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Just about a month after watching the Millenium Falcon flying for the first time in 30 years, I was mesmerised by a local movie that was released last week. I have been watching their promotion on TV and listening to them on radio over the last 2-3 months but I must admit that I never expected the film to be so well done and nostalgic. “Ola Bola” is a movie that must be watched by all Malaysians. It shows what this country was, 30 years ago.

The movie shows how great our football team was in 1970s and early 1980s. I was in primary school then and names like
“Spiderman” Arumugam, Mokhtar Dahari, Santokh Singh, Hassan Sani, Shukor Salleh, Soh Chin Aun, James Wong etc were household names. Our rivals were South Korea and Japan. We were the best team in SEA and one of the best in Asia. What happened? South Korea and Japan have reached World Cup and we are still struggling to even win SEA tournaments. The answer : “politics”.

When I went to watch the movie yesterday, the theatre was full house. It was a mixed racial crowd. Interesting to see for the first time a Malaysian movie being watched by all races sitting together. It is a multiracial movie which shows the lifestyle during the 1970s. Multiple languages are spoken but mainly English and Malay. Subtitles are in 3 languages. I must admit it is a movie of high quality. Every detail was well planned and captured. We can see old radios, old black & white TV, old houses, old cars and even old motorbikes. Even dressing and hair styles follow the 1980s era. I really don’t know where they got all the items from. It’s really nostalgic!

Despite having new actors and actresses, the movie was well made. Some moments may really give you goosebumps and may even give you some tears. It reflected how Malaysia was during those days. All races getting together and celebrating the achievement of the country. A multiracial football team that was the best we have ever had. I grew up during those era and I must say it is sad to see what we have become. Racial politics, first engineered by Dr M since 1981 is the reason why we are in current situation. Sports, education, Universities, public service were all politicised to the extend that everything should be controlled by a single race. That was DR M’s philosophy which he has publicly said and written in his book. Every sports association and education centres are now run by politicians!

The football scenes of the movie was well choreographed. I really don’t know how they actually did it. It was like watching a real football match. Some dialogues can be a bit draggy but that is expected from new actors who was chosen based on whether they can play football! I would not reveal much of the story to avoid spoilers but suffice to say that the movie is not just a football movie but it tells us a story of what type of country we were, at one time. Will we ever reach that status again with all the racial and religious politics being played around over the last 25 years?

The ending was really impressive! Don’t forget to sit through the end credits where they will show you all the old pictures of our football greats. For the first time, audiences actually clapped/cheered at the end of the movie!! I only see that in Rajini Kanth’s movie!

Well done to Chiu (the director, a Batu Pahat boy) and the production crew. Every Malaysian should  see this movie, including our politicians!

 

Just a week ago, I wrote on the same topic quoting an article written by a philanthropist, Mr Koon on why he refuse to provide scholarship to those who wants to do medicine. Unfortunately, similar to what I had experienced before, multiple nasty comments were made against him in various blogs and newsportal where his article was posted. Readers can check for themselves. People still do not understand what we are trying to say. It is not about passion we are talking about but the economics. If you are doing medicine purely for economic reasons, than medicine is not the field you should choose at the moment, worst still by taking huge loans. I saw comments like ” there are no such thing as jobless doctors“, ” doctors never get retrenched” , ” doctors will always earn money no matter what the economic situation is ” etc

Today, there were 2 articles that caught my attention. The first was a letter in The Star written by a GP (see below). I have been talking about how opening a GP clinic is not as easy as it used to be. I know quite a number who had closed shop and gone back to work as employee of franchise clinics. Most GPs survive on panels. The letter today clearly illustrates how companies and panels demand what they want from the doctors. Either you take it or leave it. If you don’t want to take, someone else will! That is their motto and since many doctors are also struggling in their business, they do not mind taking the offer. It is interesting that the institution had requested the doctors to pay a fee for the contract renewal and further limit the consultation fee. I know some insurance companies which even controls what medicines that can be given etc. I had written about these issues before. The letter again tells people the actual income of GPs nowadays and not to assume that all GPs are rich with big cars! He quoted 1-2% of GPs of being succesfull which is lower than 10% of doctors that I quoted in my last article.

Another interesting article was published in Malaysian Insider on the issue of patient load in private clinics and hospitals. As I had written before, private healthcare is almost 70-80% supported by insurance and corporate panels. Thus, it is not right for anyone to say that doctors will earn no matter what’s the economic situation is. No doubt you may be able to earn to survive but to say that you will still earn handsomely is not right. The general public still do not understand the economics. The private healthcare cost is simply too high for any middle-income group. Once economic slow down occurs, people will tighten their pockets which in turn reduces the visits to private healthcare. Some will treat themselves with medications bought from pharmacy or cheap medication sold by traditional healers which suppose to cure everything under the sun. Some will default their insurance payment which makes their medical card invalid. Majority will turn to public hospitals and clinics. That is the reality. Income of many doctors especially GPs will decline considerably. Even hospitals can close shop due to high overhead maintenance cost. Insurance companies have already started to control what we do and what we are not supposed to do. They simply refuse to pay if they don’t agree what you had done. And the patient will also not pay! BTW, please read the comments in Malaysian Insider. Just see how many give sarcastic remarks about private doctors!

A GP friend of mine had refuse to sign with most panels due to their unfavourable contracts. He only has one insurance panel. He got this to say “I’m lucky that people around here earns S$… Otherwise I’d be full time Uber driver.. …. ”

So, please listen to Mr Koon! He is a businessman and he knows what he is talking about. 

To make matters worst, it is reported that the government has SUSPENDED JPA and MOE bursary scholarship with immediate effect ( see below)!! 

 

Panel doctors feeling the squeeze
I AM writing to highlight the underhand methods which some corporations are using to squeeze doctors and general practitioners (GPs) in this country.

