House Man Ship Presentation RSMU-2010

1

No Glory…No Honor

Housemanship

Are You Ready? By Norris

2003-2006- Diploma In Medical Assistant .MOH, Malaysia

College of Medical Assistant, Perak

(Pemenang Anugerah Pelajar Terbaik Konvokesyen 2006)

2006-2009- Assistant Medical Officer U29 (APC NO.8913)

Outpatient Department (OPD)

Klinik Kesihatan Jinjang,JKWPKL

2007- Pemenang Anugerah Khidmat Cemerlang JKWPKL 2006.

2010- present-Undergraduate RSMU, Russia (on paid leave)

Clinical experiences:

Emergency medicine – Hospital Taiping,Hospital Slim River,Hospital Parit Buntar.

Hospital Ipoh.

Medical /Surgical - Hospital Ipoh

O&G -Hospital Parit Buntar

Orthopedics -Hospital Ipoh

Paediatrics -Hospital Ipoh.

Family Medicine -KK Lenggong, KK Tanjung Rambutan, KK Beruas,

KK Greentown(Tuberculosis clinic )

ENT /Eye - Hospital Ipoh.

Psychiatry - Hospital Bahagia, Tanjung Rambutan.Forensics - Hospital Parit Buntar

CONGRATULATIONS

You have made it….

YOU ARE NOW DOCTORS almost

BUT……………..

Syarat Lantikan

• Rakyat Malaysia;• Berumur sekurang-kurangnya 18 tahun pada masa iklan tawaran

dikeluarkan;• Mempunyai ijazah perubatan daripada universiti yang diiktiraf oleh

Kerajaan dan berdaftar dengan Majlis Perubatan Malaysia (MMC);• Lulus Bahasa Melayu / Bahasa Malaysia termasuk Ujian Lisan

dalam Sijil Pelajaran Malaysia (SPM) atau kelayakan lain yang setaraf dan diiktiraf;

• Calon yang dilantik di bawah Seksyen 12 (1) (a) (ii) Akta Perubatan

1971 dan memenuhi kriteria di bawah Medical Regulations para 12 (1) (aa) serta berdaftar dengan MMC; dan

• Calon juga boleh dilantik di atas gred jawatan yang lebih tinggi berdasarkan pengalaman kerja (multiple entry); U41, U43, U47, U51 dan U53.

TUGAS DAN TANGGUNGJAWAB PEGAWAI PERUBATAN

Pegawai Perubatan bertanggungjawab menjalankan tugas pencegahan penyakit dan rawatan perubatan kepada orang ramai yang memerlukan perkhidmatan kesihatan di hospital, klinik kesihatan dan institusi kesihatan di bawah KKM. Pegawai Perubatan juga bertanggungjawab menjalankan pemeriksaan ke atas ibu-ibu mengandung dan menyambut kelahiran bayi, melaksanakan diagnosis perubatan dan pembedahan, menjalankan postmortem, mengurangkan beban kesakitan pesakit dan tugas lain yang menuntut profesionalisma seorang Pegawai Perubatan. Pegawai Perubatan turut terlibat dalam pembangunan kesihatan keluarga dan masyarakat di samping melaksanakan aktiviti pengawalan penyakit, pemantauan kesihatan dan menjadi anggota penting dalam program peningkatan kesejahteraan kesihatan rakyat. Pegawai Perubatan juga menjadi penyumbang kepada penghasilan sistem dan teknologi perubatan melalui hasil penyelidikan yang dijalankan di institusi penyelidikan KKM.

Berita Harian 12/8/2009

Section 13(2) of the Medical Act 1971 States that fresh medical graduates shall undergo further

training for the purpose of obtaining experience as a house officer. This was explicitly stated as follows:

The provisionally registered person, shall, immediately upon being provisionally registered, engage in employment in a resident medical capacity to the satisfaction of the Medical Qualifying Board for a period of not less than 2 year in a hospital or institution in Malaysia which is approved by the said Board for the purpose of such employment; four months in a resident medical post and four months in a resident obstetrical and gynaecological post at the conclusion of satisfactory service, as certified by the Medical Qualifying Board, under this paragraph, the provisionally registered person shall be entitled to a certificate issued by the Council in the prescribed form as evidence thereof.

