Why doctors in Myanmar quitting their job ?
Everybody thinks being a doctor is a miracle and he can make big money and assume as a noble career.
However, although I finished my study in medicine, I don’t want to be a doctor anymore in Myanmar.
Seriously? Why?
I have some reasons that I don’t wanna do.
Check out the following to know the life of a doc in Myanmar.
However, although I finished my study in medicine, I don’t want to be a doctor anymore in Myanmar.
Seriously? Why?
I have some reasons that I don’t wanna do.
Check out the following to know the life of a doc in Myanmar.
Before I continue, you first need to familiar with the education system in Myanmar. Unlike other countries, only students who passed the matriculation exam with flying marks have the chance to attend medical school. There are 5 study years and 1 internship year during my time. Now, the school years have been extended and my next generations will have to spend 7 years in medical school.
The first year is more like pure science subjects, chemistry, maths, English etc. The lectures are quite similar to Grade 11 curriculum but primarily focus on medically applicable. Anatomy, Physiology, and Biochemistry have to be learned in the second year.Then, in the third year, students have to visit hospitals to obtain knowledge of medicine and surgery. At the same time, they also have to learn pathology, pharmacology, and microbiology. Final part I is another year teaching pathology, preventive and social medicine, forensic medicine and other clinical specialties subjects. The major subjects in final part IIare medicine, surgery, OG and paediatrics including bedside teaching.
The last year is a house officer internship, fresh doctors are assigned in different wards and hospitals to learn in a real clinical setting by exposing with real patients.
The last year is a house officer internship, fresh doctors are assigned in different wards and hospitals to learn in a real clinical setting by exposing with real patients.
Even though we had studied a lot of things in 6 years, we don’t we want to become a doctor after all. It’s quite different from other countries in which doctors are paying high but they still want to quit for other reasons.
Low Salary.
The official salary of a doc is about 2.75 lakh per month which is equivalent to 200 USD. If you open GP clinic by yourself, the maximum amount you can charge per a person is 2 USD.I am saying about the ordinary medical doctor, not a specialist level. Sometimes patients think 2 USD is too much for them and they want treatment at cheaper prices. Because of very low treatment fees, most of the doctors who are not descended from wealthy family choose other high salary jobs such as product specialists in pharmaceutical companies, project officer in NGO, the medical doctor in private hospitals and so on. Although they still want to study more and want to become a consultant, there are many barriers limiting them to be. Government salaries are the lowest but it can give you an opportunity to obtain a master degree.
Therefore, young doctors always want to be government servants regardless of low payment and high workload. But, they can not survive on their salary alone, their families need to support them or find an alternative income by opening GP clinic and some other works. In some countries, though the monthly salary is not very high, other social welfare services are still supporting to ease the life of government staffs. It doesn’t work well in Myanmar.
High Workload
Shortage of medical professionals is a countrywide crisis in current Myanmar. The former government produced a large number of doctors and nurses in previous decades. But, the government can not hire all those medical staffs to assign in their vacant positions. Therefore, unemployed doctors nurses and doctors are queuing to take civil service entrance exam while a few numbers of doctors and nurses are operating the hospitals with their uttermost efforts. In recent years, the government conducted free healthcare services in hospitals. As a consequence, the more patients went to hospitals. Free services hospital can provide and quantity of patients needed to care always an imbalance. As far as I know, hospitals should take responsibilities for every patient they are able to care. But now, primary and secondary centers are always referring patients to tertiary centers. Some of the patients do not even need to admit in tertiary hospitals. That’s why hospitals in cities are always a crowded place.
Even though the government is developing more and more hospital building, they can not offer satisfactory care to that patients because of no human resource. Besides, in my eyes, the buildings are not standardized and not suitable for a hospital setting. For instance, not enough toilets, elevators, emergency exit, restrooms etc. So, in Myanmar to get a tender loving care from a doctor is like a miracle of a patient. That’s because of the high workload of doctors, they can not give a sufficient amount of time to look after each patient.Even an originally patience doctor may be raged out if they are assigned 36 hours under stressful conditions.
Competitive
The world is a competitive place.Yes, I understand. Doctors also want to get a promotion which can make them breathable in daily struggling. There is two way to choose for doctors if you have been graduated from college. First, will you join civil service or will you take oversea medical exams and work independently in foreign countries?
Yes, to answer the civil service exam, you need to have general knowledge about current governments.
In my own opinion, the exam held for doctors are not quite fair. Most of the questions asked in the civil service entrance exam are nonsense and nothing related to the doctor career like which bridge in Myanmar is longest? answer the speech delivered by the president in which events? list the name of leaders in which countries? And so on.
Yes, to answer the civil service exam, you need to have general knowledge about current governments.
