This is an article that was published today in The Star (08/02/2011). It included my comment about the entry qualification to medical schools which is a growing concern for many people. It is becoming increasing common for medical schools nowadays to guarantee a seat for any SPM leaving students by doing their foundation studies. This foundation studies has no standardization and it is conducted and marked by their own college lecturers!! It is all about money as I will say again and again! Most students will obviously choose the easiest part to do medicine and thus the mushrooming of the so-called ” Foundation studies”. I still feel that only STPM, A Levels and certain other internationally recognised Pre-U courses should be recognised for medical school entry. The rest should be abolished. Then, we can see the actual number of students who really qualify to do medicine. The NOC(no objection certificate) is a total crap.
MMA: Raise the bar for future doctors
By JOSHUA FOONG
joshuafoong@thestar.com.my
//
This is due to the low prerequisites allowed for preparatory medical colleges, known to accept SPM-level students with the minimum requirement of Bs in sciences.
From there, the students have a high chance of getting into universities in countries like Russia and Indonesia.
“There must be some quality or level of excellence before one can realistically aspire to be a doctor,” Malaysian Medical Association (MMA) president Dr David Quek told The Star.
“If one is not good enough there will be problems of quality later on when he or she becomes a doctor.
“It is not simply about getting a degree or a name. It has bearings on human life and patient safety,” he added.
“The association is unhappy that we are having so many routes to medical schools.
“We are creating an unrealistic atmosphere of easy entry for anyone who can afford to pay but whose scholastic ability may be way off the mark,” added Dr Quek.
Readers of The Star have also written in to express their concern on the many “shoplot medical schools.”
While medical universities require recognition by the Malaysian Medical Council (MMC) before their graduates can practise medicine, the council does not have the authority to regulate pre-university courses tied with medical degree programmes.
“We are now looking into the entry criteria for medical students, and if these are too low, then we have recommended remedial measures to limit these medical colleges from being recognised as acceptable standards,” said Dr Quek, who is a council member.
“We are also working with the Higher Education Ministry and its agencies to ensure that foundation courses be of acceptable standards and duration, and that only sufficiently qualified students are accepted,” he added.
Universiti Malaya physiology professor Dr Cheng Hwee Ming said a student also had to master the art of decision making besides having clinical skills.
Rheumatologist Dr Pagalavan Letchumanan, who has trained housemen and lectured for 13 years, said the key point should be clear standardisation for entrance requirements.
“If we regulate the intake of medical students, say through MMC-certified prerequisites, just like our medical degrees, we can be more assured of the quality of our future graduates,” he added.
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Ya totally agree with Dr Paga. All this foundation programme should be abolished because it is totally crap and some courses are only 3-6 mo. It was so depressing when I started working by age 25, I have colleagues who are 23 years old who worked side by side with you.
I think the MMA should set a minimum age for doctors to start working, for eg. 25 years. Is that possible Dr?
I think your being naive by using AGE as a measure of quality. There’re many cases where people graduate at age 22, especially the products from IMU-PMS, and they are good.
I have never underestimated the capability of any doctors according to their age. No doubt they are many geniuses or smart people out there.
What I meant is there must be a rule or guideline to enter medic school. Take for examples, countries like USA, Aus, NZ, once has to do 2-3 years of biologial related course and pass with good results before enters medic school. The same happens in UK where one has to have satisfactory A-level or IB results to gain entrance to their medic school. What M’sia is doing is totally reverse. Anyone can enter medic school (private or foreign) anytime they want after Form 5 and whenever they want regardless of their pre-med results provided they have money. I believe if there is a proper guideline and screening of intake of medic student in M’sia, there wont be any issues regarding our health system in the news so often.
Again, you cant just diagnose RA patients straight if they dont follow the diagnostic criteria given. All in all, we have to follow the guidelines or rules.
Aus/NZ are still have undergraduate entry med school, though Aus is moving towards graduate entry med school ie queensland, melb, and the coming WA.
Believe me, many people graduate from NZ med school when they are 22 years old. They are freaking young – and mostly had primary school else where and this explains the young age for medschool admission.
Ya I believed you but they have shorter period of primary and secondary school years compare to M’sia and that explains why their junior doctors are young.
The truth is they follow the rules whereas M’sia bends the rules making what seems to be impossible possible. In order words those countries have a proper way of taking students for medic course.
Dear Dr.Pagavalan,
It is always interesting to read your blogs as your post very interesting articles. I’ve also got a couple of things to say…I’d really like to hear your feedback if possible.