Goal

• Provide you with an educationally sound experience that professionalizes new medical graduates not only with appropriate knowledge, skills and experience but above all attitudes.

Objectives• Consolidate theoretical knowledge you gained

as an undergraduate and learn to apply it in caring for patients.

• Develop the technical, clinical, personal, and professional skills .

• Responsibility for patient care .• Develop professional judgment .• Ethical and legal framework .• Multidisciplinary health care team .• Personal career goals and expectations

Pekeliling Ketua Pengarah Kesihatan Bil. 11/2007 bertajuk

Pelanjutan Pindaan Tempoh Latihan Pegawai Perubatan Siswazah Dibawah Akta Perubatan 1971’ bertarikh 21 Disember 2007 menerangkan mulai Januari 2008.

Semua pegawai perubatan siswazah perlu menjalani latihan siswazah selama dua tahun di dalam enam disiplin berikut:

a. Perubatan;b. Pediatrik;c. Pembedahan;d. Otopedik;e. Perbidanan & Sakit Puanf. Perubatan Kecemasan.

The postings in the six disciplines should provide opportunities for you to participate in:

• Assessment and admission of patients with acute medical problems.

• Management of in-patients with a range of general medical conditions;

• Discharge planning, including preparation of a discharge summary and other components of handover to a general practitioner or a subacute or chronic care facility.

• Ambulatory care.

Medical Act 1971, The Medical Qualifying Board.Do’s and Don’t

• Only be allowed to proceed to the next discipline if your supervisor is satisfied with your knowledge, skills, competency and attitude.

• No gap of more than 4 months between postings • Not allowed to move to another training hospital.• Total duration of your internship training should not

exceed 6 years .• Not satisfactorily complete internship training

requirements your training shall be discontinued and you will not be eligible for full registration.

• As there is no restriction to the number of leave during the internship training stipulated in the Act, the Council concurs with the period of leave granted by the Ministry of Health which is not more than 10 days for each posting .

• Not allowed to endorse Births and Death Registration documents or carry out post-mortems.

• Not allowed to issue sick leaves for patients .• Referring an inpatient to any personnel outside the unit

is not your duty .• The diagnosis should be according to the International

Classification of Diseases (ICD). • Insurance and Professional Indemnity

Hospital Negeri Hospital

1) Perlis 1)Hospital Tuanku Fauziah, Kangar

2)Kedah 1)Hospital Sultanah Bahiyah, Alor Star

2)Hospital Sultan Abdul Halim, Sungai Petani

3)Hospital Kulim

3)Pulau Pinang 1) Hospital Pulau Pinang

2) Hospital Seberang Jaya

4)Perak 1) Hospital Taiping

2) Hospital Raja Permaisuri Bainun, Ipoh

3) Hospital Teluk Intan

4) Hospital Seri Manjung-Lumut

5) W.Persekutuan 1)Hospital Kuala Lumpur

2)Hospital Putrajaya

6) Selangor 1) Hospital Tengku Ampuan Rahimah, Klang

2) Hospital Kajang

3) Hospital Serdang

4) Hospital Ampang

5) Hospital Sungai Buloh

Hospitals Negeri Hospital

7) N. Sembilan 1) Hospital Tuanku Jaafar, Seremban

2) Hospital Tuanku Ampuan Najihah, Kuala Pilah

8) Melaka 1) Hospital Melaka

9) Johor 1) Hospital Pakar Sultanah Fatimah, Muar

2) Hospital Sultanah Aminah, Johor Bahru

3) Hospital Batu Pahat

4) Hospital Sultan Ismail, Pandan, Johor Bahru

10) Pahang 1) Hospital Tengku Ampuan Afzan, Kuantan

2) Hospital Sultan Haji Ahmad Shah, Temerloh

11) Terengganu 1) Hospital Sultanah Nur Zahirah, Kuala Terengganu

12) Kelantan 1) Hospital Raja Perempuan Zainab II, Kota Bharu

13) Sarawak 1)Hospital Umum Sarawak

2)Hospital Sibu

3) Hospital Miri

14) Sabah 1) Hospital Queen Elizabeth

2) Hospital Tawau

3) Hospital Duchess of Kent, Sandakan

Hospitals

Negeri Hospital

15) Pusat Pengajian Tinggi 1)Pusat Perubatan Universiti Malaya (PPUM)

2) Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

3) Hospital Universiti Sains Malaysia (HUSM)

MD (RSMU)

Housemanship UD41

Medical OfficerUD44

Specialists(Pakar

Perubatan)

You are here

AdministratorClinical Medical

Officer

KKM – Kementerian Kesihatan MalaysiaMOH – Ministry of HealthSPA – Suruhanjaya Perkhidmatan AwamJPA – Jabatan Perkhidmatan AwamMMA- Malaysia Medical AssociationMMC- Malaysia Medical Council.BMD –Borang Maklumat Diri.UD – Gred untuk kakitangan kesihatan.

