The Effectiveness of the Medicorp House Officer (HO) Preparatory Course for Medical Graduates on Confidence, Readiness, and Psychological Well-Being: A Quasi-Experimental Study
Phase: NA
Conditions: Psychological Stress, Depressive Symptoms, Anxiety State, Motivation
Sponsor: Universiti Putra Malaysia

1 
 
PROPOSAL 
 
The Effectiveness of the Medicorp House Officer (HO) Preparatory Course for 
Medical Graduates on Confidence, Readiness, and Psychological Well-Being: 
A Quasi-Experimental Study 
 
Intended Protocol Registry: NIH 
Dr. Aneesa Abdul Rashid 
Version: 3 
Date of Version:  6th April 2018  
Funding:  
No 
Funders 
Funds 
Contact 
Information 
 
1 
Medigrow (Medicorp 
Resources)  
Venue, Trainers, 
Equipments 
No 44, Jalan Bidara 
3/2, 
Off Jalan Selayang 
Jaya, 
Batu Caves, 68100, 
Selangor 
 
2 
University Putra Malaysia 
(UPM)  
University Community 
Transformation Centre 
(UCTC)  
Knowledge Transfer Grant 
Scheme (KTGS) 
Research grant 
Pusat Transformasi 
Komuniti Universiti 
(UCTC UPM), 
Bangunan Jaringan 
Industri dan 
Masyarakat, 
Universiti Putra 
Malaysia, 43400 
UPM Serdang 
Selangor Darul 
Ehsan 
decision to 
submit the 
report for 
publication, 
authority over 
study 
activities 

2 
 
Role and Responsibilities: 
No 
Name 
Affiliation 
Roles 
1 
Dr Aneesa Abdul Rashid 
Universiti Putra Malaysia 
(UPM) 
Principal Investigator: 
study design; collection, 
management, analysis, 
and interpretation of 
data; writing of the 
report 
2 
Dr Iliana Mohamad 
Medigrow (Medicorp 
Resources) 
Industry (Training & 
Education) study design; 
collection, 
management 
3 
Assoc Prof Dr Sazlina Shariff 
Ghazali 
Universiti Putra Malaysia 
(UPM) 
Co researcher 
study design; collection, 
management, analysis, 
and interpretation of 
data; writing of the 
report 
4 
Dr Dalila Roslan 
Islamic Medical 
Association of Malaysia 
(IMAM) 
Co researcher 
collection, management, 
analysis, and 
interpretation of data 
5 
Dr Maliza Mawardi 
Universiti Putra Malaysia 
(UPM) 
Co researcher 
collection, management, 
analysis, and 
interpretation of data 
6 
Dr Husna Musa 
 
 
 

3 
 
INTRODUCTION 
Background 
After completion of 5 years of medical school training, the next step of becoming a House Officer 
(HO) is said to be associated with high levels of stress. It has been associated with mental health 
problems amongst HOs and sometimes quitting the medical line altogether. In Malaysia, the number 
of HOs not completing housemanship training within the allocated time is slowly declining from 
86.4% (2009) to 58.8% (2012) (Lim, 2017). The dropout rate is said to be increasing yearly. This 
causes a lot of constraints on the HO, their family, sponsors, patients and also the country. Amongst 
the reason for stress is the feeling of incompetency or “fear of making mistakes”. Other work-related 
issues include workload, time management, financial, colleague and superior related issues. Medicorp 
is a company that specializes in training for junior doctors and has come up with a module to help 
medical graduates cope with these issues. The module is a 3-day-course named the HO Preparatory 
Course. It was initially the brainchild of the Islamic Medical Association of Malaysia (IMAM) but 
was later privatized to accommodate the demand and the running of the module and courses. The 
module has been re-evaluated through feedback of participants and trainers to cater to the needs and 
wants of the newly graduate; be it local or overseas. Therefore, we would like to assess whether this 
intervention module is effective in addressing HO stress, consequently reducing the risk of drop out 
and extension in HO training 
 
Problem Statement 
 
Housemanship is the first 2 years of a Malaysian doctor’s career. It is associated with various causes 
of psychological stress (Vivekanandan et al., 2016; Yusoff, Tan, & Esa, 2011) . The top cause of 
stressors found among House Officers (HO) is fear of making mistakes (Al-Dubai, Ganasegeran, 
Perianayagam, & Rampal, 2013; Yusoff et al., 2011). Time management-workload pressure, work 
colleague and financial issues are the other top causes of stress. (Al-Dubai et al., 2013; Yusoff et al., 
2011). A more recent study suggests poor work-social life balance as a major cause of stress amongst 
housemen (Vivekanandan et al., 2016).  
 
