NEW SALARY SCHEME AND CAREER PATHWAYS FOR DOCTORS IN BRUNEI 2012

RIPAS Hospital expanding 2011-2013 project

The parking area near the old mortuary will be the site of the new Women's & Children Building

The proposed New building occupying the old parking place,
N.B. this is the 2009 proposal by Arkitek Idris

Proposed new A&E Department with new multi-level parking lots and Administrative Building
for more detailed info pls log-in to our previous link
http://doctorsbrunei.blogspot.com/2010/02/proposed-new-women-children-hospital.html

4th Floor Renovation in progress

Expected date of completion for the 4th floor renovation

Ministry of Health under the new administration is rapidly undergoing changes both in the infrastructure as well as services to cater for the growing demand and needs of the Brunei population. One of the major projects that will undertake is the New Women and Children Building that was suppose to lift off last year but due to some unforseen circumstances the project had to be delayed till now.

This brand new nine-storey women and children hospital is scheduled to begin construction in the Raja Isteri Pengiran Anak Saleha (Ripas) Hospital complex soon by the middle of this year to cater to the increasing needs and demands of the Sultanate. "The new hospital will also have two basements for parking which will help with the congestion as it will help ease traffic circulation," said M Jamarludeen Hj M Hussein, a representative from Arkitek Idris.

The new hospital, which is scheduled for completion 30 months after tender, will house a clinic on its ground floor, delivery and neonatal wards on the first and second floor respectively while the third floor will be used as administrative offices for CEO.

The remaining floors will cater to women and children wards which include services such as Obstetrics, Paediatrics and Gynaecology.

To address the shortages of parking spaces and the increase in traffic flow during the construction periods, MoH has introduced the RIPAS Hospital Link Shuttle Bus. For those visiting or seeking treatment from the hospital,can now park their car at the parking lot close to the Jame' 'Asr Hassanal Bolkiah mosque, and from there take the bus up to Outpatient lobby. Four buses from Ripas and two additional buses from JKR have been allocated and can hold a capacity of up to 29 people and will stop by the designated checkpoints every 10 to 15 minutes.

Shuttle bus pick up and parking space new the Jame' Asr mosque

Doctor's Mess No more.... for now..

For those familiar with the Doctors Mess, it was located on the 4th floor of the E block RIPAS hospital. Since it first opened in 2004 by then DGMS Dr Hj Affendy, the President was Dr Abdul Rashid and has undergone several refurbishments and upgrades. It was then led by Dr Chong CL followed by Dr Chua HB, Dr Azmi and now Dr Munir. Various activities have been organized in the past at this mess, including clinical teaching, Pool tournament, Organizing Charity bowling tournaments, Video Shooting of Doc Mess Idol (hehe.. that was fun... especially when Dr William Chong was auditioned... priceless video clip that was) and many more.

We have also had many famous important visitors including, His Majesty the Sultan dan Yang Di Pertuan Negara Brunei Darussalam, The current Malaysian Queen, and our previous minister of Health YB Pehin Suyoi who kindly participated in our Pool Tournament.

Otherwise on a normal day, you may find during lunchtime our junior doctors gathering having take-away lunch packs, and catching up with day to day issues (work-related ofcourse ;) , or just socially interact, shooting some pools, or even just catching a nap before an afternoon clinic on one of the nice sofas.

What has happened to it now? Well the 4th floor where it resides is currently undergoing renovation to build another floor of wards. The Medical Library has been shifted to the ground floor of the Old Nurses building (beside the specialists building) and the Doctor's Mess have been relocated (temporarily we hope..) to the ground floor of Ehsan Apartments, which is currently majorly underused due to the distance it is away from everything else.

So the plan will be to build two wards, one will be a 24 bedded ward housing both male and female orthopaedic patients, and the other ward will be a new 1st Class ward. The 4th floor will also be completely enclosed so there will no longer be open air balconies, instead fully air-conditioned alleys. Meanwhile in between the wards the New Doctors Mess will be built, which is slightly smaller than the previous one and will no longer have on-call rooms like they used to. Work is actively currently under progress and is estimated to last till... further notice.

We hope the work will finish as soon as possible so that we can have our doctors mess back again. I think a lot of people underestimate how important it is to have a place where the doctors can just relax and hang out and perhaps socialize with colleagues and friends. So we hope the doctors mess culture will continue and the dedicated space for it will be kept and maintained for the use of our future generation of doctors.

