The past 5 to 10 years have been a watershed period for medical education in the country. During this time, Malaysia has embarked on an ambitious if misguided (in my opinion) approach to rapidly attaining ‘self-sufficiency’ in health care providers for the nation’s perceived needs and demands. For doctors, it was finally announced that there is now a directed plan by the government to try and achieve a doctor-population ratio of 1:400 from the current (2010) 1:903.
To achieve this, some 34 medical schools have been now licensed by the Ministry of Higher Education (MOHE), with almost 50 medical programmes (these include public medical schools teaming up with other foreign or local medical schools to form for-profit private joint medical programmes). The objective is to generate the requisite medical graduates to quickly fill in the projected and computed vacancies for the various public sector health facilities. The ultimate goal is to become a country with the so-called ‘recognised’ developed status doctor-population ratio of under 1:400. And we aim to do this in a short span of under 10 years—by 2020!
By comparison, the United Kingdom has some 32 medical schools for a population of 63 million, producing some 7,500 medical graduates per year. It is good to remember that the UK has had a long hallowed tradition of excellent medical services and education for centuries, with an extensive cohort of ready-made clinical teachers, professors and academicians. We are just about 45 years since we began our first medical programme at the University of Malaya, in 1965.
In UK, the annual output of medical graduates is around 7,500 and they are trained in 140 hospitals; in Australia 3,400 graduates are trained in 60 hospitals; in Hong Kong, 350 graduates in 13 hospitals; and in Singapore 150 graduates in 4 hospitals. In Malaysia, 2008, there were 2,274 graduates undergoing training in 38 hospitals and, since then, the number has increased tremendously, so much so that the Ministry of Health has had to increase the number of accredited hospitals for housemanship training, barely scraping by with sometimes just a single clinical specialist for each discipline, at more remote district hospitals.
And the truth is that we really don’t have a happy history of strong medical educational expertise and consistency of academicians; most of our senior and experienced medical specialists and professionals are in the private sector, or they would have migrated overseas. (It is estimated that as many as 40-50% of Singapore’s health service personnel are manned by Malaysian medical graduates!)
A few dedicated senior doctors are in our medical schools, but most are driven and run by relatively ‘young’ post-graduates or even specialist in training, whose ability to impart and inculcate ethical healthcare values and inspiration for compassionate care may be untutored, wanting or uninspired.
(I would at this juncture like to apologise to our younger colleagues out there, that this is not a disparaging remark to belittle their efforts at medical education or their skills—age and seniority are not requisites for medical excellence, for sure. Indeed when we are young, hungry, and foolish even, we tend to have the best and most aggressive approach to learning and hopefully teaching special skills—“see one, do one, teach one”.
<!–[if !supportFootnotes]–>[1]<!–[endif]–> I began as a lecturer at the age of 29 years, and I fully recognise that we can all be good dedicated teachers, when we choose to become one—yet there is no denying that experience and seniority helps create a sense of stability and perhaps more importantly, ethical balance and professional equipoise, particularly in the field of medical education and the hugely important responsibility and privilege of training medical professionals!)
Yet by 2020, we are targeted to produce some 5000 medical graduates every year for our projected population of 35 million, excluding those others who might be returning from foreign medical colleges. This is by any measure a humongous number of new medical graduates, which any middle-income country can ill afford to sustain or worse to develop a sensible program at accommodating the requisite progressive training of young interns or even to provide a quality health service!
Table 2.4.: Number of Annual Practicing Certificates Issued
According to State and Sector, 2007 to 2009.
STATE
|
2007
|
2008
|
2009
|
Public Sector
|
Private Sector
|
Public Sector
|
Private Sector
|
Public Sector
|
Private Sector
|
KUALA LUMPUR
|
2,239
|
1,762
|
2,590
|
1,881
|
2,797
|
1,952
|
LABUAN
|
18
|
16
|
12
|
17
|
12
|
17
|
PUTRAJAYA
|
254
|
9
|
257
|
10
|
294
|
10
|
JOHOR
|
612
|
981
|
752
|
1,041
|
933
|
1,072
|
KEDAH
|
446
|
458
|
484
|
483
|
580
|
482
|
KELANTAN
|
637
|
209
|
784
|
207
|
926
|
218
|
MELAKA
|
306
|
378
|
322
|
363
|
374
|
406
|
NEGERI SEMBILAN
|
354
|
341
|
401
|
401
|
532
|
372
|
PAHANG
|
340
|
355
|
440
|
378
|
489
|
385
|
PULAU PINANG
|
514
|
874
|
559
|
938
|
683
|
960
|
PERAK
|
662
|
803
|
759
|
835
|
924
|
854
|
PERLIS
|
95
|
28
|
120
|
28
|
139
|
38
|
SELANGOR
|
1,198
|
2,337
|
1,393
|
2,508
|
1,692
|
2,624
|
TERENGGANU
|
260
|
166
|
266
|
182
|
335
|
193
|
SABAH
|
462
|
342
|
592
|
358
|
696
|
379
|
SARAWAK
|
471
|
357
|
543
|
378
|
605
|
382
|
TOTAL
|
8,868
|
9,416
|
10,274
|
10,008
|
12,011
|
10,344
|
GRAND TOTAL
|
18,284
|
20,282
|
22,355
|
<!–[if !
supportEndnotes]–>
Malaysian Medical Council—Annual Report 2009
By 2011, we suddenly realized that we had taken on more than we could chew, literally! And this is not simply because of the huge financial burden of reimbursing these young doctors; almost double that number from just a few short years before! Since 2008, there was an unprecedented hike of public sector doctors jumping from 12,000 to almost 21,000 by early 2011, which appear to totally overwhelm the capacity of the public sector facilities to cater to this sudden influx of so many medical graduates. This glut has placed at severe risk the quality, the consistency and the efficiency of apprenticing these young trainee doctors!<!–[if !
supportFootnotes]–>
[2]
This unforeseen supply glut (together with the recent introduction of the 2-year foundational housemanship period) has created a bottleneck of
poorly anticipated training or residency programmes.
<!–[if !supportFootnotes]–>[3]<!–[endif]–> We have now a reversal of the ratio of public vs. private sector doctors, by more than 2:1 (~21,000 vs. 10,500)!
Houseman training hospital wards are now awash with white coats of medical interns (some as many as 50-60 per shift, per department!), scampering about with somewhat aimless, under-instructed and under-prepared purposes. Harassed and hassled medical officers, registrars and specialists now have great difficulty remembering even the names of their charges and most cannot guarantee the adequacy of the proctor-apprentice contact time relationship.<!–[if !
supportFootnotes]–>
[4]
What’s the Beef on Medical Education?
At the risk of sounding self-important and elitist, I would venture to state that the medical graduate is expected to be different from that of other professions, including our counterpoint nemesis—the lawyers! Medical education has by long tradition been exceptionally controlled and regulated.
Our ethical and professional boundaries are jealously guarded and inculcated because of our singular privilege of exercising our ‘bedside’ manners i.e. having expected and unimpeded access to our patient’s medical histories of symptoms, their innermost thoughts, secrets and also that special license to bodily contact and intrusions i.e. the medical physical examination, and the mental examination.