According to a recent report by the Penang Institute; a think-tank funded by the Penang state 
government, the percentage of HOs completing their training in Malaysia within the allocated time of 
2 years has declined from 86.4% in 2009 to only 58.8% in 2012 (Lim, 2017; Penang Institute, 2018). 
The dropout rate, which is defined as HOs not completing their training within 5 years is said to be 
slowly increasing from 3.7-4.8% per batch year (Lim, 2017). In 2016 1.2% were either terminated or 
quit due to the inability to cope with stress (Lim, 2017).  
 

4 
 
The House Officer’s Preparatory Course was initially organized by the Islamic Medical Association 
of Malaysia (IMAM) in early 2011 to address the mentioned issues. Since then, it has evolved and has 
been privatized to Medicorp, a company that specializes in junior doctor training. The module has 
been further refined through feedback from participants, speakers and organisers who still remain to 
be active IMAM members, some of them UPM lecturers. There is one main HO Peparatory Course, 
and also small follow up courses that covers other topics in depth. 
 
Medicorp takes into account that peer training is one of the top learning methods preferred by junior 
doctors (Wiggins, Haldar, & Biswas, 2013) . Hence this training course relies heavily on volunteers 
mainly feedback from participants and its alumni. To date there has been more than 20 courses with 
more than 1500 participants who have benefited from this course. The courses are now run in 3 
different states based on demand, Selangor, Sabah and Kelantan. They are followed up even after the 
course via social media networks and whatsapp groups for further support. 
Housemanship preparatory course training is slowly gaining attention here in Malaysia. Prior to this it 
was very limited. The modules in the training sessions vary with irregular times Research done on 
these training modules are also very limited if not done at all.   
 
Significance of Study 
 
We aim to evaluate this peer-lead course to see its effect on medical graduates’confidence,  readiness, 
and psychological wellbeing to better prepare them for housemanship training. With the improvement 
of these factors it is hoped that this will reduce the level of stress amongst the junior doctors’ just 
starting work to give them a head start to become a more prepared, confident and motivated doctor 
and will hopefully reduce rates of extension and dropouts. 
 
 
 

5 
 
Objectives 
 
General 
To determine the effectiveness of Medicorp’s House Officer (HO) Preparatory Course for medical 
graduates in confidence, readiness, and psychological well-being to work as a HO. 
Specific 
1. 
To determine the socio-demographic and past clinical experience of participants attending 
Medicorp’s HO Preparatory Course  
 
2. 
To determine the level of confidence, readiness, and psychological well-being of 
participants to work as a HO before attending the Medicorp HO Preparatory course 
 
3. 
To determine the level of confidence and readiness of participants to work as a HO after 
immediately attending the Medicorp HO Preparatory course 
 
4. 
To determine the level of confidence, readiness and psychological well-being of 
participants to work after 1 month working as a HO  
 
5. 
To determine the effectiveness of the Medicorp HO Preparatory course on the level of 
confidence, readiness and psychological well-being before attending the course and after 
1 month working as a HO 
 
6. 
To determine the determine the effectiveness of the Medicorp HO Preparatory course on 
the level of confidence and readiness immediately after attending the course 
Study Hypothesis  
1. 
The HO Preparatory Course is an effective module in improving the confidence level, 
readiness and psychological well-being of participants in preparing them for HO-ship in 
Malaysia 
 
2. 
The level of confidence, readiness, and psychological well-being of participants to work 
as a HO before attending the Medicorp HO Preparatory course is low 
 
3. 
There is a high level of confidence and readiness of participants to work as a HO after 
attending the Medicorp HO Preparatory  
 
4. 
There is a high level of confidence, readiness and psychological well-being of 
participants to work after 1 month working as a HO  

6 
 
 
LITERATURE REVIEW 
 
Current Housemanship (HO) Scenario Worldwide and in Malaysia  
Reduced psychological well-being amongst House Officers (HOs) is a known worldwide issue. For 
example in Norway, 11% of house officers are reported to have mental health problems needing 
treatment. (Tyssen, Vaglum, Gronvold, & Ekeberg, 2000). In the UK (Midlands), 46% is said to have 
clinical depression (J Firth-Cozens, 1990). The numbers don’t run far amongst local Malaysian 
studies where it is said to be at a range of around 31-58% reported on various psychological 
conditions.   
 
