Monday, 29 October 2012

Doctors without work

This year is my 30th year teaching at the USM medical school. I have not been to or seen other medical schools except that at UniKL in Ipoh where I was an external examiner for the first year students. So my impression below is a rather closed one (like katak bawah tempurung). Anyway, it is good to read.

When I first joined as a lecturer in June 1982, there were many PhD lecturers and very few medical lecturers. There was at least one medical lecturer per discipline. In my department (Chemical Pathology/Medical Biochemistry/Biochemistry), we had a medical doctor as HOD (Dr Mohamed Said bin Hashim Tahir, MBBS UKM), Dr Kalavathy Jayavant (MBBS India), and 4 basic science (non MBBS) lecturers - Musalmah (MSc Reading), Akmal (MSc Hull), Nadiah (BSc UK) and myself (MSc California).

While in Penang, as lecturers, we helped out at the USM Specialist Clinic beside GH Penang. I spent a lot of my time at the clinical lab upstairs as I was interested to learn about the chemistry analyzers and all the other machines which was my first time working in a clinical lab. I even wrote my first clinical lab manual for my department which was used to train our medical lab technologists. I then made further versions as the machines changed and new knowledge came to the fore. I enjoyed my clinical lab work. (I was from a pure science research lab in California.)

When I was transferred to work at Hospital USM (HUSM) in Kubang Kerain, Kelantan, I worked in the admin side and did purchasing for the hospital. I did not do medical teaching as only the 4th and 5th year were at HUSM while the 1st, 2nd and 3rd year students were still based in USM Penang. I worked at HUSM from September 1983 till mid-February 1985, and then left to do my PhD in Australia.

When I returned to Malaysia, I was directed to go straight to USM based in Kelantan and report there. I was back at my old workplace but had lost my job as HOD in Chemical Pathology at HUSM. A female medical specialist was now the new HOD. I was told they preferred an MBBS since it was a hospital.

Time passed and I matured with my job. When I learned to read my pay slip correctly with the codes deciphered, there was hardly any money to my name. I paid my taxes to LHDN, first to the Penang branch and later to the Kota Bharu branch after my income tax file was transferred.

Along the line, there was a big argument about how PhD-holders should be addressed, ie differently from the MBBS lecturers, ie to alienate them. The tall order came from the Dean's office in B/W. My name became DR Faridah Abdul Rashid (if I was an MBBS doctor, it would have been Dr Faridah Abdul Rashid). For a long time, DR and Dr did not bother me because I just typed all the names with Dr and that was that. I didn't follow the rule because it was a stupid rule.

Somewhere down the line, another phenomenon struck the PhD-holders. This time USM paid all its medical lecturers what is called a clinical allowance. This clinical allowance is for medical doctors (also called specialists) to do clinic. They get this special allowance for being involved in clinics, handling patients, dealing with patients face to face, prescribing medicines for patients, etc. The PhD-holders did not get any clinical allowance as they don't have clinics and are not involved with clinical duties. Fine.

But, not all specialists have clinics! Many medical doctors become lecturers so they are medical specialists but many do not have clinics or see patients. Would they qualify for clinical allowance? Outright NO! So what did these doctors do? They fought for a critical allowance as opposed to clinical allowance. What is this critical allowance? When I first heard of that term, I was lost! I had thought that critical allowance was meant for critical injuries suffered by lecturers during their line of duty. But I was wrong. I went to ask at the medical school registrar (Pendaftar). The critical allowance is paid to medical specialists who are not involved in clinics and have no clinical duties. I was really lost when I found this out. Just because they are medical specialists and don't have any clinics, they get the critical allowance (which is 75% of clinical allowance).

Recently, the medical specialists went to KKM or some other, to fight for an additional perk called the teaching allowance. I first heard about it when I was in my car and headed to Kota Bharu to get some groceries. My husband informed me about teaching allowance for medical specialists. I laughed because to a PhD-holder, the idea was ridiculous.

So now, medical specialists with a postgraduate degree have a lot of money - basic salary + clinical allowance/critical allowance + teaching allowance. If they run clinics they are paid clinical allowance. Otherwise, they get a critical allowance.

