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Much has been written in this blog about the future of medical graduates, the declining quality of products, oversupply of doctors and the eventual unemployment of graduates. The world is undergoing many changes. Wars are breaking out everywhere with extremist killing innocent people in the name of race and religion as well as territorial fight. Malaysians are only interested in Gaza but forgotten the fact that Syria has killed almost 170 000 of their own citizens, Boko Haram is killing their own citizens in Nigeria and ISIS in Iraq killing Christians who refuse to convert or leave. The Ukrainian crisis would not have come into the spotlight in Malaysia if not because of MH17! When people ask me why I don’t support Palestine openly, I ask them why they never bothered about what is happening in the rest of the parts of the world. Why people never marched to the Syrian embassy? Why don’t people march to the Arab country’s embassies for not helping the Palestine? Historically, more Muslims have killed Muslims compared by anyone else. I support humanity and that’s why I am a doctor! I condemn any atrocities no matter where it happens and who is involved. I do not support any particular race or religion or country. In fact, we may end up like them if our PM does not act as a leader in condemning the racial and religious bigots who are running amok in this country at the moment.

Now, coming back to the topic above, life as a practicing doctor does not seem to be getting any easier. We were just informed that the Annual Practicing Certificate (APC) fee would be increased by 2016. The proposed rate is RM 300/year, up from RM 50/year now. MMC will be corporatized as mentioned in the amended Medical Act 2012. Thus, one of the source of income for MMC will be the APC and NSR (National Specialist Register) fee. The NSR fee will remain at RM 1500 every 5 years. The renewal of APC will not be automatic anymore. You need to have a minimum amount of CME points to be renewed. I was informed that it would likely be 10 points per year for MO and 20 points per year for specialist.

Ministry of Health is also strengthening their enforcement unit and introducing many new rules and regulation for private hospitals and clinics. Recently, we were told that Visiting Consultants in a private hospital cannot admit any inpatients. They are only allowed to see outpatients. I understand that this new rule came about after the incident at the Chinese Maternity Hospital, Seremban where MOH had to close down the inpatient services, end of last year. The hospital was surviving with visiting consultants to run their inpatient services. Unfortunately, this new rule will have severe impact on hospitals and consultants. This basically means that a consultant who runs his own clinic outside would not be able to admit any patients to any private hospitals anymore. It also prevents Consultants from government sector to have any admission rights in private hospitals despite government allowing them to do locum/out of office hour’s session in private hospitals. Is this an indirect way of MOH in preventing their doctors from doing locum outside?

As for individual Maternity Centers, license is NOT going to be renewed if they do not have a full time Pediatrician and Anesthetist. This will force most maternity centers to close shop within the next 1-2 years. I have already had few O&G consultants from maternity homes calling our hospital for visiting rights. Unfortunately, it is a double whammy. We can’t accept them as visiting consultant as we can’t give them admission rights!

There is also another new rule, which says that we can’t run an ICU if we do not have at least 4 ICU trained nurses! Oh my, it looks like most of the small hospitals will have to close down their ICU services. How are we suppose to get ICU trained nurses when the training can only be done in a government hospital (under their post basic training) but they do not provide any allocation for private nurses?

By April next year, patients will have the option to choose between getting their medication from doctors as they do now, or to insist on the doctor giving them a prescription to buy the required drugs from a pharmacy. It was published in The Sun last month.This will be another big blow for the General Practitioners. It is a catch 22. Most GPs survive on the commissions they get from selling medications. If the above rule is implemented, they will have no choice but to increase their consultation fee. This in turn will chase away a lot of their patients. You can’t survive by charging RM 25-30 consultation fee! The Malaysian Pharmaceutical Society is fighting hard to get this implemented. As you would have noticed, many small pharmacies are merging to create big branded retail pharmacies almost everywhere in every town.

The cost of private healthcare is increasing tremendously. There was a saying that only 20-30% of the population seeks treatment from private hospitals. Unfortunately, the number of cash paying patients in private hospitals is dwindling over the years and only constitutes about 10-15% of the total number of patients attending a private hospital. The rest depends on insurance such as employee benefits and medical cards. In my hospital, almost 90% of patients are paid by insurance. This is where another huge problem is arising.

