Dental Postgraduate Studies Dilemma

Doing a 2 year program would only entitle you to get 3/4 of the specialist allowance in the civil service and technically you can’t call yourself a specialist. Even in developed countries being a specialist is not just getting your 2 year postgraduate degree/training, it would take years and years of study/clinical internship for you to be acknowledged as a specialist.
Scholarships for dental postgraduate studies in the past years are scarce in comparison to our medical colleagues. Dentists in the civil service fret for not being able to secure the measly amount of scholarships given out per year. Some do get scholarships but do not get a place in university (think of Orthodontics, specialists who do braces, in Malaysia would only accept 4 candidates, 2 in Universiti of Malaya and 2 in Universiti Kebangsaan Malaysia). Some who are lucky enough may get to pay (or paid by somebody else, cue mommy and daddy). To get study loans is also possible, though financing a postgraduate study in dentistry is not that cheap.
Local universities charge between RM100k to around RM160k for a 4 year clinical program. As what Universiti of Malaya is charging, a dental clinical postgraduate degree costs around RM103,816 for 4 years as of this year. Compare that with a medical postgraduate degree costs only RM10,180 for 4 years.
So it’s no wonder the amount of scholarships for dentists per year is small compared to our medical colleagues.
I can see private medical general practitioners studying for their MRCP exams while doing their locums and continue their specialist training later on, but for dentists it would be a very big sacrifice indeed.
Suddenly it makes me think that the overrated dental treatment fees are such a non-sense issue as being a dentist or dental specialist worth every penny that one could ever ask for!

Career Enhancement

I've been reading on post out posted by a friend of mine in FB. It is an interesting topic about the promotion of dental officers in Ministry of Health from U41 to U44. A sensational topic I suppose as he has got more than 15 comments already, an indication that the topic is truly heart touching (for me whoever has more than 15 comments on a single post out posted in FB is considered as hot topic). Yeah, coincidentally I also have been thinking about the prospect of a dentist or dental officer has in Malaysia. For now there are four major streams in my mind that most dental undergraduate would work with.
i.   Ministry of Health (MH)
ii.  Ministry of Higher Education (MHE)
iii. Ministry of Defense (MinDen)
iv. Private
Well, I won't be too much stress on the two latter streams as Ministry of Defense (MinDen) requires one to be bound to them by giving early undergraduate scholarship to be put on one-way ticket train.Perhaps it's a bit too harsh and correct me if I'm wrong but somehow I see MinDen as a rigid ministry in term of human resource for which they don't really permeates influx or eflux of other ministry member to them. For instance, a dentist from MH would face a hard time to change ministry to work under MinDen. But, shame on me if I put all the blame on MinDen as I see there is another strong reason why switching ministry is a tough process to get through. Perhaps, the existing ministry or especially MH purposely to put such hurdles so that the eflux won't be too significant!
Career enhancement for MH personnel as the Prime Minister proposed weeks ago seems a candle in the dark. Even though the pathway is far from ideal but the concept is undoubtedly a well timing. The new pathway has been specifically designed for medical officer, dental officer and pharmacist which carries the rank starting from U41.
Firstly, the new scheme reinforces on the duration of one tier to be promoted to another tier or so-called time frame. Interestingly, the time frame has been fixed in such a way that for U41 to become a U52 it takes precisely 12 years. This particular duration applies only for non-specialist path. The specialist path on the other hand shows a better prospect with a shorter period which takes only 9 years to become a U52. There is a major flaw that associates with this kind of pre-fixed duration path which is the Penilaian Tahap Kecekapan (PTK) is going to be undermined by the system. Plus, the fixed 2 year duration of U41 to U44 seems kind of absurd to me as one has to be confirmed in service in order to enjoy the tier elevation and the process of confirmation is a long process that would take up to 3 years.
Secondly, the new scheme fails to give an express promotion for the officer who showed a great and excellent record in service. University system is doing better by giving a more open promotion for the lecturer specifically to enjoy an express promotion. For instance, a grade 45 lecturer can go up to VK7 under extreme special condition. Even though the case is under extreme special condition but at least there is a chance for one to go for it.

The Convivial First Day..

I remember my first day at the workplace. Do you?