2009/2010 Doctors Mess team
after the Video Shoot of MME

2008/2009 Doctors Mess Team
after organizing Charity Bowling Tournament


2007/2008 Doctors Mess Team taking picture with
Honourable Minister of Health YB Pehin Suyoi, Hounourable Deputy Minister YB Pehin Hazair
DGMS (Dr Hj Affendy) and our CEO Dr Hjh Norlila
during Pool Tournament

Doctors Mess 'transformed' awaiting Her Majesty Malaysian Queen visit

Local Bruneian Doctors at RIPAS Hospital

As requested by one of our readers, here are the compiled number of local doctors working at RIPAS hospital as of March 2011.

Disclaimer:
These are not official figures from the MoH or PGATB database, but are information kindly collected from our peers and colleagues working here at RIPAS Hospital. The table figures also does not take into account the doctors who have not returned back to Brunei yet, and the junior doctors in their Specialty rotation who have not decided on a specialty yet and those still doing the Foundation year training programme.

In summary there are approximately 30 local specialists in Brunei, but as you can tell there is still a large void in local talents that needs to be filled up. Around 30+ local trainees are currently undergoing trainee abroad mainly in Singapore, and a few others scattered in the UK, Australia, Malaysia and Germany, and about 27 still awaiting to be trained.

Hopefully this information will be useful to our local boys and girls out there in planning for their specialty training. Word of advice would be to try and secure specialty training whilst you are still abroad if you have already decided what you want to do. Trying to go from Brunei will be difficult because we are running out of training places even in Spore, and currently we only recognize UK, Spore, Australia and U.S. 'Advance level Training' and the others are case by case basis for e.g. Germany. If you have manage to secure a place yourself abroad, please let PGATB know to find out if that institution will be recognized when you want come back home.

The incentive to be trained as a specialist would be the new scheme of service which start Consultant's pay at $12,000 (including On-call allowances and M allowance) and up till $18,000. Currently we are still on the Old Scheme of Service which we are still awaiting to be migration. The details of the new scheme is still sketchy, and no official memo have been released as yet from our ministry, but we will keep you posted of any further progress.

Doctors Mess is back!

Assalamualaikum w.w.

Sorry for keeping this website dormant for awhile but soon we will be active again. More information to disseminate like the new salary scheme! (Scheme of Service) that has just been recently approved, what happen to oncall allowances, etc. More news to update, like the Brunei Medical Association etc and more medical cases to review... Anyway I just got back from Singapore and there is more to write about that experience as well.

See you guys around again!

Salaries For HOSPITAL Doctors working in Brunei (Locals and Expatriate)

I think this is the most popular questions posed to us, i.e. what's the salary like working in Brunei and what are the qualifications required? We have posted this information several months back, so this is a repeat... with some added information below..

N.B. This information is valid for Hospital Doctors only. GPs, Public Health and Dentist may have a different entry requirement and allowances.

The figure above summarizes the the current salaries of Hospital doctors working in Brunei. The basic pay is the same for locals and expatriate (foreign) doctors, the major difference however is that expatriate doctors gets other additional perks like:

• $800/month of each child going to private schools
• A gratuity which amounts up to 25% of 3 years cummulative basic pay salary which can be claimed at the end of their 3 year contract service (can be up to $30,000 - 61,200 depending on grade)
• Free health care
• Heavily subsidised (Almost free) Housing

NEW UPCOMING CHANGES

Currently the salaries are being revised and will undergo some big changes in the figures. The clinicians have been working very hard in co-operation with the Ministry of Health and with a strong support from our Minister, a proposal have been met by the Public Service Commision & the Salary Committee. Insyallah, gods' will the new salary scheme will be rolled out once approval have been met.

BDMC is very optimistic that this will happen in the near future.

An Overview of On Calls Allowance in Brunei

Introduction:
The payment of On Call Allowance Claims which has been approved since 1 March 2009 has been implemented since March 2010 with a special budget being allocated. This instrumental change to the welfare of the doctors has been brought about thanks to the initial efforts made by our senior doctors who have been working very hard to get this allowance approved eversince 4-5 yrs ago. Some of them have already left the service but others are still around. To mention a few are Dr Hj Affendy (ex-DGMS), Dr Rashid (Orthopaedic specialists), Dr Syafiq & Dr Zulkarnain. Their groundworks has laid a strong foundation for the proposal to be revived again in 2008 by Dato Paduka Dr Hj Latif (former president of Brunei Medical Association) and his team and finally the proposal for on call allowance was approved by JPA in March 2009.