Since the New Fee structure was introduced by MOH in February this year, insurance companies are becoming more stringent in their assessment. For those who do not know, the fee increase of about 15-30% is the first increase after almost 16 years! And yes, our fees are regulated by the government but not the hospital fees. The insurance companies are now dictating what we should do and what we should not. They are even limiting the number of times we can see a patient in the ward. I have had insurance companies which specify that only 1 visit per day is allowed. If you visit more than once, either the patient has to pay or we have to do it for free! It does not matter whether the patient is ill or not! My surgical colleagues are having a tough time, as some of the fees are not being paid as it is deemed unnecessary by insurance companies and they decide this by sitting 400km away without even looking at the patient! Yes, I agree there are black sheep’s in our profession. I had written enough about this. Unethical and “go for money” doctors are increasing day by day due to stiff competition and reducing income. However, to query what a doctor should do and should not do, cannot be decided by some junior doctors who might not even have completed housemanship! FYI, insurance companies do take those who quit housemanship to become their underwriters! They even got the stupidity to ask why an appendicectomy cannot be done the next morning just because doing after office hours increases the cost! I hope we can say that to them when they get admitted for a similar problem. Interestingly, these insurance companies do not say these directly to their client/patients!!

All insurance companies are increasing their premiums as of now, to minimize their loss from the recent fee increase. How many percent of the population will drop out of the scheme? As the premiums increases there will definitely be certain portion of the population who will not be able to sustain their policy. This in turn may reduce the number of patients visiting private hospitals. On the other hand, the cost of private healthcare will continue to escalate. Eventually it will reach a tipping point where the private healthcare system may collapse, especially the big tertiary private hospitals. This did happen in the US in 1990s after which they started building smaller primary and secondary care hospitals to keep their overhead cost lower.

While we are having constant pressures from all these external factors, the litigation rate seem to be going up by leaps and bounds. Last year the court of appeal decided to award RM 3.5 million (before interest) in damages for a cerebral palsy case in a private hospital in Klang Valley. It has set a record as the highest amount ever awarded as well as a benchmark for future cases. Recently, a government hospital was asked to pay RM 2.78 million in damages for a similar type of case. Interestingly, the mother of the child is a doctor who is still in government service! Another consultant in a private hospital in Klang Valley was asked to pay RM 280 000 for causing death of a child due to mismanagement of labor, and the patient is a foreigner! Just today, another case involving an Orthopedic surgeon and a government hospital was found guilty of negligence. These are just the tip of the iceberg as many cases are being settled out of court!

These cases have now increased the premiums for our medical indemnity insurance and it will only go higher! A couple of months ago I had a father who said that doctors can’t be suit in court because no doctors will give evidence against another. I think he is leaving in the 80s. Those days are gone. We have many consultants hired by lawyers to attend court cases as expert witness. On the other hand, an increasing litigation rate will also increase the cost of healthcare as doctors will become over cautious and order unnecessary investigations (as happening in US). It is known as CBM: Cover Backside Medicine!  The production of poor quality doctors with poor training during housemanship will only make things worst for the field of medicine in the future.

Well, many things are changing in medical fraternity. Some are for good as it ensures safety of patients and general public. The practice of medicine will not be the same anymore as many rules and regulations are being put in place. Income of doctors will continue to decline due to various factors mentioned in this blog. Doctors will be pressurised from every corner, which include debts, high indemnity premiums, high litigation rate and high maintenance cost of practice. AND I have not even started talking about TPPA and ASEAN Trade agreement! So, never do medicine for easy life and money!

2014 has not been a good year for this country. Anyway, I wish everyone a Selamat Hari Raya and have a safe journey home……………

*** please click on the links to see the articles*** 

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It has been 3 weeks since I last posted an article in my blog. I am sure you know why! I started watching World Cup since 1982 when I was still in primary school. I had never missed any of the World Cups since then. As the greatest show on earth, it proves to be one of the most exciting sporting event that everyone waits for, every 4 years. I watched the Final of World Cup 2010 between Spain and Holland in Hong Kong as I was attending a Rheumatology conference then. By co-incidence, I watched the opening match of World Cup 2014 between Brazil and Croatia also in Hong Kong, as I was having a family vacation.

Of all the World Cup that I watched over the last 32 years, I must say that this years’ World Cup is the best I have seen. It was a World Cup filled with goals, excitement, upsets and unexpected underdogs. Top European countries like Italy, Portugal, England and Spain crashing out of the tournament in group stage where as underdogs like Costa Rica, Algeria, Columbia , Mexico showing flowing football that brought most of them to Round of 16 and Quarterfinals.