Pendaftaran dengan SPA / HR

Interview

Induksi /BTN

Housemanship

Proses Perlantikan

Obtain from Bahagian Sumber Manusia (KKM)Or online application : www.spa.gov.my• Borang Biodata ( BMD);• Borang Tapisan Keselamatan;• Borang Pendaftaran dengan Majlis

Perubatan Malaysia• Borang SPA 8

Jabatan Lokasi Tujuan Perlu di bawa Makluman

JPAUnit

PengurusanKerjaya

Level 5, C1Parcel C

Self-reporting 1. Borang Akhir Pengajian2. Salinan :- Degree- Examination Transcript-Bukti Permohonan Kerja (SPA)-Provisional Offer Letter (after the interview.)

BMD to be handedto KKM.

Jabatan Lokasi Tujuan Perlu di bawa Makluman

SPA(Bhgn

Pengambilan)

Level 6, C7Parcel CTel: 03-88856338

Hand inprovisionaloffer letter

1. Provisional Offer Letter olehSPA2. CERTIFIED COPY of:-- IC- Birth Cert- SPM Cert- Degree Cert- Examination Transcripts

You will begiven the SuratPerlantikan as Pegawai PerubatanGred UD 41, melalui pos.

Jabatan Lokasi Tujuan Perlu di bawa Makluman

KKM(Bhgn Sumber

Manusia)

Level 9, E7Parcel ETel:03-88832798

1. BMD complete with thefollowing CERTIFIED copies(1 copy is sufficient);- Birth certificate- IC/ Pasport- SPM- Basic medical degree- Examinationtranscript2. ONE passport sized photo3. If married, a copy of- Marriage certificate

Make thechoices of yourHospital.You need to rank yourtop 3 choices.

Jabatan Lokasi Tujuan Perlu di bawa Makluman

MMC Level 2, E1Parcel ETel:03-88831401

ProvisionalRegistration

1. Form 4*2. MONEY ORDER for RM20addressed to ‘PendaftarPengamal Perubatan’. (Cash not accepted)

For MMC, the copiesmust not only mentionit is a ‘true copy’. Itmust have the coprasmi of the personcertifying your documents.

Jabatan Lokasi Tujuan Perlu di bawa Makluman

MMC Level 2, E1Parcel ETel:03-88831401

ProvisionalRegistration

3. 2 passport size photos4. One CERTIFIED COPY of;- Basic Medical Degree- Examination transcriptfor whole training period- IC/Passport- Birth certificate- TWO COPIES ofSPM/MCE orequivalent.(certified front and back!)

You will get atemporary registrationLetter on that daymentioning that youhave registered withMMC, while theyprocess yourapplication. To be shown to yourSupervisor just in caseyou have to reportearly to work.

Other Info

• Once terima surat perlantikan’ from SPA, you are to send one copy out of the three reply forms, saying that you agree to take up the post within one month of the dated letter.

• Medical check-up.• Information regarding induction week.• Submit SPA letter to JPA for ‘Lapor diri’ please

send a copy of this letter to JPA, write Untuk Perhatian - Unit C

Interview• Dewan Temuduga, level 6 SPA (Parcel C, Block C7)

Putrajaya.• SPA form, original and 1 copy of IC, birth certificate, SPM

cert, transcripts, Basic Medical degree, examination transcript for whole training period.

• Interviewer : Usually doctors• Q :- How is Russia? -Why become doctor? -Tell something about MOH,Carta organisasi,activities. - Clinical problems. -etc.

www .moh.gov.my

ALL THIS WITHIN 3 MONTHS

so plan ……

STILL WANT TO DO HOUSEMANSHIP?

