Fact or Fiction?

OK, OK a lot of people don't trust this guy...he's been labelled a nutcase, crackpot and what not, but he does put up a credible hypothesis: The Real Significance of The Fed’s Zero-Interest-Rate Policy (ZIRP) - The Battle To Save The Fiat Money System Has Begun

Guys just imagine if the scenario is real...


Perhaps a book to read, if you can find it? Kind of pricey though...

Doctors

Excerpt from The Star, 7 December 2008:

Sunday December 7, 2008

Young docs walk a tightrope

By RASHVINJEET S. BEDI and HARIATI AZIZAN

After completing a gruelling course, young doctors have another challenge to face – a demanding two-year housemanship where they rely on lots of coffee, cope with very little sleep and put up with public chastisements.

SHE had always wanted to be a doctor but six months into her housemanship, she snapped and just couldn’t take the stress anymore.

*Kavitha found the workload and endless hours on call a real burden, sapping her energy and spirit. Today, says her concerned father *Gurdave, she is close to having a nervous breakdown and is seeing a psychiatrist for counselling.

“The work load was too heavy and the hours too long. When she was on call, she sometimes had to work for up to 36 hours straight. She wants to be transferred to another hospital but every hospital is just as bad.

“But I don’t want her to walk away from the profession. I have spent close to RM400,000 on her education. I don’t want anything back but just for her to get through this,” says Gurdave.

Unfortunately, housemanship is taking its toll on many young doctors like Kavitha. Statistically, she is one of at least five housemen a month who is found to be suffering from mental illness.

Health Ministry director-general Tan Sri Dr Ismail Merican revealed last week that many of the medical graduates are unable to cope with their housemanship.

“The mental cases range from psychotic to neurotic. Psychotic cases include delusions and hallucinations, and neurotic behaviour includes anxiety, fear and anger due to the competitive environment.’’

On-call system

The term houseman refers to an advanced student or graduate in medicine gaining supervised practical experience. In Malaysia, it is compulsory for doctors to undergo housemanship for two years after completing their medical degree. During housemanship, they are rotated among six departments – emergency department, medical, paediatric, general surgery, orthopaedic, and obstetrics and gynaecology – where they are attached to for four months each.

Over the years, those undergoing housemanship have been voicing their unhappiness but these complaints have generally fallen on deaf ears. The biggest grouse housemen have seems to be the on-call system, where they are sometimes subjected to work 36 hours at a stretch.

*Pedro, who is into his sixth month of housemanship, says he has on occasion worked 38 hours straight with only one hour rest in-between.

“In some hospitals, the patient load is non-stop as they have to accept referrals from other hospitals,” says Pedro, adding that this is more apparent at hospitals in Johor Baru and Klang which are the busiest in the country.

Housemen are provided facilities such as beds and they can sleep if they have no cases to attend to. However, this is rarely the case and the most sleep they get is about two to three hours. And that is only when the housemen take turns to sleep, says *Lalitha whose housemanship stint ended recently.

“We force ourselves to carry on. What keeps us going is coffee and tea. It is only after we are no longer on call that we can go back and crash until the next day,” she says. Depending on the department and the hospital they are serving in, housemen could be on-call for up to 15 days a month. Lalitha says that during her first posting, she would work from 6am to midnight every day.

“We go home, have a bath and sleep for five hours before the cycle is repeated. They are preparing us for the on-call,” she says.

Shortage of doctors

Dr Kuljit Singh, president of the Malaysian Society of Otorhinolaryngology and Head Neck Surgeons (MSO- HNS), believes that one factor that can cause high pressure for trainee doctors is the shortage of doctors at some hospitals.

“Some hospitals have a lower doctor to patient ratio, so the housemen, being the lowest category in the medical fraternity, have to take on a lot of the work and responsibility, especially the lousy tasks, in the name of training,” he says.

Universiti Kebangsaan Malaysia Medical Centre (PPUKM) dean and director Prof Datuk Dr Lokman Saim agrees, saying that pressure from their heavy workload can push some doctors to the brink of breaking down.