1) Well I agree that MMA/MMC should regulate the quality of medical schools and maybe all these local colleges/uni’s should not be allowed to do their own pre-u/foundation studies as lot of hanky pankies can arise, resulting in non-competent students getting a medical seat. But as they regulate this, maybe somebody needs to regulate all the so-called Mara/ Yayasan Selangor pre-u programmes as well, coz the gov is sending thousands of their students via this programme to study medicine, and half of them don’t qualify if compared against the A-Levels/ STPM method! Once again, it’s one rule for some people and another rule for the rest of us 😦
2) These past few days, I’ve also been reading the newspaper with deep disappointment and heaviness as I see thousands of Malaysians who have been conveniently sent to Egypt to study medicine (and 90% of them don’t have the NOC letter!!!) Before this, MMC used to argue that Ukraine/Russia were taking in thousands of students, thus the quality of the medical graduates could be jeopardised. Now can somebody please tell me how can there be 5000 Malays studying medicine in Egypt? Are those universities so big and advanced to accomodate 5000 MALAYSIAN medical students???? So what’s the difference now between Egypt and Russia/Ukraine??? Or is it because a particular kind of people only study in Egypt, so it’s perfectly normal for 5000 of them to study there and get adequate knowledge? Forgive me for saying this, but I’m forced to think out of the box regarding this logic! Where is the fairness??? Why doesn’t MMC/MMA/MOH check on this?
3) Every year without fail MMC says that the local universities are all full and so busy, so they can’t have the MQE for us unscheduled medical graduates. Now how is it possible that overnight all the local universities have no problems to hold examinations for all the Malaysians who studied in Egypt? After me and my friends were blatantly and deliberately failed in the MQE last October, MMC told us that UM, UKM and USM has no place or facilities or people to conduct the MQE this coming March, so we have to waste another year and wait till October this year, that also if MMC decides to conduct the examination again for us. And now somebody please tell me how can they accomodate 5000 students to do their exams locally overnight? If they can’t accomodate 200+ medical graduates, something is wrong in the maths if they can suddenly accomodate 5000students!!!
4) MMC wants to go all the way out to help these 5000 students so that their knowledge is not wasted and that they won’t forget medicine. How about us who have also graduated and are slowly forgetting our medical knowledge while wasting our time waiting for MMC to give us a chance to do our internship in Malaysia. And with their so called ‘standard-fair’ marking system for us unscheduled graduates, it seems that we will never see daylight at all! Here we are as beggars trying to get a chance to observe and also assist in some clinical procedures in private clinics so that we don’t forget what we’ve learned, and MMC has the gall to come out in aid of this 5000students while they continue to keep us out in the lurch.
My heart is so pained to see all this utter unfairness….why can’t someone do something. Dr. Quek, you and other MMA authorities speak out so strongly against quality graduates and all that, why can’t MMA do something about this…after all you all are the big guys out there, please try to do something for us! We really want our arguments and voices to be heard, coz we’re really being abused in this system of unfairness. Could MMA please hold a meeting for us and find out exactly what is happening? Coz Malaysians should be aware of the exact picture of what is happening to medical graduates from unscheduled universities. Just because we studied in unrecognised uni’s due to unfortunate circumstances, it doesn’t mean that we’re stupid.
If I were to delve into the issue of recognised/unrecognised universities, it will take forever, but the bottomline is that universities are recognised not based on meritocracy, but more on the monetary gains they can generate for some top authorities. Honestly, there’s no difference if you come from a so called recognised/non recognised uni in Russia/Ukraine because they all adopt the same method of teaching, thus any Russian/Ukrainian medical graduate would have been exposed to the same teaching and all would have had to pass their Licensing exams before being able to graduate, so why is it that some people are allowed to do their internship whilst the rest of us are not allowed to even step into a hospital although we’ve been taught the same and also come from National status universities in Russia/Ukraine. (You can easily verify my information with the respective embassy officials, Russia & Ukraine’s Higher Education Ministry and also the Ambassador of Malaysia to Ukraine and to Russia).
So many of us have the passion, fire and desire to practise medicine. We left everything to pursue our ambition, and we returned back to Malaysia to serve this country, only to realise that we’re not needed and we can literally get lost and nobody will care? If the gov can go all the way out to help these 5000medical students, can’t they just divert their attention to the few hundred of us and also let us contribute to Malaysia’s healthcare system?
