House officers should be trained well to provide quality care and service.

THERE has been a worrying trend in our daily practice in recent years. The following are some the roles and duties that should be carried out by house officers (HOs), but because they are not able to, medical officers (MOs) take over:

WHEN HOs are unable to take medical history, MOs will take over the clerical duties;

MOs step in when HOs are unable to perform physical examinations; come up with sensible diagnoses; plan for investigations and management; and take blood or insert a branula;

WHEN there are basic, life-saving procedures to be performed, and HOs are unavailable; and,

WHEN HOs are clueless about handling daily issues and common emergencies in the wards.

Some of these undertrained HOs and those with limited competency and attitude issues become junior MOs. The title and status may have changed, but not their capability and attitude.

Therefore, another worrying trend has cropped up in recent months and will likely persist for years to come. Among them are:

WHEN MOs are unable to take medical history, specialists will do it; and,

WHEN there are basic, life-saving procedures to be performed, MOs are unable to perform or even attempt to because they did not learn it during their housemanship.

When junior doctors are not adequately trained, there will be a mismatch in their responsibilities and capabilities. This creates stress and will affect their work. They may make mistakes in their daily duties. This, in turn, will deprive them of satisfaction in the profession.

Worse still, they become depressed and disheartened. Caught in this vicious cycle, some commit suicide.

This upward shift of job scope can potentially disrupt the equilibrium of the team at every level. The superiors and senior doctors will have more work to tend to, resulting in less time, energy and resources to focus on their priorities. This leads to longer working hours, higher stress levels and disruption in work-life balance.

Yet, our compensation remains the same, with increment lagging behind the rate of inflation and rising cost of living. Capable senior doctors opt to join the private sector for better compensation and work terms.

As recent as a few years ago, junior doctors were working long hours with heavy patient loads as well. We were stressed, exhausted, yet happy and motivated to continue with our hard work.

Thanks to our superiors and senior doctors, we were given the autonomy to take ownership of patients even when we were junior doctors.

We were given the opportunities to help patients, who recover day by day and give us a big smile and the heartiest “thank you” when they are discharged. The satisfaction was immense.

What has changed in such a short time?

Instead of merely taking over their tasks, we should emphasise training HOs. We should improve the system. We need to empower HOs to play significant roles in the team. We need to help them get involved in the daily care and management of patients.

Guide and nurture them. By training HOs, we can reap the benefits of working with competent colleagues. More importantly, by having well-trained and capable colleagues sharing our workload, patients benefit from quality care and service.

Dr Schee Jie Ping, Medical officer, Kuala Lumpur

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