PhD-holders (like me) get only a basic salary. Our work is the same as that of a medical specialist. PhD-holders also have to teach clinical sessions such as problem-based learning (PBL) in Phase 2 Medicine (year 2 & year 3), which is actually clinical discussion. Some have to do IDA (interdisciplinary discussion which is also a clinical session). PhD-holders are not paid critical and teaching allowances. So that alone makes the PhD-holder a second class citizen within the medical school. It is bitter to be paid less than our medical counterparts but that is a fact of life. The medical specialists are greedy, that's all I can say. They are very greedy indeed and all that they care for is getting more money for doing nothing (no clinic).

Many medical specialists retired but immediately returned to the medical school or other, to continue to hold their old posts (usually some high posts). When they rejoin, they are paid a pension plus a salary (their old salary). I don't know whether they are still paid the clinical/critical and teaching allowances because I haven't approached anyone to ask. I will when I have some time.

Now that the 4 old universities are research universities and being such the proof is to have the elderly lecturers stay on their jobs till they drop. So, the emeritus will remain till death do us part. The young retirees will continue to 'work' for blind money till they also drop. However, the PhD-holders usually return to work but soon leave. The PhD-holders find it useless to return for long. There is no point to work after early retirement (at 55 or 56) for the PhD-holders. The last 2 PhD-holders who left my department didn't consider to work after 60 (or till they drop); they left quietly. One retired at 56, rejoined for 5 years and left for good at 60. I asked him why he wanted to leave and not return - he said "malas lah". The other left at 56 and never returned. I asked him why he wanted to leave and he said he wanted to busy himself with his own business. He went on into the goat herding and milk industry.

I guess, the PhD-holders are playing a losing game by joining and staying on in medical school. We are made to believe that our presence is heart-felt and much desired but the truth is, we are second class citizens and down-trodden (macam hamba abdi). The medical school can do without us. They don't need us. Because universities have General Orders (GO), they cannot easily hire and fire lecturers. However, when we were forced to accept the more recent work & pay scheme (SSB, SSM, etc), the hire and instant fire are realities. Thus, if a medical school is to fire its lecturers (down-sizing), the elderly PhD-holder will go first.

People have choices and they can either support the medical specialists who have and get everything or they can support the poor PhD-holders who have nothing and get nothing. The PhD-holders are honest lecturers but I can't say the same of the medical specialists. I don't see their names on the time-table where I think their names should be.

Gaji buta is a new term that I learnt very late in my career. It means a lecturer can be paid for no work done. How is that possible? Ask the medical specialists how they do it. Most medical specialists hold a job that does not require them to do anything! Would you believe that?! Yes, it is true. Nowadays, HODs are paid RM600/mo. A program head is also paid RM600/mo. Any head of anything for that matter is paid RM600/mo. In an autonomous university, any post can be created and a person can be paid for holding that post. Some posts are redundant and ridiculous but they exist because someone needs to be paid - usually a medical specialist. So it is not surprising to see many posts being held by medical specialists when I feel they should be seeing patients in clinics (that's what they were trained for). Why have they left their clinical duties? Isn't it a waste of national resources and funds when medical specialists leave clinics altogether and assume non-clinical functions? Why have we let these things happen right in front of our eyes? Why has no one spoken about such ill practices at our medical school? We need the doctors in the clinics so our patients don't have to wait so long in the stuffy humid corridors.

To keep the ledger straight, I came across one instant where I asked my graduate student (who became a medical specialist) how much she was earning. It turned out that my own postgraduate medical student (with a Master of Medicine degree) is earning close to what I earn as a PhD-holder! I almost cried when I found out but I promised myself not to cry in front of my student. I hope this post will make PhD-students think twice if they think it is fun to work at a medical school. It is fun in the first year but trouble will strike when others get increment for even the smallest job in medical school. I still feel that today's doctors are mean and greedy, especially the ones whom I have seen at my workplace. Aren't they ashamed of the gaji buta that they get? Don't they know that they are draining our national funds? Don't they feel guilty at all? Will our doctors ever stop from begging the government for higher pay and bigger allowances (for no work)? Will our government stop to think or ask the PhD-holders of the truth about all this terrible mess?

I don't know what will happen in future but it is my worry that if things are  left unchecked, doctors will become super rich and patients and PhD-holders will become ordinary poor. Many patients are already fakir and wajib dibantu. Why are we helping the doctor and not the poor patients and PhD-holders? The medical doctors and specialists have an avenue and they complain to the medical council and association (MMC and MMA) but the PhD-holders have nowhere to complain, vent their grievances or let their voices be heard. So nobody knows the real situation in medical school, the place where I worked for more than 30 years. I still have another 6 years to work in this medical school unless I also want to leave early.