First of all you must undertsand and accept that you are in a country where there is NO equality!! Just find your own way. And to answer some of your questions:
1) That’s exactly what I have been saying that there should be only few Pre-U courses that should be recognised!! Most MARA students who go overseas do IB, which is recognised internationally.
2) Yes, MARA especially and JPA started to send students to Egypt over the last few years to cut cost. As reported we have 5000 medical students in Egypt, which is 1000/year. Quality who cares? That’s the reason I support a common licensing exam for all graduates.
3) If you read carefully, only the written exams will be conducted in Malaysia by the Egypt universities, that if the university allows. So it is not an exam that is conducted and organised by our local universities. There is no way our local universities can organise and conduct exams for 5000 studnets who have undergone different curicullum and training.
4) MMC has not said anything about these Egypt university students, it was the PM and Minister of Higher Education who is talking about this and there is no final confirmation whether the Egypt universities will conduct the written exams over here.
Please gather all your friends and make an appt to see Dr David Quek. We did something like this few years ago and the MMC developed a special programme for the students.
I know that lately you’ve been telling people to forget about working as a doctor in Malaysia, due to the unusually high number of medical graduates. But so many of us went 6-7 years ago, when this issue wasn’t even thought of.
Malaysia says they’re full of doctors and houseman, in fact the ratio of HO’s is more compared to patients at times. Well, it could be true, and it could be not. During my summer vacations, I always do a short internship in some of the local hospitals in Malaysia. One example will be Klang hospital. I see patients everywhere, sometimes right up to the doorstep of the ward. That’s when I get opportunities to draw blood and assist doctors/HO’s in other procedures (which makes me really excited). Doctors are so busy scurrying around the ward, patient load increases, and being overworked, they start getting annoyed and scold patients (doctors are also humans..i understand). My logic is this, Klang hospital caters to people from Klang, Shah Alam, Meru, Banting, Kapar, Kuala Selangor and some other smaller places. If more hospitals were built, patient load could be distributed more evenly, thus more doctors could be employed, resulting in a more effective working system with a happy doctor and a happy patient.
Take for example the Shah Alam hospital that was supposed to be ready by now (but as usual the tender was given to some unscrupulous cronies who never completed the project, and now the hospital is growing algae and fungi!) If this hospital was built and ready, it could easily serve the Shah Alam residents and maybe Subang/PJ residents as well. And all the so called surplus of medical graduates could nicely be employed. So many other hospitals can be built in so many other places, especially rural areas in sabah/sarawak and this can drastically reduce the waiting time of patients. Instead of that, MMC keeps on saying that there’s surplus of med graduates and not enough specialist to guide them. But all this while patient’s waiting time keeps on increasing and doctors are overworked. MO’s and specialist should be enough, but most run away to the private sector where they’re treated more humanly and given due promotion based on their merits and not ethnicity. Can we blame them?
So again, there’s lots of root issues to be sorted out, and instead of blaming the surplus of medical graduates, Malaysia should be so grateful and happily employ us all!
What I’m saying may sound absurd to you, but we as medical graduates in the lurch strongly feel that our talents can be utilised for the benefit of the Malaysian healthcare system.
I think you don;t understand the actual situation. Klang Hospital is not a good hospital to use as an example. It is an hospital which has been overloaded since the 1990s. The issue is the training capacities in Malaysian Hospitals. Of course you can build as many hospitals as you want, but there is just not enough consultants to train the junior doctors. Furthermore, employment of doctors depends on the availability of post in civil service. Civil service posts depends on financial status of the country. You must understand that our healthcare system is fully funded by the government and the government’s financial status do play an important role in creating the number of post. As you can see, from this year onwards the number of new doctors will increase from 6000+ to about 8 000+/year by 2015 and the number of post in government service will be filled up by 2016. After that, if the government cannot create 7-8000 post annually, doctors can be jobless. It is more complex than what you think. Remember, even the Ministry has said that we will achieve a doctor: population ratio of 1: 600 by 2016 and 1: 400 by 2020. What does that mean? That we have enough /surplass of doctors by then?
dont waste your time pouring your feelings here..already this person dont like unrecognised university grads you think he will care about your plea..
1st of all you all know you cannot work in malaysia if you study in unrecognised uni then why you took risk n went?
I think ‘grad’ and ‘government’s’ comments are both irresponsible
Grad: You have not seen the damage a poorly trained doctor can do. I’m not discriminating. In fact, I have seen good doctors from untrained unis, and bad doctors from Ireland. No one ‘likes’ or ‘doesnt like’ anybody here, it’s just the reality of the situation.