<!–[if !supportFootnotes]–>[5]<!–[endif]–>
This traditional ritual is more than simple routine. It is now considered as an integral exercise, which can reinforce and enhance the physician-patient encounter and relationship, even if there is that constant unequal tension of antipodal opposites—that paternalistic giving vs. the pliant receiving and the surrendering of one’s innermost self to some extent. However, this dynamic is now changing, with greater patient empowerment these days.
<!–[if !supportFootnotes]–>[6]<!–[endif]–>
This discrepancy of the doctor-patient relationship and asymmetric privilege carries immense responsibilities, self-control and conscientious self-abnegation on the part of the physician, the doctor. This concept has to be incessantly inculcated so that the physician’s hitherto uninitiated ‘blank slate’ mindset becomes habituated toward embracing this professional ethos. Of course we expect that the acquired medical professionalism and skill must be of a certain ‘standard’, be Hippocratically-modeled and be universally acceptable!
Thus, it is not surprising that we expect stringent and well-defined clinical pathways and regulatory mechanisms which are directed toward ensuring patient safety, reducing medical errors, safeguarding against potential physician abuse, while at the same time also addressing or ameliorating medico-legal concerns.
Students under training are rarely allowed to practice independently on their own, unless rigorously supervised. Thus, medical students have very limited hands-on experience, while in medical school—they are expected to have closer and greater ‘hand-holding’ guardianship and proctorship. Hence, medical schools must adhere to the mandate for adequate and comprehensive clinical material as well as proficient teachers! So we need good teaching hospitals, clinics, wide range of disease or illness spread, with wide spectrum patients, as well as good experienced and dedicated teachers and professors!
All medical graduates are expected to further hone their experience and skills in internship and residency (medical officer) programmes following graduation, before they can be fully registered as medical practitioners and certified to practice autonomously. Depending on the discipline or specialty that one wishes to pursue, the duration of residency or apprenticeship programme varies. Even then for some highly specialized disciplines, post-specialist experience (and ongoing further training) is critical to ensure the highest standards of skills required to function as acknowledged experts. It is a travesty of good apprenticeship; if the new intern is left on his or her own device to muddle through what is probably the most critical formative period of the doctor’s career.
It is no longer acceptable that sporadic exposure to some esoteric or mundane ailment will do for the young learning doctor, most training hospitals and institutions are now insisting on greater structure and more hands-on supervised approaches.
<!–[if !supportFootnotes]–>[7]<!–[endif]–>
Our unique professional learning-teaching structure dictates that the fresh medical graduates would need more in-depth practical training and closer supervision. Clearly this is crucial because in many instances we are dealing with extremely narrow tolerable margins of errors and possible life and death encounters. While no doctor is infallible, medical mistakes and lapses are not readily acceptable options, and the consequences are too dire for society or the patients and/or their families to bear.
Each and every medical graduate must therefore, experience that arduous if rigorous and preferably well-structured apprenticeship-internship programme, and be personally certified as safe and competent by a host of supervising seniors, to ensure that the final product is as sound and safe for our Malaysian rakyat, or for that matter, for any other patient anywhere around the world!
However, it is also increasingly clear that haphazard and poorly planned approaches to instituting change and innovation can lead to severe disruptions of service and training within health systems, as recently experienced by the United Kingdom’s hurried implementation of the so-called
‘Modernising Medical Careers’ initiative.
<!–[if !supportFootnotes]–>[8]<!–[endif]–>
In 2002, there was an attempt to transform postgraduate medical education and training in the United Kingdom. This ill-fated initiative called
“Modernising Medical Careers” plunged the entire system of training application and implementation of junior doctors into complete disarray, with many good and qualified trainees failing to get job interviews. This heavily criticized debacle lasted some years until the Tooke Report in 2008 highlighted and recommended some 47 rectifications to offset the weaknesses of this scheme.
<!–[if !supportFootnotes]–>[9]<!–[endif]–>
Thus, transformation of health care structure, training and systems need gradual progressive initiatives rather than revolutionary frissons of disruptive madness, even if well-intentioned!
Let’s return to the question of medical education for our nation’s needs.
Foreign and Local Medical Schools Malaise
I am sure that most of us are aware that we have nearly as many Malaysian students studying abroad as at home for a medical degree. That many young Malaysians and their parents hanker for such a tertiary education in medicine is legendary—year in year out, we have vociferous complaints of inadequate medical seats for so many of our aspiring young students. Many aspirants unfortunately do not fully comprehend what it really means to want to become a doctor. Many too would find the cheapest, perhaps the easiest way in which to achieve this result, that they become vulnerable to the untested promises of so many medical programmes, which are now available to them!
What irks us is that there have been mounting complaints that some of these very questionable foreign medical schools have educational programmes that have been formed purely as business concerns. These medical programmes have blossomed of late, to cater for the lucrative foreign medical students from third world countries, or as luck would have it, even from middle-income nations such as Malaysia. Worse, the end product i.e. the foreign medical graduates appear to be of dubious quality with grossly inadequate clinical training and very divergent foreign experiences.
We have Russian, Indonesian or Ukrainian universities offering medical programmes strictly for foreigners in the English language just for the sake of it, when many if not most of the teaching staff have problems even speaking, much less mastering the English language. Medical graduates are expected to leave upon graduation and not practice in the host country! So, one wonders as to the commitment and trustworthy responsibilities and duties of such medical schools!
Whether the standards, communication skills and didactic quality of these dubious medical schools are as good as expected, is therefore difficult to determine; although on paper, the programmes appear to meet the minimum standards of most medicals schools around the world. Diploma paper mills are often more attractive on the surface and self-claims, than its true worth in depth and practice!
So for parents and students wishing to invest in such medical programmes, please seriously reconsider the options, it’s not just the medical degree from ‘any’ university, but ‘the’ prestige and quality of the medical university or college that truly matters!
These concerns also apply equally to some of the local private medical schools, which have sprouted up recently. Our own mushrooming newer local medical schools and programmes unfortunately also appear to suffer such predicaments.
Therein lies the difficulty for quality assessment of these programmes, and the Malaysian Medical Council faces an unenviable dilemma of having to balance a hard-nosed strict sanctions approach to deny or to approve such standards based on a minimum of requirements, and then possibly sacrificing some quality parameters, or earn the wrath of parents, medical school agents and politically-linked investors/detractors.
The formation of these newer medical schools are more often than not, politically motivated—election promises by the government as pork barrel quid pro quo. It has become an accepted norm that every state should have at least one medical school.
The public wants this, so the government complies, notwithstanding the fact that the requisite standard ground rules cannot be applied and that fulfillment of time-honored quality cannot be assured. This leads to the ‘compliant’ lowering or ‘adjustment’ of the minimum standards for establishing these schools. The pressure is to have as many medical student numbers and intakes as possible to cater to the demand rather than to worry about the quality of the medical graduate, or the capacity to deliver in terms of teaching staff and the necessary appropriate standards of excellence.
A Recent Example: Recently a local private medical school has been set up with just one professor of surgery, and 2 associate professors of orthopaedic surgery and obstetrics. Others recruited were young trainee lecturers on a lecturer-training scheme as part of the school’s postgraduate programme. Yet, the ‘standard’ paper work detailing the syllabi and the course programme appear intact and adequate. There are also ‘sufficient’ teacher to student ratios, based on arbitrary naming and recruitment of ‘teachers and instructors’ whose qualifications and experience are undisclosed. Can just about anyone become a medical school teacher or professor, these days?!