Who would have thought that Holland will whack Spain by 5-1 in one of the earliest of the group matches. Who would have thought that Brazil, the country where football is second to religion will be trashed 7-1 by Germany and 3-0 by Holland? It was a spectacular show with tactical football taking over the stage. Individual skills come second. Brazil should start playing like a team rather than depending on individual skills. Those eras are gone! I am glad that I was in front of the TV when Germany trashed Brazil 7-1 in one of the tournaments biggest upset in history! It was the most humiliating defeat by Brazil, furthermore in their home ground.

Germany has always been the most consistent team in World Cup since 1970s. They work as a team with superb energy and spirit. They deserve to win this World Cup 2014. Along the way they broke numerous World Cup records such as all time top scorer, the country with most number of goals in world cup, the highest score line in a semifinal, the biggest thrashing of a home country, the first country to reach 4 consecutive semifinals , the first european country to win in a south american soil etc etc.

I could not update my blog over the last 3 weeks as I was having sleepless nights while working everyday. Age is catching up and I am not as “fit” as I use to be. Watching the game early mornings is becoming a torture. BUT I will continue to watch these World Cups till I am 6 ft underground!

Good bye World Cup 2014 and I will wait for Russia in 2018………………….

 

FINALLY, I mean finally, the word is out from the horse’s mouth!! Of all these years of me screaming that this will happen and all the insults that I had to take from those who were in denial, the verdict is out from the Ministry of Health !!

Today’s Star reported our Health Minister as saying and admitting that we are producing too many doctors with too few training slots. Just 1 year ago, this very Health Minister denied that we have too many doctors in a dinner organised by MMA. Fortunately, he has come to terms with the fact that it is unavoidable. Now, he says that our situation is extraordinary, the Malaysia Boleh style! According to the article, a waiting list has started for Housemanship posting which is about 3-6 months now and will become longer eventually. This is happening with just below 5000 graduates last year and 20 more medical programs yet to produce graduates locally, as I had mentioned in my previous post.

Of course , he has not mentioned of what is going to happen to those who will finish housemanship but got NO MO post! That will be another issue all together which likely be addressed by an exit exam or removal of compulsory service.

Interestingly he mentioned that MOE is being asked to review the entrance criteria to do medicine. This is really difficult to be implemented as you can’t prevent anyone from doing medicine anywhere in this world. My suggestion is to limit the type of PreU courses(standardised established ones) that can be accepted as an entry requirement and to implement the MMLE. Will the government refuse to give job to those who do not have the minimum requirement but already graduated ? It looks very likely!

Another issue mentioned below is the requirement for a credit in BM. This is actually a standard requirement for all civil servants. You must have a credit in BM to join the civil service. However, to encourage doctors from overseas to return to Malaysia and work in civil service, MOH requested an exemption from JPA in 2006 when Chua Soi Lek was the Health Minister. At that time, there were severe shortage of doctors and the need to even recruit foreign MO. Unfortunately, it will not be the same anymore. So, for those who do not have a credit in BM, be prepared not being able to be employed by MOH.

Well, I hope those who do medicine for the purpose of job security will think twice before doing medicine.Do not waste your money and time. Do medicine only if you have genuine interest and passion( with the required minimum criteria), after reading about a doctor’s life in my “For Future Doctor’s” page above.

Next,  I will write another post about the situation in private sector where our income is now being determined by Insurance companies!

 

Waiting list for housemen positions at public hospitals

BY LEE YEN MUN

 

PUTRAJAYA: Public hospitals can only absorb about 5,000 housemen each year, but more than 6,500 medical graduates emerge from both local and foreign institutions annually, said Health Minister Datuk Seri Dr S. Subramaniam.

There is now a waiting list (for housemen positions) of between three to six months and the wait could be longer in time to come. As part of a measure to control the supply of new doctors, we are now in discussions with the Education Ministry to review the minimum qualifications (for entry into medical schools),” said Dr Subramaniam at a press conference here yesterday.

The two-year housemanship is part of a compulsory apprenticeship for medical graduates who, upon successful completion of their training, would be granted a full practising registration certificate by the Malaysian Medical Council (MMC).

There are now 33 medical schools offering 44 medical programmes locally but the Cabinet has imposed a five-year moratorium on new medical courses effective May 1, 2011.

