Junior Doctors’ Calls For Better Treatment At Workplace Fall On Deaf Ears

Recently, plenty of testimonies by junior doctors had cropped up on social media regarding their working experience in public hospitals after the tragic death of a house officer in Penang. I wish to respond to this article written by a senior medical practitioner who seemingly missed the issue at hand and either 1) tried to deny the existence of abuse in the first place or; 2) is saying that the reported behaviors are in any way justifiable. Unsurprisingly, this defensive attitude is part of the constant narrative that there is absolutely nothing wrong with the status quo and hence, the unwillingness to change and provide any solution. If one is following the Johnny Depp’s trial in the US religiously like this writer does, one cannot help but notice that this is akin to a bully’s defence. It even resembles the cyclical pattern of abuse which relies on diminishing or invalidating the other party’s experiences.

To understand this unique bullying phenomenon in our public healthcare system, one has to understand that there exists an imbalance of power without any sort of check and balance. One, there is a vertical power structure which gives seniors complete autonomy to determine a junior’s value, and it is also possible for them to effectively block the latter’s career progression as well. This also applies to juniors who are looking to apply into a higher specialty training. If one is hindered in their progress for whatever reason whether it is justifiable or not, there is simply no channel for the junior to challenge the senior’s perception, or address their bias if any. There is no neutral third party to oversee this transaction. You cannot be a doctor if you do not complete houseman-ship, and you cannot be a specialist if you fail to gain entry into the higher training pathway. Many remain in silence realizing the stakes at hand while the perpetrators can bask in their relative security and knowledge that their juniors will not want to make trouble. Is it no wonder then that some might think that the only solution is to take their own life? Threatening us that we cannot complete our houseman-ship or progress into a chosen specialty is all too common occurrence that we hear around the hospital. It is punitive and not at all designed to impart lesson nor encourage juniors to have a better commitment to their job. It actually robs us of the motivation to perform well and aim for more.

Second, even if there exists a report which highlights a case of abuse, there is no way for the junior to report this without running the risk of being targeted. Their involvement in these proceedings may taint their records; and in fact, some juniors I know had been demerited either directly as a consequence of their involvement (in some cases, only by making a report to the administration or SISPAA – talk about lack of transparency issue here), or indirectly – by being hawkishly supervised in their work which resulted in them being A) made to answer to stricter and dubious assessments; or B) so preoccupied with the extra layer of stress that they end up making mistakes that may endanger a patient, and can result in their training period being prolonged or contract termination.

Third, the lack of accountability. Even if the abuse had been reported and the perpetrator was identified, there had been no real consequences observed, no examples made for public reassurance – we have heard stories of how some got away with bullying in recent days – some of those bullies were able to enter the Master’s program despite their abusive pattern of behavior being reported again and again – and you wonder why the cycle keeps repeating itself. Some of the perpetrators were not even remorseful, to say the least. It leaves us with the impression that some  members of our fraternity are more protected than others. Are junior doctors disposable?

I had taken the decision to quit the public sector after having passed two steps of an international board exam which I had taken on my own initiative. I had made the decision after considering what is best for my professional and personal development. I do not think I was in any way ‘weak’ to do that. Like so many others, I had also been through the experience of being targeted at work and made to feel insecure and less worthy. Our feelings and motional experiences were not being invalidated, and there was the gaslighting whereby when you try and stand up for yourself, they would accuse you of playing a victim. It was ugly. There was no supportive working environment.

The statement by the MMA president on The Star on 11th May 2022, “Those who are not cut out to be medical doctors will just quit…” disappointed me. Why would you want to waste the resources to train and develop someone’s potential when you can screen if someone is good enough to stay in the job? Talk about knowing the future, maybe the MMA possess a crystal ball? And what about those perpetrators who remained in the system and had been caught dealing out any sort of abuse to their powerless juniors, did they not see that coming? To pressure someone to quit a job whilst in training is somewhat premature and myopic, not to mention simply unkind.

We must not let this issue be reduced to “the fact is some people just could not cope with the high career demands.” A fair reader can surmise that this is far more nuanced than that. It is an issue of targeted abuse, unfair treatments, lack of protection for the less powerful members, lack of transparency issue and proper accountability, as well as the impacts of those abuses to someone’s psychological well-being and mental health. Difficult, sometimes traumatic experience on top of an already challenging profession. Do not be apathetic. Don’t let’s wait for things to die down and the cycle to repeat itself. Calling these complaints ‘isolated incidents’ shows a lack of class and empathy for those who were and are still suffering. We can change the status quo. Malaysians, we are better than this. Recognize the red flags and treat the issue with as much urgency as it deserves. Or else, we could only be losing in the long run as there are more and more quitting each year, less and less passionate specialists we will have in the future.

(Artikel ini adalah tulisan saudari Ezra Wilson dan tidak semestinya mencerminkan pandangan pihak Solidaritas)