A letter to anyone wondering why I'm not a doctor

I graduated medical school in October 2019, and as of July 2021, I have not yet begun my housemanship. This post answers why.

Dear [insert your name here],

This is by far the most frequently asked question I get from anyone I know. It is the one FAQ to rule them all. Since I graduated in October of 2019, I have answered this question more than I have done anything else in the time since. Well, okay, I've brushed my teeth more, but you get what I mean.

I am going to answer this ambitious question in three parts, which hopefully will get the point across, and simultaneously increase traffic to my site. Let us begin.

Part 1: The gap year

I wanted to take a year off to live in Jogja for an additional year while working as a freelance writer. This was my 2020 goal. Yes. My goal after graduating was to stay home, all day long, and write. Not everyone's typical gap year goal, but with whose money was I going to backpack around the whole of Europe and climb Mount Tibidabo with? My parents? Hell no. I have more creed than that.

As you can imagine, when the pandemic swung by, nothing really changed for me. Everyone else's life had been brought to a standstill, but I was doing exactly what I wanted to.  The 'fear of missing out' had been replaced with 'just pandemic things', and I found myself grappling with the guilt of privilege once again. Many of my favourite street food stalls being forced to shut down, countless people struggling without work, the economy and healthcare systems crumbling, plus the politics of it all in full view 24/7 on social media... Yet here I was in my kampung-style loft typing away, the worst of my problems being the mouse eating my bananas...

Anyway, this post isn't about my gap year. In the months leading up to the first anniversary of my graduation, I decided that it was time for a change. There were many things going on in my life at the time that prompted a voice in my head to chirp 'Leave!' over and over again. Eventually, I did.

Part 2: The housemanship application process

Housemanship, or HO for short, is the word used to describe medical graduates who are undergoing a two-year training before earning their annual practicing certificate, or APC. Without this, you cannot legally practice medicine in Malaysia.

The typical journey going from medical graduate to full-fledged physician goes like this: Graduate medical school and immediately apply for HO because the time it takes to secure a placement is anywhere between six months to a year. Then you wait, and kill time however you want. Travel, live out your dream to be a barista, go on a Tinder-thon... Essentially enjoying every last drop of freedom you have before it begins. Assuming you go through HO without any delays, you get your APC two years later. At this point you become a medical officer, and do that for another two years. Hopefully in that time, you meet your soulmate, get married, buy a car and/or house, have kids, and live happily ever after (but more importantly, parents are happy). The end.

Let me just warn you now that nothing about my story is typical, and I'm not going to keep it short either.

My parents have been on my back about this whole doctor thing for as long as I can remember. Or rather, since it became clear to me that my aspirations to study English Literature and/or Journalism was nothing more than a pipe dream, as well as an elaborate lie they carried on telling me for years. At 19, a part of me died, knowing that I was being forced to a life that wasn't meant for me. I knew it then as I know it now: I'm meant to write. Spare me the "But you can do both!" quip, teenage me wanted to bury her face in the classics all day long, and that's that.

But one medical degree, one year of freelance writing, and seven years later, I can look back and say that I have no regrets. I'm really glad I finished what I started, because I wouldn't give up my time in Jogja for anything. I'm grateful to my parents for the education they provided me. The journey to reconcile the part of myself that died long ago, my identity as a writer, has been an immensely satisfying one. Of course, investing in a writing coach and having supportive friends and family (my sisters) helped too. The point is, after everything I went through, I was finally ready to let go of the "I never wanted to be a doctor" sob story, and apply for HO, on my own terms.

Right before the pandemic kicked off in March 2020, I returned to Malaysia to stock up on chickpeas, visit family and Fraser's Hill etc. In that time, I was nagged into submitting all the documents to apply for HO by my parents. I wasn't ready, and so I intentionally left everything to the last minute. The day before my flight back to Jogja, I learnt that the application is now done online.

"Oh no! Really?! I guess I can spend my last day in Malaysia relaxing instead, and apply when I get back to Jogja. After all, there is internet there too."