Another measure which was implemented recently to increase the number of housemen’s placement included housemen being assigned to posts in public health clinics in one of their six rotations. Dr Subramaniam said the ministry was also considering introducing primary care and psychiatry as an alternative apart from the compulsory posting.

“In other countries, there is no problem like ours because the number of doctors (overseas) are under control. Our situation is extraordinary because we have a high number of (medical training) institutions.

“In addition, the employment criteria for house officers set by the Public Service Department needs to be made similar to other professions, including a mandatory credit in Bahasa Malaysia,” the minister said.

Separately, Dr Subramaniam announced the gazetting of seven locations in Johor as smoke-free zones effective June 19.

They include Taman Rekreasi Town Park 2 and Taman Rekreasi Town Park 3 in Taman Seri Austin, Johor Baru; Taman Negara Gunung Ledang, Muar; Taman Negara Endau Rompin and Taman Negara Endau Rompin Tambahan, Segamat; and Taman Negara Pulau Kukup and Taman Negara Tanjong Piai, in Pontian.

The last I wrote an article with the title above was in February 2014. Since then many new developments are taking place behind the doors. ON 9th June 2014, an article appeared in the Star regarding the limited number of post available for graduates (see below). This is a fact and the government has finally come to terms with it. They finally realised that they had approved too many medical schools over a short period of time. I had also written what transpired during the last MMA AGM held end of last month, over HERE. Prof Adeeba is the Dean of UM and also a MMC council member. Thus she knows exactly what she is talking about. She has also reiterated the need for a common entry exam to decide who will get employment and who will not. A committee has already been formed between MMC and MOH to decide on this as well as the implementation date. She also suggested that the number of medical students and programs should be reduced by a staggering 70% !!! Oh my, didn’t I ring the bell almost 8 years ago?

Now, let’s look at the latest MMC Annual Report for 2013 over HERE. I think everyone should read this report. The number of new graduates registered for housemanship for 2013 was a staggering 4472, a 42% increase from 2009. Local graduates contributed about 60% of the total graduates. It was also noted in the report that more and more foreign graduates are returning back to the country for Housemanship due to limited job opportunities in other countries. I had also mentioned this several times before. The number of NEW MOs has also increased tremendously in tandem with the increase in housemen. It increased from 2592 in 2010 to 3754 in 2013, a 45% increase (including those returning after housemanship overseas).

REMEMBER: there are still 20 medical colleges which are yet to produce any graduates ! In page 62 of the report, these 20 medical programs have not been accredited as of 31/12/2013. Imagine what the number of graduates will be when ALL these medical colleges starts to produce graduates. Something that many people never believed would happen, will happen in this country : jobless doctors!

It is also interesting to note that the number of APC issued to practising doctors has increased from 24 783 in 2011 to 30 057 in 2013 (page 33), a 20% increase in 2 years. However, the increase in the number of doctors in private sector is only 927 compared to 4347 in public sector between the years mentioned. The MMC has reported that more doctors are now staying back in government sector. These again will make the number of available post for new doctors very much limited in public sector. Due to declining income of private doctors with increasing competitiveness, less and fewer doctors are resigning from civil service. A random survey done by MMA showed that almost 70% of General Practitioners are earning a net income of below RM 7K, despite working 11 hours a day, 7 days a week.

Even in UK, many graduates are finding their salaries declining year by year. An interesting article over HERE (see below), says that medicine and dentistry are some of the fields that are worst affected. Whenever the supply exceeds demand, salaries will go down and job opportunities will decline. The same will happen to our civil service in the future when our government reduces some of the allowances to doctors such as Critical Allowance which is not a permanent allowance. The government will not be able to give job to everyone  due to the financial implications.

Finally, another interesting phenomenon was the fact that more and more doctors are becoming sick! A total of 334 cases were referred to the Medical review Panel in 2013, compared to 49 cases in 2009. The MMC has to form another committee to handle these cases, known as Fitness to Practise committee. If you look at page 51, you will be shocked to see the type of cases being investigated. These could be only the tip of the iceberg! That’s the reason why I keep saying that you should never do medicine for wrong reasons. Parents should also stop forcing their children to do medicine. From my friends in psychiatric department, the most common cause for housemen and doctors being referred to their department is due to depression. And the reasons for depression is always “doing medicine for wrong reasons” and ” parents told to do” !

