Perks or qwerks?

A letter of mine was published in the Star a few days ago. The gist of my letter was the apparent random posting of some returning subspecialist. This came up after hearing of yet another case of an outstanding US-trained laparoscopic surgeon who was made to do donkey work in some other department back home instead of laparoscopic surgery. Despite training in world-class institutions. Not that it's his loss. Last I heard he's looking at jobs back in the US with a salary of US$300,000.
Surgeons being made to work in peds. Internists in surgery. Psychiatrists in obstetrics. Scary, if you ask me. The last time I treated a kid was 5 years ago. I think many share my concerns about returning.

"Many Malaysian doctors I know are keen to return. However, we all share the same fear, that after having trained for up to 10 years in our areas of sub-specialty, even in a top US or British hospital, that when we return, we are forced to work as housemen, in whichever department we are assigned to.

I know of a laparoscopic surgeon who was trained in New York and was not given the job he had trained for when he returned. I also know of a Malaysian anaesthesiologist who spent 10 years in the United States, who was made to work in obstetrics when he returned. "

Personally, I think I'm willing to live with the 1200% pay cut many of us will face working in the public health sector back home. But I'm not sure I'm willing to be posted an area I have no interest nor skill in. Which is dumb, considering we have less than 30 endocrinologists in the entire freaking country of 23 million. So my point was, why waste the expertise on random 'mandatory' postings?
Anyway. The President of MMC was kind enough to reply (condensed below):

"I refer to the letter,“Don’t waste these talents,” (The Star, Oct 4).
I would like to thank the writer for expressing his views, all done with good intentions, I am sure (is he being sarcastic or what???). New incentives introduced include:
·Exemption from compulsory service rule for Malaysian practitioners working abroad who are above 45 years old (both specialists and non-specialists), specialists with rare subspecialties (was just talking to Nick about this. Most of us are thinking, this sounds awfully vague and subjective, doesn't it? Which usually means, up to the whims and fancy of the MOH)
·Medical practitioners who have completed their housemanship and are accorded full registration with foreign medical councils;
·Although the Medical Act 1971 mandates that obstetrics and gynaecology posting be a compulsory component of the housemanship training, the Malaysian Medical Council imposes this ruling only on those who have recently completed their housemanship without undergoing this particular posting during the training. Medical practitioners with post-graduate degrees or specialists are exempted from this posting;
·On the issue of placement, the Health Ministry, being a caring ministry, will consider requests by those returning from abroad to work in specific areas or localities as long as their services can be optimised for the benefit of patients in need of their services (please excuse me while I throw up)
I am all for encouraging Malaysians working abroad to return to serve the country in the hope that their valuable services can be utilised fully to further enhance the standards, quality and accessibility of healthcare in this country. I give my firm assurance that the policy of the ministry to place specialists in their relevant specialty areas will be adhered to. "

Actions will have to speak louder than words. For although that letter seems encouraging, I do know of so many who were randomly posted. And perhaps it was just me, but I felt that the statements in the letter were so vague. 'Rare specialties'. Yea, right. Someone tell that to my surgeon senior who's making plans to leave. Or that Sarawakian anesthesiologist I met in Canada. Though he's happy with the life he's leading now.

When my time comes, I really hope they don't give me a reason to leave home permanently. For while medicine's ideal here, I really do want to return, and to help out.