Doctors Working in Brunei

About Brunei Darussalam

Were it not for the fabulous wealth of its most famous resident, Sultan Hassan Al-Bolkiah, the impossibly small country of Brunei Darussalam would be unknown to the world. Once the world’s richest man, the Sultan is the head of a ruling dynasty which has presided over the affairs of this prosperous nation for 650 years. During the early years of the family’s reign, Brunei was an empire which controlled the entire island of Borneo, the third largest in the world, and parts of the Philippines.

Over the years, Brunei’s territories were gradually conquered by the colonial powers until the Sultanate was reduced to its present day geographical location which is on the northwest shore of Borneo occupying 5,765 square kilometres1 divided into the four districts of Brunei-Muara, Temburong, Tutong and Belait with a population of 374 000.2 In contrast, Pakistan’s largest city, Karachi is 3,527 square kilometres with a population of 18 million.3 Most of Brunei is covered by beautiful unspoilt rainforests which are inhabited by some of the world’s most exotic and rare species of plants and animals.

The majority of Bruneians are the Muslim Malays; the largest minority group are the Chinese, most of whom are Permanent Residents not citizens; there are small numbers of indigenous races and a sizeable number of expatriates from the Subcontinent, Southeast Asia as well as Western countries. Brunei is an Islamic state governed (mostly) by the Shari’ah. However, the country also espouses the ideology of "Malayu Islam Beraja" (MIB) which means Malay Islamic Monarchy. MIB is a blend of Islamic and nationalistic ideas which seeks to preserve, as the name suggests, the Malay traditional culture, Islam and the monarchy and it is taught and studied in all Bruneian schools.

Brunei’s wealth is derived from oil and gas. The country has a good infrastructure, modern facilities and there is very little crime. The national language is Malay but English is widely spoken.

Brunei’s Healthcare system

A small number of Bruneian students are sent abroad for medical training but almost all of Brunei’s doctors are expatriates. The majority are from India and neighbouring countries such as Malaysia, Burma and Indonesia. There are three grades of seniority amongst doctors: Medical Officer, Senior Medical Officer and Specialist (equivalent to Consultant). The nurses are mostly locals graduating from the country’s only nursing college. There is an extensive primary care network throughout the country and each district has its own general hospital. Most specialist services are available in the country. However, healthcare standards are modest compared to what may be expected. The Brunei Ministry of Health provides a comprehensive list of available services.

Pakistani doctors in Brunei

About thirty doctors hailing from Pakistan grace the Bruneian healthcare system. The majority work as medical officers in the primary care sector. A small number work as medical officers in the hospitals. In spite of being some of the most able doctors in Brunei, there is not a single Pakistani Specialist in the country. The reason for this unfortunate state of affairs is that Brunei does not recognise Pakistani postgraduate qualifications. However, most of them have been in Brunei for many years.

Dr. Masroor Ali is a psychiatrist. He had his own private practice in Karachi for ten years before leaving Pakistan for Malaysia initially where he worked as a specialist. However, he and his paediatrician wife soon moved to Brunei where Dr. Masroor took a post as a medical officer. In spite of moving into a junior position, he found himself better off financially. He cites his reasons for leaving Pakistan thus: "In the two years before I left Pakistan, 68 doctors were murdered in Karachi. Private education for children is very expensive and government education is of a poor standard. In Pakistan, the working hours are very long and you work very hard. Here in Brunei, I have a better quality of life; I can spend time with my family."

Other doctors have similar reasons for coming to Brunei. Dr. Asad Dar is also a medical officer. He is in the primary care sector and has been in Brunei since 2003. "In Pakistan, I was working as a medical officer in a Basic Health Unit. In Brunei, I have a higher salary, more family time and an opportunity to get a postgraduate qualification."

Dr. Asad has taken the opportunity to acquire an MSc in Primary Care part-time at the University of Brunei Darussalam; he also intends to obtain the MRCGP International qualification. Most of the Pakistanis have similar reasons for being in Brunei. Whilst acknowledging that things are far from perfect, they are generally happy and intend to stay long-term.

Requirements and benefits for foreign doctors

The ability to speak Malay is not a requirement but it is certainly helpful and anyone intending to work in Brunei would benefit from acquiring the language. A good command of English is essential. The basic requirements for working in the primary care sector are an MBBS (the Pakistani basic medical degree is recognised) and ten years experience. In the hospitals, a postgraduate qualification followed by five years experience in the relevant specialty is also mandatory. With Western postgraduate qualifications, one is eligible to apply for the position of Senior Medical Officer as long as the prerequisite five years have been completed. With a British Certificate of Completion of Training (CCT) or equivalent, one may apply for the Specialist grade. However, it should be noted that there are exceptions to these rules.

