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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.

 

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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.

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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………………………

 

 

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Over the years, I had many queries about a “generous” medical college up north which has been giving multiple scholarships etc to budding medical students. Many at times, I was very sceptical about this university which has backing of many top political masters. It boast itself as the only university in the world which was offering 5 medical programs, 2 of their own and 3 twinning program. Even in developed countries with 500 years of medical education, no university can run more than 2 medical programs. With the typical Malaysia Boleh attitude, we can do it ! Of course, by becoming the laughing-stock of the world.

When this college announced that it will build its own teaching hospital, not one but 2, I wrote that it is economically not viable. In 2012, I wrote THIS.  From what I gather, Perdana University might abandon their plan to build their own hospital. IMU is planning to build a hospital of their own in Klang (abandon their plan to buy over Pantai Ampang) and Melaka Manipal has bought over a small hospital in Klang. I am not sure what is happening to UCSI which suppose to build a hospital in Port Dickson. Whatever said, my comment on these issues will remain the same as what  I wrote in 2012.

Some interesting development has appeared from this infamous college. Few weeks ago, I heard that 3 of their twinning program has been scrapped and many students were left in the limbo. These twinning program does not appear on their website anymore. Two of the twinning program was with Ireland universities which were withdrawn. Another was from Indonesia. They are officially only running 2 programs now , one of their own and another using UKM degree. Please be informed that both these degrees are yet to be accredited by MMC. Furthermore, please also be informed that the MD(UKM) degree offered by this university is NOT recognised by Singapore.

Today, I saw another interesting development. It was in the Star (see below). In July 2013 this college bought a building in UK to start a “so-called” twinning program with Malaysia!! The unused Middlesex University Trent Park Campus was bought over by this university at an exotic price and was targeted to take its first batch of  300 medical students in October 2013. I am not sure whether it really happened but it says that the students will be on credit transfer ?? Is this where all those students who are supposed to be on their twinning program were dumped? Is this why they are in financial crisis? I can assure you that GMC will never accredit this program if it is going to be a twinning program where the clinical years are going to be done in Malaysia. So, what’s the purpose of this campus? What’s the point of doing pre-clinical years in UK?  There were also reports that this campus in UK will be used for research purpose, making reusable gloves!

UK laws are not like Malaysian Bolehland laws. I have my reservation on this venture and I can foresee that the university will end up with problems. What is reported in The Star is probably the tip of the iceberg. When even both of their local programs have not been accredited by MMC, why venture into overseas campus? I leave it to the readers to ponder upon……………………

 

College staff turn to loan sharks after salaries unpaid for four months

BY RAHMAH GHAZALI

PETALING JAYA: Employees of medical school Allianze University College Medical Sciences (AUCMS) are in dire financial straits as their salaries have allegedly not been paid in four months, with some turning to loan sharks in desperation.

An employee, who spoke on condition of anonymity, told The Star Online that most of the college’s staff, both academic and administrative, had not been paid due to the college’s alleged financial woes.

He claimed that the situation escalated since Tabung Haji withdrew as its strategic partner on July 3, 2012.

“Some were forced to borrow from loan sharks as their applications for personal loans were rejected by the banks because of the employer’s reputation as a bad paymaster.

“Some employees, who are married to each other, have it worst. They cannot depend on each other financially,” he said.

“Some have had to use their savings to survive, with some even selling their belongings,” he added.

He also said the employer had failed to contribute to their Employees Provident Fund (EPF), income tax and Social Security Organisation (Socso) since Nov 2012.

He added reminders to the college administration had been given repeatedly, with “temporary” solutions such as allowances given.

“Many people, including myself, have stopped coming to work because of this. The Education Ministry and Human Resources Ministry should come forward and help us,” he said.

He said the college now is now on the brink of ceasing operations if the lecturers decided to stop teaching altogether.

In an immediate reaction, AUCMS president Datuk Dr Zainuddin Md Wazir told The Star Online said that the situation was under control and the academic programmes are working as usual.

However, he admitted that they were going through some “financial hiccups” and would only reveal the college’s financial situation to the press once outstanding payments are made.

“We have found a solution and would make the payments, together with compensation, as early as next month.

“We truly understand the staff’s anxiety but I can assure you that business is running as usual over here,” he said when contacted.

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.