The principle of On call Allowance
From a banding system of on call allowance (initial proposal) based on the UK system, the proposal has undergone various changes and eventually it was decided that the on call allowance should be based on 'monthly claims' method using the Singapore system. Whatever system it is, the principles of awarding on call is the same, doctors who work 'extra-hours' and whose daily lives (personal & professional) are affected by it should receive an allowance.

Using this very principle of awarding on calls, the JPA has come up with a definition of On call. On Call by definition is A Doctor who has been rostered to work outside his/her normal working hours to treat patients in the hospital. From this definition, JPA has decided that on call can only be given to the doctors working in hospitals on full shift system (24hrs). Thus those working on shift system (A&E), GPs, Public Health & Dentist cannot claim for on call allowance.

The respective Administrative & Finance Department of each Hospitals in the country has been tasked to manage the claims of 200+ doctors through out the nation, except for the Renal Doctors whose claims are directly manage by the Administrative Dept at the Ministry of Health.


The rates and types of oncall:

There are 3 types of on-call allowances, Resident On-Call, Non-Resident On-Call and Consultant On-Call.

1) Resident On-Call are given to those who stay in-hospital during the 24hr On-call period, mainly Medics, Surgeons, Orthopods, Anaesthetist, Renal, Gynae, Paeds, ICU and recently ENT has also been approved to do Resident Calls. The rate depends on their grade whether it's Medical officer or Senior Medical Officer.

M.O. - $11/hr

SMO - $14/hr

2) Non-resident On-call are given to those who are on-call from home. e.g. OMFs, ENTs, Opthalmology, Neurosurgeons. These doctors will have to claim the hours they come to hospital only and attend patients. Calls taken from home are not counted apparently. The rates are similar to the above. Non-residents On Call also refers to the 2nd Oncall (usuall SMO) who are not resident.

3) Consultants/Specialists Oncall are given only to specialist who has been given a permenant post. Its fixed amount of $1,250/mth. However If you are Acting Specialist, you will only be entitled SMO rate and you get paid only when you come to hospital.

Problems encountered:

Unfortunately there has been some significant delay in the payment of on call allowance due to various factors:

1. The method of claiming the on call was not finalized until sometime early 2010, this was mainly because

• There was issues raised by the administration about how to 'audit' the claims of doctors
• Admin weren't sure how much the budget needed to be allocated, because this is the first time, on call allowances were claimable.
  
• Who are entitled to claim? Resident and Non-Resident
  

2. After the above issues were addressed the administration has come up with various forms that required to be filled in, but again there were delays in processing these forms due to several factors:

• The forms were issued without any guideline as to how to fill them correctly, therefore it has lead to many forms being returned back due to incorrect information provided.
• Initially the dateline given to issue all claims was less than 2 weeks, but due to the large volume of claims dating back to March 2009, Hospital Finance Dept (Tafis) was overwhelmed.

As a result of these teething problems, some claims are still outstanding, but to those who have received their on call allowances, please don't forget to give 2% to Brunei Medical Association (The force behind all this).

Conclusion

The rough estimate of monthly resident on call INCOME
M.O. ~ $3,400 - 4,000 (Basic Pay) + $800 - 1,200 (On call 1 in 5) = $4,200 - 5,200
S.M.O. ~ $5,400 - 5,900 (Basic Pay) + $1,100 - 1400 (On call 1 in 5) = $6,500 - 7,300
Specialist $6,800 - 8,000 + 1,250 (Basic pay & M allowance) + $1,250 = $9,350 - 10,050

• Don't abuse this previlage. It can be revoked at any time.
  
• The idea behind those who have relentlessly fought behind the scene to get the on call allowance was to lend appreciation the unsociable and high health risk career medicine & surgery is. At risk of becoming the most unpopular career choice for bright students, the authorities have taken initiative to revive this career by giving an incentive. We hope this will serve as an initial stimulus to entice more people to join medicine as a career.
• Don't forget that we are still fighting to get on-calls for our colleagues at the Accident & Emergency Department.
• The revision of salary scheme (Scheme of Service) is well underway. Details of the new scheme are still unofficial, but as soon as it's official it will be shared here.
  

Guidelines for claiming On Call Allowances - for doctors only

This guideline has been drafted by Dr Munir (Internal Medicine, RIPAS) and approved by DGMS office. For any further queries please contact him on his e-mail
munman_stk@hotmail.co.uk

DOCTORS GUIDELINES FOR CLAIMING ON CALL ALLOWANCES

In reference to the memorandum dated 5th of May 2009 (KK/JPK/S/96/04/A J.2) which attached a letter from the Director General of Public Service Department (JPA/R/JTG/KSN/1/8/6 (462)), “on-call” allowance will be approved for MO, SMO, Specialists working for Ministry of Health except Dental doctors, Public Health and A&E effective from the 1st of March 2009.