Recently, an established and well-known institution of higher learning sent an official communication to all of its existing panel GP clinics, informing them that they were being offered an extension of their panel status with the said institution.

After decades of providing quality primary healthcare services to the institution, these GPs now have to renew their commitments. This is a common exercise, as times are changing and the terms of the contract will need to be reviewed from time to time.

However, what is shocking is the manner it is being done and a new condition which has been introduced. This institution has now decreed that, in order to continue providing services to the institution, the GP clinics would need to pay a processing fee of RM2,500 for the two-year contract period. This means each GP clinic has to pay RM2,500 in order to be eligible to provide services to their employees.

To us, in the medical profession, we feel this is an attack on the integrity of doctors. Through the Hippocratic Oath, we are bound to provide our services to any and all, regardless of race or religion.

Now we have an institution of higher learning, which incidentally also has a medical faculty, that has single-handedly turned this most noble of oaths completely on its head. They are sending a message to the world that doctors now have to pay before they can render medical help to mankind!

They will argue that there is a cost to manage and process the clinics and doctors who provide this care to their employees. They will say that the costs to manage and administer this is rising due to many factors.

But yet, they have the gall to fix consultation rates at RM15 per visit, as opposed to the prescribed rates of between RM35 and RM50 by the Malaysian Medical Association (MMA) through the Fee Schedule.

They have also the nerve to fix medications at unfair rates. For example, upper respiratory tract infection has been fixed at RM21. One pays more for a cup of coffee at certain places these days!

Does this institution, which is also a breeding ground for new doctors, realise that the healthcare industry has also not been spared the increasing costs of doing business?

GPs are subject to increasing costs through higher rentals, utility charges, consumable and disposable charges, equipment costs, etc. This is mainly due to the introduction of the GST, which healthcare has been exempt and therefore cannot transfer the costs to patients. To these people I ask: Who is looking at the welfare of doctors?

The public may have the perception that doctors are wealthy and live the high life. I implore those who have this perception to stand outside any GP clinic and observe what car these GPs drive.

I agree that just like any profession, there would be the top 1% to 2% who have made it. But just because there are high-flying GPs who jet-set across the world, it doesn’t mean all GPs have the same life.

The average income of GPs these days is between RM7,000 and RM10,000 per month, and this is after 15 years of working. Most other professions provide better and greater opportunities to earn much more than that.

In the end, it is the poor GP who suffers. More and more organisations are taking advantage of the market forces to push doctors into a small, pitiful corner.

Additionally, I would like to highlight one important fact. This institution has now also introduced a kickback system into the market. Pay them in order to be allowed to eke some living out of their employees. Pay them before being eligible to provide services and send bills to them. Doctors now need to pay before being allowed to have patients.

What message are they sending to the medical students in their own faculty. This is against the Private Healthcare and Services Act 1998, which outlaws such practices of kickbacks.

Doctors have stood by and just allowed this entire thing to get to this stage. But as a member of this profession, I cannot just stand by and watch anymore.

I am imploring, even begging, for the Health Ministry and the Government to tackle this issue with utmost urgency and importance. Please, help the GPs.

A CORNERED GP

Kuala Lumpur

 

Private healthcare patients feel pain of weak ringgit, higher cost of living
BY MELATI A. JALIL AND DEBORAH LOH

Published: 20 January 2016 7:00 AM
Private healthcare, the preferred option for those who can afford it, is reportedly seeing a drop in patients with practitioners attributing the trend to the effects of increased cost of living and the ringgit’s depreciation against the US dollar which has made certain treatments more expensive.

Tan Sri Dr Ridzwan Bakar, consultant cardiologist at a private hospital in Kuala Lumpur, said some of his patients have transferred to public hospitals.

He noticed a 10% drop in number of admissions to private hospitals since April last year, when the goods and services tax (GST) was first implemented.
“I think this is the general finding of almost all doctors working at private hospitals in the Klang Valley,” the cardiologist with more than 30 years of experience in private healthcare told The Malaysian Insider.
“The drop has remained persistent towards the end of last year,” added the former president of Association of Private Hospitals.

“People have less disposable income,” said another industry professional, Malaysian Medical Association (MMA) president Dr Ashok Philip.

“We have GST, the economy is not so buoyant, the ringgit has depreciated, and times are uncertain.”

Correspondingly, the number of people seeking treatment at public hospitals appears to have risen. Public healthcare in Malaysia is almost free or certain treatments are heavily subsidised although patients have to endure a longer waiting period for procedures compared with private healthcare.

“My colleagues at public hospitals have noticed a 25% rise in the number of admission in public hospitals, maybe there has been a drifting of patients from the private sector to the public sector,” Dr Ridzwan said.

Dr Ashok concurred.

“Anecdotally, the outpatient load in private clinics and hospitals has declined. This is because the outpatient treatment at government clinics is almost free,” he said.

It’s a sign of the times when even cancer patients are opting to cut back on essential chemotherapy at private facilities in order to trim expenses.

Dr Ridzwan said oncology was a good example of one area in private healthcare affected by the exchange rate because of the nature of the treatment.

“The drugs can easily run into five figures per month and there is no replacement. (Patients) have to be given those drugs.”

Private hospitals which have more patients with insurance might not be as badly affected, but given that about a quarter of patients at most facilities pay out of their own pockets, the impact on the hospitals’ bottom line is of concern.

“Between 30% and 40% of patients at private hospitals are self-funded. We can safely assume that many of them have to tighten their expenses, they have to go to public hospitals,” Dr Ridzwan said.

The weak ringgit has impacted on medical fields requiring expensive chronic therapy, a pharmaceutical industry player said.

“Healthcare involving babies, children and pregnant mothers is less affected,” said the sales representative of a drug firm, who declined to be named.

“The drop in patients also varies greatly between different therapeutic areas.”

Some private clinics are seeing a drop of more than 50% while others seem to have smaller decline of 15% to 20%.