For example 31% of HOs are reported to be distressed, 36.6% indicates a high level of emotional burn 
out and the level of stress to be 34% in Kuala Lumpur and as high as 58% in Kota Kinabalu. (Al-
Dubai et al., 2013; Shahruddin et al., 2016; Yusoff et al., 2011)  
 
There many consequences of this psychological impact towards the HOs themselves, the healthcare 
system and towards the nation as a whole. Among the direct impact of stressed HOs is the number of 
them completing training within the allocate two years has been decreasing from 86.4% in 2009 to 
only 58.8% in 2012.(Lim, 2017) The dropout rate, which is defined as HOs not completing their 
training within 5 years is said to be slowly increasing from 3.7-4.8% per batch year.  
 
A high level of stress is related is likely to affect thoughts of quitting HOship by up to three times, as 
evidenced in 2016 where 1.2% of HOs were either terminated or quit due to the inability to cope with 
stress. (Lim, 2017; Shahruddin et al., 2016)   
 
 
Causes of Stress amongst HOs 
 
Many studies have linked the causes of HO stress to be related with performance issues. This can be 
related to dealing with patient demands, intensity of the workload, mental strain and feeling 

7 
 
overworked (J Firth-Cozens, 1990; Tyssen et al., 2000; Williams, Dale, Glucksman, & Wellesley, 
1997; Yusoff et al., 2011).  
 
One of the contributing factors that cause this burden is the lack of confidence in performing. This has 
been described by participants of these studies to be “coping with diagnostic uncertainty”, “perceived 
lack of skills”, ‘fear of making mistakes’, and feeling “insecure”.   (Al-Dubai et al., 2013; Tyssen et 
al., 2000; Williams et al., 1997; Yusoff et al., 2011)  
 
A qualitative study done amongst nursing students with regards to their clinical practice highlighted 
the feeling of anxiety as a result of feeling incompetent and lack of skills and knowledge (Sharif & 
Masoumi, 2012). Another study done on Senior House Officers in the UK also derived that 
confidence levels are linked to psychological distress (Williams, Dale, Glucksman, & Wellesley, 
1997). Although these two studies were not done among House Officers specifically, it highlights the 
psychological impact of lack of confidence, skills and knowledge in the clinical setting.  
 
Other factors said to be a contributor to this issue is poor social life and work balance including time 
management, interpersonal skills, and factors related to financial issues.  (Al-Dubai et al., 2013; 
Yusoff et al., 2011) 
 
Impact of Stressed HOs  
Apart from the impact of prolonged and termination of training as mentioned earlier, there is a huge 
economic implication related to stressed HOs.  As we know, training of doctors cost around RM500, 
000 or even more per person.  Hence this leaves a huge economic burden to our nation. 
(afterschool.my, 2016; The Straits Times, 2017)  
Apart from that, stressed HOs can lead to substandard quality of care and patient safety issues as high 
levels of stress and depression is associated with lower standard of care.  (J Firth-Cozens, 1990; Jenny 
Firth-Cozens & Greenhalgh, 1997) 
 

8 
 
 
The Housemanship (HO) Preparatory Module for Medical Graduates  
Currently, there are HO Preparatory courses offered by independent bodies to address the above 
mentioned issues.(The Star, 2017) Medicorp offers regular training 10 times per year with 50-100 
participants each course for the past 3 years. 
Medicorp takes into account that peer training is one of the top learning methods preferred by junior 
doctors, apart from textbook and online materials (Wiggins et al., 2013) . Hence, this training course 
relies heavily on volunteers mainly feedback from participants and its alumni. To date there has been 
more than 20 courses with more than 1500 participants who have benefited from this course. The 
courses are now run in 3 different states based on demand, Selangor, Sabah and Kelantan. They are 
followed up even after the course via social media networks and whatsapp groups for further support. 
 