In my own opinion, the exam held for doctors are not quite fair. Most of the questions asked in the civil service entrance exam are nonsense and nothing related to the doctor career like which bridge in Myanmar is longest? answer the speech delivered by the president in which events? list the name of leaders in which countries? And so on.
So, doctors have to attend tuitions to know all these kind of questions. In my personal experience, the smartest student in medical school can even fail in that exam while the dumbest one can pass easily. That’s why I am saying the exam is not fair. (This system has been abolished since the government desperately needs new doctors. If you submit a form and sit in the exam room, you have a 99% chance of being chosen.)
You have to overcome these steps if you want to be a government doctor. Another step is 4-month training in central government servant training school. They have to do exercise, carry guns and practice to shoot and listen to boring lectures which are just propaganda. It’s more like a soft military training. (This one has also been fixed, doctors don’t need to attend military training anymore. You only need to listen to boring political lecturers )
If you successfully overcome these steps, you officially became government doctor, that’s why you have to go to the place you are being assigned. You still have to wait another year (sometimes 2 years, I don’t know, the policy is always changing) to sit entrance test of master class. Most of the doctors failed in the first time because few candidates are selected from many doctors. It also depends on the subjects you choose. Some peripheral subjects are less popular and you are easy to pass while popular subjects like medicine and OG have less chance to pass.
Another way apart from government staff is answering oversea medical exams like MRCP, MRCS etc.
It is also not an easy way also. You need to have sufficient amount of money to have a chance to answer these exams. Tuition and exam fees are very expensive of an ordinary doctor descended from a middle-class family. Total cost might even reach 5000 USD for one attempt. If you failed in that exam, all the money lost. That’s why you need to be qualified before you answer that examination. That’s why these oversea exams are like for doctors with the rich family background. Meanwhile, ordinary doctors who needed to support families are opening GP or work in high salary NGOs and pharmaceutical companies.
If you successfully overcome these steps, you officially became government doctor, that’s why you have to go to the place you are being assigned. You still have to wait another year (sometimes 2 years, I don’t know, the policy is always changing) to sit entrance test of master class. Most of the doctors failed in the first time because few candidates are selected from many doctors. It also depends on the subjects you choose. Some peripheral subjects are less popular and you are easy to pass while popular subjects like medicine and OG have less chance to pass.
Another way apart from government staff is answering oversea medical exams like MRCP, MRCS etc.
It is also not an easy way also. You need to have sufficient amount of money to have a chance to answer these exams. Tuition and exam fees are very expensive of an ordinary doctor descended from a middle-class family. Total cost might even reach 5000 USD for one attempt. If you failed in that exam, all the money lost. That’s why you need to be qualified before you answer that examination. That’s why these oversea exams are like for doctors with the rich family background. Meanwhile, ordinary doctors who needed to support families are opening GP or work in high salary NGOs and pharmaceutical companies.
Complicated situations
In this country, medical staffs are not happy. There are a lot of quacks in villages. Traditional birth attendants proceeding abortion with unsterilised tools. Street vendors selling onetime used cocktail drugs for occasional sickness. That drugs contain a high dose of anti-inflammatory pills and corticosteroid. It’s true the sickness will be relieved suddenly but the consequence of that drugs are nightmares for doctors and patient’s families. There are other MLM (Multi-level marketing products) selling at a high price to terminally ill patients. And there are a lot of MLM’s fans. On the other hand, media are always waiting for the weakness of doctors. Most of the time, it’s a misunderstanding between doctors and patients. As I’ve said earlier, doctors don’t speak much and that increase tension between patients. It’s right for the patients to question about their disease and treatment plan, but I don’t know what’s being wrong to answer. But, there are two extreme patients. Patients nothing know, and patients know everything. Both of them are very difficult to communicate.In most countries. Healthcare system might be well operating. If you are a doctor, you only need to focus on your side. Not about other stuff like patient’s social welfare, budget, and rehabilitation etc. I have worked as a doctor for a moment, a patient with old stroke came to me for treatment. No drug can heal his weak limbs. All he needs right now is physiotherapy. I referred to a physiotherapist, but he didn’t go. He only wants medicine, don’t want to do any exercise. Besides, the physiotherapist is not always present in town, only present in major cities. Sometimes, the option for a patient is dialysis, but dialysis machine is not available. The patient is an emergency but CT is broken.These are the burdens pulling doctors backward, fighting for patients.
So, you might have seen the challenges we are facing. This is just the tip of the ice bag.There are so many things I haven’t explored. Especially, the pressure inside the workplace. Now, I’m developing medical apps to support my colleagues battling in the front line and patients hungry knowledge. Healthcare trend is changing in the world. I don’t want to stick to the traditional practice and want to set some foundation for the future of medicine. Even though I haven’t reached the mere 10% of my goal, improving health standard with technology is my lifelong mission.
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