Organisation and Management of Health Services

The Organisation and Management of Health Services (OMHS) is the second part of the field training programme for the Bachelor of Medicine, Bachelor of Surgery (MBBS) students as part of the New Integrated Curriculum (NIC). The first part of the field programme was the Community Residency Programme (CRP) which is a 4-week programme. Both the OMHS and the CRP programme was combined as the Community Programme when the NIC was replaced with the University of Malaya Medical Programme (UMMP) in 2012.

The OMHS seeks to afford a period for the potential graduate to interact with the various systems of health care delivery in a district in the country. These systems, ranging from the traditional to the scientific, are present concurrently and patients usually seek assistance from more than one system at the same time. The programme also allows the potential graduate to familiarise himself/herself with his/her future work environment as he/she learns about the functions of the various categories of staff who man the hospitals and health centres.

Rationale of OHMS

Upon graduation from medical school, the new doctor will be posted in a ward as a house officer. He is to “take charge” of the ward as he is now a qualified professional. He will be responsible for what goes on in the ward as far as the care of the patients in the ward is concerned. It is usually not clear what the responsibilities of the new doctor are. He is not told clearly and he had had very little training in management during medical school to be confidently “in-charge“.

When he completes his house-officership year, he becomes a medical officer (MO) and will be involved with clinical duties in a hospital ward or to become a medical and health officer (M&HO) in a health clinic in the district and he will be doing partly curative and partly preventive medicine. In either case, the new MO or M&HO will be “in-charge” of either the ward or a health clinic.

Thus apart from academic training, the Faculty offers an opportunity to the potential doctor with which to know, understand and have a feel of his future work environment. It is necessary for the new MO or M&HO to know what his ward or health centre looks like from the perspective of being the “person-in-charge” rather than from the more familiar view of a student learning from clinical material in the ward or health centre. He has to understand that work here is done by a team and the team is as strong as its weakest link. He will have to relate to his other team members who may have more experience than he does. He will have to know what the other team members can or cannot do and what are their legal limits.

In other words, the potential doctor should now look at the world of Medicine from a very different angle from what he had been used to since entering medical school.

The programme Organisation and Management of Health Services (OMHS) gives the potential doctor this opportunity to be exposed to this “in-charge” perspective before he is officially responsible for it.

Thus when posted to a district as a medical officer or a medical and health officer, the graduate is expected to perform his/her duties right from the first day. The OMHS programme supersedes the previous District Health Services Survey programme.

OHMS Programme Outline

To execute this program, the Year 4 class is divided into 8 – 10 groups of about 16 each. They will be posted to different areas, which includes rural, semi-urban, urban and metropolitans. The class is then briefed about the aims and conduct of the OMHS. The duration of the programme is three weeks divided into:

Week 1The groups then engage in a 1-week “planning workshop” where they decide on how to achieve the objectives of the program.
Week 2The second week is spent gathering information about the various aspects that they need to know about the district. To achieve this they travel to the selected districts which are reachable with day trips.
Week 3The third week is spent on debriefing and writing reports on what has been achieved. This information is compiled into a book and submitted to the SPM Department.