“A large private hospital closed one of its wards due to the lack of patients,” he said, adding that he expected 2016 to be a difficult year for private healthcare, especially those requiring costly and chronic therapies.

“The use of generic medication may increase while health supplements may be affected negatively,” he said.

The Association of Private Hospitals Malaysia did not respond to The Malaysian Insider’s queries on these matters.

Expanding public healthcare

Director-general of the Health Ministry Datuk Dr Noor Hisham Abdullah in a reply to The Malaysian Insider said government facilities have seen a steady increase in demand for services but he did not have data from the private sector to compare with.

“The current economic situation has caused a surge in the demand for our services but with the current strategies we have implemented, we are well prepared to face this surge.”

Figures from the ministry show an increase in total admissions at government hospitals by 13.9%, from 2.16 million patients in 2013 to 2.46 million last year.

The number of hospital outpatients also increased by 2.7 million or 5% from 54.2 million in 2013 to 56.9 million in 2014.

To cope with the numbers, Dr Noor Hisham said the ministry has increased the number of public healthcare facilities, especially Klinik 1Malaysia (K1M), employed more staff by an average of 9% annually and expanded the scope of primary healthcare services.

“For example, in our K1M, from the original treatment of minor ailments, the services have extended to include maternal and child health services, doctor services as well as treatment of chronic diseases.”

Operating hours have also been extended, as well as moves to increase the number of beds throughout the country by building new hospitals, upgrading facilities and using day care services to reduce inpatient demand. – January 20, 2016.

– See more at: http://www.themalaysianinsider.com/malaysia/article/private-healthcare-patients-feel-pain-of-weak-ringgit-higher-cost-of-living#sthash.RqlSI7N3.dpuf

 

Putrajaya suspends JPA scholarships amid falling revenue

Published Today 9:13 pm     Updated Today 9:25 pm     

Putrajaya has suspended the Public Service Department (JPA) Scholarships for degree courses and the Education Ministry’s bursary for pre-university programmes amid falling national revenue.

According to Sin Chew Daily, this was confirmed by Minister in the Prime Minister’s Department Wee Ka Siong who raised the issue at the cabinet meeting today following several complaints from high-achieving students.

Wee said he had asked the Prime Minister Najib Abdul Razak to rethink and reinstate the scholarship.

“The prime minister understands that the economy is not good at the moment and the people are facing heavy burden so he has instructed the chief secretary to the government and JPA to come up with a new solution.

“I can’t say for certain if there will be a change of decision but we (MCA) have tried our best to appeal the matter because we don’t know how the economic situation will develop,” Wee was quoted as saying by the Chinese language daily.

The suspension applies to both overseas and local scholarships and affects some 700 placements this year.

Urgent resolution

Wee urged for an urgent resolution to the matter as some university commence their intake as early as Feb 1.

He added that Najib had asked the chief secretary and JPA to submit a report to the cabinet next week with their proposal.

The Sin Chew report also pointed out that some students have questioned why the JPA scholarships were suspended, but not Mara scholarships.

However, Wee declined to respond to this claims, citing that he had not heard them personally.

Asked if the suspension of the JPA scholarships was linked to the planned budget revision on Jan 28, Wee said he did not know.

A check with JPA’s website found the “bursary e-filing system” link which is used by students to apply for the scholarships, have also been removed.

Putrajaya is struggling with shrinking revenue as the Brent crude oil price has fallen to a 12-year low, settling at US$27.78 per barrel.

This is in contrast to a high of US$114.81 per barrel in 2014.

Najib has announced that the 2016 budget will be revised to adust for falling revenue and will see government expenditures optimised.

6 months ago I wrote my first part. 2 months before that, I wrote an article titled ” Passion vs Debt” when some students gave some nasty comments in my blog after the AUCMS loan fiasco issue that I brought up. I had always said that no matter what passion you have, in the end, medicine is just another job to earn a living. No one is going to come to your assistance when you got no money. Just because you help safe some lives does not mean people will come to your help when you are left with nothing. It is a capitalist world.

It is also naive to think that doctors are job guaranteed. I had explained enough in this blog. Frankly, there are close to 50K doctors in this country. How many do you see driving big cars and staying in big houses? Probably less than 10%. Isn’t that the same figure for any other profession? Furthermore, most of these doctors are still working 24 hours a day, 7 days a week. The public perception is usually biased towards what they see you having externally. They never see or want to see what happens behind the stage. That’s why many quit medicine after graduating. Never do medicine for wrong reasons!

Few days ago, a philanthropist made an announcement that he is willing to give free additional scholarship to those students whose parents are earning below Rm 4K/month.  Not even 3 days later, he was shocked and amazed to receive close to 50 applications, almost all wants to do medicine (see below)! Thus, today, he wrote an interesting article asking these students and parents to wake up to reality. He had decided not to give scholarship to those who apply for medicine. Well, this is the very reason why I started this blog almost 6 years ago but yet again, no one listens. Every now and then, I too receive phone calls from students and even parents asking for financial assistance. Almost always the students will be doing medicine and already registered for 1st year. However, she/he is unable to pay the tuition fee for the 2nd year. When I ask them what happens for third year if you can somehow manage to get your fee for 2nd year, they almost always can’t answer. I find it ridiculous at times.

No matter how cruel and harsh it may sound, we are living in a capitalist world. Money talks. If you can’t afford to get scholarship, please do not do something that will lead you to huge debts. Never forget the house loan, married life and car loan that will come along the way. We just have to accept the reality and pursue what is affordable. Success in life comes in many ways. The philanthropist above is an engineer who built 2 conglomerate. How many doctors do you see becoming a philanthropist? How many doctors do you see retiring early at age of 40-50 and going for holidays around the world and being financially independent?