Preparatory housemanship training is very scarce here in Malaysia, especially those that are aimed at 
helping housemen be more functioning, motivated and be familiar with the system. Research done on 
these training modules are also very limited if not done at all. 
 
We aim to evaluate this peer-lead course to see its effect on medical graduates ‘confidence, readiness, 
and psychological wellbeing to better prepare them for housemanship training.  
 
With the improvement of these factors it is hoped that this will reduce the level of stress amongst the 
junior doctors just starting work to give them a head start to become a more motivated doctor. The 
results of this course will further help to refine this module to be a more comprehensive and effective 
module and create an assessment tool for future training modules.  
 
 
 
 

9 
 
Methodology 
Study Setting:  
This study will be conducted in International Youth Centre, Cheras. It has been the main focal point 
of where most of the courses have been conducted. It is within easy reach and centrally located near 
Hospital UKM. Many participants will come from all around Malaysia to attend. The centre is 
equipped with a lecture hall and boarding for the participants.  
 
Study Design:   
This is a pre-post quasi-experimental study that will be conducted over 12 months duration. 
Participants in this study will undergo a House Officer (HO) preparatory course. The level of 
confidence, readiness and psychological wellbeing will be evaluated. There will be three assessment 
time points: at baseline (before the course), immediately after the course (only for level of confidence 
and readiness) and 1 month after working as HO. This study is unable to have a control because of 
constraints in resources.  
 
Study Duration:  
This study will start from April 2018 – March 2019 
 
Sampling of participants: 
Recruitment 
Participants who attend the Medicorp HO Preparatory Course from April 2018 –March 2019 will be 
recruited into this study as the sampling frame. The eligibility criteria are based on the following: 
 
Inclusion Criteria 
1. Participants that have registered to attend the Medicorp HO Preparatory Course 
 
Exclusion Criteria 
1. Participants declared to have psychiatric illness 
2. Participants who have not completed a medical degree (medical students) 
3. Participants already working as a HO 
 
The sampling methods employed in this study will be taking all participants who fulfil the eligibility 
criteria and agree to participate in this study.  

10 
 
 
 
Intervention: 
The intervention in this study will be the Medicorp HO preparatory course which comprises of a 3 day 
training touching on aspects of HO training that is needed practically for a HO to function. The training 
will touch on the nature of the HO job, explaining about technical details such as the shift and on call 
system. The tagging period, and assessments that HOs need to undergo during their training. They will 
be guided on how to clerk, review and present common as well as emergency cases. Other aspects 
involved in clerking such as common forms used in the wards and also how to refer cases is also 
discussed.  Apart from that, soft skills such as communication among staff, financed, balancing social 
life and future career  planning is incorporated in the training. There are hands on training for 
participants for common procedures such as continuous bladder drainage insertion and venepuncture. 
The trainers are specialists, specialists in training, medical officers, and also house officers who come 
to share their experience. Medicorp encourages their alumni to be part of their training program.  This 
module will be held on a 1-2 monthly basis. The Module Content is moderated by Medicorp based on 
discussions with board of directors, advisors and feedback from participants. The training program are 
done as lecture, tutorial and hands on session. Before commencing the course, participants will be 
included in a whatsapp group, for easier content sharing and updates of the course. They will continue 
this networking even after completion of this course. They will be also be guided in the online 
applications of their job through this application and also through Facebook. During the commencement 
of their job, Medicorp will use their database to guide them into different whatsapp groups according 
to their place of work for additional support.  
 