So theoretically, this program passed muster and was duly awarded the license by the MOHE, as well as the temporary recognition to begin the medical undergraduate programme, by the MQA and MMC. There are just paper plans of where these students would be placed for clinical teaching and in which hospitals, which as many of us know, are already under siege from the surfeit of medical graduates already present! There are no plans to build a dedicated teaching hospital; and even if there was, this attempt would be fraught with difficulties of staff and personnel shortage as well! The brutal truth is that such a piecemeal slipshod medical school starting off this way can at best be described as incredible—perhaps only possible in this nation!
Indeed this has been the trend over the past few years of recruiting medical teachers in as nonchalant a manner as possible. Isn’t this a travesty of our expected medical excellence when it comes to medical teaching? Isn’t this a shame that it is now acceptable that anyone will do when it comes to being considered as medical school teachers—what happened to the concept that only the best and the most academic doctors are recruited as teachers and professors? How would the finished product of medical graduates be, if and when the teachers teaching them, are as mediocre or as uninspiring as the basis of their lacklustre recruitment has been?
Non-clinical teachers (many not registrable as doctors in this country to practice) are imported from our neighbouring nations to fill the quota of our chronically short teaching staff. Young professors are elevated, as are instructors promoted, without adequate quality assurance standards, to simply provide the minimum teacher-student ratio. Sometimes these are contracted on part-time ad hoc basis, and tasked with scheduled but unregulated point-of-contact teaching hours, which short-sell the impact of the teaching quality. Patient simulators and simulated clinical teaching are more the norm than real life student-patient contact.
Thus, we hear of anonymous complaints of disparate and substandard teaching and learning experiences. Many students are left on their own to muddle along, in what are increasingly known as “self-learning” modes and even that touted catchphrase of “instilling of self-responsibility and maturity”! Except that many of our young charges are not quite mature or ready enough for such unsupervised learning! But perhaps, I wrongly underestimate them, in which case, I humbly apologise…
But sadly, unless the student is exposed to better medical schools and teaching, they would not have known any better. My own niece, who was enrolled in one local private medical school for one semester before transferring to the National University of Singapore, faced a huge educational and cultural shock! The quality of teaching and programmes are worlds apart, but luckily she is coping well because clearly NUS did their homework when assessing which exceptional student to accept into their very high standard medical school!
But alas, do our medical students have any recourse to complain? I fear not, because there is simply no mechanism to do so; neither is there, any straightforward comparison of quality and standards—ignorance is bliss, so it seems. Thus, caveat emptor is the buzzword!
Whereas some of our neighboring universities are pushing their standards higher and higher, while chasing the globalised expectations of excellence and prestige, we in Malaysia appears to be doing the opposite—just provide the seats because there is great demand, produce the numbers, and let the quality deliver itself, as if economics alone would suffice to temper the emboldened but invisible hand of the free market for profits!
Conversely, and out of sync with many developed nations around the globe, our students are clamouring for more and more medical seats. The lure of becoming a doctor appears an unquenchable one for many a young Malaysian chasing that vocational dream to become a professional, with a supposedly assured job post-graduation. The oft-painted picture that the doctor would not starve and would almost always be assured of having a decent, somewhat respected, even luxurious quality of life, remains the colour-blinded vision and dream of many an aspiring student! Sadly for many, the reality is quite the opposite. In the near future, this could become a nightmare!
So, Can we do better?
It is clear now that with the ever-increasing numbers of medical graduates coming on-stream, there is an urgent and compelling need to systematically address their training-internship programmes, so that there is sufficient work and experience which can be imparted, shared or taught. There has to be more structure and planning, and less ad hoc piecemeal slotting into whatever vacancies there are to be had.
Teachers, proctors and supervisors have to be identified and their job descriptions clearly spelt out so that proper logbooks, minimum professional tasks and learning skills can be properly taught, documented and approved. The objective must be to ensure that at the end of each posting to a discipline, the house officer would be certified as competent in some minimum core skills and also be safe as an independent medical practitioner, ready to embark on to another level of his or her career.
The MMA has been urging the training hospitals to ensure that there is a better-defined career path for each house officer or trainee. After going through the mandatory rotations, there should be mechanisms to allow the trainee to embark on a planned rather than a haphazard chancy career development pathway. It is unfair to simply slot these freshly brewed medical officers into every available vacant discipline just to fill them, although of course some compulsory distribution to rural or remote postings would still have to be worked into the system as part of their national service.
But simply jostling these young medical officers into vacant and unpopular service areas without much supervision is also highly irregular, even irresponsible, although this may be inevitable, for some. For those brighter trainees with clearer goals and determination, i.e. those who aspire for specialist training, they can be encouraged to take and quickly pass preliminary specialist examinations, so that they may be placed on fast track toward specialty training opportunities. Of course those who volunteer or who have been earmarked for remoter postings should be given priority to choices of specialty or advanced career paths, upon stipulated return.
Unfortunately our available seats for post-graduate specialist training are quite severely in short supply. Annually our major university and hospital trainee posts number less than 800, which means that increasingly, the greater majority of medical officers completing their internship, would be left by the wayside of unfocussed and directionless service. But what do we do with these exponentially growing numbers, which will be the majority of these unplaced or misplaced junior medical officers?
Already enough young trainees have been querying if there are indeed sufficient places for them to train or to work towards some form of specialist training—many fear rightly that there would not be enough places, and that competition for the rare postgraduate programmes, severe.
We must recognize that such unprecedented numbers of medical graduates place a severe strain on the available system for such postgraduate medical training. We simply would not be able to cope and a time will surely come when, medical officers would have to compete even for simple service jobs. There may be no guaranteed placements with either internship programmes or any other programme!
The time may come when fresh graduates might have to apply and wait for vacancies, and they may also be selected based on other criteria such as graduates from more prestigious medical schools, those with better grades or honours, those with better testimonials from teachers/professors, or worse, those with political strings and cables!
Already, recently, the Health Ministry and Public Services Commission have asked the MMC to seriously reconsider the necessity for compulsory service for our medical officers, principally because of the huge number of interns completing their service.
In June this year, house officers are no longer employed as permanent service civil servants, but instead as contract workers. Thus, their forward service as automatic medical officers would no longer be guaranteed. In October this year, the ongoing glut of house officers has led to the MOH towards embarking on a mandatory rotational shift basis of work and training—no longer will overtime be paid, but a fixed shift allowance! These are the signs of our system bursting at the seams!
Why is shift rotation unacceptable in our current service of training house officers?
<!–[if !supportFootnotes]–>[10]<!–[endif]–> Because, as of now, there is no mechanism of ensuring that the quality of supervision and teaching can be consistent, especially for those who have been earmarked for nocturnal shifts. Such ‘graveyard’ shifts are notorious for lack of senior doctors reliably being available for attending to the many patients presenting in the night or early hours. There is also fear of lack of continuity of care both for the patient and the intern, the latter’s learning skills may be curtailed by disjointed passing over of cases and patients to temporary shift-empowered trainees—transitional responsibilities are known to lead to greater missed diagnoses, mishaps and errors.