“It is normal for a doctor to be on duty for more than 36 hours with on-call duties. In Europe, this has been recognised as a problem and they have passed a law to state that doctors cannot work more than 12 hours straight. Maybe we need laws like that if we want to improve our doctors’ welfare,” he opines.

Under the European Working Time Directive in 2004, junior doctors can work no more than 56 hours a week. They can work up to 13 hours a day but then have to have an 11-hour break.

Acknowledging that the number of doctors in Malaysia may still be too low for such a ruling, Dr Lokman nevertheless thinks it is a possible solution for the future.

Dr Lokman thinks that the problem of housemen suffering from mental problems can be prevented at the entry point of the profession.

“Currently, for public universities, students are selected by the Higher Education Ministry based on their exam results and co-curriculum activities. No interviews are conducted, so there is no way for the individual medical schools to assess their attitude and character. If we get the right candidates for the programme, we can be sure of the doctors we produce,” he argues.

However, he admits that it is not a foolproof method but he believes that it will help weed out the obviously unsuitable candidates.

“Many students are forced by their parents to take up medicine and these students end up very stressed because the course is difficult and they are not motivated. It will help us ascertain if a candidate has the right attitude and disposition to be a doctor,” he adds.

He highlights that a majority of students who fail and drop out of medicine are those who are forced by their parents into the field.

Bullying

But for those who successfully completed their degree, the challenge is dealing with the hospital environment.

They may have to contend with a handful of senior medical officers with the “Napoleon” complex who make the lives of the housemen difficult, says Dr Kuljit Singh who had served in government hospitals before branching out into private service.

“There is sometimes an element of bullying and high-handedness in the way some senior medical officers and consultants treat their junior house officers. They become Little Napoleons and are dictatorial. They say they went through the same regiment and that made them good doctors, so the newbies need to go through the same process,” says Dr Kuljit.

A senior doctor in the Johor Baru hospital, *Zul is also not happy with the treatment dished out to housemen.

“I have seen the degrading treatment given to medical officers, even after they have finished their housemanship,” he says. Zul himself was a houseman in the same hospital a few years ago and he says nothing has changed.

“If they talk about your work then it’s all right, but then they go into character assassination,” he says.

The housemen are usually screamed at by their specialists in the wards and in the clinics, he adds.

“The words used in front of patients are sometimes so degrading that in my opinion, it is these specialists who are the ones suffering from ‘mental woes’,” says Zul.

Those who fought back would be referred to the head of department who would either try to rectify the situation or extend the posting of the houseman, adds Zul.

A few of the housemen say there have been times when they were threatened with extensions in the department by medical officers.

Zul says that three of his friends quit the medical profession during their housemanship, with one of them ending up as a housewife.

“One of them would get anxiety attacks whenever she came to the ward. The thing is she was an excellent student,” says Zul.

*Maniam was barely a week into his housemanship when a specialist yelled at him in front of a patient.

“He asked me if I paid to pass my exams and also said I was the worst doctor he had ever come across. How can he say such a thing when I was there for only a week? They tend to look down on us as if we don’t know anything,” says Maniam.

However, Dr Kuljit, who taught at Universiti Malaya, shares that many students today are more pampered and have led a sheltered life, and thus cannot stand the pressure. Many come from a protected family environment, so when they are reprimanded, they get stressed and depressed. He believes that medical schools need to instil more soft skills, particularly interpersonal skills, in their students.

“We have many top scorers taking up medicine but many of them lack people skills. These students can manage with their studies but when they start working, they don’t know how to deal with their superiors, especially when they get scolded by them,” he says.

Pedro, on the other hand, does not have problems with any of the senior doctors he has to work with and says they are gems.

“I have no complaints because they teach us a lot. They offer us the opportunity to learn complicated procedures. They are willing to teach you even if there are possible complications. Even the specialists take time to teach you,” he adds.