These are the Amendments and Guidelines for claiming on-call allowance:

General Information and Amendments:

1. On-call time is taken as the time the on-call doctor arrives in the Hospital grounds
2. On-call time for Resident on-calls are 0745-0800 for weekdays, and 0800-0800 for weekends and public holidays
3. On-call time for Non-Resident on-calls are 1630-0800 for weekdays, and 0800-0800 for weekends and public holidays
4. Non-Resident on-call doctors will be able to claim 'extended' on-call time (after 0800 endtime) for Weekend or Public Holiday
5. All claims are accumulative for the whole month
6. There is no 'minimal time' or 'minimal claim'
7. Total time to the nearest minute will be claimable
   

Guidelines for Claims:

1. Applying for approval

• All claiming doctors must first apply for on-call allowance by submitting the EOC 09 FORM
• Forms are available from your Departmental clerks or CEO Office
• Accepted on-call applications will be given a unique Reference number which need to be quoted for each claim
• All applications must include:

1. Completed EOC 09 FORMS
2. Copy of Identity Card
3. Copy of latest payment slip
4. Copy of appointment letter
   

2. Filling in Attendance books

• Attendance books must be filled in with the EXACT time of entry and exit
• Attendance books will be placed in ALL wards, ICU, Radiology, OT and A&E
• Attendance books shall be placed in a conspicuous and easily seen area of the ward/facility
• Resident on-call doctors need only to sign the 'time in' of the first ward/facility they enter at the start of the on-call and 'time-out of the last ward/facility they leave (example 1, eg. for weekday 0745-0800 and example 2, eg. for weekend and public holiday 0800-0800)
• Non-Resident on-call doctor need to sign 'time in' and 'time out' of every ward/facility they enter for the on-call (example 3, eg. for weekday 1630-0800 and example 4, eg. for weekend and public holiday 0800-0800)
  

3. Filling in Logbooks

• Logbooks must be filled in with the EXACT time of entry and exit
• Logbooks must be verified by end of on-call day
• It can either be 'witnessed' by staff nurses or Allied health care professional or Specialist on-call
• Where logbooks cannot be 'witnessed', it can also be 'verified' by the Specialist on-call at the end of the on-call day
• Logbooks can also be verified retrospectively after 24 hours with the discretion of the respective Specialist on-call or Head of Department
• Resident on-call doctors need only to fill in entry and exit time and general ward/facility where they will be working (example 5, eg. for weekday 0745-0800 and example 6, eg. for weekend and public holiday 0800-0800)
• Non-Resident on-call doctor need only to fill in entry and exit time of each on-call, any breakdown of wards visited must be written clearly in the 'Place of Duty' column (example 7, e.g. reviewing 2 patients in ward 21 and ICU respectively, example 8, eg. joining on-call team for wardround to more than one ward such as ward 19 followed by ward 21 and CCU and example 9, eg. staying after 0800 end-time for weekend or public holiday)
  

4. Filling in BT EOC 09 Claim Forms

• All Claim Forms must be filled with identical entries from your logbooks
• Each doctor's unique 'Reference number' must be quoted in each Claim Form
• Claims should be written in chronological order
• All claims are accumulative for the whole month
• There is no 'minimal time' or 'minimal claim'
• Total time to the nearest minute will be claimable
  

5. Claiming process

• Please submit only 1 copy of completed BT EOC 09 Claim Forms2. Please include your original logbook and a copy of a finalized rota for the respective month
• Please submit all Claim Forms by the 14th of each following month
• All claim forms should be submitted to respective departmental clerks

The proposed new Women & Children Hospital Building - The update

You may remember sometime last year we reported that one of the latest MoH project was to build the New building for Women & Children Hospital due to begin end of 2009... the most recent update we've heard is that the project has been frozen for now pending new assessment and allocation of the budget. As a result we heard the project will be re-tendered again. So in the meantime we wait. At least the on-call allowance is through :)

The following is excerpt from the previous post about this project:

These pictures were taken during the recent World Health Day 2009 exhibition. We manage to speak to one of the architects from the 'awarded' consultants Arkitek Idriss, and he said that the project is estimated to cost around $BND 60 million and if all goes well (i.e. budget approved) is due to start end of 2009 (Need to verify this information).

It is suppose to accomadate the Obstetrics & Gynae, Paediatrics, Accident & Emergency and the RIPAS Administration... hey what about Doctors Mess! We put that question forward too and still awaiting answers.

