As I have said before, soon the government will introduce a common exam for all medical graduates from overseas. The news in Star today by our Director General of Health is the clearest indications of that. However, we need to wait till the Medical Act is amended, which will likely take place this year or after the general election.
BUT I do not agree that this will only apply for the foreign medical schools. No doubt that it is difficult to monitor the quality of foreign medical schools by the Malaysian Medical Council. As such, like most other countries, the best way will be to ask everyone who graduate from overseas to sit for a common exam to be able to get a job in Malaysia. I wonder whether it will apply for JPA and MARA scholars as well but usually JPA students should not have any problems as they are the top students in the country. Can’t say the same for MARA students as the drop out rate for MARA medical students internationally is almost 30% (this info is from MARA itself).
I feel the MMC should come up with a structured exam for the local private and public universities as well,or at least have periodic inspection to monitor their lecturer ratio, teaching quality and entry qualifications. The quality of their graduates should also be monitored. With unemployed doctors being a distant reality, I just hope parents will stop thinking that medicine will give their child a luxury life!
Exam for docs won’t cause brain drain
By LOH FOON FONG
newsdesk@thestar.com.my
PETALING JAYA: A proposed amendment to the Medical Act to compel all overseas medical graduates to sit for a common licensing examination will not worsen the brain drain situation, Health Ministry director-general Tan Sri Dr Ismail Merican said.
“The Malaysian Medical Council examinations are not meant to make things difficult for them but to assess their core knowledge. They should not worry if they have passed their university examinations,” he said.
Dr Ismail, who is also Malaysian Medical Council president, said in view of the weakness in monitoring foreign institutions, the council had proposed to do away with the Second Schedule of the Medical Act, containing the list of recognised foreign medical schools.
“Students can choose any university they wish to attend abroad but they have to sit for and pass a common licensing examination before being accepted for registration,” he said, adding that this was practised in many developed countries.
The proposed examination, which would be different from the current Medical Qualifying Examination for students from unrecognised universities abroad, would ensure that doctors were “fit to practise” as safe and competent doctors, he said.
Recently, Health Minister Datuk Seri Liow Tiong Lai said the examination was one of the proposals it was looking into when amending the Act.
Although the Malaysian Medical Association and senior doctors had suggested that all medical graduates be made to sit for a common examination, Liow said it would only apply to overseas graduates.
It was not necessary for local graduates to sit for the examination as local institutions were easier to monitor, officials said.
However, senior doctors advocated otherwise, claiming that local schools could lower passing grades to make their universities look good.
Recently, The Star reported on the lack of training hospitals to meet the influx of housemen and a doctor had expressed concerns that some graduates lacked core knowledge and could jeopardise patient safety.
Asked where people could get advice on medical schools that met the country’s requirements if the Second Schedule was removed, Dr Ismail said they could get this from colleges and the council.
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It was not necessary for local graduates to sit for the examination as local institutions were easier to monitor, officials said.- End of quote
ALL medical grads MUST ALSO SIT FOR THE EXAM!!
No exception must be given.
As for the monitoring of local institutions, we all know that any kind of monitoring whether for doctors or other professions is a JOKE! In Bolehland! In fact, it’s not called Bolehland for nothing!!
However, in the case of doctors, they have the lives of their patients in their hands!!
And their abilities must be beyond a shadow of doubt!!
Dear Dr Pagalavan,
Would like to thank you for all your interesting and enlightening posts on the medical field and especially medical education in Malaysia, they have been a good source of information for me.
1 quick question:
I’m currently a final year medical undergraduate who will graduate in a few months time. Would you mind listing the hospitals, which in your knowledge and experience, would be the best to undergo housemenship? (in terms of training, leaning experience, and clinical exposure).
*I’m from peninsula and would not mind going to rural areas or East M’sia for housemenship.
Thank you
With the current situation of too many housemen, it is very difficult to say where you’re gonna get good training. Penang GH, Ipoh GH, Kuching GH, HKL and JB Hospital use to be the good ones where you can get a lot of experience. Pls do not go to Selayang, Ampang, Sg Buloh, Sultan Ismail Hospital, they are very subspecialise hospital which is not good for housemen training.