Our students lack in financial literacy. They are too dependent on family to the extent that they don’t understand what life is all about. Passion is one thing but living a life is another. At the end of the day it is all about money and living a life. Even in UK, doctors are going for  a strike to challenge the government in reducing their income as mentioned in this blog before. I had warned many times that we are producing future generations with huge debts. Again this was brought up by another newsportal today.

Happy New Year 2016 to everyone. Sure we have a tough year ahead……….. while I publish my first book……….

Be realistic in your pursuit of a medical degree

January 10, 2016

Students should consider other courses such as accountancy, finance, engineering, marketing etc.

By Koon Yew Yin

Since the publication of my scholarship offer to help students whose parents are earning less than RM4,000 per month a few days ago, my wife has received more than 50 applications for financial help and most of the applicants want to pursue a medical degree which costs the most.

The sole purpose of writing this article is to help inform students who wish to study medicine not to apply for my financial assistance.

There are 40 Medical Colleges and about 500 Universities and Colleges in Malaysia. All of them are lowering their entry requirements to compete for more students.

Tuition Fee for a Medical Degree in Malaysia is between RM250,000 to RM1 million:

Among the cheapest are:

• University Tunku Abdul Rahman (UTAR): RM255,000

• AIMST University: RM250,000.

Among the mid range are:

• Asia Metropolitan University (AMU): RM300,000

• MAHSA University College: RM300,000

• Malacca Manipal Medical College (MMMC): RM348,000, Monash University Sunway: RM455,000

• Newcastle University Medicine Malaysia (NuMED): RM450,000

Among the more expensive are:

• Penang Medical College: RM650,000

• Perdana University offers the following: Royal College of Surgeons Ireland: RM800,000, John Hopkins University School of Medicine: RM1,000,000

All the above mentioned fees exclude accommodation, books, traveling costs, food and other expenses which could easily add another RM100,000 to the total cost of studying medicine.

A student will require at least RM350,000 to complete a medical degree. Assuming he can get a RM150,000 PTPTN loan, he will still require RM250,000.

Is it really worth pursuing a medical degree in Malaysia with such high fees?

It is compulsory for all medical graduates to practice in a government hospital for five years to complete their housemanship.

During this period their salary ranges between RM2,600 to RM4,000. As housemen they work for a minimum of 12 to 15 hours a day. After two years, their salary increases gradually to RM4,000 per month.

When they are promoted as medical officers their salaries range between RM4,500 to RM5,000. After the final year they have an option to continue their career in the government service or private concerns.

However, after 12 years and spending a minimum of RM350,000, is it worth it just to earn RM5,000 to RM6,000 per month as a doctor?

They must remember that they have to pay back the RM150,000 PTPTN loan at RM2,000 per month for about 20 years.

An alternative proposal:

I like to suggest to these students to consider other courses such as accountancy, finance, engineering, marketing, etc. The tuition fee for a one year foundation course is RM8,500 and for a 3 years degree course is about RM38,000 in UTAR. The fees for all government universities are less than RM20,000 for a degree course.

All students whose parents are earning less than RM4,000 per month can apply for my scholarships worth RM15,500 to cover the one year foundation course fee and the cost of living. After the completion of the foundation course, all students are entitled to receive PTPTN Government loans to complete their degree courses.

Since I made the offer to consider helping students who find the PTPTN not sufficient, my wife has received more than 50 applications in 2 days and most of the applicants want to study medicine. We found that most of the applicants are not realistic. They are poor and with poor results they want to study medicine.

With the PTPTN loan, the parents need to subsidize a small amount to complete their degree courses with the exception of a medical degree. If the parents are really poor, I am willing to consider helping them. My offer to help students doing degree courses has opened the door for all students in the country. But the students must be realistic. In any case, we reserve the right to reject any application for financial help.

Note: All scholarship recipients do not need to work for me or pay back the money I spent on them. But they must promise me that they will remember I helped them when they were poor and when they are financially solvent they must help other poor students. I believe many graduates will continue to help poor students when I die. Since I started offering scholarships about 10 years ago, I have given out about 300 scholarships and a large number of the recipients have graduated.

Koon Yew Yin is a retired civil engineer and one of the founders of IJM Corp Bhd & Gamuda Bhd.

With a firm belief in freedom of expression and without prejudice, FMT tries its best to share reliable content from third parties. Such articles are strictly the writer’s personal opinion. FMT does not necessarily endorse the views or opinions given by any third party content provider.

READ MORE: Philanthropist Koon offers scholarships to needy

Day by day, the waiting game seem to be getting more interesting. Right from the beginning of this year, we knew that fresh graduates are waiting for a period of 4-6 months to get a Housemanship post. We also know that MOH has stopped any foreigners, even if you are married to a Malaysian from getting a Housemanship post. I know a person who spend time and money sitting for MQE last year only to be told to take SPM BM paper in order to get a job. She went on to do her SPM BM paper and passed ( she is an Indonesian). Unfortunately, after going through all these hurdles, she was yet again told that jobs will not be given as they do not have enough post, even for Malaysians.

Today, our DG aka Chairman of MMC has issued a press statement. The statement says that due to long waiting time to start Housemanship, provisional MMC registration will ONLY be given once your job and posting is confirmed. Till then only a letter stating that you are eligible for provisional registration will be given for submission to SPA/MOH.

This basically proofs once again that more and more housemen are being retained for poor performance and competency which is making the waiting period even longer day by day. By 2016, all medical schools in Malaysia will be producing graduates. This will further increase the numbers which will create a bottle neck into housemanship. As I predicted almost 5 -7 years ago, the year 2016/17 will be the year when this will happen. We will be flooded by medical graduates!

The Star went a step further by saying that all medical graduates will be screened before being offered a job. I feel they interpreted it wrongly. All graduates have to undergo SPA/PSC interviews before being employed into civil service. It is a standard procedure. It is nothing new but the The Star make it look like it is never done before.