After doing a bit of asking around amongst the doctors, two very common comments were forwarded. One is that... it's quite an impressive and nice building... but secondly is that the worry about congestion it will create to an already congested Hopital area. Relevant issues considering we have just undergone a workshop for ensuring safe hospitals, and that one of the indicators of a structural risk is that the location of the the hospital... in this case right at the hill. I'm sure the professionals would have already thought about it, but we are not sure if the congestion problem can be minimized. Something to ponder...

Brunei Medical Association - New constitution & new president

After a period hibernation.. BMA has finally resurfaced again. It's back to square one again... When BMA was launched a year and so ago.. there was echos that the constitution by which this association stands upon was too rigid and unrepresentative of the whole medical practitioners in Brunei Darussalam. The interim committee took upon this seriously and have been working closely together address this issue.

Finally it has been decided that after being pursued its members, the Brunei Medical Association will propose certain changes in it's current constitution and and Extra-Ordinary General Meeting will be held sometime in March to officially vote for these changes. Amongst others BMA proposes that

• All members (regardless of citizenship) will receive equal rights to vote
• All Brunei citizen members are given opportunity to run for executive office

For more details of the proposed new constitution, please contact BMA

BMA would also like to inform it's members that Dato Paduka Dr Hj Latif b Ibrahim have officially resigned from his post as the Interim President and

Dr Hj Isham b Jaafar (Cardiothoracic Surgeon/Medical Director of JPMC) has been nominated to lead the BMA for now, until the official AGM.

NB. The current members are required to renew membership by 28th February 2010, to be eligible to vote for the change of constitution during the EGM.

On Call Allowances for Doctors in Brunei

Doctors can now start claiming for on-call allowances and this is can be backdated to March 2009. That's the current update on on-call allowances for doctors working in Brunei. The delay was mainly due to allocation of the budget, and talks about how to distribute them correctly.. unfortunately not all doctors qualify for oncall allowances.

Currently these allowances are given to:-

1. Doctors working in the 4 Government hospitals
2. Doctors working on Full-24 hr Shift System
3. Medical Officers, Senior Medical Officers & Specialist

The different type of On-Call Allowances are:-

1. Resident On call
2. Non-Resident On call
3. Specialist On call

Resident On-Call (RC)

Doctors who work 24-hour shift who resides in the hospital e.g. Medics, Surgeons, Paeds, ICU, Anaesthetist. These are usually doctors who are 1st line to receive referrals and attend to emergencies. The amount varies according to your level e.g. M.O. or SMO. and are calculated by a pre-determined rate. (I think it's around $11/hour for MOs). Total amount are calculated from 4.30pm till your shift ends i.e. 7.45am the next day only. Therefore for weekdays oncall an MO can claim around $11x15=$165, and for weekends & Public Holidays it will be $11x24 = $264.

Non-Resident On Call (NRC)

Doctors who are suppose to be on-call for the 24-hour shift but does not reside in the hospital. These are usually the 2nd line doctors (if it's a 3 tier oncall MO-SMO-Specialist) or 1st line doctors of certain specialty that are usually on-call from home e.g. Psychiatrist, OMF, Dentist, Opthalmology. The doctors are required to note down the time they attend patients, the identity of the patients in a logbook which will need to be verified by a nurse. (This part being signed by a nurse have been met with certain opposition by the relevant doctors and a move towards the logbook being countersigned by consultant on-call have been proposed.)

The rates of claim are the same as above and can only be claimed 'outside office hours'. I.e. if you attend a patient during office hours 745am to 4.30pm, it cannot be logged in your on-call claim. Qns: What if you get called at 2am for advice? Ans: It does not count as NRC either. So for ALL NRC doctors, start logging in your on-call referrals.

Consultant On-Call

As far I know, All Specialist/Consultants with a permenant/contract post with salary scale of M18 and above will receive a fixed amount of on-call every month of $1,250 bnd. This is regardless of their specialties and will be automatically credited into their salary every month.

Comments from doctors:

There are a couple of issues that have been raised from the current scheme:

1. The NRC are not getting a fair deal because we know that when there is a 3-tier oncall, the 2nd On-call ie. SMOs also carry a big responsibility in ensuring the MOs are covered by someone senior if the juniors find themselves out of depth. The amount of oncall allowances they logged in a month using the above method does not reflect the level of responsibility and the intensity of work undertaken by the NRCs. Perhaps this needs to be revised in the future and a flat rate for the NRCs would be better sense.
2. Consultants have a flat rate, but certain specialties have far busier take than others e.g. Anaesthetist vs Psychiatrist. Should consultants have varying flat rates according to the level of activities in their specialties? Maybe we should group the consultants according to the level of intensity of their oncalls and pay them accordingly.
3. Emergency Medicine, the busiest department in the hospitals are not given On-Call Allowances. Although they work on shift system, but we all know when they work for 8 hours, they really work hard all the way through. Again perhaps we can come up with a flat-rate as well for these doctors.