Government: Again, your comment doesnt make sense either. The risk was well understood, the passion was above it. You cant reverse an old decision, we need active solutions for the future. Be practical.
Sad Medical Doctor has a point, but i do not completely agree with him.
on the positive side, I do agree that ppl are almost ‘deliberately’ failed in certain exams. Why is this so? Because of the tutup-mata attitude to a certain group of students from other unis. So relatively, you would feel that you are deliberately failed. In other words, if the local unis implement the MQE to its absolute quality control, the passing rate would be quite low. Having said that, I wonder how many malaysian houseman’s can pass the true MQE test.
Sad Medical Doctor is also right in that we must find a way to absorb all our human capital productively. This is 2010, we need our ppl to contribute to the country.
sorry chillax already 2011..
btw chillax who you are supporting..have your own stand..
Dr.Pagavalan : Thanks for your reply. All the unscheduled medical graduates and their parents are so frightful of making a public appearance for fear of being blacklisted by MMC etc etc…it’s really hard to do anything together.
Anyways, I’ll give it one more try to get together some students and make an appointment with Dr.David Quek as per your suggestion. I really hope justice prevails at the end of this coz what they’re doing to us is rubbish and utter unfairness.
Actually, after much discussion with affected students, parents and some experienced doctors, we’d really like to ask MMC/MOH/MMA to consider one of these 3 options if possible (We must be dreaming to think that they will even consider, nevertheless we’ll just give it a try) :
1) Absorb us but prolong our internship (instead of the present 2 years to 3 years) and send us to rural areas. We are ever willing. Then the gov can stop complaining of lack of doctors in rural ares.
2) Absorb us into the military service as military doctors.
3) Come up with some better alternative for us.
(but definitely not to do their 18months programme or resit their unfair MQE. Considering their suggestion regarding the Licensing Exam for all overseas medical graduates, I’m afraid once again we will be unable to trust them as what is the guarantee that they won’t continue their present hanky-pankie and fail us med graduates. As it is, there’s no transparency or standardization in their examination methods, do you think the LE will be any better. Unless WHO or some international body is part of the panel of examiners, we will remain sceptical. “Once bitten, twice shy”!
government : As much as I am to be blamed for entering a non-recognised university, I believe you should also understand the circumstances surrounding my predicament as well as other students who got into the same situation as me. It’s really a long story twisted with factors of insufficient money, wrong information from agents, MOH/MMC representatives who recognise universities based on monetary returns and not really based on meritocracy. Chillax has said it well, that is “The risk was well understood, but the passion was above it”. Driven with passion and ambition, we studied doubly hard, thinking that we could get through the MQE, little realising that you could be the top scorer or the gold medalist of your university, still you would never make it according to MQE’s IMPOSSIBLE DOUBLY-BIASED standards!!! So you don’t expect us to sit quietly and not fight for our rights!
Chillax : I’m happy that you agree with me on a few matters and it’s really heartwarming to know that there are some souls out there who understand our dilemma. Thanks!
why don’t you open your medical books and get ready for the assessment, rather than talking about unfairness. Somehow, I’ve this feeling that you are not up to the mark… Hope I’m wrong.
Doc : It’s easy for you to comment, but you’re entitled to your own thoughts as I am to mine. Ok maybe I’m not up to the mark although I scored well in my uni, but don’t tell me ALL the other medical graduates from China, Romania, Ukraine & Russia inlcuding some students in our batch who got 1st class degrees and gold medals from their respective universities are so stupid to be failed? Something is really amiss! Anyways, enough said and done. I’ve already opened up my medical books again lest I forget everything that I’ve learnt!
Sad medical graduate : why not do your USMLE part 1 2 3 rather than studying for that funny biased exam =D
hey sad med doc which uni r u from? bangla?
hi everyone, nice days…
1. what is MMC doing?: Attending dinner… unrecognized grad (unregcognized lah, sit exam, pass jadi dr lah; fail jadi sampah)
2. government: i like ur phrase: “1st of all you all know you cannot work in malaysia if you study in unrecognised uni then why you took risk n went?” thumb up. But… “i want to become dr… local uni hard to enter, private expensive… ” how…? but is because of the passion. still we cant blame them, is their own choice, they chose that road.