Despite such serious concerns, which have been raised by many senior physicians, the MOH has seen fit to push forward this major shift in practice! For many of us doctors, we are appalled that this has come to pass. Such changes are not for the betterment of the houseman training programmes, but simply to stop gap and whittle down the yawning financial and administrative bungles, which have resulted from such an explosive medical graduate glut!
If there had been more planning, this could have been avoided. We could have transformed more controlled numbers of medical graduates into more competent doctors by ensuring that we have in place systematic training modules for general or family practice, emergency medicine, administration and health management, public health, etc. But we must get these administrative steps in place before these unwieldy numbers overwhelm us totally!
Thus, there must be an urgent moratorium not just on the number of medical schools, or programmes, but also the number of medical student intake or graduates. The rampant production of medical graduates must be drastically checked to ensure that only the best and most well equipped can be allowed to continue. No medical school should be allowed to arbitrarily increase its intake or output, and neither must there be 2 or 3 batches of intake, which makes a mockery of good or even adequately high quality medical education, both for undergraduate and postgraduate programmes.
Tactics that control the number of fresh graduates entering the local workforce
<!–[if !supportLists]–>• <!–[endif]–>Continuous reevaluation of future requirement for health workers.
<!–[if !supportLists]–>• <!–[endif]–>Controlling the number of Malaysians being admitted and graduating from medical schools. This can be achieved through:
<!–[if !supportLists]–>◦ <!–[endif]–>Creation of a body to oversee the quality of medical education, the functions of which may be similar to the Council on Medical Education in the United States.
<!–[if !supportLists]–>◦ <!–[endif]–>Introduction of standards to improve the quality of medical education, e.g. requiring a basic university degree before acceptance into a professional degree program (as in some parts of the world), establishing minimum expectations in a medical curriculum, and a minimum number of full-time medical faculty.Following the Flexner Report which advocated these changes (and more) in similar circumstances to the present in Malaysia, a large proportion of medical schools in the United States merged or closed, and the average physician quality improved significantly.
<!–[if !supportLists]–>◦ <!–[endif]–>A standardized examination for all newly graduated medical practitioners entering the workforce.
<!–[if !supportLists]–>◦ <!–[endif]–>Review of requirements for admission and graduation.
<!–[if !supportLists]–>◦ <!–[endif]–>Review of school recruitment practices.
<!–[if !supportLists]–>• <!–[endif]–>Manage student and parent expectations.
All of these points, I have already alluded to in my above discussion. The ball is strictly at the feet of the Ministries of Health and Higher Education.
What do we want or wish for? Just the numbers game, or should we ensure more importantly, the product i.e. quality medical doctors, and ultimately, the safety of our populace? There must be a better alignment and cohesion of purpose and vision, and not just reliance on whimsical bureaucratic or political expediency!
Who would you rather have at the end of the day to look after you when you are ill, when you are older and who would you perhaps entrust the healthcare of your children, your loved ones? Just a barely competent inadequately trained doctor, or the slightly stressed, overworked but experienced and highly skilled one?
Conclusion
The standards of our medical education are falling. This is an unacceptable trend, which should not be allowed to continue. If we do not take drastic remedial steps and actions to stall this slide, we might see a deteriorating climate of healthcare services in the country, with possible lowering of our medical professionalism and our clinical expertise as a whole. We might be reduced to the standards of some of the third world countries’ health services, where excellence is a rarity than a norm.
We could see a decline in our competitiveness, our competence and a deteriorating belief in ourselves, as a developed nation—perhaps to be bogged down once again in a quicksand trap of mediocrity and ‘tidak apa’ lackadaisical mindset. We might soon be having so many poor quality doctors and medical graduates who may be unemployed, even unemployable, and not trusted to be good enough to be our healthcare providers!
Potentially, there could be greater chances of endangering of patient safety and lives, for medical mishaps and errors, and greater risks for medico-legal challenges. Finally, the quality of our health service could deteriorate so much that our routine services would be called into question, with possibly the skeptical questioning of the integrity and foundations of our health service. Instead of trust in our health service, we could see the reversed medical tourism of more and more of our own citizens to other neighbouring countries with perceived higher standards of care and excellence of service!
Disclosure:
I am the immediate past president of the Malaysian Medical Association, and have been arguing against the glut of medical schools and graduates in the country. I am also a 3-term elected member of the Malaysian Medical Council (since 2004—2013), where despite our independent stance as individual autonomous members, we have to abide by collective decision-making and policy determinations, as well as to respect certain Official Secrets Act mandates.
I have taught undergraduate medical students at the Universiti Kebangsaan Malaysia (National University of Malaysia) from 1985-1991. Since then, I have been actively involved in post-graduate teaching in cardiovascular medicine as well as in medical professionalism and medical ethics.
References: <!–[endif]–>
[2] Loh Foon Fong.
Houseman Glut: Too many new doctors and too few hospitals to train them, in The Star, Saturday, 27 November 2010, pgs 1, 4.
[3] MMA Press Statement on the Extension of Housemanship to 2 years. August 4, 2009.
[4] Richard Lim and Loh Foon Fong
. Cleaning house. The Star, 12 December 2010
.
<!–[if !
supportFootnotes]–>
[5] Abraham Verghese, Erika Brady, Cari Costanzo Kapur, and Ralph I. Horwitz.
The Bedside Evaluation: Ritual and Reason. Ann Intern Med. 2011;155:550-553.
[6] Jerome Groopman. How Doctors Think.Mariner Books, Houghton Mufflin Company, New York, 2008.
<!–[if !supportFootnotes]–>[12]<!–[endif]–> Flexner A.
Medical education in the United States and Canada: a report to the Carnegie Foundation for the Advancement of Teaching. New York: Carnegie Foundation for the Advancement of Teaching, 1910.
Original post on Dr Quek’s Blog:
http://myhealth-matters.blogspot.com/2011/11/standards-of-medical-education-in.html
Among local medical schools in Malaysia,which are the best and could confer prestigious medical degree?
The better ones are still UM/UKM/USM and IMU was the better one for private medical school. I don’t think there is any such prestigious medical school in Malaysia anymore. UM use to be.
@QUALITY, probably the one recognized by Singapore Medical Council
This problem need to be highlighted again and again to the MMC,Ministry of Health,Ministry of Higher Education and popular media stream in the television,radio and website for meaningful action by government.
Come on,is there anyone here who are influential enough to bring this matters?Email this article to the popular media faster…
Main stream media is aware but all are controlled by politicians. They will not report anything that paints a negative future!
There must be something that we could do to rise up this problem..how about the board of MMC?Do you know any of them who could published this article or raise the issues to the POPULAR mass medial like main stream newspaper?
We cannot just discussing the issues here because it wont produce something great and significant..Other than that,we need to do something because we are professionals and we are capable of it,dont let politicians decide everything because we are the people of this who care enough about this medical profession.Come on people!!!start now
FYI, Dr David Quek is a member of MMC board and if you read carefully his speech, you will find that MMC is powerless!
Penang medical college..is it good as IMU and how about UNIKL RCMP..before this is under UM now change into unikl..is it quality same as UM..with all the complete facilites they have.and for both the college, are the student competent enough to become a doctor??
So far these 3 colleges are OK.
the best medical schools have already been listed above..the rest of the medical schools,whether they r good or not,still not so so sure
The point is,go to the best medical school,learn at your best,graduate from the school,become a competent doctor with professional attitude
At our hospital, when we have our regular monthly review for house officers performance and placements, the general consensus is that IMU produces some of the best junior doctors in the country. Other than that, UM, UKM, USM and IIUM are quite respectable as well.