These are only some of the comments that we have encountered after talking with some of the doctors involved. However overall most of the doctors have welcome this move positively and we look forward towards the continuity and improvisations of it's implementation.

Doctors Mess would like to thank those who have been quite instrumental in pushing forward this proposal and finally getting it approved.. senior doctors, administrators at MoH, JPA & SPA! We look forward for our New Scheme of Service (Payscale) to be approved as well :)

Share your opinion...?

Working in Brunei Darussalam

I came across this article about working in Brunei Darussalam, which was published by Pakistan Journal of Medical Sciences. It is a very interesting read about the experience from an expatriate doctor, about working in Brunei Darussalam, and I thought I'd like to share it with our readers.

Hopefully it will give a better insight to other doctors who wishes to come and work Brunei.

Here are the links

http://pjms.com.pk/issues/octdec107/pdf/brunei.pdf

http://pjms.com.pk/issues/octdec107/article/bc3.html

Hospital Medicine Career Pathways + Current Doctors Salary in Brunei

I think this flowchart best summarizes the different career pathways available in hospital medicine, that Brunei Government recognizes at the moment for our doctors. On the left hand side you can see the pay scale corresponding to your grades and your required qualifications in the middle column. Other Post-Graduate qualifications are not included, because it seems to be quite variable at times. We are not sure why this is so.. just an observation. Probably best to direct that questions to the PGATB and relevant authorities.

Also to note is that only Housemanship/Foundation year and Basic Specialty Training (BST) programme are available in Brunei at the moment. For AST, Seamless training pathways and other equivalant, you'd have to go abroad to places like Singapore, Australia, UK and the US.

At least this information will be most useful to our undergraduates whom are still studying abroad especially for those planning to stay in hospital medicine. For GPs and Public Health this flowchart does not apply. Please note that our undegraduates from Australia & New Zealand will be considered the same like UK.

This information is the based on the current scheme of service. Please bear in mind that this does not take into consideration the New Scheme of Service which we're still working on with JPA and it hasn't included the On-Call Allowances which is still awaiting it's implementation.

Xray of the month

Male 92, unable to remember fall, wounds on forehead and wrist, neck pain. No neurological deficit. Whats the abnormality?

courtesy of rpullinger, BMJ.

Application for Renewal of Licence to Practice - from Brunei Medical Board

Dear Doctor,

Application for Renewal of Licence to Practice

The Brunei Medical Board would like to inform you that all Medical Practitioners and Dentists in the government sector need to apply for renewal of licence to practise by 1 December 2009, for the year 2010.

Please find attached the application form to be used, which is to be returned to the Brunei Medical Board before 1 December 2009, with the following:

1. Two recent passport photographs

2. Evidence of 30 CME points in the past 12 months or from 1 September 2008 to 31 August 2009. This will normally be in the form of the CME log book and supporting certificates

3. $50 fee in cash, which will be waived if the complete application is received by the Brunei Medical Board before 1 December 2009

The form can also be downloaded at http://www.moh.gov.bn/bruneimedicalboard/regform.htm

This form will also be coming to you by post, in case contact by email fails. I would be grateful if you could ensure that your colleagues and those under you also know about this requirement to renew licence to practice for next year.

Yours sincerely,

Dr Melanie Chin

Secretary

Brunei Medical Board

Ministry of Health
Commonwealth Drive
Bandar Seri Begawan BB3910
BRUNEI DARUSSALAM

Email: bmb.brunei@moh.gov.bn

Tel: +673 2 384 182

Festive season's mishaps

This year we did not get any serious 'fireworks' accident or 'sugar-cane machine' crush injury like we used. Perhaps increased public awareness kept these occupational and home injuries at it's minimum. Unfortunately Road Traffic Accidents are on the rise and we've had at least two major accidents just during the fasting month, where in one of them a husband lost a wife and his 4 children ended up with multiple fractures of long bones.

The public has been warned about Safety whilst driving incessantly, No talking on the phones, No texting, No cutting corners, No drinking alcohol, Keep to your speedlimit, Safety belt.. but still these accidents do occur. The sad things are, the culprits escape with moderate injuries, the innocent law abiding road users lose their precious ones.. how many times have I seen this is .... one to many.