 
 
 
Study outcome measures: 
1. Primary outcome 
a. Level of confidence: 
This will be adapted from the IMU Student Competency Survey (Appendix 2) as 
there are no published studies on the confidence level of medical graduates before 
beginning HO-ship. The questionnaire comprises of 5 sections.  The first 4 sections 
asses on generic skills,  practical tasks, soft skills and their confidence as a whole,  
using a  Likert scale assessment. Scoring is a mean score of 1-5 and the higher the 

11 
 
score, the higher the confidence. The last section asks on the one daunting aspect of 
being a HO out of a list of 7 things, this section is descriptive. 
2. Secondary outcome 
a. Readiness 
This is also adapted from the IMU competency survey and is asked on a likert scale 
of 1 to 5 for their level of readiness. It is assessed after the confidence section. The 
higher the score, the higher the level of readiness.  
b. Psychological wellbeing 
This is using the Depression Anxiety Stress Scale (DASS): This questionnaire is used 
to asses Depression, Anxiety and Stress. It uses a likert scale. The scores indicate 
normal, mild, moderate, severe and extremely severe for each of the domains. The 
higher the scores, indicates the more severe the conditions. 
 
Each of the three DASS-21 scales contains 7 items, divided into subscales with 
similar content. The depression scale assesses dysphoria, hopelessness, devaluation of 
life, self-deprecation, lack of interest / involvement, anhedonia and inertia. The 
anxiety scale assesses autonomic arousal, skeletal muscle effects, situational anxiety, 
and subjective experience of anxious affect. The stress scale is sensitive to levels of 
chronic non-specific arousal. It assesses difficulty relaxing, nervous arousal, and 
being easily upset / agitated, irritable / over-reactive and impatient. Scores for 
depression, anxiety and stress are calculated by summing the scores for the relevant 
items.  
 
The DASS-21 is based on a dimensional rather than a categorical conception of 
psychological disorder. The assumption on which the DASS-21 development was 
based (and which was confirmed by the research data) is that the differences between 
the depression, anxiety and the stress experienced by normal subjects and clinical 
populations are essentially differences of degree. The DASS-21 therefore has no 
direct implications for the allocation of patients to discrete diagnostic categories 
postulated in classificatory systems such as the DSM and ICD. (Lovibond & 
Lovibond, 1995) 
 
Sample size 
Sample size was calculated using G*Power 3.1 sample size calculator software. 
Based on reports by confidence score from a study analysing pre and post emergency 
department posting in junior doctors was used. The mean overall confidence score 

12 
 
was 56.475(24.67) at the end of month 1 and 62.775(28.69) at the end of month 
4(Williams et al., 1997). The estimated sample size was 208 participants after 
accounting for  power of 80%, significance level of 0.05% and 30% attrition.  
 
 

13 
 
Instruments & Data Collection 
 
Intervention: The Medicorp HO Preparatory Module 
Tools for assessment: 
 
1. Baseline questionnaire  
The study instrument will be a set of questionnaire that will be divided into sections A-E.  
The English versions will be used. 
a) Socio-demographic data :  
This will include certain details of participants such as: 
 
Age 
 
Sex 
 
Religion  
 
Ethnicity  
 
Year of graduation 
 
University of Graduation 
 
Marital status 
 
Place of work (evaluation during 1 month post HO-ship) 
a) Clinical Experience: 
This will be adapted from the IMU Student Competency Survey. This will show 
participants past clinical experience on common procedures during their 
undergraduate years.  
b) Confidence level:  
Adapted from the IMU student competency questionnaire as explained in study outcome 
measures 
c) Readiness : 
 Adapted from the IMU student competency questionnaire as explained in study outcome 
measures 
d) Psychological well –being : 
  DASS as explained in study outcome measures 
 
2. Post course questionnaire (immediate) 
a) Level of confidence 
b) Readiness 
 
 

14 
 
 
3. Case report form  
Conducted via telephone call at 1 month after starting work as HO 
Content will include:  
a) Level of confidence 
b) Readiness 
c) DASS 
d) Work place information: which hospital and posting 
e) Any suggestions to improve the course based on your current working experience? 
 
All the questionnaires will be pilot tested by testing this on 30 medical graduates before using the 
questionnaire.  
 
 
Data collection  
 
A pre-tested self-administered questionnaire which includes baseline socio-demography, 
adaptation of the IMU Student Competency Survey, and the Depression Anxiety Stress Scale will 
be used. 1 month follow-up will be done by telephone. After the participants have completed the 
course, their level of readiness and confidence will again be assessed via a self-administered 
questionnaire.  This will be done on the last day of the course. 
The participants will later be followed up 1 month after they have been working as a HO in their 
respective hospitals. The organisers will keep track of placements of all participants via social 
media applications as part of the course is still maintaining connections and informal training after 
the course has ended and as participants start the process of job application and working.   
 