3. sad med grad: i see the fire in u. hope u will become a true dr soon. but what am i going to say, grad from unrecognized uni MAINLY lack of competence… as malaysia health care system is different from the western.
Met one HO from ukraine. during ward round, a dr asked her how would u treat AGE. HO just mention “is a normal aging process, why should we treat.” …
a patient who had poorly uncontrolled DM, he (HO from russia) was ask to to fundoscopy. ans:”i’m not sure how to do.”
insert branula: “@#$%^, medical student cucuk 1 atau 2 kali dah dapat, u nak bunuh saya ke apa ni, dah lah tenat…”
ABG: insert needle into the arterial and syringe out air?!?!?! so that is so called ABG !!!
lotz more… but i met a ireland HO been suspend for 2 postings too… so??? what to do?
malaysia health care system is far more rooms for improvement. just hope they memang boleh …
MIAO
1 question for you..if at all ukraine or russia in 10 years time richer than malaysia and you guys in malaysia dont have job in malaysia and have to work in russia and you dont know what is zimnitsky test so can i laugh at you??
well… i really like ur sarcasm… but u must remember tat if u want to work in malaysia, u need to know our healthcare system. But, why graduates fr russia and ukraine wants to work in malaysia whereas they can work their country they had studied????hmmm…. still wondering…when u all know the glut is happening around malaysia…
well… i think there are sure some rotten apples in every universities even in the best universities. I have met good and willing-to-learn russian graduates and some are better to left them rot…. all i could think is more about ATTITUDE!!!
To superb,
Who on earth will think of going to work there. Even if they have no choice, that two countries are definitely a NO. They would prefer countries where English is the main language.
Refering to all those clinical skills, practice makes perfect. If they really cant master it after a month into their HO service then that will be their problem.
you have to understd the pay of the doc not even enuf to support urself here then how to support ur parents?? thats why we are coming back to malaysia..if at all the pay is 3/4 of what they giving in malaysia we really dont need to come back..i realllllly wish 1 day russia will be a powerhouse again..
who on the earth uh???when you dont have a choice lets say malaysia become haiti or egypt and russia give you place to stay and work i will see whether you stay in malaysia or sitting on the last seat and silently travelling..
dear superb:
medical is easy. from history taking, we can get the dx already plus PE.
lab test only to assist in diagnosis.
zimnitsky test is used commonly in “russified” countries. some simple test is enough. a simple Renal Profile is good enough to diagnose if you KNOW how to interpret it. Malaysian don’t afford it/ we are saving govn. tax as i am one of the tax payer!!!
Nice days…
nvr knew medicine is easy..
Dear Sr Pagavalan,you asked us to gather the unrecognised medical graduates to met Dr. David Quek regarding this known issue.I did gathered more than 300 students to meet our Minister of Health and only 58 were allowed to meet our DG (Datuk Hasan) on 17th February 2012.Unfortunately the DG doesn’t like to find any beneficial solution for us. We been writing letters to meet our Health Minister since Oct 2011 and till now we couldn’t make any official appointment to see him. I did contacted few graduates who are currently working and some doing specialization abroad and they were willing to come back if our Minister really want to solve this matter.It is so sad when the government don’t bother especially MMC who are trying to sent a bill to parliament to apply to be a independent body.Funny to know that MMC office has been shifted to some other place few weeks after the meeting with the DG and the best part is they never mention to any of us even they know that we are still doing our paperwork which been told to do so by MOH!
Wellcome to Malaysian bereaucracy!! This is the main reason why many leave government service. Our current DG is hopeless from what I hear from my MOH friends. He even refuse to meet specialist who went to his office to see him!! Yes, under the amended Medical Act, MMC will become an independent body and hopefully if will make them more competent. MMC now is toothless. They are under MOH(where the DG automatically becomes the chairman) and have to listen to the politicians!
Hi Dr. Im a spm student of 2014. I’ve got my spm result but Im very confuse and blur for my future. I dont know what should i study. I am a science stream student with average result. I got 3A which is English, moral and maths. B+ for Biology, physics and C+ for Chemistry and add maths. Im interested to study pharmacy but worry that i cant handle in future . I love Biology so much. I also interested in biomedical science and food science. Im just dont know whether should I take science field or not as I only got 3A. Please give me some advice doctor. A 3A student is it suitable to study in science field? will it be tough for me in future ? Im so blank now 😦
please help me .
Do what your interest is. Just because you love biology does not mean you have to do something related to it. There are many fields out there. Trust me, biology that you do at your school and real life courses are totally different.