That was my ticket out applying. Of course, they text-nagged me incessantly, so I did it to buy myself some peace. I went to the website, created an account, and looked up HO to familiarise myself with the whole process. Here is a brief summary of how it should go:

  1. Register on Medical Register Information and Technical System (MeRITS).
  2. Obtain a 'Letter of Eligibility' (which contains a reference number you will need for the next step).
  3. Register on Suruhanjaya Perkhidmatan Awam (SPA) or the Civil Service Commission using said reference number to be officially waitlisted.
  4. Await an email notification informing you that the batch you are enlisted in is ready for the next HO intake.
  5. Register on E-housemen, pray the site doesn't crash, and you are enrolled in the hospital you so desire to begin your HO.

Now here is the fun part: Murphy's Law of "Anything that can go wrong will go wrong" is the motto of my HO application. I have encountered several problems throughout the process beginning in March 2020 till now, June 2021. It's been a year and three months, and I have not even made it to Step 2. Here is a timeline to illustrate this arduous time period.

March 2020 | Created an account on MeRITS in Jogja. Could not update profile, and therefore could not upload any of the documents. Spent six months corresponding with their support via email and WhatsApp, but to no avail.

October 2020 | Left Malaysia, and went to the Malaysian Medical Council (MMC) Headquarters in KL to ask them the same questions that they couldn't seem to answer via email and WhatsApp: "Why the bleep can't I seem to update my profile??!" but in formal and polite Malay of course. They fixed the problem, but while I was filling out all my details, I noticed that under 'Citizenship Status', it said 'Indonesian'. Wondering whether all that extra time in Indonesia had automatically naturalised me, I was quick to point this out to them, to which they responded, "Oh, this has never happened before! Please email our support. We cannot do anything about this here," and so there I was, standing in MMC, being told to email the same people that could not help me to begin with. My dad was with me at the time, and having spent his whole life dealing with bureaucracy, we thanked them and went on our way. "Red tape," he says.

December 2020 | Two months of back and forth emailing later, it was decided that I was not in fact Indonesian, and by year end I finally submitted all my documents for the first time. Count with me, it's important.

January 2021 | Problems round three. If you're not keeping count of the problems, let me remind you: The first time, it was my inability to update my profile. The second time, it was my citizenship status. This time, it was two-fold:

  1. There were discrepancies between the name of the applicant on their identity documents, and the medical degree itself. I.e. My name, as stated in my birth certificate, identity card and passport is Seetha D/O Govindaraju, but the name written on the medical degree is Seetha Govindaraju. Naturally, they are concerned that these two names are entirely different people. Baffling, I know. (Oh, and D/O stands for Daughter Of, for those of you who aren't familiar with the curious ways of Malaysia.) To solve this mind-bending problem, I needed a Statutory Declaration (SD) asserting that the two names belong to the same person.
  2. I needed to obtain a Primary Source Verification (PSV) to prove that my Indonesian medical degree is not a bogus one.  
Read that last sentence carefully.

The SD was easy enough to get. The PSV on the other hand, cost USD 144 and took about six weeks to come through. Of course, while all this waiting was going on, my parents were kind enough to remind me that none of my batchmates had to go through this because they didn't take a gap year. I know they can't help it, but it still hurts.

March 2021 | Two more problems knocked out of the way, bringing the total problem count to four. I pressed 'submit' for the second time around. Six weeks passed before my parents badgered me to badger them. The fact that my colleague was also applying for HO and was getting on just fine drove them nuts. At first, the emails, calls and WhatsApp messages were responded with "Bagi kami masa, Puan," meaning "Give us time, Miss."

But one day they said, "Your university and/or degree is being gazetted," and when asked how long this would take, how I would be notified when it was over, when I could re-apply, their answer was a resounding "I don't know."

