An Inspirational Journey from Contract Doctor to University Hospital Clinic Manager
In the evolving landscape of medical practice, doctors often find themselves at crossroads, having to make career decisions that could dramatically impact their lives. One such inspiring story is that of Dr. Bessima Jamal, who chose an unconventional path and found her niche as a Medical Officer (MO) in a primary care department at a University Hospital, and a manager at one of the University Hospital clinics.
Born and raised in Malaysia, Dr. Bessima pursued her medical degree in the United Kingdom under a sponsorship. Upon her return, she embraced the traditional pathway and completed her housemanship in Queen Elizabeth Hospital in Sabah. However, the reality of being a contract doctor soon dawned on her. Dr. Bessima was part of the second batch offered contracts and the news that only 50% of her seniors from the first batch secured permanent positions left her feeling uncertain about whether she would be able to secure a permanent position herself.
Despite the uncertainties, she was driven to succeed. She worked hard and passed her parallel pathway training paper by the end of her housemanship, hoping it would give her an edge. Unfortunately, it did not secure her a permanent position. Still determined to continue practicing medicine, Dr. Bessima began exploring options outside of the MOH.
Opportunity knocked in the form of a service MO position at a university hospital. After a successful interview, Dr. Bessima left KKM at the end of her contract and transitioned to the university hospital, who offered her a permanent position. This marked a significant shift in her career trajectory, yet it was a decision she describes as a “no-brainer”.
The Rude Shock
The University Hospital offered different pathways for their doctors, and navigating these proved a challenge.
As a service MO, Dr. Bessima’s career pathway was similar to MOH MOs, focusing on specialty training and becoming a specialist. However, she quickly found out that service MOs at a university hospital can only pursue Masters in their own university. If the desired specialty is not offered by the university, the only option is a parallel pathway. This proved to be a stumbling block for progression and career pathway in university hospitals.
In cases where the parallel pathway is not recognized, these MOs face significant barriers to career progression. They must either wait for their university to offer the necessary master’s program or transition into a trainee lecturer position, which entails a different career trajectory.
The Difference Between MOH & MOHE
Unlike traditional hospitals, these institutions often involve teaching and research components in addition to clinical work. As a service MO, Dr. Bessima dedicates 80% of her time to clinical practice and 20% to teaching medical students. However, the career pathways and opportunities for progression in university hospitals differ from those in MOH hospitals.
An important distinction to note is the difference between service MOs and lecturers in university hospitals. Service MOs primarily focus on clinical work and teaching, whereas lecturers devote 80% of their time to academic activities such as teaching and research, with the remaining 20% dedicated to clinical practice. The pathways to becoming a lecturer and a service MO diverge, with the former requiring a trainee lecturer position, a master’s degree sponsored by the university, and a subsequent bond to the university upon completion of the degree.
The University Hospital Experience
Dr. Bessima found that working in a university hospital, especially a newer one, required wearing many hats. Due to the relatively limited number of senior colleagues, she had to take up various administrative roles that she might not have been exposed to in the MOH. She took on tasks such as managing budgets, asset management, and drug procurement, providing her with a broader perspective on the bureaucracy of the system.
In addition to administrative tasks, university hospitals offer opportunities for teaching and research. The push for involvement in these areas, even for service medical officers, is substantial. This exposure can be especially beneficial for those with a passion for teaching and a desire to contribute to the academic community.
Challenges and the Power of Change
Despite the benefits, working in a university hospital comes with its challenges. Taking on administrative roles that were initially unfamiliar required a steep learning curve. However, Dr. Bessima found that these experiences equipped her with an understanding of the management side of healthcare, which could be key to initiating and implementing change.
She argues that understanding the system, even at its bureaucratic level, can empower doctors to make improvements. This could start with something as simple as changing the work culture within a small clinic and gradually ripple out to influence the larger institution.
Despite these challenges, Dr. Bessima’s experience in the university hospital setting has been rewarding. She enjoys the variety of services and cases she encounters in her primary care department and appreciates the opportunity to work alongside clinical specialists from the lecture side who offer specialist clinic services. This unique environment offers a blend of hospital outpatient clinic services and general outpatient clinics, providing a rich learning experience for both students and practitioners.
Advice for Young Doctors
For young doctors facing the uncertainty and frustrations of the contract system, Dr. Bessima advises keeping options open and being flexible. This includes considering non-clinical job options and exploring skills and interests beyond medicine. She believes that there are many ways to help patients beyond being a clinician and encourages doctors to find their niche.
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