The duration of contracts is usually three years. The following benefits are generally included in every doctor’s contract regardless of grade/seniority: free tickets into Brunei for yourself, your spouse and up to four children up to the age of eighteen at the start of the contract and free tickets back to the point of origin at the end; in addition, return tickets are provided halfway through the contract. A modest freight allowance for your personal effects is subsidised by the government. Housing, usually of very high standard is provided virtually free of cost. Your children receive an education allowance (up to the age of twenty-one even if they are in a foreign university). You and your family are entitled to virtually free healthcare in Brunei. The annual leave allowance is forty-eight days a year. There is a yearly bonus and an end-of-contract gratuity of 25% of your monthly salary for each completed month of service paid as a lump sum (i.e. 25% of your monthly salary multiplied by 36).

Salaries for medical officers start at around BN $3600 and go up to BN$5400. Senior medical officers start at BN$5400. Specialists start at around BN$6800 (plus a monthly supplement of $1350). One Brunei Dollar is equivalent to thirty-nine Pakistan Rupees. These figures are approximate. Contracts are generally renewable. However, in the primary health care sector, a small number of doctors have not had their contracts renewed due to local doctors qualifying for their positions.

Advantages and disadvantages of working in Brunei

The aforementioned benefits compare favourably with other foreign destinations for Pakistani doctors. Although the salaries are not particularly high, it is possible to save money in Brunei whilst maintaining a high standard of living due to a relatively low cost of living. Fuel is particularly inexpensive due to government subsidies – in fact, petrol is cheaper than water!

Brunei is politically stable and is very safe; violence is virtually unheard of. Hence, it is considered to be a very good environment to bring up a family. Since the population density is very low, there is very little traffic congestion and almost no environmental pollution. However, the choice of schools is rather limited.

Some of the major disadvantages of working in Brunei are the lack of career progression in terms of seniority and knowledge. Sometimes, local doctors are shown favouritism and one may find a junior local becoming a departmental head. Moreover, there is a lack of control over one’s assigned duties; it is quite possible that a doctor will be posted in a different region without prior consultation. However, this is more likely in primary care and tends not to be the norm. The workload and hours in most departments are considerably better than in Pakistan. Most doctors enjoy a relaxed lifestyle but the flipside of the coin is that, after many years of working in Brunei, doctors may become de-skilled. Pakistani doctors working overseas are often subjected to prejudice and mistreatment either by patients or employers. In Brunei, patients are generally pleasant and employers at least treat doctors with respect. Bruneian Malays have a social hierarchy based on kinship with the Royal Family which foreigners often find difficult to understand. VIP patients tend to be the minority since the well-to-do will often seek medical care in either Brunei’s only private hospital or in Singapore. Brunei is also notorious for its bureaucracy. It is for this reason that allocation of housing is usually delayed for an average of three to six months and, in some cases, a year or longer. Initially, temporary accommodation is provided in hotels with basic facilities.

Finally, it must be kept in mind that, while it is perfectly possible to live and work in Brunei for many years (indeed, there are many doctors who have been in Brunei for twenty-odd years) there is virtually no possibility of acquiring citizenship there.

Enquiring about employment

The Ministry of Health in Brunei has a website6 with a list of vacancies but it is unlikely that the site is kept up-to-date. Therefore, it is perfectly acceptable for anyone interested in employment in Brunei to send a copy of their Curriculum Vitae speculatively even if no vacancy is advertised. One of two outcomes is to be expected: either you will be invited to formally apply for a vacancy or your CV will be stored in a database and you will be contacted if a future vacancy arises. Be warned, however, that even if there is a vacancy, you are unlikely to be contacted for several months. In fact, the whole process of securing employment may take as long as a year. Furthermore, the Ministry of Health does not pay for travel expenses incurred as a result of coming to Brunei for interview.

The Ministry website gives extensive information about which documents should be sent along with the CV. The website also provides a downloadable application form and an email address which can be used to send documents electronically. It should be noted that applications for a post in primary care services should be made to the Director General of Health Services whilst applications for hospital posts should be sent to the Director General of Medical Services. The Pakistani doctors in Brunei have established a very cohesive and welcoming community and any interested applicant should not hesitate to get in touch for advice and further information.

ACKNOWLEDGEMENTS

I would like to thank the Pakistani doctors of Brunei for the valuable information they provided, in particular Dr. Masroor Ali and Dr. Asad Dar.

source :

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