The statement by DG is quite clear that Provisional Registration will only be given once your job and posting is confirmed. The only hidden message I can sense is that ” job may not be guaranteed” soon!

Now, didn’t I say so!

 

Kenyataan Akhbar KPK/YDP MPM 29 Dis 2015: Penyelarasan Pengeluaran Sijil Pendaftaran Sementara bagi Graduan Perubatan

Posted on December 29, 2015 by DG of Health

KENYATAAN AKHBAR

 

KETUA PENGARAH KESIHATAN MALAYSIA

 

PENYELARASAN PENGELUARAN SIJIL PENDAFTARAN SEMENTARA BAGI GRADUAN PERUBATAN

Majlis Perubatan Malaysia (MPM) dalam mesyuaratnya yang ke-347 pada 15 Disember 2015 telah membincangkan dan mengambil maklum bahawa semua graduan perubatan perlu menjalani temuduga yang dijalankan oleh pihak berkuasa Suruhanjaya Perkhidmatan Awam bagi tujuan mendapatkan pekerjaan sebagai Pegawai Perubatan Siswazah (Gred UD 41).

Mesyuarat juga mengambil maklum bahawa pada masa kini terdapat sejumlah Pegawai Perubatan Siswazah yang sedang menjalani latihan siswazah di hospital-hospital Kementerian Kesihatan Malaysia, gagal menyempurnakan latihan siswazah dalam tempoh yang ditetapkan dan terpaksa melalui pemanjangan tempoh latihan oleh kerana pelbagai sebab; antaranya adalah masalah kompetensi dan juga masalah kesihatan.

Pemanjangan tempoh latihan siswazah telah menyebabkan ‘backlog’ Pegawai Perubatan Siswazah yang sedang menjalani latihan di hospital dan telah menyebabkan kemampuan untuk mengisi kekosongan jawatan gred UD 41 bagi tujuan latihan menjadi amat terhad.

Keadaan ini menyebabkan graduan perubatan terpaksa menunggu bagi tempoh yang lebih lama bagi mendapat peluang untuk dilantik menjalani latihan siswazah.

Dengan mengambil kira faktor yang tersebut di atas dan selaras dengan peruntukan Seksyen 12(1)(b) Akta Perubatan 1971, MPM telah menetapkan bahawa:

  • Proses pengeluaran Sijil Pendaftaran Sementara kepada graduan perubatan diselaras dengan keperluan Seksyen 12(1)(b) Akta Perubatan 1971, iaitu Sijil Pendaftaran Sementara (Provisional Registration) bagi tujuan menjalani latihan bagi memenuhi keperluan di bawah Seksyen 13 Akta Perubatan 1971 hanya akan dikeluarkan kepada mereka yang dapat menunjukkan bukti bahawa mereka telah dipilih dan ditawarkan untuk bekerja sebagai Pegawai Perubatan Siswazah (Gred UD 41) bagi memenuhi sebagaimana peruntukan Seksyen 13(2).
  • Sehubungan dengan itu, tatacara pengurusan permohonan Sijil Pendaftaran Sementara bagi memenuhi keperluan peruntukan Seksyen 13 telah dikaji semula, di mana semua permohonan yang layak akan diberikan satu surat memaklumkan bahawa mereka layak dipertimbangkan untuk Pendaftaran Sementara dan tertakluk kepada mereka dipilih dan ditawarkan jawatan Pegawai Perubatan Siswazah sebagaimana yang diperlukan di bawah Seksyen 12(1)(b) Akta Perubatan 1971.
  • Sijil Pendaftaran Sementara bagi membolehkan mereka menjalani latihan sebagai Pegawai Perubatan Siswazah di hospital KKM hanya akan dikeluarkan setelah graduan berkenaan mengemukakan surat tawaran bahawa mereka telah ditawarkan jawatan Pegawai Perubatan Siswazah.

Penyelarasan proses pengeluaran Sijil Pendaftaran Sementara kepada graduan perubatan dilakukan bagi tujuan mengemaskini proses dan juga bagi memastikan pematuhan kepada Akta Perubatan 1971.

 

DATUK DR. NOOR HISHAM BIN ABDULLAH

KETUA PENGARAH KESIHATAN MALAYSIA

Merangkap YANG DI PERTUA MAJLIS PERUBATAN MALAYSIA.

 29 Disember 2015

DSC01142Well, it has been more than a week since I am back from Middle Earth. It was my 15 years dream of going to New Zealand after I first saw ” Fellowship of The Ring” of the Lord of the Rings trilogy in 2001. My first son was just 2 years old and I was earning a salary of only RM 2200 with a rented house. It took me almost 15 years to be able to visit Middle Earth with my whole family. My first son is now 15 years old! How fast time flies but eventually, I fulfilled my dream.

It was an hectic but worthwhile 12 days where I travelled from North to South island. Landed in Auckland, moving to Rotorua and Wellington before going to South Island. Driving in New Zealand is like being in another world. Sceneries and weather changes from one place to another. I drove from Picton to Christchurch to Dunedin to Te Anau to Milford Sound where I took a wonderful cruise of  the 8th Wonder of the World. Then I drove down to Queenstown where we spent 3 days before driving back to Christchurch. A day in Christchurch and we flew back to Singapore.

Despite being the beginning of summer, I could still see the snow topped mountains. Roads were beautiful with not a single pot hole over thousands of kilometres that I drove. Visiting Hobbiton brought back memories of seeing the Hobbits and the ” ring that ruled them all”.

DSC00668 DSC00773 DSC01104,
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Well, I am back to work. In 2 days time I will be seeing the Millennium Falcon flying for the first time after 30 years! Bringing back my memories while I was still in school! The Force has awaken ……………..