Well, the writing is on the wall. It is up to the readers to ponder upon the future that this country is heading due to poor human resource planning. The MMLE committee has been formed in MMC (Page 24) and has already conducted 2 meetings and has submitted proposals.

 

Meanwhile, it’s time to watch Germany vs Portugal  in World Cup 2014………. it’s raining goals in this World Cup……………..

OLA OLE  Brazil……………………..

 

Limited training slots available for medical grads

BY LOH FOON FONG

 

PETALING JAYA: Medical students who slogged through their five-year year programme may just find that places are limited in the training hospitals.

Senior doctors foresee that a selection process might be imposed on medical graduates in the near future in view of the high number of 5,000 graduating each year.

Students may stand a better chance of getting into the limited number of training hospitals as housemen if they graduate from better ranking schools.

Training hospitals, where graduates planning to practise locally have to undergo housemanship, could only cope with about 3,000 new housemen each year.

Healthcare sources said that about 4,000 to 5,000 medical students would graduate annually, with more than half returning from overseas.

While those graduating from local universities, especially public universities, and established overseas universities have fewer issues entering the healthcare system, those graduating from foreign universities with a poor track record might face difficulties.

Universiti Malaya Medical Faculty dean Prof Dr Adeeba Kamarulzaman (pic) said the Malaysian Medical Council was considering introducing a common licensing examination for all graduates to ensure that only those with adequate training were given positions in these hospitals.

“There may not be enough houseman and medical officer posts. The Health Ministry may select those from schools with a proven track record,” she said.

A source said training hospitals in the Klang Valley, for instance, were accredited with multiple private medical schools, as well as some public universities, resulting in doctors being overstretched and too many students practising on patients.

He said the Cabinet should reduce the number of programmes and the number of students entering local medical schools by 70%.

Dr Adeeba said funding bodies too need to be selective and send students only to better ranking schools.

“My concern is that our top students are being sent abroad to universities of much lesser ranking than local medical schools,” she said.

Dr Adeeba said that while the various authorities need to do proper human resource planning, parents should wake up to the fact that there would not be adequate posts for doctors in government hospitals and hence, should not push their children into studying medicine if they did not have the aptitude for it.

She cited a number of students who struggled with the demands of the five-year programme, which they had no interest in.

A senior doctor, who declined to be named, said the situation would only get worse each year if nothing was done.

The Cabinet, he said, should start capping the number of students entering medical schools.

 

Graduate salaries tumble in the UK
Published: 13 June 2014 | Updated: 13 June 2014 5:14 PM

 

The United Kingdom has always been a lucrative study destination for students all over the world including those from Malaysia. Having some of the best universities in the world including the likes of Oxford and Cambridge, there are immense opportunities for employment not only in the UK but elsewhere in the world including the home countries of students.

Hence, students have been opting for UK as a popular study destination but as of late, it has been found that studying abroad might not be as lucrative as it used to be. So let us find out what the latest trends are and the possible reasons behind these trends.

Rising cost of education

 

The cost of education in the UK has been rising steadily and even in the current year, expert projections estimate a hike of about 2% where the current average cost of a degree stands at 8, 647 pounds (RM47, 203) per year.
This basically means that the average cost of a typical 3-year undergraduate course will stand somewhere in the region of approximately 26, 000 pounds (RM141, 932).

Moreover, although there are provisions for loans, it has been reported that the average cost of repayments over time, especially for students in lower income jobs where they pay-off their loans slowly, could amount to as much as 100, 000 pounds over a period of 30 years after which the loans would be waived off.
Rising costs Vs Diminishing returns

If students are still attracted to studying in UK universities despite the spiralling costs, there is only hope for a better and much more secure future where students can look to gain back more than what they have spent in the long-term. However, the statistics reveal otherwise.

A study conducted by Complete University Guide showed that in the United Kingdom, graduate starting salaries have plummeted by a huge margin of 11% in the five-year period for which the study was conducted namely between 2007 to 2012.

This is not a new trend. The past 5 years have shown a continual drop in salaries, albeit at a much slower rate. In fact, the rate of decline was just 4% in the period between 2002 and 2007.

Reasons for the decline

Several reasons can be cited for such a decline and some of the most prominent ones are the rise in competition between graduates and the increasing number of graduates that are available for certain jobs.

With the abundant supply of graduates, employers do not have much incentive in raising the salaries. Rising inflation is another cause which erodes minor salary hikes.