BTW, I don’t think you can choose your hospital anymore. The MOH will decide for you since the post will be very much limited!
Dear Dr Pagalavan,
Hello sir my name is Harjeet and im currently a final year medical student and will be graduating in june.Do u think that the licensing exam would affect the current student graduating in year 2011 or will it be for students who are gonna start med school?thank u
No, I don’t think so. If they amend the medical act this year, it will come into effect earliest by next year.
Thanks for your reply.
Is there currently a new application process?
From what i know, the application form has 3 choices for each applicant to fill- the 1st, 2nd and 3rd hospital of choice of the applicant.
MOH would then allocate them by considering the available spots at each hospital and tailor them according to their choices and also the needs of each hospital. (Of course if all 3 choices are popular hospitals at big towns, it is unlikely for the applicant to get their preferred choice as there is too much demand)
The 3 choices are still there but the chances of getting it will be low especially for the popular ones.
dr pag…
im a medical student who will be finishing this november 2011 and my graduation will be in january 2012….so will this exam apply to us ?? how will the exam be held??
The details are not available yet. Likely a theory and clinical exam, similar to what they do for unrecognize universities before. You have to keep your fingers crossed and hope it is implemented by then!
Sorry, NOT implemented by then
dr pag does it also apply to twinning universities ???
Depending on where you are going to graduate from! Locally or from overseas!
“the council had proposed to do away with the Second Schedule of the Medical Act, containing the list of recognised foreign medical schools”
“Students can choose any university they wish to attend abroad but they have to sit for and pass a common licensing examination before being accepted for registration”
Thank you Health Ministry director-general Tan Sri Dr Ismail Merican.. you are my saviour..
many universities in the Second Schedule of the Medical Act rejected me when i applied to study medicine..they say my results not good enough.!
Soon I can study to any university abroad..hope to pass the test after i graduate
friends tell me it is cheaper to study medicine at far places like Botswana, Adis-ababa and south Yemen. Also i found got online medical course with coursework..only 3 years and very cheap..they say students can choose any university abroad.. that means online university also can is it?
Good doctor
The MMC entry exams are not going to be that easy either. Yes, you can go and do medicine in whatever university you want but as long as you pass the MMC exam, you should be able to work in Malaysia, that if there are still vacancy for doctors in Malaysia by then
This is interesting. The way I see it there will be more JPA scholars in the UK/IRE/OZ/NZ who will not return to serve their bond with the introduction of this qualifying exam. Why bother wasting time for another exam just to get a substandard intern position with low pay and poor supervision. I find it ridiculous that JPA spends almost a million to train a medical graduate in Western countries only to be placed in a system where training is poor with almost no postgraduate opportunities.
Why the double standard? MQE should be for all like USMLE in America, why should local universities be exempted?
JPA is very strict now about making students return home. They instruct the immigration departments of those countries not to give work permits for newly qualified sponsored students. MARA are quite slack on the other hand.
My personal view is that sponsored students overseas should be allowed to stay until they finish postgrad education. It’s not like Malaysia needs HOs … they need specialists and we can’t train enough so these sponsored students should come home and serve the govt once they’ve received their postgrad qualifications.
Nav,
Finishing post-grad qualification before coming back home would be at least age 30, which means most likely they’re married with kids.
An uprooting process including spouse and kids at age 30+ would be disastrous, and also they could have paid back the scholarship in that 8-10 years.
Hi Queen,
While I absolutely agree that uprooting the family is no easy task, it’s different when you know that’s what you have to do. People move overseas all the time to study for PhDs, medical postgrad, etc.
The amount that the scholars have to pay back is usually more than the actual amount – don’t ask me why. It is actually very difficult to pay it back in 8-10 years because of the high amounts involved (in Western countries anyway), though not impossible. JPA/MARA could set a time limit. If you show proof you’re in a postgrad programme, you have to come home 5-6 years after you started your postgrad. If you don’t get into a postgrad programme within 4 years after uni, then you have to come home. Consequences are: go after your guarantors and bar any siblings from accessing govt subsidies.