President of the Malaysian Medical Association Datuk Khoo Kar Lin is unsure about the cause of mental problems faced by the doctors although he says the finding by the Health Ministry is a concern. He says a survey should be done on housemen to find out the causes.

“We have not received any complaints (about housemanship). I went through the system myself and from my impression it is not different from say 30 years ago. They are not being more overworked than yesterday,” says Khoo, adding that he enjoyed his housemanship.

“Every profession will have its challenges. We have to be cautious because people will always think that they are victimised and work longer hours compared to others,” adds Khoo.

President of the Malaysian Mental Health Association Datin Dr Ang Kim Teng says that housemanship could be a contributing factor to mental problems.

“It is not the job that causes it but the underlying susceptibility. Some people are more prone to this and the job stress could be a triggering factor. Factory workers, policemen and teachers can also face the same problem.

“It all depends on the individual’s ability to cope with stress. A lot of housemen go through their stints without any problems,” says Dr Ang.

Lalitha enjoyed her housemanship despite the many challenges in the different departments.

“We know this awaits us in the field. When I first started, I asked myself what I was doing here. The doctors pick on your mistakes and are not bothered if you have enough rest,” says Lalitha who got used to housemanship by her third posting.

She believes adaptation is the hardest and those who studied in foreign universities may have it tougher as they may not understand some of the terms used.

For *Tan, her social life took the backstage and she had to cut down on spending time with her family and friends.

“Those were the times when I thought of quitting but the feeling passed very quickly,” she says.

Tan didn’t really encounter any problems with the staff but has friends who have had books thrown at them and senior staff nurses giving them a hard time.

“At the end of the day, I am satisfied that I have somehow made a difference in a patient’s life. I don’t have any regrets getting into this line,” she says.

For Pedro, the only time he feels discouraged is when he has to get up at 5.30am for work.

“Once you get there it’s over in a snap,” he shares, adding that he feels really good when patients come out of life-threatening situations.

Pedro also says with all the running around they have to do, housemanship is the best weight loss programme.

“I can now fit into pants which I wore in Form Five!” he quips.

Prevention at entry

Dr Lokman Saim thinks that the problem can be prevented at the entry point of the profession, which is the medical course.

“Currently, for the public university, students are selected by the Higher Education Ministry based on their exam results and co-curriculum activities.

“No interviews are conducted, so there is no way for the individual medical schools to asses their attitude and character. If we get the right candidates for the programme, we can be sure of the doctors we produce,” Dr Lokman argues.

He admits that it is not a foolproof method but he believes that it will help.

“Many students are forced by their parents to take up medicine and these students end up very stressed because the course is difficult and they are not motivated. It will help us ascertain if a candidate has the right attitude and disposition to be a doctor,” he adds.

He highlights that the majority of students who fail and drop out of medicine are those who are forced by their parents into the field.

*Names have been changed to protect identities

How true, how true...this is how house officers are treated from time immemorial. Wonder why people are making a fuss of it now? Getting more lembik? More pampered?

Trust me, enjoy the experience...and remember: what doesn't kill you only makes you stronger!!

Still At The Top?

Well...come the first week of December and Liverpool is still at the top of the BPL. Surprise surprise!! Anyway it's only a one point lead above Chelsea so nothing to shout about. Could have been much much more. Dropped points against Stoke, Tottenham, Fulham and West Ham - games that should have been won comfortably. Will these points matter towards the end of the season? We'll see...

What's different about Liverpool this season?

1. Use of width. Riera has been refreshing. Dossena looks good. But I'm still worried about the right wing...Kuyt isn't exactly a winger, though one has to give him credit for being the Duracell bunny of the team!

2. Torres. Remember that Torres has been out for most of the season. Better for him to be out now than later in the run-in. Liverpool have been playing fairly well without him - MU and Chelsea can testify to that! 

3.  MU and Chelsea. Great victories and confidence boosters. Well done lads. Notably in both matches both teams hardly got a look in at goal.

