One out of five doctors undergoing their housemanship quits annually in Malaysia and some are working as waiters, running pasar malam stalls and even an air stewardess.

The Star Online reported today that the resignation rate was alarming given it cost up to RM500,000 to acquire a medical degree locally and up to RM1 million overseas.

The portal reported that many newly qualified doctors were also quitting because of the longer wait to be posted as housemen.

Deputy director-general of Health Datuk Dr S. Jeyaindran was quoted as saying that about 1,000 of the 5,000 housemen employed each year failed to complete their two-year training stint.

He said the increase in numbers of housemen quitting had been growing over the past three years.

Among the reasons cited for dropping out include unsuitability for the profession, misconception of a doctor’s life, inability to work long hours and suffering from burnout.

Dr Jeyaindran said many of the housemen who left did not tender official resignation letters.

Housemen were hired by the Public Services Department (PSD) and the termination process was tedious, taking up to several months to more than a year, he said.

“Until the person’s service is terminated, the vacancy cannot be filled and those who replace them have to wait for their turn to start,” he told The Star Online.

The large number of medical students graduating each year is reportedly another reason for the long wait for postings as a houseman, especially under the new e-houseman system, which allows for newly qualified doctors to choose the place of their posting.

The average waiting time is about six months, but it could be longer for urban hospitals like Kuala Lumpur Hospital, it was reported.

“With 10,000 housemen in all the 45 training hospitals nationwide, these hospitals have varying degrees of waiting periods except for hospitals in Sabah, Sarawak, Kelantan and Terengganu,” Dr Jeyaindran said, adding that the Health Ministry must explore other ways which allowed greater flexibility in employing housemen to replace those who had left.

He said a common entry or fitness to practice examination as proposed by the Malaysian Medical Association (MMA) and a longer induction period for housemen to understand their work better were among the steps being considered.

“It is not to control numbers as proposed by MMA, but to ensure a minimum standard of competence.

"The common entry examination is already in place in some Asian countries, the United States and Australia and it might become necessary to ensure safe medical practice, especially once there is a liberalisation of trades and services,” he was quoted as saying.

Dr Jeyaindran said a houseman’s workload in Malaysia was lighter than those in other countries, adding that on average, housemen here took charge of between four and six patients in a ward compared with eight to 12 in Singapore, Australia and the US.

“Moreover, house officers in those countries also work an average of 80 hours compared with the average of between 65 and 72 hours for Malaysian housemen.” – March 30, 2015.