But the rule of thumb is, all medical schools have at some point produced some lower quality grads at some point. so watch out for it.
That’s the reason Singapore wooing IMU Doctors!
Singapore does not recognise the IMU degree. They only recognise the degrees of the partner medical schools that you transfer to. If you get your whole degree from IMU you cannot work in Singapore (unless you have a suitable postgrad qualification). But that doesn’t stop them having roadshows in IMU early on.
The other reason Singapore likes IMU students of course is because the vast majority of students there fits their social engineering agenda
good day Dr.
i’m a final year medical student in indonesia. Reading all the previous articles about sub-standard doctors, it gets me equally worried as i’ll be graduating next year.
i would like to know what is actually expected from a fresh graduate during their housemen. is there any particular techniques that should be acquired?
and i would like to know where do we get posted for housemanship during the 1st 2 years and how does this differ from rural placement which is compulsory for another 2 years…
and is there any exams we are required to sit for during this period?
thank you for your time Dr.
Information on what is expected of you can be found in the House Officer guidebook:
http://mmc.gov.my/v1/index.php?option=com_content&task=view&id=17&Itemid=40
Other information can be found in the Malaysian Medical Council website. If I can read thru it, so can you.
You can go through this blog and the comments to know what a graduate need to know before working. Basically, you need to know how to clerk a patient, do physical examination and come to diagnosis. You should be able to order relevant investigations and interprate it. Your placemeneship for housemanship is decided by MOH. Looking at the glut that is happening now, you will not be given a choice to choose.
At the moment there is no exam unless you are from a unrecognised uni.
Thank you for your prompt reply Dr.
just a little unclear about the posting, for example, if the 1st 2 years of housemenship i’m placed in east malaysia will the other 2 years of compulsory service be in east malaysia as well or elsewhere?
Anywhere depending on MOH!
WHAT?MMC is powerless?then whats the point of having MMC if its powerless,lets empower it with powerful people,tell your friend in MMC to reveal the real thing to the ministry and to the public..make their existence in MMC meaningful…dont just follow everything which is not right..if they cant,then give their position in MMC to someone else who can…only the best people and people with credibility should be part of the MMC…come on..tell them about this..ask them to read this blog thoroughly and carefully..only brave people should be in MMC..
In Malaysia, MMC is NOT an independent body. They come under Ministry of Health. The DG automatically becomes the MMC chairman! DG answers to the Minister!
There you go. That’s exactly the root of the problem.
Visha. unfortunately, the way the situation is structured, its difficult to get the place that you want for horsemanship and subsequent postings.
I would recommend making sure you are in West Malaysia and have a basic, safe car. Secondly, focus on settling each posting as it comes. Don’t think TOO far in the future. The situation is not that bad yet for your batch. Its still salvageable as long as you finish each one of the six posting learning the fundamentals and not getting in trouble.
I don’t care what ppl say about the quality of junior doctors and where you graduate from. You must develop a head-strong character right from the beginning for the RIGHT reasons. And regardless of who you are and where you come from, the most important skill that will get you through the crap days is ‘people skills’. Deal with your superiors by MASSIVELY SUCKING UP and deal with your patients by FAKING YOUR LOVE TO THEM. This two elements may sound unethical, but try it, it works.
MASSIVELY SUCKING UP – there are various degress of this. Doing what you’re told and doing it right does not equate to sucking up. It means you’re doing a good job.
FAKING YOUR LOVE TO THEM – Don’t you mean showing empathy to patients? Being a caring doctor is something we should all be doing in our practice. I have seen HOs & MOs shout at the poor patients for no good reason, which is absolutely disgraceful.
What about Monash?! IMU was undoubtedly the top private medical school as of a few years ago..but with Monash offering better salaries and better career status, there’s been an exodus of the best of IMU’s lecturers to Monash. Everyone here has made some very valid points but I simply cannot believe that everyone has forgotten about Monash.
I would also like to point out that I am not affliated to Monash in anyway, I was offered a place but chose to go to UK.
Really? The list of Monash Malaysia staff is here:
http://www.med.monash.edu.my/About-Us/Academic-staff.html
Ex-IMU staff (that I am aware of) are Phua Kai Lit, Rakesh Naidu and Paul Jambunathan. PKL is an excellent researcher, but I wouldn’t say there’s been an “exodus of the best of IMU’s lecturers to Monash”.
Having said that, IMU didn’t have a reputation of treating their lecturers well and staff have left in the past for this reason. Things may have changed recently.
‘IMU didn’t have a reputation of treating their lecturers well and staff have left in the past for this reason’
I agreed with the above statement. IMU first batch student indeed had most of the Malaysian best brain in their faculty. IMU initially promised them a lot of things (but never fulfilled) but most of them left after the 1st batch of IMU students graduated.
No, MOnash did not attract many of IMU lecturers simply because the clinical lecturers did not want to come down to JB. Yes, their salary were higher by about 10% but it only attracted some who are willing to stay in Sunway campus in KL. AS I have said before, the only good thing about Monash Malaysia is that they are recognised by Australian Medical Council. There will be a reaccreditation exercise next year. With the number of lecturers that they have, they may end up with some problems.
Monash suppose to build a 500 bed teaching hospital in Sunway but the plan was scrapped as they felt it is not economical. So, far the graduates are OK as the numbers were small for the first 3 years. Now, they are slowly increasing their numbers almost reaching 150 students for next year intake.BUT the number of lecturers have not changed! I heard that they have also lowered down their entry standards compared to Monash Australia to get the numbers.
Say Dr Pagalavan, I notice some recurring themes in the questions that get asked in the comments. Perhaps a FAQ page is in order…
Nav – thanks, ill accept your interpretation.. its probably true anyway 🙂
About Monash, on paper they look acceptable. The real impact of their grads, however, has yet to be tested. We need to see them in service for 3-4 years first.
1. Phua Kai Lit – top notch health policy and sociology prof in the private side.
2. Rakesh Naidu – another good biochemist + lecturer
3. Paul Jambu – more celebrity than anything else.
IMU still has Dato Kanda, Dato Siva, Dato Kew, Dato Zaki Morad.. among other ppl actively teaching and steering the clinical side..
How come no one really mentioned PMC? Not too bad and probably up there among the better Msian unis.. but freaking expensive at almost 500k
I heard most of the Monash graduate went to work in Australia.
Yes, out of almost 80 students who graduated this year, only 10 stayed back!
Won’t continue for much longer. The health authorities in Aus had to bend over backwards to create more intern jobs for this year. Graduates from 4 more medical schools hit the Australian workforce next year, and 1 more in 2013. It will soon become very very difficult for foreign students to get intern jobs, and even then those who did their clinicals in Aus are likely to be preferred over those who did their clinicals in JB.
Again excellent points. Just very curious as to why none of you mentioned Monash in the first place! Still waiting for an answer! Chillax, PMC is probably one of the better ones too, but with the RCSI option, you’re looking at 800k..
This is how doubling the number of medical schools in just over 10 years has affected Australia:
http://www.asms.org.nz/Site/News/Top_Story/21_Nov_2011.aspx
And mind you, they have a much more mature hospital system with good facilities in their base (district) hospitals, unlike Malaysia whose district hospitals have no specialist presence (though this is very slowly changing). Also, the increase in numbers in Malaysia is much much more profound.
