3 Students Reveal The Reality Of Being In Malaysia's Medical Sector

It includes anxiety, depression, and drugs.

Cover image via Stanford Medicine

A 39-year-old medical doctor from Seremban recently opened up about his battle with drug addiction

In an interview with Bernama early last month, Dr. Sasitharan Ayanai recounted how he got hooked on methamphetamine due to job-related stress. 

His addiction began nine years ago while he was doing his houseman training at a government hospital in Johor Bahru, where he was subjected to long work shifts – sometimes up to 48 hours without proper rest

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Image via theSun

"At that time, I was stressed and after some time, I was introduced to methamphetamine. It was the booster needed for long working hours. I only wanted energy, that's all," Dr. Sasitharan told Bernama. 

"I thought I will be spared addiction because I thought, as a doctor, I'll be able to keep (the urges) under control, but I was wrong," he added. 

Dr. Sasitharan is just one of hundreds of medical doctors across Malaysia who are reportedly resorting to illegal drugs due to stress and depression

Free Malaysia Today reported on 7 June that a government psychiatrist, who wished to remain anonymous, revealed that there has been a rising number of medical workers in the northern region who are mostly addicted to heroin, meth, and even opioids

The psychiatrist, who has been treating patients who were doctors and medical workers themselves, claimed that most of them cited lack of sleep, depression, and stress as reasons for their addiction

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Image via Canada Journal

While the exact number of medical workers with drug abuse issues was not disclosed, the psychiatrist claimed that the number could be in the double-digit range at a few hospitals in the northern region.

"While the number in hospitals in the north can be seen as high, we were told that the situation in Klang Valley is worse, with close to triple digit numbers," the psychiatrist said.

Stress, anxiety, and depression are prevalent among Malaysian medical practitioners and students – as proven by numerous studies

For instance, a 2016 study on 676 medical students in Management and Science University (MSU) revealed that 32.5% of them had depression.

Meanwhile, another study on 501 International Islamic University Malaysia (IIUM) medical students in 2016 found that 39.7% of them were depressed, while a whopping 65.8% of the students had anxiety

Moreover, IIUM researchers uncovered that examination and grades as well as feelings of incompetence were the biggest reasons associated with depression, anxiety, and stress. 

We spoke to a few Malaysian medical students to uncover the various ways the medical field affects their mental health. Here's what we found:

The names below have been changed to protect the interviewees' identities.

1. Pressure from family members in the industry

Ross, a medical school graduate, first decided to enrol in the degree because of his family.

"I come from a family who is obsessed with having doctors in the family... They have money. I have an uncle who is a doctor, another who is a dentist, and an aunt who is a doctor. The people they married added another two doctors to the family," Ross told SAYS in a recent interview.

"My parents are divorced and were in the middle of getting that done when I was in medical school. So my young brain decided that it would be a great idea to relieve my mother of needing to pay for my education by pandering to what my grandparents wanted," he added.

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Image via Honey Kids

Meanwhile, final-year medical student Chandler revealed that his family of doctors was the biggest factor he was pressured into joining medical school.

"My parents, uncles, aunts, and cousins are doctors, so the things I wanted to do personally weren't socially acceptable in my house... My parents gave me a choice, what professional course do I want to do if not for medicine, and I couldn't answer them. That's why I joined medicine," Chandler told SAYS.

2. Substance abuse

According to Ross, he relied on alcohol the most during medical school.

"I have issues with smoking until today. My peak of alcohol consumption was during medical school," he said. 

"I have tried marijuana only a few times. No harder drugs. I would say if anything, alcohol was close to getting out of control but not quite," Ross added. 

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Image via Blue Crest

Meanwhile, Chandler has been using marijuana throughout the last three years of his degree. 

"I smoke while doing my work. I will admit I overdo it sometimes, but some people drink and some smoke to cope," he told SAYS.

"I know multiple chronic alcoholics and chainsmokers. One junior told me in first year (of medical school) that he would never smoke, but now he's a chainsmoker," Chandler added.

3. Lethargy and stress from long hours

"We're up by 6am, and we're only back in our rooms at 6pm everyday... We only have four good hours left by the end of the day," Chandler revealed, before adding that most people would prefer not to look at books then. 

The medical student added that the stress piled on to his anxiety of failing medical school, and it eventually developed into a period of depression for him. 

"I remember not going to class for two days but I wasn't sick, I just stayed in my room for 48 hours. I just didn't want to see or talk to anybody. I was just tired of it. Medical school felt very prison-like," Chandler said.

4. Fear of abuse

"I was at a really low point where whenever I thought about my degree and what lies ahead of me, I didn't look forward to being a houseman because of all the reports about housemen getting abused. It's something I have seen with my own eyes as well," Joey, a final-year medical student, told SAYS recently.

"Sometimes they are treated as if they were robots, not needing rest, always being overworked, and at times abused by their supervisors," he added.

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Image via MIMS Today

Ross claimed that the medical school culture in Malaysia is characterised by "intimidation, fear, and competitiveness".

"If you ask me whether I can think of people who have taught me who were downright abusive, sure I can think of a few. But I can also think of those who were so true to their mission to create better doctors that they inspired me," Ross said. 

"Generally, the medical field has a very poor education and work culture... A majority of doctors get defeated by the culture and end up exactly that. Doctors with very little empathy. Doctors who see patients as registration numbers, bed numbers, and diagnoses rather than people with real lives and real families," he added.

Despite these instances, it does not get better for Malaysian medical students after graduation as there is a lack of placements available

According to a report by The Star in April, the Health Ministry previously announced that doctors, pharmacists, and dentists in the civil service are no longer guaranteed permanent employment.

On top of that, Free Malaysia Today reported that a group of housemen, who claimed that mental torture is a common culture, refused to report cases of severe stress and abuse to authorities as it could cost them their careers.

Health Minister Datuk Seri Dr. Dzulkefly Ahmad

Image via Selangor Kini

Although theSun reported that efforts have been made by the Health Ministry to reduce housemen's working hours, the existing culture of the country's medical sector remains to be reformed. 

Perhaps this quote by Chandler, the final-year medical student, will encompass the issue:

When they get their housemanship, they get a solid RM5,000. But that's a bad way to look at it because to earn that money, you have to go through so much mental stress, sleep deprivation, and abuse.
Chandler, final-year medical student

Last year, a houseman spoke up about his experience of being roughed up and threatened by a specialist:

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