I still maintain that it’s a better alternative then sending these guys home straight after uni. Better to let them get quality postgrad training and (hopefully) then come home rather than compete with the thousands of others in Malaysia for very limited postgrad training spots.
I am skeptical about common licensing examinations for overseas trained graduates only. In a country such as ours, should one group predominantly fail the exam, everyone would cry racism and corruption(eg the CLP exams for law grads) etc, whether its actually true or not. That being said, it isnt entirely impossible for result tampering to take place anyway.
Solution? Common licensing examination, for EVERYONE. Want an exam thats already developed and had a lot of thought put into? USMLE!
You take it anywhere and everywhere, the syllabus are set, the questions are updated frequently to reflect current practice, and experimental questions are tried and tested in real exams to ensure they are valid, clear and fair.
We can use it as it is, as New Zealand has (last time I checked was a few years ago)
Dhssraj Singh
In Malaysia anythig is possible and I do agree that the exam should be imposed on all graduates, locally and overseas
I also think that any qualifying exam should be implemented for all graduates, from local and overseas unis but …. the candidates have to have guarantees that they will not be discriminated against their race or medical degree. Somehow I don’t see that happening just yet.
Hello doctor!
First of all I’m happy that I came across your blog doctor.
In my point of view, all medical graduate should sit for the qualifying exam if its made compulsory by the government not only for foreign graduate.
As I’m from foreign university, there will be pro and con when compared to both local and foreign medical school, but through this system we might have a better clearer view of all medical students rather then segregating based on where one is from.
As you’ve said doctor, passion for what we do which counts.
Not being grouped as JPA / MARA / Local / Foreign.
thank you.
Hello doctor,
A common licensing exam for both local and overseas graduates will be a very good solution as the current list of 330 medical universities is very shabby and questionable.
However, can we TRUST MMC, MOH and other authorities involved to give us a fair marking?
Recently, I sat for the MQE in October 2010 at University Malaya (UM) with 37 other medical graduates from China, Romania, Russia, Ukraine and Dubai. Although there were some smart students in our group (including some students who had already passed their licensing exams in other countries), University Malaya “FAILED” every one of us!!! Not even one student passed and they took 2 months to tell us that!!!
Isn’t that highly suspicious??? I’m not saying that all students can pass at the first round, but if not even one student can pass the MQE, it can only mean 2 things :
1) Either UM’s standard is sky high that it is impossible for us normal medical graduates to pass
2) Or are ALL unrecognised students so stupid?
(Which I don’t think so)
Surprisingly, 15 students passed in USM (as usual USM scores are better…I don’t have to say why coz I’m sure you all can figure it out).
Another 4 students passed in UKM.
So where is there hope for us medical graduates who already got stuck due to certain circumstances in unrecognised universities, and when we come back and study hard to pass this MQE, we’re deliberately failed miserably…..
How can we trust them to do a fair and justified marking system for the licensing exams? As it is, there’s no standard format, pass year questions or training for MQE, I wonder what other havoc they’ll create with this new Licensing Exam. I have no hope at all…I just can’t trust them anymore. Even now, I have no hope to resit the next MQE in October, coz I know the situation will be the same….hopeless case.
Therefore, unless the new licensing exam is conducted by an international body, the results will be pretty much the same….ethnic based instead of merit based.
This issue has been going on for many years. First of all, the fault lies on the agents and parents who were not aware of these recognition issues. As I have said in my blog postings, medicine is a perculiar field. MMA has brought up this issue many times with the MOH and few years ago, MOH sent all these students to MOH hospitals for training of 6 months before sitting for the MQE exams, if I am not mistaken about 6 years ago. Even then, not many of these students passed the exams.
I do agree that there are double standards when it comes to the local universitiy exams. At the moment, there are no standardised exam for graduates from unrecognised universities. You are basically asked to sit for the same exams as the final year students of the local university. So, biasness is always there.