 

A long time ago, in a galaxy far far away there was a planet by the name of Pendora. As part of the transformation program, the Emperor of the planet Pendora decided in a typical “ Pendora Boleh” style to invite a well renowned academy from planet Uncle Samy to start an academy in Pendora. The academy supposes to train young padawans to become Jedis. These young padawans are enthusiastic lots who had always wanted to become a Jedi. The force, while is strong in them could not support their stint in another planet due to logistics and financial reasons.

The academy started with grand celebration as it suppose to send fears among the neighbouring planets which includes planet Tatooin, Dagobah as well as the grand empire of Capitol. The academy was promised a lot of goodies to establish themselves, including generous contribution from the Pendora’s government. A Jedi council was appointed to oversee the program, which was introduced for the first time in Pendora. The young padawans are trained for free.

3 years passed and Pendora started to get intertwined in a big controversy involving a mega scandal. Promises that was made to Uncle Samy’s partner was not fulfilled. Uncle Samy’s partner decides to leave the academy. The academy was caught off guard and decided to bring another Jedi trainer from another part of the same planet Uncle Samy.

While Pendora’s future remains hanging, the young padawans were promised a smooth transition to become a Jedi. The Jedi council kept a close watch as not to compromise the training. The Force and the power of the Dark side need to be kept at bay. One year after the controversy erupted, the first batch of Jedi apprentices graduated. Unfortunately, the academy faced another obstacle. The Jedi council decided not to recognise/accreditate the academy’s training. The Jedi council wary of the influence of the dark side. The council felt that the academy did not fulfil the requirement to train the young padawans, to prevent them from being influenced by the Dark side.

By this time, the force has awaken. The dark side of the force has started to influence the world of Jedis. Pendora’s academy was not the only one that has been producing Jedis’. Many more similar academies from various planets were producing the same. The Jedi’s, which were once considered the crème of the society, are now degraded to unemployable status. The protectors and peacekeepers of the galaxy are now jobless. The Jedi council took it for granted as the dark force died 30 years ago. Little did they expect such a situation. The young graduated Jedis are now being asked to sit for the Jedi Council’s special exams to test their knowledge and mental strength. 6 months has passed with no answer !

Will the unemployed Jedi’s become the next Dark side of the force?

Fear is the path to the Dark Side. Fear leads to Anger. Anger leads to Hate. Hate leads to Suffering

Master Yoda’s quote that still lingers in the minds of the Jedi Council. Will the fear of un-employability of the young Jedis, turn to anger and eventually to the dark side?

The Force has awaken………………. The frustrated Jedis are bound to turn to the dark side. Only time will tell……………

 

Disclaimer:

All characters appearing in this work are fictitious. Any resemblance to real persons, living or dead, is purely coincidental.

 

 

Year-end is always a busy time for me. Accounts to settle, children’s exams, meetings and holidays. Over the last few months, I have been writing about debts, UK crisis and job opportunities. Interestingly, there have been reports in news portals regarding debts that Malaysian students are collecting. In my last article, I attached a report stating that Malaysia’s Gen Y are living on the edge due to debts. Subsequently, few more reports emerged over the past few weeks.

Malaysian Insider quoted report from Asia One that Malaysia is the 5th most expensive country to do a degree program, in relation to household income. This is not surprising at all. That’s what happens when you commercialised education. It seems Malaysian parents spend 55% of their pay in allowing their child to finish university. The average tuition fee quoted was RM 77K. This is way below any medical course tuition fee, which can reach close to a minimum of 300K. Imagine the amount of debt if you do not get any scholarship. As one of my colleague said, medicine is only for the rich and for those who receive scholarship. Taking huge loans to do medicine is not worth it! Just few days ago there were some interesting advertisement about loan for wedding (nothing new actually)! We are really creating generation in debt! From study loans to car loan to wedding loan and house loan! Do we have anything left to feed ourselves!

It is also interesting to know that unemployment is higher among the highly educated people in Malaysia. This is also nothing unexpected. The higher you are educated, the choosier you become. Imagine, once jobless scenario hits the medical field, how many of these graduates will be willing to work in another field? Everyone will be blaming the government and colleges. There was an interesting write-up in Medical Journal of Australia (MJA) (see below) regarding job opportunities for doctors who can’t get a job or training post. This was a follow-up article to this article (see below) which confirms that Australia is facing the same crisis as any other country. Doctors are finding it difficult to get a permanent job and training post. He has given some suggestions, which I don’t think many would be interested (see the comments as well). At the same time, he also feels that the situation may get better later, when people stop doing medicine. The cycle repeats itself but it definitely does not console those who are already in the situation now. Trust me, there is NO job security anymore for doctors. Parents and students should remove that from their perception and just consider medicine as another job where nothing is guaranteed. The only setback in medicine is the fact that you would have spent huge amount of money (if not sponsored) and would never be able to practise as a doctor without completing housemanship. No training post means, no hope for further advancement.

IN the UK, as I had written on 2/10/2015, doctors took to the streets to protest against the change of working hours and income. Another protest was conducted on 18/10/2015. The UK crisis once again proved to us that at the end of the day, what matters is your income and how you are going to live a life. No matter how much passion you have, living a life is another story all together. Most of the cries of UK doctors were based on their income and survival. How they are going to feed their children, how they are going to lose their family time and how are they going to settle their debts etc? As I had always said, in the end, it is just another job to earn a living. Whatever passion you presumed you had will be thrown out of the window. Only real passion can pull you through. The Health secretary of UK has finally took back some of the statements he made regarding working hours. However, change is definitely coming to NHS. You can read the other articles in The Guardian news.