The decline in the starting salary of graduates is not uniform, but varies across different sectors and segments.

For example, while the steepest decline in starting salaries can be seen in fields such as medicine and dentistry, other areas were able to keep up with the inflation rate, such as in library science and materials technology.
Advice for students

Students could certainly be perplexed by the state of affairs and get worried as to what steps they should take next – whether or not they should pursue an education from countries like the UK, spending so much time and at a high expense.

There is no definite solution and a decision such as this depends on many factors. Firstly, students need to see if the profession or area of study they wish to pursue has had a steady salary history as compared to elsewhere in the world. Students would also need to accommodate their personal financial circumstances and consider if the costs of such a degree is feasible.

There is no doubt that UK universities have world-class infrastructures, teaching facilities and students can certainly get a lot of exposure from students who are from different parts of the world.

Research also states that despite all odds, a person with a degree from a country with a prominent history in education – like the UK – certainly has advantage over his or her counterparts.

Hence, one should certainly take advantage of the available opportunities while taking heed of the factors mentioned in this article. – June 13, 2014.

* This article is courtesy of easyuni.com

- See more at: http://www.themalaysianinsider.com/features/article/graduate-salaries-tumble-in-the-uk#sthash.uEw4oR0h.dpuf

After almost 6 months of planning and almost weekly meeting since February 2014, the 54th MMA AGM is finally over! We had a wonderful weekend with almost 400+ doctors attending the AGM held at Persada Convention Centre, Johor Bahru. The committee especially the Secretary Dr Mohan and Treasurer Dr Guruparan played the most important role in running this AGM. Despite many pharma companies declining to participate, we still manage to get close to 50 booths for the event. Despite some initial glitches, we manage to end the event with a wonderful Informal Night themed “Arabian Nights”.

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Many interesting discussions took place during the AGM. MMA AGM usually gives an opportunity for many doctors to come together and meet each other. I manage to meet and discuss many issues regarding medical education and the future of medical life in Malaysia with many senior  & junior people in MMA and MOH. I also manage to meet and be reunited with my 2003-2005 SCHOMOS Johor committee members DR Nirven ( who I last met 5 years ago) and Dr James Lew (selfie below).

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The MMA Oration was given by Dr David Quek, who is a Past President of MMA and a MMC council member. His topic was “What Ails The Medical Profession And then What Ails Our Health System? ” He reiterated the fact that we are producing  too many doctors at too fast a pace. We will see surplus of doctors by 2017 and MO jobs will not be guaranteed anymore. The government has finally come to realise this fact and making steps to minimise the “complications”. MOH and MMC is seriously considering either an entrance exam or an exit exam. Reducing compulsory service is also on the cards. The government cannot stop anyone from doing medicine despite the minimum entry requirement but they need not necessarily provide you a job. They also can’t close down the medical schools as it is a business and the government need to support businesses. Probably, some of them will die a natural death when surplus of doctors occurs.

Unfortunately, unless there is a standardised entry or exit exams, we would not be able to remove the poor quality doctors. WE will have surplus of doctors but how many of them will be of good quality? The situation is so bad that many specialist has given up. The shift system just made it worst. Some good hard-working housemen have openly told me that even though their fellow housemen are their friends but they would not send any of their relatives to these doctors.  It looks like we are releasing many with a “license to kill”.

The article below which was published in The Star on 25/03/2014 summarised what I have been saying over the last 10 years. Too many students in too few “training” hospitals and “shop-lot” medical colleges with too few academics (diluted within 36 medical schools). Many from non-medical field do not understand all these issues. Many believe that as long as the college is attached to a hospital, it is well and good! Training in medicine is more than that!

Finally, I hope doctors will be more united in becoming MMA members, take a break and attend AGMs like this to meet one another for the betterment of the medical profession…………….

I will be off again for a Family holiday starting 8/06/2014. Hopefully I will reach Hong Kong safely……..

 

Docs in govt hospitals stretched by private students

BY LOH FOON FONG

PETALING JAYA: Too many private medical programmes nationwide are over-taxing public teaching hospitals.

While the Education Ministry’s university hospital teaching staff taught mainly their students, the general hospitals under the Health Ministry doubled up as teaching hospitals for private university students, resulting in a heavy workload, said a source.

“The doctors are overstretched. They have to divide time to attend to their patients, teach students from private universities and guide house officers,” said the source.