Anyway please guys... becareful on the road.

This time we feature some interesting mishaps that occured around the festive season. Perhaps some lessons could be learnt from them...




You may have heard recently on the news about a young child who was the victim of a kite string accident. The above picture is the neck of the child which got caught in kite string. Unfortunately the string was directly at the child's path as the child was cycling through a residential area. It was so sharp after being treated with broken glass (a common practise amongst kite enthusiasts) that it severed the Sternocleidomastoid and Superficial veins. Luckily it missed the arteries otherwise it would have been a different ending. The surgeons repaired the injury and the child now has been discharge home.

Moral of the story: Don't treat you kite strings with smashed broken glass, you never know what or who it might injure....


This was an elderly lady presented to Accident & Emergency department with a gangrenous finger. The story, it was bitten by a cray-fish a month ago and was treated by a private GP with oral antibiotics. A month later the swelling persist and the RINGS in her finger is still there!! Ofcourse the blood supply to that digit is completely obliterated by then and the finger developed dry gangrene.

It still baffling how this was kept at home for 1 month until it came to this stage. It took a double action ring cutter to remove the rings, but eventually the digit was amputated anyway.


Moral of the story: Remember to Remove your rings at your fingers if its stung or injured!

What happen to our On-Call Allowance?

6 months ago JPA (Department of Public Service) approved the doctors On-Call Allowances, through its memo to our ministry dated March 2009.

About three months ago a form for applying the on-call allowances were released by the Finance department at the Ministry of Health via our CEO's office. It was claims for the month of March, April and May. The forms was filled and handed in.... 3 months later we're left wondering what happened to our claims...

March On-Call Allowance form

Doctors Mess approach a senior officer at the Ministry to ask some questions and Here's our answer my dear doctor friends....

Apparently NO on-call allowances will be given yet, because there are no allocated budget for it .... as yet. Yes the oncall allowances have been approved by the highest authority, and permission has been granted through JPA for the ministry to proceed with the on-call allowances... however the Finance department is still figuring how to 'correctly' award the on-call allowances to the doctors.

So what about the forms that were filled in 3 months ago for the month of March, April and May? Well it turns out it was only a "PILOT" study to gauge how much the ministry will be spending on On-Call claims. So who's idea was this pilot study... BDMC found out it was the Finance Department..

Before I elaborate on some of the querries brought forward from the "Pilot" study that was done where None of us were told about, let me just elaborate on the different type of On call allowances that you are entitled to claim.

There are 3 types of on-call allowances, Resident On-Call, Non-Resident On-Call and Consultant On-Call.

1) Resident On-Call are given to those who stay in-hospital during the 24hr On-call period, mainly Medics, Surgeons, Orthopods, Anaesthetist, Gynae, Paeds & ICU. The rate depends on their grade whether it's Medical officer or Senior Medical Officer.

M.O. - $11/hr

SMO - $14/hr

2) Non-resident On-call are given to those who are on-call from home. e.g. OMFs, ENTs, Opthalmology, Neurosurgeons. These doctors will have to claim the hours they come to hospital only and attend patients. Calls taken from home are not counted apparently. The rates are similar to the above.

3) Consultants/Specialists Oncall are given only to specialist. Its fixed amount of $1,250/mth. However If you are Acting Specialist, you will only be entitled SMO rate and you get paid only when you come to hospital.

We overheard Several querries were brought forth, I thought we'd share with you some of them:

1. Some doctors were claiming to be on-site when they are not.

2. How do we know if the doctor claiming for 3 hours duty, actually came for 3 hours?

3. Some specialists were claiming on-site oncall allowances, although their on-calls are fixed.

Well, firstly we think the Pilot study was a bit on the unfair side. It's fine to do a pilot, but at least let us know so that everyone understands there will be a long delay.

Secondly, the doctors claiming wrongly, would probably have been avoided if there was a proper briefing held by the Finance department on How to Fill in these forms.. If you have a look at those forms, there is no way to differentiate between who is on-site and who is not. How do you expect the doctors to fill in the forms correctly.... if no body actually tell them how to? It is not surprising that some of the doctors would have filled them incorrectly..

Thirdly, the claiming of correct hours can be overcome by using 'thumb finger-print' recognition technology. You just 'thumb in' and 'thumb out' when your done. I'm sure the money used to acquire this technology is much less than the money some of the doctors would try to claim wrongly... right?