The world of medicine is not the same anymore. Patient’s demands are high, huge debts to become a doctor, increasing litigations and increasing risk of being unemployed. Not enough with these issues, we now have to compete with traditional healers, anti vaccine movements, home births, religious and non-religious supplements etc. Patients rather trust these guys than us, who had spent years studying evidence based medicine. Below I attach a Facebook post of a “crying” doctor:

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It is the same thoughts that run through my mind. Over the last 20 years since I started my medical career, I am seeing increasing number of patients who trust all these “non-western and natural ” based treatment. No matter what you tell a patient, he will always consider you as a person who is making money by selling drugs/chemicals for profit-making pharmaceutical companies. Patients rather spend thousands of ringgit buying a product that supposedly can cure Diabetes and Hypertension. But, do they sue the seller if it does not work? The answer is NO, because you bought the product voluntarily and there is no written agreement between you and the seller on what he had promised. We have various magic drugs being promoted in Internet and even at roadsides, which can cure your Gout, Body aches and Joint pains. Almost all of these pills contain high dose steroids. Instant cure and pain relief is definite. Who are you to say it does not work? Most patients get a shock when I asked them how long have they been taking traditional medicines whenever they walk into my room. The first question they ask “ How do you know?” The answer is right on their face: “Cushingoid” facies!

15-20 years ago, I hardly hear anyone rejecting vaccination. Only a small group of people belonging to a certain religious sect refuses vaccination. Now, we have groups of people who openly rejecting vaccination claiming it is a Jewish plot, causes brain damage etc. We even hear stories that it is a Jewish and Christian plot to poison the Muslim community! Sometimes I do not know whether to laugh or cry but what shocks me further is the fact that there are people who actually believe all these nonsense, even the educated ones. Now, we are beginning to hear cases of Diphteria, Measles and Pertusis increasing day by day. TB will be the next epidemic. Parents are putting their child in danger. Should we create a law to punish these parents? While it is their right to take whatever treatment offered, spreading infectious disease can also be considered as a crime! Some countries have started to remove certain benefits from unvaccinated parents such as reducing tax relief, isolating them in schools etc. Proponents of home birth are another group that is increasing day by day. I had talked about it before.

Frankly, day-by-day I am losing interest in treating patients. The art of medicine is dying. Almost 5 out of 10 patients do not take your advice nor compliant to your medications. We are seeing younger and younger Diabetics and Hypertensives but do they care? WE will be seeing more and more complications from these diseases in years to come. We hoped that as the population gets more educated, we should be seeing fewer complications of chronic diseases but it’s the opposite that we are seeing. Patient feel that it is their right to do what they want as it is their life and body. Who are you to tell them to take medicine? Gone are the days when the community regarded doctors’ advise as golden! This write up from a Malaysian doctor in US is worth reading. That’s exactly what is happening over here as well.

Patients demand that investigations must be done to prove their diagnosis. Do we have test to prove everything in medicine? That’s where clinical skills come into the picture. A good clinician can diagnose a condition from history and examination alone. But patient will never trust you as long as you can’t provide a proof of your diagnosis. Tell them it’s Viral fever and they would want you to show the proof of the type of virus that infected them! These are the type of patients you are seeing nowadays. Tell them the liver derangement is caused by Dengue Fever and they will demand an answer why the liver enzymes are going up despite taking treatment from you! For those who think can do wonders by being a doctor, please understand that doctors don’t cure anything. We are just supporting the body to heal itself. Most of the time we are just buying time. The body will decide which way it’s going to go: recover or succumb! No surgeries are without complications but most patients nowadays do not except that fact either!

The comment below which appeared in my blog few days ago is worth reading:

“Interesting read Dr Paga.
I am amazed by your patience in answering questions here. I think you must be a good and patient doctor!

Anyway, when I was in medical school many years ago, I was already worried about job security and it was not like we have over 30 medical schools in Malaysia back then as it is now.

I think young people will need to look at themselves honestly and not just jump on the bandwagon and try to do medicine just because everybody think it is the right think to do and it is best way to earn money.

If you do something passionately, very likely you will succeed no matter what profession. Need not be medicine.

I used to be a top student in my school and naturally I studied medicine (because I thought that was the best thing to do!). My brother never understood science and he did law. My sister was an average student and did finance. Both of them are far more successful financially than me. Fortunately I have no aspirations to be a very rich man but I do enjoy what I do.

If you want to be rich and successful, you may be disappointed if you think medicine is the answer. Malaysia has very little control system and they allow all sorts of medical schools to sprout out.

UK has twice the number of people as Malaysia and is a far richer country and yet we have more medical schools than them. Something is not quite right.

So my advice is, if your real passion is to be a doctor, to be sensitive and compassionate with people, please go ahead and try your best if you have the means. Going to a good and well-recognized medical school is important. After leaving medical school for over 15 years now, I can still remember the basic medical science taught well to me but many housemen, fresh out of uni, can’t remember a thing!

If you need your dad to sell the house and car for you to realize this dream, you may need to think twice, because you will not necessary return a multi-millionaire to repay him.

If you want to become a doctor because other people tell you it is good, you also need to think twice. Life of a doctor is not for everyone and not everyone will be successful. You may see some successful ones but many are struggling too.

I always like to bring my brother as an example. He is hopeless in studies but can talk and argue really well. Today he is a very successful lawyer, earns easily 5 times more than me !!”

Well, it is time for me to take another break to release my stress. This would be the only article I will likely write for this month. I will be away next week with my parents for Deepavali. A week after that I will be exploring Middle Earth for 2 weeks. Hopefully, when I return early December, my mind will be fresh to start the cycle all over again!

Happy Deepavali to everyone………………..

Simon Hendel: Job opportunities

Simon Hendel

Monday, 2 November, 2015

MORALE is low and burnout across medical specialties is high. In part, this is fuelled by the constant worry about job security for junior doctors. 

 Some doctors who complete their training struggle to find regular work in the public sector for reasons too complex to detail in this short article. As discussed in MJA InSight last week, many junior doctors might not be able to even get a training place.

 However, the lack of job security for junior doctors is likely to be part of normal cyclical workforce patterns, which indicates we shouldn’t be too worried. However, that offers little consolation to new practitioners who can’t find work now.