The source was concerned this would lead to students receiving little attention.

Private hospitals in Malaysia were not used as teaching hospitals as they did not have the needed case-mix (various types of patients) and high bed capacity to provide the needed training and exposure to students.

The source said the Cabinet needed to reduce the number of programmes and the number of students entering local medical schools by 70%, or get the private schools to merge and pull their teaching staff together.

Although the Government had argued that it needed to increase the number of doctors for the nation, he said there was more than enough doctors now and it was a case of uneven distribution.

In the Klang Valley – the doctor-patient ratio was 1:100 while in Sabah and Sarawak – 1:1,000, he said.

In Putrajaya, Deputy Health director-general Datuk Dr S. Jeyaindran admitted there were too many students taxing the limited resources.

The ministry would have to look at the nation’s needs first before deciding if it could reduce the number of medical programmes in private universities.

He said the system could cope with 2,500 to 3,000 medical graduates a year currently and foresees some private schools subsequently closing down or merging.

 

Today, another piece of news appeared in the Star regarding the same college which I wrote about, 3 weeks ago over HERE. It is rather sad to hear that hundreds of students will likely be affected. None of their programs are yet to be accredited by MMC except the abandoned twinning program with Indonesian University. What will happen if MMC decides not to accreditate this university? Looking at the current scenario, teaching facilities and staff situation, very likely MMC will NOT accreditate this university. The worst affected will be their local program and the MD UKM program.  From my previous post, i received few comments from students who were doing the twining program with the 2 Ireland universities. It was mentioned that most of the government sponsored students were absorbed into the Ireland university’s 5 year program. If I am not mistaken, they had to start from Year 1 again.  I am not sure about the self paying students. The whole idea of twinning is to reduce cost.

Over the years, I told many students who wanted to do medicine in this university NOT to accept the offer. Right from the beginning I had doubts about this university. No university in this world can run 5 medical programs. Unfortunately, due to their “generous” scholarship offer, many students/parents were “tricked” into accepting the offer without checking the background, teaching facilities etc. The human nature is to find the cheapest possible way to make their children a doctor. As I have said many times before, doing medicine is not just about getting a degree. It is more than that.

If indeed the university is in dire need of money, the only option is to sell it or ask the state government to buy over. Sheffield university was bought over by the Perak state government when they went into financial difficulties in late 1990s. It was renamed Royal College of Medicine of Perak till it was sold to UniKL few years ago. The same situation might happen over here. It is considered a bail-out but do the government have enough money now? Furthermore, the state government is under the opposition where as the owner of this uni is considered a close ally of the federal government. This was evident from past newspaper promotional activities of the college where DPM, ex-PM attended.

From today’s article in the Star (see below), it was mentioned that students are not allowed to enter the teaching government hospitals. I am not sure what is happening but very likely the university is not paying the HODs of the hospital. Generally every university has to pay each HOD of the hospital a monthly allowance of about RM 800-1500 to facilitate teaching of the students in the wards. The HODs have every right to block the students from entering the wards if there is a conflict.

Over the years, many did not believe the advice that I gave. I talked about the reality on the ground but people get carried away with the promises given by businessman. Many would like to believe what is written in the brochure and promises by the respective marketing team. For over 4 years, I wrote about all these marketing gimmicks and yet people refuse to believe. Perdana University promised their own teaching hospital by the time the first batch reaches final year! Again, I was sceptical. To date, even the ground work has not started!! The government is to be blamed for all this mess but our society also need to wake up from their sleep. WE have an ignorant society. Many refuse to believe what is written in this blog despite facts and figures. Many feel that it is all negative and nothing positive. BUT, what is written in this blog will NEVER be told to you by anyone else. It is the reality and the truth. The truth hurts. If you want to hear positive things, just open the mainstream newspaper daily!

Anyway, I hope an amicable solution will be taken by the college for the sake of the students. Many of them may need to transfer to another college and redo their entire course. UKM may even pull out their degree. Hope everything will end well.

This will likely be my last blog entry till the MMA AGM in Johor. Please do come down to JB to attend the AGM

 

 

AUCMS students badly hit by school’s financial woes

BY RAHMAH GHAZALI

 

PETALING JAYA: Hundreds of Penang-based private medical school Allianze University Medical Sciences (AUCMS) students have suffered from the school’s financial crisis, which has allegedly dragged on for a year.