Hi Dr Paga,
Like Camden, I too am studying in a Russell Group university in the UK. The problem is, my family’s financial situation isn’t very stable at the moment. There is a possibility I might need to drop out after completing my second year. If that were to occur, what are the chances, in your opinion (as well as everyone else’s), of me being able to continue my medical education in Malaysia? For example, in Monash University or Newcastle or even, IMU for instance? Will they even consider my case, if I were to get top grades in my exams in the UK? I would also be grateful for any advice on alternative options.
P,s. I am determined to graduate with a Medical degree from the UK or the three Malaysian medical schools I have already mentioned. My parents will absolutely refuse to let me go to Russia, India or Indonesia.
This is not unheard of. You will have to apply to the universities you’re interested in and they will judge your case. Supplying them with a comprehensive curriculum of your university and your full academic record will help. In the end, most will be happy to take your money but it just depends where they slot you in (could make you do an extra 6-12 months). Good luck.
I am not aware of any reputable university that allows ‘credit transfer’ of partly done medical course. They will reassess you on merit, and if they decide you satisfy their criteria, they may admit you, but from the beginning again.
This is in part, due to the differences in syllabus, and system of delivery.
There isn’t much fees savings between UK and Monash Msia/numed. If you take into account having to start all over again in Msia, you might as well stay on and finish up in UK.
Monash will not accept you as the curicullum is totally different. Every medical school got their own curicullum and thus it will be difficult to do what you want to do. Newcastle is new and may consider your application as they are desperate for students. However, Newcastle Malaysia’s degree is not the same as Newcastle UK degree in terms of recognition. IMU usually do not take.Other samller colleges do take students who even fail 1st or 2nd year in overseas universities. You may want to consider Cyberjaya, Allianz, Mahsa etc.
You may need to start from Year 1 most of the time.
Thank you Nav, that was what I was planning on doing. JK: There is ALOT to be saved if I were to go back to Malaysia. At least Rm300k..I don’t know what your financial situation is, but from where I come from, that ALOT of money. It is also money I would prefer to keep for my parent’s old age.
You have already finished the 1st 2 years. If you have chosen your Russell Group uni properly, you may only need another maybe 65-70k quid to finish the clinicals. That is about RM350K.
To complete Monash Malaysia from year 1, you need RM450K, and IMU local, RM400K.
Of course, if you have unwisely chosen an expensive Uni, eg Edinburgh, it will cost another 100K quid, or RM1/2 million. But that is still not much savings.
Dear light blessing,
Why not india or indonesia? you dont need to spend to much money.
University fee in India is not cheap. It is approximately RM350K-RM400K. Living expenses is cheap. Indonesia is cheap.
If anyone were to apply to med school in India, I would strongly suggest AIIMS and CMC,Vellore. they rank the first and second out of 200 med schools in the country, recognized by Singapore Medical Council as well.
Quality? Definitely good!
Graduates from these 2 colleges consistently being accepted into the most sought after PG programs, a lot of them are practising in the US.
Their seat are very limited, total seats are around 50 by AIIMS and 100 by CMC. AIIMS offers 5 seat to NRI/International students while CMC offers only 1or 2.
Imagine there are almost 100k students sitting for the All India entrance exam every year, and only the top will make it into these two colleges, chances are like 0.15%!! (This has not yet excluded those reserved seats for students from certain caste)
I heard that the application for AIIMS has to be through the Indian Ministry of Health and Family Welfare, as it is a public university. For CMC, one can apply to it directly.(but has to write a test)
i am a graduate from CMC vellore
Doing medicine in AIIMS or CMC is cheap BUT VERY competitive
AIIMS is nearly impossible as it si only throught the Ministry of Health in India and that now Malaysia is a ” nearly developed nation” India thinks with the number of medical school there is no necessity to reserve seats for medicine
CMC: you will compete with over 6-7,000 applicants, need to pass an entrance exam and tne 110 will be chosen to go for a 3 days strict interview and testing to be selected amongst 60 students of whom 55 are church sponsored
yang
Thanks for the info.
It is the strict entry requirement which makes these colleges stand out from the others.
Private medical education is just too expensive nowadays yet the teaching quality is not ensured, like many private colleges in Malaysia. There is no point spending so much money for the degree and being a slave to pay back the debt in later life, unless one is really interested in doing medicine, but most will have a change in mentality only when they are into it.
That is why i recommended AIIMS and CMC, not sure about the others like JIPMER and MAULANA AZAD, they too have good reputation but I have never spoken to anyone from there. Regarding KMC Manipal/Mangalore, the fee is too high (approaching 170k USD) and is no more recognized by Singapore Medical Council, although they still maintain the strict entry requirement (minimum 2As not including maths in A levels/ STPM)
[…] The letter in the Star below is well written, http://thestar.com.my/news/story.asp?file=%2F2011%2F11%2F27%2Ffocus%2F9978991&sec=focus. I am not sure why so much attention is given to these housemen. I presume that the government knows what is coming. So, before the storm comes, better give these doctors some goodies. As someone said in this blog that the honeymoon period may just last another 2-3 years before everything start to fall apart. In fact at this very point, SPA is asking MMC to review the need for compulsory service as they may not be able to provide job to all graduates in another 2-3 years time. Housemanship will be given on contract basis. Dr David Quek has confirmed this as in my earlier blog posting (https://pagalavan.com/2011/11/17/for-future-doctors-the-standards-of-medical-education-in-malaysia-an…) […]
how about the quality of graduate from melaka manipal medical college? any comment?
average.
What is interesting is a study on the graduates from the newly acquired colleges for the past decade:
1. drop-outs are not continuing to work as qualified doctors
2. No: of postgraduates following MBBS
3. What R & D or contribution these doctors have given to interms of medical education and medical sciences
4.
Dear Dr. pagavalan,
What do you mean by Newcastle Malaysia’s degree is not the same as Newcastle UK degree in terms of recognition? And Monash Malaysia is being recognised by Australian Medical Council is it meaning that graduate from Monash M’sia can work in Australia ?
Newcastle Malaysia’s degree is not recognised elsewhere. In fact I just got feedback from GMC that they are yet to accreditate Newcastle Malaysis’s degree. So far, they had only given permission/approval to Newcastle to conduct a medical programme outside UK. Their quality review committee is still evaluating the first cohort of students before they decide whether it will be given equal accreditation as Newcastle UK. Thus, at this point of time, Newcastle Malaysia is just another local degree where you will not be able to work elsewhere without sitting for an entrance exam. Even if GMC accreditates NuMED malaysia, it does not mean it will be recognised in other countries other than UK.
Yes, you can work in Australia/N Zealand if you graduate from Monash Malaysia.
What is soo important about recognition from other WEST countries?Does it mean those unrecognised not good?
Dont be too proud of the WEST…anything from WEST might be as good as some people think..open mind, think in a broad aspect.They have their own agenda in giving recognition to medical schools in certain countries only
Look nowadays, medical graduates who graduated from medical schools not recognised by USA,Canada,Ireland,UK,Australia or New Zealand are the graduates who have MRCS,MRCP,MRCOG,FRCS,FRCP and all those MR or FR something..Open mind people
I don’t think you understand what we are talking about. Pls read all my articles which I had written before. It is not about quality etc but job opportunities!