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For close to 3 weeks, I did not update my blog. I decided to keep silent as a mark of respect to the disappearance of Flight MH370 since 8/03/2014. It will remain as the greatest mystery in aviation for many more months/years to come, looking at the way it is unfolding. During these 3 weeks, the SPM and STPM results were announced. As usual, thousands of students are scoring straight As. Since our national exam results are under Official Secret Act ( the only country in the world probably), the only information we get is from the official announcement to the press. From what I gather from the report HERE, there were close to 14 000 students who scored straight As in all subjects with almost 400 students scoring straight A+. What a remarkable figure! It is either our students are getting  smarter or our exam standards are dropping drastically. According to World Bank Senior economist, the poor quality of our education system is more worrying than the amount of household debt !! I still do not understand why the passing mark of our national exams are considered an official secret! For your info, the passing rate of MRCP exams worldwide since it’s inception has remained about 45-50%! In this Bolehland, everything can be adjusted to give the “feel good” factor! The same goes to our tertiary education. Ask any employer who interview job applicants and see what they say.

Now, with this “top scoring” rate of our students and the MMC’s minimum entry requirement , how many students do you think would be eligible to enter medical school ? We should be filled with doctors, walking on the road. As usual, around this month I will receive numerous emails and phone calls from potential medical students/parents asking what they should do. You will see numerous advertisement in newspapers and ASTRO , promoting medical education in countries like Russia, Indonesia, Egypt etc etc. It is a business out there! A good money making business indeed.

Firstly, as I had mentioned many times before, I do not consider SPM as an entry qualification to do medicine. It should be a standardised established Pre-U course. I will never agree using foundation programs to enter medical school. It is just a marketing tool for the universities to get students. Most of the time the medical seat has already been booked.  Students being students and parents being parents, they will definitely choose the easiest and most guaranteed route.

As I have always said, NEVER do medicine for wrong reasons. I still get a lot of questions about future job prospect in medicine. Much has been written in this blog about the possibilities of oversupply of doctors and jobless scenario. If you have genuine passion and interest in doing medicine (after reading this blog on the reality of medicine), why worry about job prospect ? A person who does law, is he worried about whether he will get a job ? Same goes to the rest who does engineering, pilot, business admin, actuary etc etc. Do what you are interested and after knowing what is the demand of each job. Never jump into anything just because your results entitles you to do so. Many of our students nowadays do not understand the reality of the world out there.

Always remember ” A Grade students work for C grade students ” . That’s the reality. Most millionaire’s (if earning money is your intention) are not professionals. In fact, many of them do not even have a degree. They start to learn how to make money when they were late teenagers and become rich by the time they reach 40 years old. Warren Buffet started making money when he was 12 years old! While they are busy making money by investing in stocks, property etc, you are still slogging in the university! So, do medicine only if you have real passion in serving mankind.

Today, 50 top students were given scholarship to go overseas for their courses. The way it is portrayed in the newspaper sounds like, being trained overseas is superior than local graduates. Than why call yourself as an education hub? Frankly, you should only send students overseas if the course is not available in this country. WE can always sponsor students overseas for post-graduate studies rather than undergraduate.

I came across THIS interesting video about life as a Houseman. I must say, it was well done and does show the reality of a junior doctor. However, the scenario  does not tell the actual hectic life of a doctor in a busy general hospital. It dwells more into the emotional aspect of a young graduate. Most of it has been written in this blog since 2010. For those who are interested in doing medicine, please read all the topics under ” For Future Doctors” page

 

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26th February 2014 was the day I woke everyone up. When I wrote an article with the title A Wake Up call? , I never ever thought that it will go viral in social media and indeed, waking everyone up! I posted the article on 25/02/2014 at around 11.30pm. The next day I had a staggering 51 113 views in a single day, the highest ever recorded, equivalent to what I usually receive in a month! Almost 4000 came from Russia. It received almost 450 comments to date. 7 000 people shared in Facebook and 96 tweets were made. I spent almost the whole day trying to reply to many of the comments that I received,  replying mainly from my iPad and Blackberry Z10 mobile phone.