 Doctors looking for work and those feeling uncertain about their job security often fear that if they deviate from the “normal” training conveyer belt they will be further disadvantaged and passed over in the competitive workplace. 

 I would like to challenge that notion. 

 Medicine as a profession is always changing. New evidence is regularly discovered that informs and changes the way we all practice. These changes are vigorously and appropriately debated. 

 There is no reason to think that significant changes in our workforce should be met with any less critical debate. In that debate, one thing that all practising doctors can be sure of is that workforce changes, like changes in practice, are inevitable. 

 And that change is hard. 

 No other professional graduates have job certainty and few other professions ever have the job security that we have enjoyed. Yet medicine also requires a level of personal sacrifice that is quite different to most other professions. So it’s understandable that this change to a less certain job future is a bitter pill for us to collectively swallow. 

 But it doesn’t have to be.

 Amid change there is opportunity. Junior doctors now have more opportunities than their predecessors to shape the way they balance their life with work. And this is the real elephant in the room. 

 There is more to life than medicine. 

 Having just spent the better part of 15 years learning how not to have a life, but at least being assured of employment, that can be hard to remember and even harder to believe. Studying and specialising in medicine teaches us to sacrifice other parts of our life rather than nurture them. 

 So when we reach the end of the study and training road to find our future job prospects are not as certain as we expected, it can be very daunting. But this is where the opportunity lies.

 For doctors still in training there is opportunity to gain experiences out of the ordinary through locum work, travel or volunteering abroad, or practise in an entirely new setting like the military, or accept an overseas fellowship, or even work as a doctor in Antarctica

 I’m willing to bet that doctors with this broader experience will be more marketable in a competitive job market than those with a generic ticket who are the same as the next applicant.

 And for those of us recently qualified? This is our opportunity too. 

 This might be our only chance to really think about how we want to work — or perhaps how we don’t want to work. Is it time to do part-time clinical work so we can learn other skills we always wanted but never thought there would be time to achieve? Or time to be home for dinner and our children’s bath time? Or time to build a successful private practice? 

 Whatever we choose to do with our time, we have a choice to use it as an opportunity or waste it wishing things were how they used to be. 

 Before we know it there might be too many jobs again and we’ll wish we’d taken the chance when we had it.

 Dr Simon Hendel is a Melbourne based anaesthetist.

 

Tim Lindsay & Harris Eyre: Career crisis

Monday, 26 October, 2015
LAST week the ominous situation facing medical graduates in South Australia was exposed with an estimated 22 domestic graduates projected to miss out on internships in 2017, and up to 39 to miss out in 2018.
Unfortunately, this training gap only represents the tip of the iceberg, with a national workforce report predicting that more than 1000 junior doctors will miss out on an advanced training place by 2030.
The recent approval of a new medical school in Western Australia shows that the tsunami of medical graduates is unlikely to abate, so is it time to rethink medical education?
This year, an estimated 3736 Australian medical students are expected to graduate, an increase of almost 280% from the 1347 who graduated in 2001. Despite this massive increase in graduates, there has been a comparatively small increase in the number of training places available to junior doctors. This leaves many graduates facing a grim training outlook.
The latest Royal Australasian College of Surgeons Activities Report indicates that in 2014 more than 800 applicants to surgical education and training (SET) were unsuccessful. There are reports of similar results for training places in other specialities, including general practice.
Few, if any, training programs across the medical landscape have been under subscribed, with the net result being an unprecedented training backlog with little relief in sight.
When this mass of prevocational junior doctors is added to the still growing tidal wave of graduates year on year, the stark reality is self-evident — not all of us can be clinicians.
Unfortunately, there is no easy solution.
Junior doctors could move offshore, but increasing regulatory barriers mean that the days when young doctors could simply move to the UK or the US and expect to work are gone, let alone come home and have qualifications recognised.
Medical training in Australia could be completely overhauled to more closely resemble US-style training. This would mean service registrar positions, the utility of which has long been questioned, would be abolished and training streamlined.
However, reform would take years and would likely face tenacious opposition.
Another option is to reduce student numbers, but for various reasons this has proven untenable. One reason may be the high cost of establishing and managing medical schools, so reducing numbers is unlikely and potentially short-sighted.
Nonetheless, with an oversaturated market, should these new schools have a moral imperative to ensure that their graduates are employable?
Australian medical education is, by tradition, clinically focused. Variation from this invariably includes teaching, research and, more recently, public health.
The shortening of contemporary medical courses as postgraduate degrees has resulted in an even greater prioritisation of clinical skills, possibly to the detriment of skill diversity. Graduate medics may benefit from exposure to varied subject matter in their undergraduate degrees, but these too are becoming increasingly prescribed and narrow in focus.
The result? Junior doctors often graduate with few transferable skills, making the ramifications on their career prospects even more dire.
The trend towards focused clinical education in Australia actually goes against what is happening in other countries, particularly in the US and UK. In those countries, programs combining degrees such as a Master of Business Administration, Master of Public Health, Juris Doctor or Doctor of Philosophy degree with medicine are booming in popularity and some Australian institutions have been quick to follow this trend.
However, for debt-laden graduates, further studies cannot be the sole answer. Industry placements, non-clinical electives, innovation training and mentorship and coaching programs should all be considered as ways to better equip medical students for modern career challenges.
Producing competent clinicians should always be the main priority of any medical school, but the time has come to ensure that medical schools also prepare graduates for careers outside of practice.
After all, for those trapped in the midst of the graduate tsunami, one thing is crystal clear — we cannot all be clinicians.
Dr Tim Lindsay is an Australian junior doctor and PhD student in the department of surgery, University of Cambridge, UK, supported by the Cambridge Commonwealth Trust. Dr Harris Eyre a psychiatry registrar and is undertaking a PhD through the University of Adelaide.
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