In 5 years time, when graduates become jobless, where else are you going to go when your degree is not recognised elsewhere? We are not just talking about recognition of western countries but also eastern countries. Every country have their medical council.
Recognition is also important for your postgraduate education. If you don’t get a post for Master’s here, you would not be able to go anywhere else to do your postgraduate degree! MRCS is not a postgraduate degree, FRCS not available anymore. Only MRCP, MRCOG and MRCPCH is available. This is when you will realise the importance of doing medicine in a well recognised university.
No need 5 years. I just spoken to the senior HO in Hospital Sultanah Aminah. She said that HO now is given 2 years contract. So, some might not get renew after 2 years housemanship. All the peripheral hospitals post already filled up (max 10 doctors / hospital) now. The jobless condition might not need 5 years, maybe in 24 months.
David Quek did mention it in his speech that since June they have started giving housemanship on contract basis. So, now it is confirmed! I should say ” didn’t I say so?” Yes, I too predict it will happen much earlier then 2015
RECOGNITION blustered:
What is soo important about recognition from other WEST countries?Does it mean those unrecognised not good? Dont be too proud of the WEST…
You’re correct that western/developed nations at times do have their own agenda when choosing whether to recognise non-domestic medical degrees. That is another matter for another discussion.
As far as this thread goes, Dr Paga has already pointed out the “global village” opportunities that come with a medical degree that has international recognition. Of course some people cannot see beyond the shores of Bolehland, so the global village issue means nothing to those who prefer to stay within the comfort of their coconut shell. But that shell is starting to look mighty crowded already.
The main advantage for a Malaysian institution gaining international recognition for its degrees lies in the utterly useless systems of quality assurance in Bolehland. There is no transparency, accountability or independance in these systems.
In the developed nations, systems of quality assurance do have transparency, accountability and independance. When you have to pay so much for a private medical education, wouldn’t you want some reliable and believable indicator that the course has some measure of quality built into it? Or do you think the shoplot medical schools are just as good as any other?
finally …… is it better for youths to pursue their studies for doctor ?
please read through this blog and decide.
thanks anyway there were quite a lot to read ……
sir can you explain briefly about your blog …. what i find from some short survey from your blog is .. doctors are becoming saturated … is it ?
YES
will this affect the future doctors….? And will this effect will be also faced by specialist such as ENT ? (IN MALAYSIA)
I think you should spend some time reading this blog.
At the moment there is still shortage of specialist but getting into specialist training programme is not going to be easy in the future due to oversupply of graduates which has already started.
Hmm, if doctors are becoming saturated – why do many fresh graduates still complaint that they have to work a lot and it is super tiring?
– Is this a prove of an ineffective system? You can push on a boulder very hard, but if you are doing it the wrong way, the boulder won’t move
Because they are over pampered and DO NOT want to work but wants easy money!! It is happening in ALL field if you ask everyone.
There are more then enough doctors nowadays in each ward and that is the Reason why the shift system was introduced to make it look smaller in numbers.
How many post is available per year for Ob-Gyn training at Universiti Malaya ?
How competitive is the entrance exam ?
What I know is passing MRCOG part 1 will enable me to “avoid” conjoint written exam, so is it better to take MRCOG exam part 1 ?
How fair is the interview ?
Is there age limit to apply Ob-Gyn training/ residency in Malaysia ?
Will this specialty getting saturated too ? When will this “saturation” happen ?
This question is best answered by someone who is doing the O&G Masters currently or teaching it. If no one responds to your query, you should try approaching someone in the system directly.
You need to ask the university or someone who is doing O&G master’s locally for the number of intake as it varies every year.
Whether you get a place or not depends on the university and KKM.
Yes, having MRCOG Part 1 may give you a better chance but I am not sure whether you are exempted from the Part 1 exam.
Age limit for Master’s is 45 if I am not mistaken
The big 3 are currently conducting a common entrance exam for the Master in O&G but the final decision rest on the respective univerisities. The waiting period for joining the Master is getting more, the last I knew is between 4-8 years depend on your experience in O&G. Getting part 1 is an advantage but UKM and USM do not waive the Part 1 Master anymore for candidates with MRCOG Part 1. Not this is true for UM or not. My experience (and my friends as well) tells me that pride of the univeristy takes a lot of weightage. If you put UM as first choice your chance with UKM or USM will be almost NIL because they think that you are insulting thier university. For UKM once they called you up for interview you are almost sure of the trainee post provided your MOH approval is in place. UKM also tend to take back their own MD graduates.
To give you an idea of how difficult the entrance exam, the most recent batch got only ONE passing the entrance exam (out from 60 plus applicants). They have to lower the passing marks for a few points to let in about 10 candidates. This is for UKM. Not sure the other U. All UKM candidates are required to take MRCOG as well (i am told).
“Will this specialty getting saturated too ? When will this “saturation” happen ?” This is an interesting question. O&G specilaists will never be saturated in public hospitals provided the maternal mortality is still high especially in East Malaysia. But if you are referring to private sector, yes it is saturated. For big centre you can only join if you got some subspeciality qualification or as female (this is a clear advantage of getting job in private sector).
I am currently in the middle of choosing local medical private university,any recommendations?
try IMU, Monash, PMC, MMC
Lincoln college is well known, good, cheap and offers scholarship as well.
I am beginning to think Karl is a marketing salesman from Lincoln.
thank you!!!this definitely helps me a lot.Is MMC refer to Melaka Manipal medical college?
how about UCSI and UTAR?
UTAR not recognized by MMC yet and have not produced any graduates. Don’t have much to comment on UCSI.
okay,thank you^^
Which universities are recognized by the Singapore medical council?
@Kishita
Click to access Second%20Schedule%20-%20Registrable%20Basic%20Medical%20Qualifications.pdf
Thank you 🙂
you can visit the SMC website for further info
Ok thanks dr… 🙂
hi doctor… im a spm student this year .. well my ambition is to become a doctor…. but im folowing your article since last year …. what i can conclude in a word is that …. MALAYSIAN DOCTORS LEVEL IS TARNISHED ……… so do u think that i should still need to aim to become a doctor ……?
Do what you are really interested in. What I write is the reality of a doctor’s life. If you are up to it, then go ahead.
I think the correct way to look at this issue is, to appreciate that Malaysia still needs 3000 GOOD, WELL TRAINED, AND COMMITTED new doctors a year, no matter what. So if you think you fulfill these conditions, go ahead.
You are right, the whole profession is already tarnished by a big group of mediocre, poorly trained, reluctant and pampered young doctors, and you will also be branded as such by the seniors in the profession and the public.
But there is always a need for good doctors, and if you are indeed good and committed, you will, like cream, rise up above the rest. Trust me, within a week of working together, it is easy for the senior doctors to see who are the cream.