I had a lot of nasty comments but many of it were from people who did not really understand what I actually wrote. Many were accusing me of degrading Russian graduates etc. This is a problem which I commonly see among many of the younger generations. They pick a single sentence and accuse people of something. I saw many “would be” doctor’s attitude which is rather shocking and just proved some of my comments on quality! When you read an article, the interpretation should be based on the entire article and not a single sentence. The fact remains that there are many unqualified students who are doing medicine overseas, including Russia, Indonesia, China and Middle East. Some of the comments that I received proved that as a fact. This is one of the reason why the quality of products of these universities are poor. No matter what people think, you need certain level of intelligence coupled with true passion and interest to become a good doctor. This is what the entire article is all about. Of course, I did mention that there are good, hardworking graduates from Russia/Indonesia etc but majority of these graduates are those with good entry qualifications who had no choice but to go to these countries due to financial constraints or government sponsorship. This fact was again supported by many of the comments in this blog. Many comments also supported the fact that graduating from these universities are not difficult. Trust me, the same scenario is happening within our own country.Of course there are also students with good results but turn up as a “bad” doctor but the probability of these happening is very much lower than the other. This usually happens as they were not interested in medicine anyway.

Then, there was another issue on using SPM results as an entry qualification. Despite me mentioning very clearly that I would prefer a good established, standardised Pre-U course as an entry requirement into medical course, there were many who accused me otherwise. The SPM minimum requirement is from MMC and not by me! I believe that it was the SPM result that I posted in the article that attracted visitors from all over the world. Many were shocked to see a person with such a result becoming a doctor. You can argue till the cow come home but it is a fact that you need a good entry qualification (established Pre-U course), at least top 10% of the cohort, to enter a medical school in many developed countries. For those who say otherwise, why not you try to do that  in countries like US, UK, Australia/N Zealand and many of the European countries? They will ask you to fly kite! These countries also have a good quality monitoring system in place, after graduating.

It is also a known fact that the quality of doctors are deteriorating. This is due to reasons such as the one mentioned above, mushrooming of medical schools with inadequate academics and inadequate housemanship training (due to oversupply). These poorly trained doctors are then released to the community with a “license to kill”! Frankly, a doctor can kill a patient with a stroke of a pen. Many of these doctors do not even know what they don’t know (lack of insight)! Imagine a patient with Chronic Renal Failure being given high dose NSAIDS leading to a fatal Acute Renal Failure! Yes, it has happened! Imagine a postmenopausal bleed being told to be normal and discharged ! A 74-year-old lady with 1st episode of seizure being discharged after a pint of drip (Na 115)! These are just the tip of the iceberg. I can give you dozens of examples which is happening on a daily basis. These doctors who are completing the housemanship are the ones who are forming the backbone of the entire healthcare system in this country. Klinik Kesihatans, District Hospitals and even in general hospitals, MOs are the most important front liners. The deteriorating quality of doctors will bring down the entire healthcare quality of these country! Numbers does not matter, quality matters! Thus, when I said that many of these poor quality doctors will end up as GPs or chronic MOs, many GPs were unhappy with me. Again, they quoted a single sentence in my comment and said that I am degrading GPs. My sentence was from a series of comments that I was replying. I was saying that, many of these “poor quality and poorly trained” doctors will end up as GPs, and who monitors them? Once they open their clinic, they answer to nobody. Again, don’t misquote me. I know many good doctors who have become GPs. Many of them are my good friends and they know what I am talking about. I am talking about the future. We can’t compare the training that we got from what the current generation of doctors are receiving. Same goes to some of the junior specialist who leave to private sector too early without adequate experience. We need a proper monitoring/upgrading system in place.

2 days after I wrote the infamous article, I had a chance to meet up with the MMA President and Secretary in JB. They came down on 27/02/2014 to discuss our preparation for the upcoming National MMA AGM in May 2014.  Our President just attended a meeting in Putrajaya with MOH officials, WHO representative etc. He revealed a shocking information. According to WHO representative, they had never issued any statement regarding doctor: population ratio of 1: 400 for a developed country ! WTH! All these while, it was these ratio that was quoted by our government in producing more doctors and the mushrooming of medical colleges. The news appeared in the Star on 9/03/2014 (see below). The reason why WHO never made such statement is because they are well aware that quality will be compromised to achieve the ratio. That is exactly what is happening in this Bolehland………………..

AS we mourn the lost of MH370 and being in the spotlight of the world with flying bomohs, I hope we will not see a future where our people go to neighbouring and other countries to seek medical treatment!

