PETALING JAYA: Physically exhausted and mentally strained, junior doctors are becoming patients themselves, seeking psychological and psychiatric help.

       But it’s a vicious cycle. They then get branded as “mad doctors” or “mental cases” which only make things worse for them.

       These are among the horror stories that several junior doctors told The Star.

       Their on-call hours could stretch up to 36 hours while some claimed that they have worked an average of 100 hours a week – equivalent to 20 hours a day in a five-day workweek!

       These extremely long working hours and poor work-life balance are compounded by the bullying by seniors and it takes a huge toll on the mental health of junior doctors.

       Young doctors, who spoke on the condition of anonymity, claimed that the bullying culture is deep-rooted within the healthcare system.

       Dr Nuraina, a house officer in Selangor, said she works an average of 90-100 hours per week.

       “The workload for a junior doctor, on paper, is acceptable. However, there are numerous odd jobs that junior doctors do which do not contribute to the training.

       “These include running all over to send patients for scans, sending blood samples and tracing blood investigations because nobody else would do it and the house officers would bear the brunt if these were not carried out,” she said.

       “A typical day would include coming in as early as 4am to 5am to take blood, review 20 patients which includes knowing the clinical history, socio-economic issues, investigations, summary of medications and management that have been done,” she added.

       Another houseman, who is in the fifth of his six postings, said a house officer typically works between 12 and 16 hours a day.

       “During tagging period, it’s officially 6am-10pm for six days a week. But we usually have to come in earlier,” he said.

       The tagging period lasts for a total of 14 days and the houseman may not get a day off during this period.

       Some doctors said a shortage of manpower has increased their workload.

       A doctor in the anesthesiology department at a hospital in Kedah said some junior doctors can be subjected to seven to eight on-call duties a month due to manpower shortage.

       “If we have to be on-call on weekends, then basically we do not have any days off that entire week,” she said, adding that each on-call session can last between 24 and 28 hours.

       However, a contract medical officer who works at an emergency department in Selangor said her workload depended on the number of patients for the day. Her shift could last up to 10 hours.

       “At times, we see up to 20 patients per shift. The workplace culture in my department isn’t so bad as most of my seniors are really helpful despite the high workload,” she said, adding that it could get stressful when the workload increases.

       However, the doctor noted that 15 of her colleagues had quit the civil service this year alone.

       Meanwhile, Dr Anna (not her real name) a district health officer in Sarawak, said sometimes doctors are stigmatised and mocked by superiors if they are unable to grasp their work or seek help when they are mentally or physically exhausted.

       “When you are new, you take time to remember your patients, know what’s going on with them. But you have to know every patient under you,” she said.

       “Some are penalised over small matters, and it is this fear of needless punishment that pushes house officers to the brink,” she said.

       Sometimes, senior medical officers have told juniors to quit if they can’t take it, instead of showing empathy.

       Exhaustion has led to some doctors being involved in accidents, even fatal ones, while driving home after work, she said.

       “Some are clinically depressed,” she added.

       She hoped that the Health Ministry would look into revamping the housemanship system.

       “I also hope all healthcare staff can be educated on mental health issues within the fraternity,” she said

       Administrative medical officers should also undergo training on how to organise their juniors.

       “If they don’t care for them, they have no business being in charge of house officers.”

       The problem, she said, was that these MOs had gone through the same regimen.

       “This culture of ‘I went through hard times, so you need to do so too’ has to stop,” she said.