I was a student then. Bored stiff of my remaining year 5 clinical sessions in which I didn't have anything left to do except inventories and gossiping around I took up a part- time job or called locum sensationally by students. The word locum was not a sensational word as it has been widely used for many medical and dental practitioners. As a student we were prohibited from doing so in the name of professional integrity which of course I was fully aware of but yet the serious financial constraint had taken its toll on me on that particular time. Alas, economically.

The clinic was located at a residence in a leafy area of Sentul downtown. As I walked in to the first floor I saw a pretty tight collection of desks and chairs, lots of color-coded paper and stacks of medication-labeled boxes. An assorted group of women were behind the insurmountable waist height desks. One engrossed by a hand-phone lingered with fancy girlish tinglings , a pen hanging from her fingers. She looked up, a twinkle in her eye and a curl to her lip. There was another with a tea glass in her hand circling what I thought was coconut water. A whiff in the air told me it was creosote and a child screaming next door confirmed my pre-diagnosis. There was a cheerful elder lady greeting me at doorway as if we have been friends for years. The gang seemed bohemian, clever and fun. I was bitten but I was hooked to their sense of wit and openness and warmth.

After a brief introduction of my room and some other things whereabouts I managed to catch a few names of the staff; the hand-phone girl Asmah who later became Mek Semah, the tea glass girl Ida and remained as Ida and the bubbly elder lady Kak Sadiah-cum-dental-assistants-supervisor who later developed her underground name, Taliban (a discreet pact between Mek Semah and Ida) for her strong opinions about almost everything. The owner of the clinic was such an amiable lady. A BDS holder herself she had a scarce gait that made her a bit unique in a way. Well, I'm not going to elaborate more on that hence I'm sorry.

There it was, the clinic was quite spacious in size. The waiting place was as good as the other clinics who charged quixotically RM 100 for only consultation. Not that I say this clinic didn't charge for its consultation but it would rather more lesser than RM 100. Even though the seats for patients were adequate to keep every patient comfort while waiting to get drilled or jabbed but in any given school holidays or most Mondays one would not be able to even see the floor rugs! It was as if I was doing an out-patient in government clinic only locum required one to do most of the treatment stats.

The first time communicating to a real patient in clinic was still a vivid reverie for me. Being a wet-behind-the-ears fresh graduate made me a bit sluggish to bloviate facts that I so used to regurgitate in the form of essays during college time. Locum somehow taught me how I could communicate with patients in such a way that I couldn't get in government clinic. I could explain from ABC treatment options to rather more cutting edge technology all around. Yes, honestly I would be able to do the same thing in government clinic but what abstain me to abide were the times and the thought of worth doing it. The times were remained the major obstacle to deliver primary health promotion when one has got dozens of incoming cards (represented the patients awaiting ques number) to be finished before lunch time. Subsequently these would lead to another different entity that made every government dentists second guessing themselves whether or not some treatments to be given to the patients.

There are a lot of factors contribute to these kind of quintessential act and the critical part that are always undermined by government turns out to be the most essential one. The cost of some treatments in dentistry within government sector are surprisingly ludicrous. For instance, the ceiling cost for molar root canal treatment (RCT) is only RM 4 regardless of how much times and difficulties to put on such a delicate work. Not that I want you to imagine how hard it is to do RCT as not everybody is a dentist. What I'm trying to pull here is what the impact of these low cost treatments will do to patient's perception. The patients won't appreciate the value of the treatment and in fact will still be bigotry in a balloon of stale thinking that dental extraction are the biggest breakthrough in history of dentistry.

Believe it or not this trend will continue as a dim spotlight within a fire house, not enough to shine but simply cannot be vanished.

Perhaps the greener grass beckons?

