when come into setting branula in various situation. I only had 2 experience of setting a branula before my graduation. I struggled a little during my first week of posting, but eventually it was okay the subsequent weeks. Branula setting always needs a good basic anatomy of the vessels, and great patience. I think the most challenging line setting is neonates. Your struggle could have been relieved if your paediatric posting was earlier.

This post has been edited by sjr: Apr 26 2017, 07:31 AM