 
Ethical considerations 
 
This study’s approval for ethical clearance will be obtained from Jawatan Kuasa Etika Perubatan 
(JKEP) University Putra Malaysia (UPM) and National Medical Research Register  (NMRR);  
Medical Research and Ethics Committee (MREC) as the participants will be working in Ministry 
of Health facilities during the 1 month follow up. This study will also be registered in the National 
Institute of Health (NIH) as a trail registration.    
Informed consent will be obtained from each study participant and they will be told the right not 
to respond to the questions they don’t want to respond to or to withdraw from the study at any 
time. All data obtained will be kept confidentially and for research purposes only. 

15 
 
The benefits of the study includes assessing issues in relations to HO wellbeing and to assess what 
is needed in training a functional HO.  The potential risk, discomforts and inconvenience is 
almost none. However, should the  DASS score be suggestive of depression or anxiety, team 
members of the research team will refer the participant appropriately.  Should participants choose 
to withdraw from study, they will be allowed to do so.  
 
Data Analysis 
The data will be analysed using IBM Social Package for Social Science (SPSS) version 24. A 
descriptive analysis of the demographic characteristics of the participants, clinical experience and 
baseline level of confidence, readiness and psychological wellbeing will be reported using means 
and standard deviations (SD) or median and inter-quartile range (IQR) for continuous variables 
(depending on the data distribution) and as frequencies and percentages for categorical data. An 
analysis to compare between participants who completed and withdrew from the study will be 
made using Chi-square or Exact test (for unbalanced data) for categorical variables and 
independent t-test for continuous data.  
A repeated measures ANOVA will be conducted to determine the effectiveness of the 
intervention within the groups across the study periods (baseline, immediately after intervention 
and at 1 month after working).  Controlling for baseline measures will be done to determine the 
change over time on the measured outcomes (level of confidence, readiness and psychological 
wellbeing). All analyses conducted are two-tailed with significant level set at p value <0.05. 
 
Operational Definitions of terms 
1. 
Medical Graduates/Participants – Those that have obtained a medical degree be it MD, MBBCh 
BAO, MBBS or the same level 
2. 
Socio-demography – the components of description of a population 
a. Age – based on the year a person was born 
b. Sex- male or female 
c. Marital Status – single, married, separated or divorced 
d. Ethnicity – background of a person’s race 
e. Religion – the religion based on identification card (I.C) 
f. Year of graduation – year they receive their certificates of qualification 
g. University- institution of higher learning they graduated from 
h. Confidence –a feeling of self-assurance arising from an appreciation of 
one's own abilities or qualities 

16 
 
i. 
Readiness - the state of being fully prepared for something. 
j. 
Psychosocial well-being - the state of, affecting, or arising in the mind; 
related to the mental and emotional state of a person. 
Expected Outcomes 
 
1. Novel theories/New findings/Knowledge  
1. A Questionnaire to asses HO’s level of confidence, readiness and psychological wellbeing to 
begin work 
2. A module for intervention for medical graduates with low levels of, confidence, readiness and 
psychological wellbeing to begin work 
 
2. Research Publications  
1. The Effectiveness of the Medicorp House Officer (HO) Preparatory Course for 
Medical Graduates on Confidence, Readiness and Psychological Well-Being: A Protocol 
Study (2020) 
2. The Effectiveness of the Medicorp House Officer (HO) Preparatory Course for 
Medical Graduates on Confidence, Readiness and Psychological Well-Being: A Quasi-
Experimental Study (2020) 
 
3. Specific or Potential Application  
1. A questionnaire screening tool for medical graduates that may need intervention before 
commencing HOship 
2. An intervention module for medical graduates that have low levels of confidence, 
readiness and psychological wellbeing prior to beginning work 
4. Impact on Society, Economy and Nation  
1. A supplementary, comprehensive, peer and research led module for medical graduates to 
prepare themselves to be functional and motivated HOs 
2. A questionnaire to Asses medical graduates’ confidence, readiness & psychological wellbeing 
to begin work as HOs. 
 
 
 

17 
 
Budget 
 
 
No. 
 