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MMA: WHO denies setting doctor to patient ratio

BY NEVILLE SPYKERMAN

PETALING JAYA: Malaysia does not need one doctor to 400 patients to be considered a developed country, said the Malaysian Medical Association (MMA).

MMA president Datuk Dr N.K.S. Tharmaseelan said the World Health Organisation (WHO) had denied setting the ratio which is often used to justify the mushrooming of local medical colleges.

“The purported WHO statistic is often quoted to deny the fact the country had too many doctors, though it is obviously so,” he said.

Dr Tharmaseelan said WHO representative Dr Gulin Gedik, during a meeting at the Ministry of Health on Feb 27, was surprised when the issue was raised by MMA.

He said the ratio had led many countries, including Malaysia, to produce more doctors without having the infrastructure or facilities in place to train them.

“Dr Gulin assured MMA no such figure existed or would be imposed by the WHO, as there were many issues to delivering healthcare,” said Dr Tharmaseelan.

He said Malaysia’s current one doctor to 600 patients ratio should not be used to build more medical colleges as these could affect standards.

“We should instead amalgamate the existing colleges into a sustainable level,” he said.

He said more emphasis should be put on raising the standards and quality of training provided to doctors and allied health professionals rather than aiming at an Utopian goal.

Dr Tharmaseelan also pointed out that the problem plaguing the Malaysian healthcare system was the reluctance of doctors to serve in rural areas including Sabah and Sarawak. He said there were wards in urban government hospitals which had up to 100 doctors when they just needed 20 or 30.

“The authorities should compel new doctors especially those who obtained government scholarships to serve in rural hospitals,” he said.

He also called on the Education Ministry to strictly enforce the five-year moratorium on medical colleges and gradually reduce the number of admissions to medical colleges.

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My last blog entry on 17/02/2014 received the highest number of views in a single day since it started, 4 years ago. It achieved 11 195 views in a single day!! This goes to show that there are many who are worried about the situation. I also received few emails and blog comments from students who are doing medicine elsewhere without the minimum requirement introduced by MMC in 2011. It is very sad that our society is still a very ignorant society. Some of them are not even aware of the guideline! Are we leaving in caves?  With the information technology, there is no excuse! I would blame it on our education system!

When I read some of the comments and emails, I realize that there are many who are doing medicine with pathetic SPM results. Majority do not understand what medicine is all about.  With many dubious and mediocre medical schools out there, getting an MBBS degree is as easy as any other course. What you need is just money!! Money talks! How many students who go to Russia ever failed their 5 years medical course?  We have heard and seen many mediocre students doing medicine in Russia as well as in some other universities in Indonesia, China and Eastern European countries. I know one who got 9Fs in SPM but was doing medicine in Ukraine! Some of the comments that I received in my last blog entry just proved the scenario. The poor entry qualification is one of the main reasons why you see graduates with poor quality from Russian universities ( the talk of the town). On another note, there are good students who go to Russia, as they could not afford any of the local medical colleges. These students generally do much better when they start working. I have heard horror stories of what actually goes on in some of the medical schools!! The fact that they do not even know how to take history and examine the patient, tells you a lot. The very basic reason why you go to a medical school !

Many were tricked by agents who promised guaranteed job, similar to what happened to thousands of nurses. They were told that as long as they have a MMC recognized degree, they would get a job when they return. Well, it is true at the moment but not anymore. With limited number of post within the next 2 years, having a MMC recognized degree does not mean anything. Having a degree, which is registrable by MMC, does not mean you will get a job. It is the same in any other country. In Malaysia, job is given by SPA and Ministry of Health. MMC only provides Temporary MMC registration for you to undergo Housemanship.

With so many dubious Foundation programs organized by many universities as a “short-cut” to attract students into their medical school, MMC had no choice but to introduce the minimum requirement based on SPM results in addition to pre-university results (only A level, STPM and few other courses can supersede)!! We are probably one of the very few countries in the world, which do not use a standardised pre-university qualifications as a sole requirement. I would rather prefer if MMC makes a few well-known Pre-U courses as the minimum requirement, such as STPM, A-Level, IB, Australian Matriculation etc etc. As far as I am concerned, Foundation studies SHOULD NOT be used as an entry qualifications into medical course. Not only it is NOT standardized but prepared and marked by the university itself!! Whatever said, you need certain level of intelligence to do medicine. You may not need to be a A-star student but at least the top 5-10% of the cohort.  Medicine is not for any tom, dick and harry. That having been said, you also need genuine interest and passion to function as a good doctor.