Jambongan in Perspective

Last week I had such a blast weekend. I was being 'selected' to go to a super rural place somewhere deep in Borneo jungle in the name of Medical Camp. The truth was, I was not being selected based on any SKT or academic or being-the-best-dentist-around reason. It was purely and utterly because it happened that I was the only male dentist and nobody seemed like to care to go (understood as the rest of the dentists are female and no one had slightest sense of adventure). Not that I full with adventurous spirit or eagerly to go or anything, I just stucked in the middle of statistical ratio of lack of male dentist in Malaysia and global I guess.
So I went.
The place called Jambongan in up north Borneo, it was an island as I could see in Google map. According to my mother in-law Jambongan had some similarity with Zamboanga which meant 'Jambangan Bunga' or a bouquet of flowers in Zamboangan aboriginal language. Yeah, I could see the similarity there.
We began our journey by hitting one of the Sabah's riddly roads. Composed by natural potholes that made every tires gasping to blow it was a mind-boggling to imagine how these people surviving every other day to even walk on it. Shame on Sabahan's politician for not making proper roads or highways for people who voted for them. I didn't think that people would mind so much to pay the tolls provided the roads were good and free from potholes. But in the end of the day politician will always be politician. Always keep their heads up and resist to look down despite being stumble at every points.
Eventually, we arrived at Paitan jetty after having a waggly body massage all the way. As you can see on the extreme right of the blog page, the dusty roads were so terrible that made the driver went blindly to go forth. Luckily, our driver was an expert of the roads and could even predicted which corners that he could go over taking. But as much as I despised the roads, I enjoyed the bumpy roller-coaster that made me feel like part of Eco Challenge drivers.
From the Paitan jetty, we took on a speed boat and attained Jambongan 45 minutes later. I must admit, for somebody who loved out-doors and physical activities so much, boat riding along the Jambongan river must be a super compelling and intriguing experience one could ever ask for. Sorry for the extreme right picture as everybody was given butts as a result of major amazement!
Jambongan itself was nothing short of remarkable and overwhelming. The beach was so picturesque that I even managed to pick couples of alive clamps within seconds I set my foot on the white shiny beach sands. The shells and corals were great and dozens of lanky coconut trees waving as if two lovers at far were about to unite after so long adjournment.
I met several cool guys while I was in the island such as Dr. Kelvin (didn't realize he was a MO until we reached the island) and some teachers who took me by surprise that most of them were from West Malaysia (orang Semenanjung we called them here). I had a good time chatting with them while being served a local food siput sedut of the ocean version. Oh my.. seriously I was stunt to see how casual they were while eating the 'thing' as if it was a goreng pisang (fried banana). Since I already mentioned about it might as well I go with description. As everybody knew how was it like for siput sedut of the river version (RV) morphologically, the ocean version (OV) were only slightly bigger in size. There was one major thing that differentiated between RV and OV which was the OV had a single claw projected out from the shells once its cooked. This claw was very important during serving as it acted as a tool to pull the filler out of the shells. Despite being called siput sedut the OV didn't really carried its name well. In stead of being sucked to evacuate the filler as in RV, the OV on the other hand needed to be pulled out single-handedly. To me the name was rather a misnomer if not totally true. As for me, after being persuaded and threaten that they will leave me in the island if I didn't eat it, I did and it was a pleasant surprise for me that the taste of the 'thing' was nothing like I imagined. The taste was good and it had a strong taste of cuttlefish. I ended up finishing the rest!
I asked one of the teacher about how they filled up the gap between after school and the next day. The answer was simple yet so powerful almost shaken the inner core of me inside out. NOTHING. Seriously?!
How could one survived and at the same time keeping the sane on par when there were no at least some entertainment or rather social activity to be done?
Well, I guess this was the major turn off for me. I could not at all living in such places that offered me no life. Call me town boy or spoiled brad or anything I didn't care. Bravo to the lines of dedicated teachers. I raised everything up for them.
So I think I got all covered up for now. See you in next writing!

10 Things You Need To Know Before Embarking To Any Government Dental Clinic

1. Removal of all sound teeth are not necessary to make a denture. (Don't bother to come and asking for total removal of your teeth for a denture, I'll definitely give you a big round of slap for that!)

2. Do not beg to do multiple extractions at one visit. (It is such an annoying thing as the dentist has to entertain 60 or perhaps 70 patients asking for it, just come next week lor..)

3. Brush up your language skills. (Malay and English are preferred, others hm.. bring along your interpreter!)

4. Get yourself dentally cleaned prior coming to dental clinic in the sense of brush your teeth before visiting your dentist. (This is majorly important as if you don't, it will surely giving rise to my sense of repulsive and you might end up getting tooth extraction with out anesthetic!)

