The Working Experience in Australia vs Malaysia

I am almost ending my second term in Mackay which means I have been working in Australia for 20 weeks now. Time really flies as you know the RMO/Registrar campaign has just started yesterday, and I have just renewed my contract for next year as well. Once, I thought I would be stuck in Malaysia slaving away as a medical officer, now I have already started thinking about entering a training program for next year. It has been a really good 20 weeks and I will be doing a GP rotation starting next week in Cannonvale, quite excited for it. I have been getting a lot of messages about the differences of working in Australia versus Malaysia and thought this would help. Here’s my very raw thought of what it’s like working in Australia, compared to Malaysia.

TLDR: Working in Australia has been a bliss.

Workload

I previously worked in Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia (or simply known as HUKM). HUKM is a busy tertiary university hospital that is not comparable to a fully public funded hospital like Hospital Kuala Lumpur or Selayang Hospital, but it is busy indeed. To illustrate the workload, I’ll be comparing working in the medical departments in two different hospitals, HUKM and Mackay Base Hospital (a secondary hospital in Australia). At HUKM, I used to wake up at 4.30AM and be at the hospital by 5.30AM to take about 6-10 bloods (including venipuncture and ABG, and inserting new cannulas) on average, all within an hour, then starting seeing about 10-12 patients and writing a all of the reviews before 8AM. This is on the basis of 2-3 house officers working in the same ward. When the medical officers (MOs) arrive, they would usually start seeing patients and writing reviews as well, taking some reviews off our hands (I remember working with really nice MOs in the past and they were all very helpful). Post rounds, our jobs were mainly making referrals, radiology requests (which means physically presenting cases to the radiology MO, getting grilled, a few back and forth before actually getting the scans done), and of course repeat bloods.

In Australia, we have phlebotomist to do our morning bloods. We start work at 8AM, the intern or the resident will usually prepare a patient list before ward rounds. Registrars and Consultants will attend handover from the night registrars regarding new admissions. Ward Rounds usually start at 8.30AM. The consultant, registrar, resident and an intern will round together, read the admission notes together and come up with a plan. As a former house officer (HO) in Malaysia, there is an expectation where the HO or the MO, but mostly the HO, are expected to present cases. In Australia, the morning handover gives a brief introduction to the patient that has been admitted overnight, because only the consultant and registrars attend the handovers, they know the case best. Generally, there wouldn’t be an expectation towards the juniors to know the cases. Because members of the team also rotate every other week, so generally such expectation doesn’t quite do any justice. Our system is electronic anyway, it is just easier to read the notes directly.

I also wanted to highlight I have only done two ABGs since getting here. ABGs are a rare phenomenon here.

Every single person in the health system has a role to play. Phlebotomist take blood. Interns and residents write notes, administrative work, blood taking, learn the management, make referrals. Registrars see patients and make decisions and where the situation is complex, the consultants step in.

Working Hours and Pay

Unlikely Malaysia where you would get paid on a monthly basis and then capped at the maximum oncall allowance rate, Australia pays by the hours, weekend, over time, night shifts, and public holidays are all paid differently. There is a detailed breakdown of every fortnightly wage, every hour is literally checked and counted. There is no room for discrepancies here.

Bottomline is, pay is good. Hours, even better.

76 hours per fortnight is the general working hours for everyone. Any extra hours are considered overtime. Thus far I have worked on average 82-90 hours per fortnight versus the 90 hours per week in Malaysia with no extra allowances. And by far, I have mostly gone back home on time at 4PM everyday on a morning shift. Blessed.

Every hour you work is accounted for. Every extraordinary hour you work is also accounted for. Your wage depends entirely on the hours.

The Good Culture

In Australia, there is simply no room for being mean or unkind, no room for bullying and abuse. I once heard a nurse tell off a patient “I will not tolerate this verbal abuse”. A group of interns filed a complaint against a registrar who was mean. While working in Malaysia, I was constantly under pressure to perform and work fast, any delays would instantly equate to incompetence and I would be told off. I remember getting yelled at in OT while assisting a caesarean section, for not retracting correctly. Situations like this now make me ponder on the need for these (micro)aggression from my MOs back then. But I suppose the root of it all is just toxic bosses putting pressure on their juniors coupled with heavy workload and patient burden, don’t really make up a healthy work environment, top to bottom. Furthermore, there isn’t an effective support system in Malaysia to promote a good working culture, but I guess the core of it is rotten to begin with, so I wouldn’t expect much anyway.

Making referrals in my current hospital is also pretty nice and decent. No one has yelled at me, be rude or unkind, in fact, they have guided my referrals, providing pointers on what else that needs to be done before that referral should be made. It is as much a learning experience than actually working.

It is also suffice to say I no longer feel dreaded to go to work. I feel energised everyday, thinking of what interesting cases might come about.

Medicine is about continuous learning. The medical culture in Australia focuses on upskilling junior doctors where appropriate. Doctors at different level have different expectations from the consultants, and they are most often very appropriate expectations. When in doubt, someone more experienced than you is always there to help.

Reminiscing working in hectic medical departments, not too long ago.

Generally, the working environment in Australia is 500% more tolerable than in Malaysia. I remember working here the first few weeks and Syameer would say “they actually treat us like human beings”. I would look at him and say “I wish I was treated the way my interns are now”. While I had just finished a streak of 4 night shifts, one of the nurses came to me this morning and said “I just wanted to thank you, you were very helpful and it really made my job easier”. I have never felt more appreciated working as a doctor.

If you’re thinking of moving to Australia to work, feel free to DM me via my Twitter.

Cheers.