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In the November issue of the SMJ, we invited medical officers to send in their feedback on the recent Ministry of Health new Medical Officers Posting Exchange Programme (MOPEX).  We wish to thank the few of you who have sent us your opinions and input. Here’s what some of you have to say about the new MOPEX programme.
Letter 1
It is with interest that I read the feedback you have collected in the letter dated 14 November 97.  As a second year MO, first year Trainee, I have some thoughts of my own as well as some collected from fellow MOs (trainees and otherwise) on some of the recent changes in the service.

At first impression, the new system may seem an improvement, with emphasis on work performance and actual “selling” of oneself to whichever department in which one is interested.  In practice, on observation of my (often unfortunate) friends, however, the pitfalls are already apparent.

1.  Most MOs obviously approach only their departments of first choice. (It’s very hard to tell some Head that you’re choosing his department as a mere second, and expect to leave a good impression!)  Well and good if you are chosen, but if not, it is nigh impossible to even be considered for your 2nd, 3rd or 4th choices, especially if they are of any popularity at all, and others have put them down as their first choice. So these poor souls end up in the balloting pool, and don’t we all know that whatever postings remain are probably there for good reason!

2.  For the very reason above, we have the very much expected resultant problems of:
 _ MOs (many of whom are quite senior MO-non-Trainees) balloted to unpopular postings.
 _ MOs (by the stroke of bad luck) given a SECOND posting in these very departments they’ve previously struggled through.
 _ the above tempted (and many succumbing to it) to call it quits on the spot. 
 _ MANY MOs choosing/appealing to remain in their current departments, so as not to land themselves in the bottomless pit of the balloting pool (better safe in their zone of comfort than really sorry!)

3.  And of course, the oft mentioned, questionable objectivity of departments in choosing their incoming MOs – surely those with previous experience, young (in service, unlikely to quit), trainees-to-be (true or otherwise!), plain good salesmanship will be favoured, sometimes above their hardworking, albeit less suave/smooth-talking counterparts. 

Somehow, the feeling is that the old system, even with its often authoritative and impersonal allocation of postings, gave all and sundry (regardless of suaveness!) a roughly 50% chance of getting their posting of choices;  and failing that, takes into account the postings one has gone through before, to prevent repeats as well as to ensure a more well-rounded training exposure.  The present system does not seem to cater for those who fail to attain their first choice, leaving the next step to pure chance (and not much choice at that!)

The second (and perhaps more serious) grouse MANY of us have is the apparently unreliable, seemingly forgotten, very disappointing state of MO promotions (especially from MSO 4 to MSO 3).  After a very uplifting initial exercise in October 96, and another major exercise for ORD MOs (3rd year) in April/May 97, the rest of us seem to have been passed over.  We can only imagine that it is due to lack of funds/poor budgeting/poor economic climate in Singapore.

The major groups are:
1.  2nd year MOs, ROD personnel (born 1969, graduated 1995) – will they be bypassed a second time compared to their male cohorts who disrupted in 1988?
2.  3rd year MOs – mainly the ladies
3.  Others who feel generally passed over

Many of these MOs have clear conscience of their performance so far in the service, though not spectacular, have made vital contribution to responsible healthcare in the country. A significant percentage are Trainees too – which hopefully does say a little about the quality of their performance thus far. Are there any hopeful signs at all that it will be our turn, at long last?

The above views are certainly not merely individual nor exclusive to a few of us. Many would like to see and hear something done soon.  When the recent survey was conducted, the poor response can be attributed to the hopelessness many of us feel towards the service.

It would be much appreciated if these specific issues could be addressed, answered and dealt with. We should not be surprised that the exodus of MOs from service continues but be amazed rather, that more are not leaving!  Perhaps the bond is still a daunting sum for many.  But it takes just a last straw sometimes.

Letter 2
Sorry to hear the plight of fellow MOs. We have heard a lot of people wanting changes and probably an equally lot of people (with good intentions) taking office (at all levels) to make changes which will hopefully solve our current woes. As a macro person and trying to look at it from an outsider (from paymaster) point of view maybe we can consider taking a critical look right from the top, (I mean the very top) and map out some clear directions of the ideal healthcare manpower situations that we want, and then set plans to achieve them over the next 5 to 10 years or maybe even longer. Quick fix (as seems to be current trend) is unfortunately not rewarding in the long run as have been proven many a times. The current generations of MOs may not directly or immediately benefit from these long term policies, but as a healthcare organisation, everybody, including patients will only stand to gain if we wised-up and start making sacrifices, (at every level) and sometimes painful decisions to achieve our vision, which have to come right from the top.