5. Should you happen to see any clean and shiny sinks around, get away from them as they are not meant for spitting your throat out. (Those sinks are designed to be a saliva-free and rather as clinical decoration, I'm kidding, they are there for hand washing purposes. Go to public rest room for spitting)

6. When asking which tooth you wanted to be extracted first (for those who have adulthood grossly rampant caries), just specifically point at it and try not to be our assistant by self-retracting your cheek with your finger. (You are risking yourself to needle prick injury plus we have just a right instrument perfectly for such purpose)

7. Root canal treatment (RCT) is an option for tooth preservation unambiguously and exclusively for those with tip top oral hygiene. (Don't bother to come asking for one when your oral hygiene is below par, and good oral hygiene indicated by non-dentist eyes are considered 'Get the hell out from here!')

8. Do not tell a lie saying you are frequent teeth-brusher when intra-orally all we see is teeth roots. (Dentists are CSIs when it comes to oral crime. We knew it way before you open your mouth!)

9. Parents are the person that will getting scolded when children have rampant caries. (Children's teeth are under parents responsibility. New act will be introduced to fine parents who neglecting their children teeth care. Be prepared for jail fellas!)

10. If you think private dentists are more gentle and nicer than government dentists, well we also think the same. (Go for private then as there will be less work for us.. Yaiy!!! ;)

What happen to Malaysian Chinese?

I was drawn to this topic way back since my university life. The place where I learned to mingle with other races or I would rather call it ethnics (to me there is only one race in Malaysia, MALAYSIAN). I ascertained that in order to be in harmony and peace, ones have to have a skill of give and take.
Even though the topic seems a bit racist but the fact is I am not a racist at all. Through observation during my practice as a government servant, I have seen loads of Malaysian Chinese who could not speak Malay and some of them could not even speak Malay and English. Sometimes I had to call upon my colleague to interpret what they needed and said. This is not something that you proud of as if we were not living in Malaysia. When asking weather are they holding IC or Passport, as quickly as a thunder, OFF COURSE I AM MALAYSIAN! (translated by my colleaque).
What on earth are you doing in Malaysia and have no idea what Malaysian national language? Are you saying that you are Malaysian just in IC to get all the benefits that Malaysia has to offer and turn your back on these essential values because you are too ashamed to learn and speak Malay?
I remember Tun Dr. Mahathir once said that one of the biggest failure of his is he failed to unite all schools in Malaysia to be under one roof. Nowadays, we see loads of Sekolah Jenis Kebangsaan all over Malaysia. Chinese-written newspapers fulfilled the shelves of every corner of book stores as if the contents were different from Malay-written newpapers.
What I am trying to lead here is why do we have to read, watch, and learn from so many mediums? These mediums are the culprit of society breaker. Let's stick with one medium and see our kids to be able to love each other unconditionally.

My Blog Sojourn ~

Back in my old days I used to think that people who blogs are people who doesn't have life. They (bloggers) will sit before their PC or laptop or whatever and blogging until dusk. No friends and social life existed. Only empty silent air and sounds of keyboard being repeatedly kissed by corny digits. This is what i really think about bloggers until recently. I read my mother in-law's blog and it came to my mind I too can make one of this my own. For the record, I have been reading her blog long before I decided to start my own. Actually, the idea came when I was on my way back to Sandakan from Telupid and Tongod for dental treatment relief (the journey which I will tell later in another chapter). Oh, before I go any further, may I address the person who inspired me to this pathway, my mother in-law, Prof. Dr. Che Husna Azhari. Thank you Che for this indirect inspiration. Oho ok ok enough with the sentimental.
So I guess I officially joining the club. Pretty hard to swallow but I licked my spit (haha.. eeuww). Becoming one of millions bloggers through out the globe (I'm tapping my own shoulder).
Oh ya, anyway as the title displays, Didi Pota Pota denotes my chilldhood pronounciation improficiency. Didi derived from Aidil and Pota Pota derived from Putera. Aidil Putera and imagine the 2 or maybe 3 years old chap say it.. Yeah I know! ~ Didi Pota Pota