Recently, the incident of a house officer falling to their death has ignited a national uproar and call for action in retribution to various reports of bullying and unjust treatment of junior doctors.

To date, two junior doctors’ lives have perished within the last two years as a result of atrocious workplace horizontal violence and intimidation.

Multiple studies and reports have too revealed the existence of atrocious horizontal violence and harassment against Junior Doctors in Malaysia.^1,3

MMI calls on the Ministry of Health to directly address the perpetuating injustices of Horizontal Violence towards House Officers and to investigate the issue justly and effectively.

1. To shift the cultural mindset of workforce bullying and implement more respectful communication in workplace policies

We recognize that it has become ‘cultural’ for housemen to undergo harsh training before becoming qualified MOs and specialists.

However, health authorities should also recognize that prolonged exposure to highly stressful and toxic workplace environments potentially results in a higher vulnerability of junior doctors to negative psychological and physical health effects.⁶

Discrimination and vulgarities should be repressed to secure the welfare of doctors.

Additionally, studies have shown that toxic workplace environments would consequently indirectly impair the quality of patient care delivered by our future specialists and MOs should they be consistently subjected to horizontal violence and unjust work expectations.⁴

Thus, serious actions must still be taken with immediate effect to curb the loss of further victim lives and mitigate the preservation of colleague self-dignity, psychological and physical well-being.

2. To instill complete transparency in the investigation and re-evaluation of the House Officer training system

We urge the Ministry of Health (MoH) to enforce a transparent front when conducting a major audit of the current housemanship work conditions.

We plead that the MoH addresses the current issue of atrocious horizontal violence seriously and enforce compassionate mentoring and professional communication standards towards all medical colleagues alike.

Bullying, verbal and emotional abuse, racist remarks and gaslighting should be strongly opposed.

3. To execute reasonable changes to the mandatory weekly work hours to alleviate both the senior and junior medical workforce’s stress and mental well-being.

Whilst countless respectable members of authority and political figures have stressed the unfairness of young doctors being expected to perform effectively under the pressure of 65-75 weekly work hours⁵, it is commendable that the Ministry of Health has formed an independent task force to investigate the matter.²

However, we humbly plead that the MoH stresses implementing effective moderations to the duration of weekly work hours of Junior Doctors and increasing the workforce manpower.

4. To encourage active maintenance of mental health and physical well being among senior and junior medical staff members

We implore the government’s insight in encouraging positive professional and pastoral support in clinical areas of high workforce stress and time-pressured settings.

In light of reports about doctors being ridiculed for seeking pastoral support when in times of personal duress, we plead that the MoH implements better maintenance of mental health and well being policies in professional workplaces, as well as to ease the accessibility of medical staff to mental health services that they need without any stigma or prejudice towards their active initiative to preserve their mental and physical well being for the sake of providing better patient care.

To conclude, MMI appeals to the MoH to implement the above necessary changes to all public hospital training settings and to closely re-evaluate the junior doctor training system.

The MoH must act urgently to ingrain compassion into the training of our future specialists and MOs.

We must put a stop to the vicious cycle of Horizontal Workplace Violence before human nature takes its course and we lose further manpower as future graduates flock to greener pastures where their well being is being recognized as a priority for better patient care.

References:

1. Report: Junior Doctors Claim Penang Hospital ‘Worst’ Place To Practise; CodeBlue.
2. Ministry task force to investigate death of houseman in Penang; Free Malaysia Today.
3. Mok O. Penang Health director confirms houseman’s death by falling, says police investigating; Malay Mail.
4. Samsudin EZ, Isahak M, Rampal S, Ismail R, Zakaria MI. Workplace Bullying Among Junior Doctors in Malaysia: A Multicentre Cross-Sectional Study. Malaysian Journal of Medical Sciences. 2021 Apr 21;28(2):142–56.
5. Sooi CC. MOH must quickly rid “houseman bullying” at public hospitals; Focus Malaysia.
6. Clampdown on horizontal violence in healthcare: Kelvin Yii; The Vibes.

MALAYSIAN MEDICS INTERNATIONAL