4. Xabi Alonso. After an indifferent 2007/2008 season, rumours had it that he'd be off-loaded this season. Must have shocked him back to reality - easily one of the better players around. Contributed immensely to the improved Liverpool performance. Scored the vital goal at Chelsea too!

5. Dirk Kuyt. Finally scoring goals. Not only the willing runner of the team. And able to step out of the shadows of Torres. Could see more from him hopefully.

6. Gerrard. Need I say more?

7. Arsenal. Jekyll and Hyde performances. But helping to keep Chelsea and MU off our back for the time being.

8. MU. Still the flair team, but more unstable this year than before. Keep it up!

9. Chelsea. The team to beat this year. Good all around team, playing well and winning even with so many players out injured. But they're no more invincible at home. 

Well the hectic Christmas schedule is coming up, including upcoming matches against Hull and Arsenal. Let's take it one month at a time OK?

Some Things Never Change...

Well, the headlines scream: Express bus crashes into tree and overturns near Tangkak, killing 10 and Massive landslide at Bukit Antarabangsa

Haven't we heard them before? Even Sleepyhead has had enough but isn't it a wee bit too late?

Talking about buses...as I was driving back from JB on Saturday my car was nearly sideswiped by an express bus driving at nearly 120 km/h!! So what do you expect??

Well I guess some things never change...

More Mang-lish Horrors!

Again from Kit's website...

YB Lim

This is found on the pages of our National Registration Dept website. Sigh, what a sad state of affairs, when such atrocious English is held up for display, for practically the whole world to see…..

And we are proud of sending a “space man” above???? A by-product of all the years that UMNO and BN has been in charge of our Education System. Now, it’s not just us M’sians who know that the quality of our local grads is hopeless, but this is being paraded for the whole world to see.

Don’t UMNO/BN have any shame? Hope you will raise this issue up at the righ forum.
Regards
Shanker

_______________

(Note, this page have since been amended by NRD)
http://www.jpn.gov.my/BI/4_5_kadpengenalan.php

1. I’m 17 year old, when should I change my identity card replacement?
A person whose had got first-time identity card namely during old 12 year, are required change again his identity card when have reached the age 18 year. If this change made within life time 18 - 25 year, no any penalty imposed.

2. I already 25 year old and still not have my own identity card. What shoul I do?
To them not yet own identity card although already aged more 16 year are advised to come to any nearby NRD to apply identity card past record. Applicant and promoter must showed up together to be interviewed, bringing with together following documents:-
Applicant Born Certificate / AnakAngkat’s Certificate / W’s Form Or
Applicant Enter Permit / Confirmation Form National Standard(if concerning)
Promoter Identity Card

3. I a foreign citizens and have gotten permit of entry from Jabatan Immigration Malaysia. Whether I qualified to apply identity card? What is conditions for I apply identity card.
You qualified to apply identity card with permanent resident status(Red). Applications requirements is bringing with permit of entry and passport and copy both of them and application fee as many as RM 40.00. Applications can be made in NRD Putrajaya Headquarters and NRD Branches only.

4. Is there any payment am being imposed in case happened damage for chip in my identity card.
Chip damage who is not due to purposely destroyed, misuse and others within one year from the date of submission card is give replacement by free, and if card period has been held by the applicant exceeding one year, payment as many as RM 10.00 imposed.

5. How many payment am being imposed if I loss identity card?
Lost identity card would be charged follow loss number. Please see payment schedule.

6. How long MyKad’s application period can be completed?
MyKad can be completed within 24 hours as applicant whose opted to take MyKad in NRD Putrajaya headquarters. For applicant opted to take MyKad in any NRD branches office in Peninsula of Malaysia, then MyKad would be completed within 10 working day while 30 working day for applicant opted to take MyKad in any NRD branches office in Sabah, a Sarawak or Labuan. MyKad’s charter completed this only involve applications from Warganegara Malaysia and prayer not problematical only.

7. Could I change address without change my identity card? If I can how many rates imposed?
Yes. With payment RM2.00 and new address information would be updated inside chip. If you want change identity card one time, the charge is RM10.00 .