Maklumat Korporat

• Kementerian Kesihatan Malaysia (KKM) adalah sebuah agensi kerajaan persekutuan yang bertanggungjawab memastikan penyediaan perkhidmatan kesihatan yang baik dan berkualiti serta meningkatkan kualiti kesihatan pelbagai lapisan rakyat Malaysia

• KKM memiliki > 100,000 anggota tetap:– > 12,000 kumpulan Profesional dan Pengurusan

(P&P)– > 60,000 kumpulan Paramedik dan Auksiliari– > 35,000 kumpulan Sokongan Gunasama

• Peruntukan tahunan KKM ialah kira-kira RM 5 ribu juta.

Maklumat Korporat

NILAI TERAS BUDAYA KORPORAT

Penyayang Kerja Berpasukan Profesionalisme

Who’s Who

• List key company executives• An organization chart might be effective here

Carta OrganisasiHOSPITAL

Pengarah Hospital

Ketua Unit PengurusanPenyelia Jururawat

Timbalan Pengarah Hospital

(Pengurusan)

Timbalan Pengarah Hospital

(Perubatan)

Ketua Unit Kewangan

Ketua Jabatan/Unit Klinikal

Ketua Jabatan/Unit Sokongan

• Pegawai Perubatan Siswazah (Houseman) yang baru dilantik ke perkhidmatan awam akan dibayar gaji Gred UD41 (P1T6) – RM2,137.73 sebulan.

• Weekdays On-call : RM 100 /night• Weekends On-call: RM 110 /day

DUTY OF HO• Taking and/or checking the detailed medical history and

examination. • Ordering and coordinating investigations. • Communicating with the referring medical practitioner in writing

at least once during the period of admission. • Liaison with all members of the health care team to facilitate

effective and efficient patient management. • Daily review of all patients under your care. • Documenting clinical history, physical examination and

management plan in the medical record at the time of admission. • Maintaining an ongoing record of the patient’s progress,

investigations and results. • Discussing discharge plans with the patient’s general

practitioner and other health professionals responsible for ongoing care.

• Writing a summary on discharge.

TimetableSay you are posted to Surgical posting…….• Tagging • Working hour 8am-5pm ( pray hard!!)• If on- call, continue 5pm – 8am and• Continue 8am- 5pm.• Eg: Wednesday /Friday – operation/elective

cases/Emergency. :Monday/Thursday- SOPD clinic• Sat/Sun – oncall – 8am -8am• Attend seminar /CME/CPD

33 hour!!

During Tagging

• BHT ,files,documents,labs,clerking system.• Dept’s protocols.• Tagged with senior HO (8am-5pm), then with

HO on call( 5pm-8am).• Ward routine.• Work process• 1-2 weeks.

Duty• Looks after 10-20 patients.(1 -2 cubicles)• Receive new patient- clerk new cases and

present to MO/specialist.• Set drip/draw blood.• Review cases – Follow morning /afternoon

and night round ward.• Update MO/Specialist on new updates.• Management of patient from admission to

discharge

On-call

• Round ward with MO/Specialist on-call in acute cubicle

• Clerk new cases/admission.• Round with MO on call on new cases/new

patients.• Set drip /draw blood.• Response to emergency cases in ward.

• On call• Post call• Bungee call • EOD on call• Pre call syndrome ( really exist!)

• 1 Poor/Bad • 2 Marginal • 3 Satisfactory • 4 Good • 5 Excellent

Academic• a. Core Knowledge • b. Case Presentation/ Communication Skills • c. Clinical Appraisal Skills • d. Medical problem solving • e. Management of patients

Basic Procedural Skills • Taking Blood • Setting IV Line • Measuring of BP • Urinalysis (urine dipstick) • Funduscopy• ECG – taking and interpreting • Blood Sugar Measurement (Glucometer) • Basic Life Support including Cardio- Pulmonary

Resuscitation • Catheterisation

Interpersonal Skills• Relationship with: • Colleagues • Other health professionals • Patients • Patients’ relatives/family/carers

Appropriate Personality/Attitudes• Appropriate dress code • Respect for patients’ rights, privacy • Awareness of legal and ethical issues • Safe handling of hazards including the practice of

universal precaution • Obtaining consent appropriately • Practice professional work attitude e.g. • Know own limitations; • Refer when appropriate; and • Teamwork