Or have somebody in each ward and department to log in the doctors that were on-call everytime they see a patient... including at 3 am when a Neurosugeon gets called in for a Road Traffic Accident.

Or alternatively, trust the doctors who really should be professional, honest and trustworthy. I prefer the later. I think $14/hr versus a sleepless night when you have to wake up at 2am to put a Cardiac Pacemaker or help your junior put a central line in is well justified.. Plus on top of this they are yet expected to work the next day from 7.30am till 4.30pm. You do the maths...

So what now... BDMC heard that we'd have to wait for an official letter from DGMS to officially allow us to claim... then there will be another form - 'The Official one' where we can start claiming.

There is going to be some delay as well, because the current on-call allowance does not include those who are 'daily-paid'. This include our newly appointed Pre-registration House Officers and some of the new Medical Officers. Fortunately our DGMS are already looking into this matter and is in the process of getting this approved by JPA.

Finally on behalf of all the doctors, we'd like to say thank you to all those who have continuously given support to improving the medical profession in Brunei. We hope this profession will continue to strive, and continuously contribute to the society, religion and country. May Allah bless you.

Comparing Doctors pay

Due to popular request, we have compiled a table that summarizes and compares the salary of doctors within 4 countries, Brunei, Singapore, UK and Australia. We have chosen these countries for comparison because most of our trainees either graduated from these countries or usually chose these countries to further their training into specialty areas, as recommended by the Post Graduate Training Advisory Board.

However in comparing these figures, we have to bear in mind that our beloved country is blessed with other factors such as a peace, no income tax, heavily subsidized petrol price, excellent education facilities for the kids and one of the lowest inflation rate in the region.

Also these figures are the current figures when we collected them and of course other countries like Singapore changes very quickly (almost yearly) according to demand of health service. The figure from Brunei has remained the same.

We also apologize for the incomplete information for it is difficult for doctors (esp consultants) to disclose their total pay especially when it comes to their private practice. This is of course understandable. We can only assume that it is somewhat more substantial than their basic pay working with their government.

The salary stated above are starting salary for each grade, and can vary widely even within each grade depending on experience and qualifications.

In providing this information, we try to be as honest as possible with the figures. The information also came from various sources such as websites, journals and individuals who have been very kind to share their information with us.

Holiday Allowances & 10 years service allowances

To most perhaps the above subject is very familiar, but to most of us who have worked less than 3 years in the government service, a holiday allowance after every 3 years of service and a 10 year service allowance is very much welcomed.

For those who have not come back to Brunei yet and medical students abroad, we are entitled to the allowances below:

1. 3 year holiday allowance of $2,500 each for you and your wife and up to 4 children below 18yrs old
2. For children below 12yrs old it's $1,250
3. 10 years service allowance of up to $21,700 (husband & wife) and if your single it's $10,850. Pls note this one is one-off allowance.
   

Don't forget to apply for these allowances well in advance (at least a month) before your due date i.e. your appointment date as medical officer.

To apply, first go to Ministry of Health, 1st floor and ask for the Allowance section. Then ask for a form to apply for the above respective allowances. Go back and fill it up. You need a copy of your appointment letter, Identity Card & Bank Card or statement (if your married I suppose you need the marriage certificate and your wife's details). At the time of writing this article, only male government officers are entitled to apply for their wives and not vice versa. Then hand in this form to RIPAS administrative department at the CEO's office - claims section (it's room 1).

The CEO then will draft a minute to confirm you are entitled to the above allowances. Once the minute is ready 2 days later, I have been advice by the Finance dept to hand this minute back to the Ministry of Health my self. Because as we all know, letters easily get lost on the way causing you to get delayed allowances. Hand it in to where you got the form from, 1st Floor MoH.

Simple right!

Other allowances that you are also entitled to are:-

1. Overnight allowance. e.g. if you are posted to Temburong - $40-45 / night
   
2. Moving to a new workplace allowance - $350 / one off
3. Mileage allowance from home to RIPAS - $29/mth if within 9.5km etc...
4. Ad hoc mileage allowance if your posted to KB or Tutong and you use your own vehicle - $0.45 / km (to and from)
5. Interest free car loan up to $15,000 (repay within 4 years)
   
6. Interest Free Housing Load up to 4 years basic pay (repay within 30 years)
7. Free Haj package worth $3,500/per person after 15 yrs of service
   
8. Education allowance for your kids

• $800/mth for overseas education
• $120/mth for local schools
• $800 / mth if you send them to JIS (Jerudong international school) Year 7 (?up till or from)

Happy Applying!