That’s the reason the MMC is looking at a standardised MQE for all overseas graduates. Hopefully this will be a better form of assessment in the future. Almost all other countries have similar exams for overseas trained doctors, some even apply it for all local and international graduates!
Unfortunately, it is the law under the Medical Act 1971 and there is no way you can change it. You just have to keep trying till you pass the MQE exams. Otherwise, please see where else your degree is recognised and apply for a job in that particular country. You can try sitting for USMLE or AMC exams but this will cost money as well.
It is sad to see this kind of situation and that’s the reason I started writing about this issues in my blog. In another 5 years, there will be oversupply of doctors in malaysia. The situation will only get worst. By then , whether you are recognised or not, you may still not get a job !
Some people still do not want to accept the reality about future prospects of doctors in this country. Some think that I am destroying their dreams etc etc but the reality is very depressing indead. Just look at recent Star and you will see that we are having too many pilots being produced and they got no job either! Almost 500 pilots are being produced annually and the job market is only for 100 pilots /year. Our government is not bothered about all this human resource planning. It’s all about politics. Make the kampung fellows happy with their children graduating and get their votes.
I am a new houseman who is an ex-scholar who graduated from the UK. I think a common licensing exam is a good idea although I also think that many of my JPA sponsored friends would see it a great opportunity to evade the bond to return home to work by failing the paper.
I do get upset when I come across news re: housemanship glut and related comments on how easy our lives are currently compared to before. For some reason, it doesn’t apply to the hospital I currently work in. On my first week as a doctor, I was the only houseman looking after all the entire ward, and when oncall one HO covers 6 general wards and 4 special units (CCU etc). The shortage of HOs improved after my third week. Yet still there are only two HOs for each ward. It is BUSY and that’s not an exaggeration at all. I’m usually at work from 6:30am until 8pm, occasionally going home past 9pm, still with some jobs unfinished. Maybe it’s me being inefficient, maybe it’s my perfectionism, maybe it’s general medicine. But the house officers in my hospital work HARD and we do not have time to eat or even pee, let alone to watch DVD and those nonsense they wrote in The Star a while back. However we do get good training and I am much more confident now in managing medical conditions.
I am not sure how many hospitals in Malaysia which still runs housemanship training like this though.
It depends on which hospital you are in and the timing of your housemanship. Most local universities graduate around April to August each year. So if you report to duty around Dec-Feb , the number of housemen is usually small and it will gradually pick up towards the mid of the year. You will see the actual number during this time. Furthermore, it also depends on how the hospital post each houseman. Sometimes, the clerk who does the rotation of housemanship do not do a good job and thus you will see the number of housemen in each department is not equally balanced.
The issue is maldistribution at 2 levels:
Firstly, half the new doctors use cables to go to their preferred hospitals, so you end up with lots of docs in certain hospitals and fewer in others (relative to their needs).
Secondly, once you report to that hospital, the person that sends you to your department has no clue what they’re really doing half the time. So some departments end up with more than others and this perpetuates itself as people rotate through the departments. Cable pulling also happens at this level, I’ve been told.
The way to overcome this problem I think (and I’ve suggested it before in an article I wrote for the Berita MMA) is to have a transparent computer matching system with set intakes 3 times per year. For example, set starting dates for the 2nd Monday of Jan, April, Aug (these will also be the dates when all the HOs switch rotations within their hospitals). Computer matching will be done beforehand, based on available spaces in each hospital (which should also be made available to those undergoing matching). The prospective doctors rank the hospitals and the computer allocates them based on those preferences. Of course, this would all be too hard for the beaurocrats at MOH to handle, although I hope to be one day proven wrong. A non-computerised system is too much for humans to handle when 6-8000 people are applying yearly – mistakes are bound to happen (and happens frequently according to stories I’ve been told)
New houseman, may I know which hospital u r working in?
Dear Dr Pagalavan,i m a medical student studying in China and I have so many question to ask you,i hope Dr Pagalavan can give me your email address,so that i can send you email.Thank you!
pagal72@gmail.com
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