Since the minimum requirement was introduced in 2011, all students accepted into local private medical schools have to submit their results to MMC for verification. The universities will do this. However, despite this I have heard and seen many students being accepted into medical schools locally without the minimum requirement.  The students are accepted and subsequently asked to appeal to MMC. When Crimea Medical University was derecognized in 2005, the NOC was introduced. The government noticed that there are students who have very poor SPM/STPMresults, from Arts stream and even those who fail SPM, were doing medicine in Crimea.  Unfortunately, there are still many students out there who are doing medicine WITHOUT NOC. This is simply because, they were told that as long as they have a recognized degree, it is not a problem.

Sad to say, the situation will change soon. Last year’s MMC’s guideline clearly says that those who do medicine in an unrecognized university without minimum requirement, will NOT be permitted to sit for the MQE exams. This basically means that you can forget about practicing medicine all together in this country. You can try to get a job in another country where your degree might be recognized.

When the job market gets saturated, the government will become choosy as any other profession in civil service. Preference will be given to government-sponsored students and local public university graduates. This will be followed, by the rest. With limited number of post available, what criteria will SPA use to offer employment? This is where your NOC will come into force. Very likely that those who do not have NOC or the Minimum entry criteria will be the last choice to be offered a job. You may end up jobless as there will be almost 6-7,000 graduates/per-year by 2017.

Obviously, there is no law to do this but getting a post in civil service is a privilege and not a must. The only problem in medicine is the fact that if you do not do housemanship, you will not be able to practise as a doctor in this country. Thus, MOH is working on a few formulas to decide on who will get a job in MOH in the future. With the civil service being controlled by almost 90% from a single race, the people as well as the politicians will make transparency and biasness as an issue. So, we need to come up with fair and transparent criteria.

Over the last few months, many suggestions are being discussed at MOH level. The first suggestion is to give housemanship post on contract basis, after which you need to sit for an exit exam. The exit exam as well as your superior’s assessment will be used to decide who will get a MO post. Basically, you need to reapply into government service after Housemanship. What happens to those who fail? Obviously, you may not be able to work as a doctor or may need to redo housemanship.

The latest suggestion, which is seriously being considered, is the common entry/licensing exam or MMLE. Many countries as well as many other professions do this. Even our nursing board has exams similar to this.  The lawyers have CLP but they can still work as legal adviser without CLP. For me, this will be the best option. MMLE should include all graduates including the local public and private universities. It should be standardized and centralized by MMC unlike the current MQE exams. Only those who pass will be able to get a job. This will definitely remove the mediocre ones as long as it is fair and transparent.  Unfortunately, this was suggested by our ex ex DG (Tan Sri Dato Dr Ismail Merican) but was shot down by cabinet due to political reasons!! In Malaysia, education is always politicized!

So, for those students who do not have the minimum criteria, please do some other course. This is my advise to you. Firstly, unless you do well in a well established, standardized Pre-U course, you do not qualify to do medicine. Secondly, with the soon to be surplus of doctors, your chances to get a job in Malaysia will be slim. Finally, do not waste your parent’s money. Put that money to good use. I would also like to advise parents that they should not force their child to do medicine and please do not ask your child with mediocre results to do medicine. You are committing  a crime to the society. I have seen enough mistakes being done by the current generation of doctors, life threatening mistakes that I have hardly seen before. It clearly shows the deteriorating quality of doctors in our community. We do not want to see students with SPM results like below to do medicine. In “real and genuine” medical schools, they will not even survive the first year. I am not saying that all good grade students will become good doctors but you need certain level of intelligence to do medicine coupled with passion and genuine interest.

FYI, the SPM result below is a Russian graduate who applied for Master’s program. A friend of mine who were interviewing them sent it to me!! She got a shock of her life when she saw the result!! Obviously, this student would not have got a NOC based on the current criteria. Obviously, she may not get a Master’s seat, as the competition is getting tougher.

Our ignorant society needs a wake up call……………………

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