An employee, who spoke on condition of anonymity, told The Star Online that the students were no longer allowed to serve their practical years in some government hospitals due to the college’s poor track record.

“There are many occasions where the students are not allowed to enter the wards as the hospital’s departments refused to accept students from AUCMS.

“They complained that the quality of teaching in AUCMS has been below the standard of medical school,” he claimed.

The plight of AUCMS employees was highlighted in The Star Online on Apr 22, with some turning to loan sharks in desperation as their salaries have allegedly not been paid in four months.

Despite repeated reminders to the college’s management including a signed petition, the employee said their concerns have been ignored.

“Our patience is running thin. It’s been five months now and we haven’t received a sen yet,” he said, adding that the employees are planning to take legal action against the college.

“More than 65 employees have signed a petition letter demanding their salaries, Employees Provident Funds contributions and scheduler tax reduction are paid according to their contracts.

“However, the management still has not responded to the petition,” he said.

He also said the employees are threatening to boycott the classes due to the ongoing problems.

“Our medical faculty is also badly hit as many high-ranked and clinical lecturers have left to other institutions,” he said.

He added that the employees have decided to take legal action against the college for the unpaid salaries.

AUCMS president Datuk Dr Zainuddin Md Wazir had previously said that they were going through some “financial hiccups” and vowed to make the outstanding payments as early as this month.

When reached for comments, Zainuddin said the management is “sorting it out the issue immediately.

“We acknowledge their problems and we are in the midst of settling it,” he said, briefly.

AUCMS is a private learning institution located at Kepala Batas, Penang that runs specialised courses of study in medicine, hospitality, tourism, sports science and allied health sciences.

Lately I have been busy for various reasons. Thus, my blog entries has been slow with the last entry being almost 3 weeks ago. So many things has been happening over the last 2 months. My hospital life has been busy, almost weekly MMA branch meeting for the upcoming AGM, family matters, politics  etc.  I became a MMA member since I was a houseman. Currently I am a life member. I have been active in MMA Johor branch since the year 2000 as a committee member and subsequently as Johor SCHOMOS Chairman from 2002 till 2005. I was also the National SCHOMOS Treasurer from 2004 till 2006. I took a break from 2007 till 2011 as I was busy doing my subspecialty as well as starting academic life (Monash) and private practise(from 2010). I went back into the committee in 2012 and subsequently as Johor CME Chairman since 2013.  I was well known for my articles in Berita MMA since 2004, many of which has become a reality soon after. All the articles that I wrote in MMA magazine are available over HERE. I stopped writing since 2012 due to some conflict with the editor.

For the first time since 1994, Johor will be organising  the National AGM, the 54th. Almost the whole organising committee do not have any experience organising it before. Thus, it was a great challenge to organise this event despite our busy schedule. In fact, I could not attend all the weekly meetings due to my busy clinical life of being On-Call on weekly basis.  I was mainly involved in organising the symposium and booths.

We all know that the medical field is not what it use to be. Quality has deteriorate and life is not as “easy” as what many would like to think. Oversupply of doctors due to commercialisation of medical education will become a reality soon. I first wrote about this in 2005. MMA is the oldest and only medical organisation that the government talks to. Our current/outgoing President, Dr NKS Tharmaseelan has been one of the most vocal president to date. Many issues were brought forward to mainstream media including the oversupply and quality of doctors. Unfortunately, despite having close to 40 000 registered doctors in Malaysia, only about  1/4 are members of MMA. Many complain about MMA but it is the only organisation that can voice out our issues/grouses. Many in government sector do not know that most of the PERKS that they are receiving now are due to constant discussion between MMA and the government. These includes the time based promotion, on call allowance, specialist allowance etc etc.  We may have a number of splinter parties but we still need to work together with MMA to achieve our goals. Medicine is at its crossroads. I hope every doctor would at least become an ordinary member to strengthen the membership of this association and make our voice stronger.I never gave up my MMA membership despite my past dissatisfaction with them.

Thus, I hope every MMA member can take a few days off to attend this important AGM in Johor Bahru. It will be held from 29/05/2014 till 31/05/2014. Election for President Elect and Secretary will be held during this AGM.  IT will be the beginning of school holidays and thus make sure you bring along your passport for a visit to Singapore or Batam.

I hope I will see you all  in JB………………………

 

 

A4 FLYERS MMA

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