Discipline• Readily available at place of work at appointed

time • Easily contactable • Speedy response

General Order / Perintah Am Kerajaan.1.Perintah Am Bab A : Perlantikan2.Perintah Am Bab B : Elaun3.Perintah Am Bab C : Cuti4.Perintah Am Bab D : Peraturan Pegawai Awam

(Kelakuan dan Tatatertib)5.Perintah Am Bab E : Rumah dan Bangunan

Pejabat Kerajaan.6.Perintah Am Bab F : Perubatan7.Perintah Am Bab G :Waktu bekerja dan Lebih

Masa 8.Perkeliling Kemajuan Pentadbiran Awam (PKPA)9. Medical Act 1971.

Future

TheStar 16/4/2010

“The compulsory government service period for doctors has been reduced from three to two years with immediate effect”, said Health Minister Datuk Seri Liow Tiong Lai.

Benefits• Increase in critical allowances from RM 500 to RM 750

starting 1st January 2008• Increase in specialists’ allowance starting 1st January

2009. • Approval for locum in private health care settings• Allowance for Compassionate Lists to reduce the backlog

of elective surgical cases• Where surgical procedures/operations are performed

during weekend. Specialists are paid based on sessional basis rate which is RM200/hr whereas Medical Officers will be paid at RM80/hour.

• Hardship allowance for rural posting based on specific locations.

More Benefits• Faster promotions for specialists and increased

number of posts for Gred Khas for specialists.• Masters students who pass Part 1 will be considered

as passed PTK 1 (level III) and upon completion of Part 11 will be considered as passed PTK 3 (level III) and will be given UD48 (Acting) on gazettement as specialists.

• Automatic promotion of house officers from UD 41 to UD 44 upon successfully completion of housemanship training and other services criteria.

• Waiving the PTK course for medical officers and replacing it with the PTK-CPD which is more flexible.

• Reducing the induction course for housemen to 5 days.

• Kemudahan perubatan percuma untuk pegawai dan keluarga serta• ibu bapa• iKuarters• Pinjaman perumahan @ 4% faedah (RM120,000-RM200,000)• Pinjaman komputer (Maksimum RM5,000)• Pinjaman kereta @ 4% faedah (RM27,000 – RM200,000)• Skim berpencen atau KWSP• Peluang melanjutkan pelajaran• Elaun dalam perkhidmatan• Elaun kerana bertugas• Elaun, kemudahan dan bayaran semasa bertukar atau berpindah rumah dalam negeri• Elaun kerana berkursus• Elaun bertugas di seberang laut• Kelayakan cuti• Cuti tahunan 30 – 35 hari setahun• Cuti separuh gaji• Cuti tanpa gaji• Cuti mengerjakan haji selama 40 hari• Cuti bersalin maksimum selama 60 hari• Cuti sakit dan cuti sakit lanjutan• Cuti kerana berkursus• Cuti tanpa rekod (perayaan, gantian, menghadiri peperiksaan dll.)• Keahlian dalam kelab rekreasi• Kemudahan Pengurusan Jenazah Anggota sejumlah RM1,000• Elaun, bayaran dan kemudahan kerana menghadiri perbicaraan kes di mahkamah• Ex - gratia

Emolumen U41 U43/44 U47/48 U51/52 U53/54

Gaji(minimum)

RM2,458.39 RM3,028.90 RM4,431.54 RM4,992.31 RM5,258.09

Elaun Khidmat Awam

RM300.00 - - - -

Imbuhan Tetap keraian

- RM400.00 RM550.00 RM600.00 RM800.00

Elaun Perumahan

RM210.00 RM210.00 RM700.00 RM700.00 RM900.00

Elaun Kritikal RM750.00 RM750.00 RM750.00 RM750.00 RM750.00

Elaun Pakar * RM1,300.00* RM1,400.00 RM1,700.00 RM1,800.00 RM2,200.00

TOTAL RM5018.39 RM5,788.90 RM8131.54 RM8,842.31 RM9,908.09

Specialization

Prosedur Permohonan• Syarat asas untuk mengikuti Kursus Sarjana Kepakaran dan Sub-

kepakaran tertakluk kepada: a. Sah dalam perkhidmatan (1 hingga 3 tahun) b. Prestasi yang memuaskan• Setelah menamatkan kepakaran asas dan latihan selama 6 bulan (universiti tempatan) atau 18 bulan (universiti luar negara)