8. Is it NRD receive payment other than cash ?
Yes, NRD comply accept payment electronically namely via credit card, card debit and MEPS.
However, there were limit minimum sum accept to payment via credit card there is as many as RM 50.00

_______________

http://www.jpn.gov.my/BI/3_3_1_pengenalan.php

WHAT IS MYKID

Mykid is identity card or introduction from children’s chip issued to children aged below 12 year.Mykid’s feature is the same as MyKad only it had no picture and fingerprints.

” My ” bring purpose “Malaysia” WHILE ” kid ” also is the abbreviation to ” Personal Identity Card “. Personal identification number that there were to Mykid this will be used in all business from born till the end.

Mykid contains 3 major application contain in chip namely:

* JPN’s Application (presentation data)
* Health information
* Education information

MYKID’S ADVANTAGE

* Current form ease of use deal government or private with the agency
* Are used during deal with the department or agencies as hospital or clinic supply health screening objective, schooling and others .
* Portable because miniaturized
* Have security feature to avoid from misused.
* With technology chip wherein information readable on the card or in chip. Chip in information stated also simple to be updated.
* Strikingly good-looking form

MYKID’S IMPLEMENTATION

MyKid were implemented in all NRD branches in Peninsula of Malaysia and it only to registration of birth just.

MyKid Enquiry, please contact 03-88808066

_______________

http://www.jpn.gov.my/BI/4_1_web.php

1. What is NRD’s website?

NRD website is abbreviation to official web National Registration Department. NRD website make major world to information and national registration department service through Internet.

2. Why this website been created?

Latterly, information and service majority National Registration Department has been prepared by online and NRD website been created to provide convenience to the public find information and service that are provided.

3. Whom were allowed surf and use this website ?

Generally, this website could be achieved by all society. However, there were some information and service that need registration.

4. What is privacy policy for this website? Am I been recorded or not?

All access and your use up on this website shall not be recorded. To further information, please visit to ‘Privacy Policy And Safety Policy’ in bottom of each page.

5. What method for I contact National Registration Department?

You can contact us:-
Public Relations Office
Tel: 03-8880 8206 / 7071 / 7077 / 7067 / 7069
Fax: 03-8880 8288 atau
Email: pro@jpn.gov.my

6. How should I sent my feedback to Goverment Agencies?

You can fill form in the division “Public Complaint System ” In NRD website. It would be channelled to the divisions relating.

Wow it's not even funny anymore!!

Another Test

Well at least Anwar has decided not to set further dates for his so-called takeover of the Government...in my opinion they should just get down to concentrate on governing the states already in control and wait for 2013. Hopping MPs just does not inspire confidence!

Sad as the death of Kuala Terengganu MP and Deputy Education Minister Datuk Razali Ismail was, the vacancy of his seat would prove another testing ground for Malay grassroot support for the contenders - PKR/PAS (not PR here) and UMNO (not BN!!). What will succeed? Ketuanan Melayu vs. the Malaysian Agenda?

I guess we will know come January 17...for better or for worse...

Scare!

Came back from the South to the horror of this message on my computer screen: A Disk Read Error Occured. Press CTRL+ALT+DEL to restart! Panic...panic!! I has so much data to lose...

Fortunately after huffing and puffing for a few hours I managed to perform Chkdsk and correct the error...back to normal I hope!

Petrol Down, But...

Has been an exciting two months for us gas guzzlers...petrol prices have come down from RM 2.70 per litre to now RM 1.90 per litre. Wow, that is even cheaper than before the price increases started!

But something still bugs me...why are all other products and services still so expensive? Haven't gone down in tandem...or maybe it'll never. Well where prices are concerned what goes up will stay up!! Why? Why?

I guess I'll have to accept this as a fact of life! Sigh...

Awwww...

OK OK it's a pic from Yahoo, but still...

P.S. I missed it...wonder why they don't announce these things on national TV/Radio??!!