 
Budget details: 
 
Amount requested by applicant: 
 
 
KTGS JINM grant: 
 
 
1. 
 
 
 
 
 
Vot 11000 -  
Wages and allowances  
 
 
- 
 
 
2. 
 
Vot 21000 -  
Travels and Transports 
 
Please provide a detailed breakdown 
 
To course venue- IYC Cheras; 
0.7c/km x 16km x 2ways x 7 courses 
= RM156.80 
 
To present conference paper: RM 500 
 
3. 
 
Vot 23000 -  
Communications and Utilities 
 
Please provide a detailed breakdown 
 
 
- 
 
4.  
Vot 24000 -  
Rentals 
 
Please provide a detailed breakdown 
 
- 
 
5. 
 
 
 
 
Vot 27000 -  
Supplies and project materials 
 
Please provide a detailed breakdown 
 
- 
 
6. 
Vot 29000 -  
Professional services 
 
Please provide a detailed breakdown 
 
Enumerator: 260 participants  x 3 
times questionnaires x 
RM10/questionnaire = RM7800 
 
Tokens for participants’ time 
(answering pre, post and 1 month post 
questionnaires) 
260 participants x RM50/participants 
= RM13, 000 
 
conference to present study = RM 
2000  

18 
 
 
7. 
Vot 35000 -  
Accessories, equipment and software 
 
 
Please provide a detailed breakdown 
A4 paper = RM 300 
Printer Cartridge (2) = RM600 
Telephone calls = RM150 
 
 
 
Total amount: 
 
 
RM 24, 506.80 
 

19 
 
 
 
Gantt chart  
The activities of the research will be described in the Gantt chart as below 
 
Prepared by  
Dr Aneesa Abdul Rashid 
Department of Family Medicine 
Faculty of Medicine and Health Sciences 
Universiti Putra Malaysia 
Email: aneesa@upm.edu.my 
Task/month 
 
2018 
2019 
M 
A 
M 
J 
J 
A 
S 
O 
N 
D 
J 
F 
M 
A 
1. Literature review & development of 
study protocol 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2. Development of questionnaires 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3. Ethics approval and permission 
from authority 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4. Validation of questionnaire  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5. Data collection 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
6. Data cleaning, entry and analysis  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
7. Write up and finalisation 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

20 
 
References 
afterschool.my. (2016). Cost of studying medicine in Malaysia. Retrieved September 26, 2017, from 
http://afterschool.my/articles/cost-of-studying-medicine-in-malaysia 
Al-Dubai, S. A. R., Ganasegeran, K., Perianayagam, W., & Rampal, K. G. (2013). Emotional burnout, 
perceived sources of job stress, professional fulfillment, and engagement among medical 
residents in Malaysia. The Scientific World Journal, 2013. https://doi.org/10.1155/2013/137620 
Firth-Cozens, J. (1990). Source of stress in women junior house officers. BMJ (Clinical Research 
Ed.), 301(6743), 89–91. https://doi.org/10.1136/bmj.301.6743.89 
Firth-Cozens, J., & Greenhalgh, J. (1997). Doctors’ perceptions of the links between stress and 
lowered clinical care. Social Science and Medicine, 44(7), 1017–1022. 
https://doi.org/10.1016/S0277-9536(96)00227-4 
Lim, C. H. (2017). Housemanship programme in Malaysia : Availability of positions and quality of 
training. 
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of 
the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety 
Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-
7967(94)00075-U 
Penang Institute. (2018). About Penang Institute | Penang Institute. Retrieved March 26, 2018, from 
http://penanginstitute.org/v3/aboutus/about-penang-institute 
Shahruddin, S. A., Saseedaran, P., Salleh, A., Ahmad Azmi, C. A., Mohammad Alfaisal, N. H. I., 
Fuad, M. D. F., … Abdullah, M. R. (2016). Prevalence and Risk Factors of Stress , Anxiety and 
Depression among House Officers in Kota. Education in Medicine Journal, 8(1), 31–40. 
https://doi.org/10.5959/eimj.v8i1.398 
The Star. (2017). Pre-housemanship courses give new docs a headstart - Education | The Star Online. 
Retrieved January 29, 2018, from 
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stressors, psychological distress, and confidence in performing clinical tasks in accident and 
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