Dear Dan,

I'm sorry it took me so long to reply you. It's been a madhouse the past few weeks, as you can see. I'm glad I can take some time to reply you now, and knowing that many ask the same questions during housemanship, I think the reply deserves its own post :P

I'm originally from Semenanjung, a real KL girl at heart. I opted to do my housemanship here in Sarawak for many reasons, one being that I heard from one of my lecturers that they give you real good training here. And after being here for more than a year, I can safely say that I did not regret coming over, as I truly learned a lot and grew up a lot here.

Doing housemanship in East Malaysia can be really challenging, mainly being that there is ALWAYS not enough housemens around. So if you're willing to work here, be prepared for long hours, EOD calls, less sleep, tons of work, and come with a willing heart to learn. Do not be like some housemens who goes home complaining and whining to their parents that they don't have time to eat lunch during tagging, or that you cannot take some mild scolding when you do wrong. And for these overly concerned parents, we have been through it, survived through it, and we've grown up to be better doctors. So tell your children to suck it up, and that it won't kill them to skip meals once in a while or survive on minimal sleep for a week. Plus, they are in a hospital, and in the event that they do collapse due to sheer exhaustion, take heart that there's always the emergency trolley is always available, and that NOTHING will come out of a lil exhaustion. We've fallen asleep during rounds, doze off while assisting in surgeries, and went on working without food or water into our bodies for 1 full day. And we survived. And every other houseman out there will too.

Upon reflection, every houseman who has trained here will tell you that the hands on experience that you get here is invaluable. Compared to those in West Malaysia, we actually get to do appendicectomy, set long lines, caesars, ERPOCs, obstetric scans, and much more that those in the West cannot get to do due to too many MOs around to do them. We're actually trained to be equipped with all these skills as there is always a need to service in the rural districts where you are ALONE and there's no MOs/specialist to come save you when you don't know how. So you NEED to know. And hence, we learn.

Now I heard housemens in the West get the next day off post call. Personally I think it can be both good and bad. I know it gets tiring after a long night, and it would be nice to be able to go home straight after your call, but if this happens, with the abundance of housemens in the West, you'll spend less time in the hospital, thus learning less. And that, isn't such a good thing in a long run. Just to let you know, we can't practice that day off thing here in East coz there won't be enough housemens to go around during office hours. So too bad, work is work. And ultimately, the drive is not the money, not the fame, not the being afraid of getting scolded by your bosses... But the passion for the people, and the truly sick.

You'll definitely have to do two years housemanship, but unlikely they will let you do your MOship in the West, coz we actually train housemens to become MOs for the rural areas. If all housemens wanna go back after 2 years, there will be a huge influx back to the West, and that would just be plain ridiculous as there are TOO many MOs back in the West that they are fighting among themselves to learn what they need for postgraduate studies. So why bother to go back and fight with them when you can do all you want here? And the good part is, you learn to live and survive with less amenities here, and most of your management will be based on clinical judgement, which is what it should be in the first place :). Sorry but there won't be any CT scans or even an ultrasound scan for you in the peripheries. X ray also maybe. Haha. And limited supply of antibiotics.

This is the reality. So if you wanna do your housemenship here, be prepared to do your MOship here too. But if you really have a heart for the people, it doesn't really matter where you work, as long as you're willing to serve.

And we really do need people who are willing to serve here.

It's sad to see East Malaysians who are not willing to come back here to work, but chose the easier route of completing their housemanship in the West. Then who is gonna serve the people here? Honestly, East Malaysia is gonna collapse if no Westies are willing to come over.

So for you Dan, you might have to consider staying here for at least another 3-4 years. But I urge you to take up the calling to serve here, not just because we're terribly lacking in manpower, but to give the truly nice people here (no, seriously, the people here are super nice) the healthcare they deserve.

It's a difficult job, being a doctor. And you'll have to be mentally prepared to sacrifice a lot to do what you do. And this, is what it means to become one. It's not the glory you get to have that Dr in front of your name, nor is it the pleasure you attain when the patients call you Dr, it's the honour you get when you see your patients walk out of your ward, well.

And thank you, for your encouraging words. I may not know you, but it's always nice to have empathy from others regarding the shitty stuff that I go through :) So thank you, because it means a lot. And I hope you keep the empathy for others too, because unfortunately, this job, will slowly try to strip it off you. It's not easy, keeping the passion. Perservere, and keep the fire burning.

All the best.

'All in a day's work'
- MGH 2009-

-jess-