If you're thinking, "But Seetha, think about the pandemic," then I rebut that I was. I was very much thinking about the pandemic. Surely they needed more hands on deck now more than ever? The media was constantly moaning about the shortage of healthcare practitioners, and I had friends who working in hospitals who could confirm this. The state Malaysia is in is abysmal with regards to Covid, and I refuse to participate in any volunteer vaccination program because volunteers themselves do not get vaccinated. No, I am not going to submit myself to a 'Harder, Better, Faster, Stronger' remix with special 'Spread Covid' spin on it by the Ministry of Health and the rest of the government doing backup vocals, thanks.

I know the job is not an easy one, and that everyone in the Ministry of Health is doing what they believe to be their best, but this is just ridiculous. I, and the hundreds of others in this position, could have done so much to help, but here I am defending myself in a blog post as to why I am not a doctor yet. The word 'pandemic' should not have become a Get Out Of Jail Free card to procrastinate, and yet here we are.

May 2021 | Just for shits and giggles, I re-submitted my HO application for the third time. The fifth problem involving the gazetting issue was out of my hands. I told my parents that I give up, that I cannot battle or beg the bureaucracy any longer, that I wanted to get on with my life. I quit my minimum wage intern job, moved out, and went back to freelance writing full-time. Just like that.

My dad emailed them. My 71 year old father emailed the Malaysian Medical Council's support department to ask why his daughter was still waiting. At this point, I just felt bad about all of it. But our hands were tied not knowing who to ask or hold accountable, and so we waited.

June 2021 | Then one week ago, my dad began spamming me with links and screenshots of news articles. I saw the words 'medical graduates', 'delay', 'housemanship', and 'can now apply'. "This is it," I thought. "It's all finally coming together."

Can you imagine my panic?

The headlines were abundantly clear. I scoured every single online publication, and quickly realised that nothing was really happening at all. All they did was acknowledge the delay and the rubbish reasons (gazetting, discrepancies in names etc.) behind it. The lucky 267 medical graduates who managed to get through to Step 3 (being officially waitlisted) would receive an email directing them to Step 5 (to choose their hospitals), whereas everyone else could just press 'submit' again, and the application would proceed at the pre-pandemic pace. After calming myself down, I went back to MeRITS and submitted my HO application again for the fourth time. Are you guys feeling for me? Wait, it gets worse.

A couple days later, my application name changed from whatever it was before to 'SPA Employment Reference Number' (which was promising) but the status became 'Request for Amendment' (much less promising). I barely bat an eyelid before heading straight to WhatsApp to text my support pals once more, asking them what that meant.

"Sorry, we're busy dealing with the new intake of housemen right now. We'll deal with it next week when we're done here. You'll have to wait."
12 years of it! In Azkaban! 

"Thank you," I said, and waited. Then this happened:

"Please upload your medical degree it its original language. Please email our support department to address the discrepancy between your name in our system with the name in your identity card."

I'm reminded of a quote from the film Hidden Figures when Mary Jackson (played by Janelle Monáe) says "Every time we get a chance to get ahead they move the finish line." My university gives us English versions of all our certificates knowing it will be requested, and if they still haven't figured out that I am the sole operator of this account, and all the related identity documents then well... Anyone I moan about this to just apathetically bob their heads, say "Well, that's the government/ bureaucracy/ red tape/ Malaysia for you la," and expect me to be okay with it all. I am so not okay with any of this, but what can I do?

I just wanted to send them a voice note of myself screaming, with the phrases "Haven't you been reading the news?" and "Do the words Statutory Declaration mean nothing to you?" at a throat-hurting decibel, but it's only insanity on my part to expect different results on their end. So, I will upload yet another document, and write yet another email, without letting any sarcasm, frustration, or profanity seep into the spaces between the formalities I copy paste from previous emails. Then, after resolving the sixth and seventh problem, I hit submit again for the fifth time.

This time, I hope it's the last time.

Part 3: Well, what now?

Short of human sacrifice, I have done everything within my power to serve as a doctor in Malaysia. Everything. So please stop asking me why I'm not a doctor, but direct your queries via email to the Ministry of Health or to the Malaysian Medical Council instead. Who knows, it might actually help speed the process along.

Best, Seetha G.

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