pegawai dikehendaki untuk memohon diwartakan sebagai seorang

Pegawai Perubatan Pakar di KKM.• Tempoh ikatan / kontrak dengan Kerajaan bagi Kursus Sarjana Kepakaran adalah selama 7 tahun dan Sub-kepakaran adalah

selama 2 tahun

PTK

• Penilaian Tahap Kecekapan• CPD point.• Pegawai Kumpulan Pengurusan dan

Profesional Kategori JUSA serta Pegawai Perubatan Latihan Siswazah (houseman) tidak diwajibkan mengumpulkan mata kredit CPD. Walau bagaimanapun, pegawai-pegawai ini digalakkan mengumpulkan mata kredit CPD bagi tujuan pembangunan kerjaya.

PU – Pass urineBO – Bowel openPcm- paracetamolNeb- nebulizerSy- syrupCap- capsuleT- tabletk/c- known caseImp- impressionO- pintGxm- group and cross matchC+S – culture and sensitivityFBC- Full Blood countLFT – Liver function testDOA- Dead on arrivalDNR- Do not resusitateAOR- At on riskLO – Last officeT&S – Toilet and sutureLP – Lumbar punctureSOPD – surgical outpatient departmentMOPD- Medical outpatien departmentSOB- shortness of breathIO – input outputPV – per vaginal

MA – medical assistantSN – staff nurseJM – Jururawat Masyarakat.IK – Inspektor KesihatanKJ – Ketua JururawatHD – Head of Department.MO – Medical officerPA- posterior anteriorAP – anterior posteriorUFEME -urine for full examination and microscopic examinationHx- historyRx- Treatment1/52- 1 week1/12- 1 month1/7 – 1 dayPS – prescription slipPOP – plaster of parisCXR – chest X-rayc/o – chief complaintSTO – suture to openPaeds – pediatricsOT – operating theatreRL – right limbLL- left limbCVS – cardiovascular systemIOP – intraoccular pressureCVP – central venous pressureABG – Arterial Blood gases

a/w – associated with

BHT – Bed head ticket

ED – emergency department

A&E – accident and emergency

HDW – high dependency wad

Echo – echocardiography

u/s- ultrasound

LMP – last menstrual period

EDD – expected delivery date

2o – secondary

1o – primary

30 – tertiary

Supp – suppository

AEBA – acute exacerbation bronchial asthma

PEARL – pupil equal and reactive to light

# - fracture

BKA – below knee amputation

AKA – above knee amputation

Psy – psychiatric patient

D&C – dilatation and curettage

CRT– capillary refill time

o- nill (eg: 0 fever)

Epi – epidural

LSCS – lower section cesarean section

L/W – lacerated wound

A/W – Abrasion wound

FIFO – first in first out

SVD - spontaneous vagina delivery.

++ - Denoting level of severity.

1)Malaysian Medical Council, Level 2, Block E-1, Parcel E,

Federal Government Administrative Complex,

62590 PUTRAJAYA. Tel :03-8883 1400-17

2)Ketua Pengarah Perkhidmatan Awam Jabatan Perkhidmatan Awam

Aras 6, Blok C1, Kompleks C

Pusat Pentadbiran Kerajaan Persekutuan

62510 PUTRAJAYA

3)The Registrar of Medical Practitioners,

Malaysian Medical Council,

Level 2, Block E1, Block E,

Federal Government Administrative Centre,

Federal Territory, 62518 PUTRAJAYA.

• Lab coat• Name tag• Protocol Book• Stethescope• Cop mohor, kalkulator, pens(lots of them)• Small note pad• Frank Shann Drug doses.• Tendon hammer , direct funduscopy(prn)• PASSION AND POSITIVE THINKING

TO BRING ALONG EVERYDAY

Some Personal Advice

• A Guidebook for Houseofficer.2008, MMC• Medical Act 1971• Buku Perintah Am Kerajaan.• Duties of A Doctor 2001, MMC• Pembangunan Kerjaya Pegawai Perubatan di KKM,

2006,2007.

• www.moh.gov.my• www.spa.gov.my• www.jpa.gov.my

READING MATERIAL

SELAMAT MAJU JAYA

Q &A