Hi Dr. Pagalavan, I find your article very interesting and true, even though it has been for some time. However, I’m in a dilemma now, in which i’m offered a place in UKM Medicine Faculty). It is a wonderful opportunity indeed, but is UKM Medicine Faculty better than IMU Medical School? The general consensus is that UKM provides an education system of better quality than IMU, but with some new regulations in the student intake of UKM and the academic system revamp (or so I heard!) this year, I’m confused now. I’m a little worried of the quality of UKM Medical Faculty compared to IMU. And I’m not sure which is better..UKM or IMU in terms of postgraduate studies prospects after my undergraduate studies as medical doctor. Will studying MBBS in IMU stand a better chance in pursuing my postgraduate studies in overseas (i.e. UK,) compared with studying MD in UKM? I am currently considering to apply for IMU (in which I will join the February 2014 intake) if it turns out that studying in IMU would be better than studying in UKM. Financial issues shouldn’t be a problem for me now, as I have a scholarship that will sponsor me in either universities I choose. I would love to listen to your opinion about this. Thank you, Dr. Pagalavan.
Jake, if your scholarship allows you to do twinning with UK universities in IMU, then I would go for IMU. Doing twinning is like a back door into British medical schools and the degree you get will be a British qualification. On the other hand, I would choose UKM over IMU in terms of local qualification. Just personal preference.
I think JPA has stopped giving overseas scholarship for medicine, so if it is the IMU local programme, go to UKM lah.
I would prefer UKM as they are more established and recognised in Singapore as well. If you planning to work overseas than the IMU local program has no value as it is not recognised elsewhere. It is only worthwhile if you take the twinning program which I don’t think your scholarship will cover.
Thank you so much doctor.. Appreciate it alot.
Hi, Doctor. I want to ask for ur opinion about MBBS programme of Newcastle University Malaysia Campus and Perdana University. I am now choosing between Newcastle university and Perdana University. Thanks, doctor.
I would prefer newcastle
Thanks, doctor..
Apparently MARA is not sending medical scholars to the UK this year. Medical scholars are now limited to Malaysia, India, Russia and Ireland. Naturally all are gunning for Ireland.
I suppose RCSI’s ties with MARA is very much intact.
you forgot Egypt! RCSI is basically selling their degree everywhere for money1
So it’s true then. It was “alleged” that all the Middle Easterns send their children to RCSI for medicine. I guess they’re not the only ones. No wonder so many locals are expressing interests to go to Ireland, which I guess means RCSI.
Doctor, I am interested in working in Singapore. According to SMC, they only accept students from ukm and um, which are both government universities. I am not interested to study in those universities. So, I planned to study in the universities in UK that is listed by the SMC. Will I get a chance to work in Singapore by doing so?
it all depends on the situation in Singapore when you graduate. You must understand that Singapore just started their 3rd medical school. If they have enough of their own graduates, you will only be considered after they have given job for their graduates.
Hmmm ok. Can I study in their medical school?
If you qualify and get a place
You can, but remember there are many Singaporeans wanting to do medicine as well. You should read up their requirements for entry on their respective web pages. Plus, asking such a general question doesn’t reflect a great deal about you.
I am a Malaysian who stay in Singapore for quite a while. My daughter went to one of the top Junior College here. I know most of her classmates and I am not belittling others, these kids are superb smart, not only in studying, playing and clubbing as well. Most of them are going to NUS and NTU medicine or dentistry, they are all belted with Singapore A Level 4As and above. Her Seniors told them in NUS medicine is pretty much like taking A Level Exam every day. Pressure and stress to the utmost.
One of the top students in her school flunked his first year medical exam in NUS last year, super stress.
The QS World University Rankings is only for reference, NUS Medicine currently is ranked 20th in the world or 1st in Asia. No joke, Singapore Government is very serious about education. They spend tons of money on education, my friend’s wife is a primary teacher with 12 years experience plus some admin work experience before joining the teaching line, her whole year salary is about SGD130k, paying very little income tax.
http://www.topuniversities.com/university-rankings/university-subject-rankings/2013/medicine
Unfortunately, in Malaysia, all medical schools have almost 100% pass rate!
Why u intersted to work in spore?
For some personal reasons…
I got an offer from monash malaysia and imu localfor medicine. Which uni do u think i should choose if i plan to further my study in australia or singapore?
If you complete the medical course locally, how are you going to further your studies in Australia / Singapore? Unless you are going their for HOship (which is getting more difficult due to number of vacancies) or sub specialization which mean you need to be a specialist first.
Both are NOT recognised in Singapore. Monash Malaysia is recognised in Australia for time being but you can’t get registered there unless you do your housemanship in Australia. Looking at the current scenario, the chances to get an internship post in Australia for Monash Malaysia grads are slim. So, if you have only these 2 options, I would suggest Monash with no guarantee you will get a job in australia
I heard that the clinical placement in imu is better than monash since imu is having their clinical at seremban and monash is doing it in jb. I wonder whether it is true or not? Not only, that my relatives who are doctors encouraged me to study at imu, saying that the doctors from imu is higher quality than monash.
IMU definitely more established with better lecturers.
So is it imu better or monash is better in terms of quality and clinical placement?
I would prefer IMU bit their local degree is not recognised elsewhere
Dear Dr. P,
How is the queue looking like for renal medicine training in Malaysia?
I have done my Part 1 and Part 2 written. Left with PACES now.
Once I have completed my MRCP in the UK, I hope to return to Malaysia to pursue renal medicine as my girlfriend is in Malaysia and I would like to spend more time with my family. I am a UK graduate.
Do you have any advice for me?
Many thanks.
Upon returning, you need to undergo gazettement process before being eligible for subspecialty training. You need atleast 4 years of medical training plus 6 months of gazettement process. Your training in UK will be considered. After that you need to apply for your subspecialty training. Waiting time can be 1-2 years unless you choose to go to unpopular place like JB. The other option is to join the university hospitals where the process can be shorter
Thank you Dr. P.
I may have more questions when it comes closer to my time coming back to Malaysia.
But for now, I have hope of pursuing renal medicine in Malaysia.
Many thanks.
Dear Dr Pagalavan,
How would you rank IMU’s local programme with monash and other public uni’s at this moment in time?
So far their products are OK.
If I don’t intend to work overseas, then would imu be a better choice as compared to monash, perdana and newcastle?
Should be OK
Hi Doctor, I’m a final year MD student soon finishing in 4 months time from one of the public univ in east coast. I always inspired to be a lecturer but my academic performances were not really as excellent as viva students. I’m planning to do housemanship training in ppum and is it possible to apply for their trainee lecturer program?
Of course you can but depends on your performance and competition
unlike some people who pull “political cable”, working in a university is a decent way to escape rural district posting.
first be a houseman, then service medical officer, later trainee lecturer of the university.
it is much easier to get into master program because you don’t have to compete with candidates from the ministry of health.
my advice is :join a university which has her own teaching hospital &master program(UM,UKM,USM).
currently your university in east coast doesn’t have her own teaching hospital, i am sure you can see how your lecturers are being treated & not respected by the MOH people.
Can i open my clinic nw after 3 yrs of MO ship? No need family medicine?
Of course you can, at the moment
Dear Sir,
Among IMU and Monash, which is more recognized by the society generally? By reading some posts above, you meant that imu is better than monash for medicine course right? How about the other courses like pharmacy, nursing and etc.)?I know this is main for the future doctors but I think you know well about the differences between this 2 universities, so I hope that I can get some advices for you as I haven’t decide which science course will I go for. Hoping for your kind reply.^_^
IMU has been around longer and more established. Monash is OK but the school in split between Sunway and JB for medical. Infrastructure/facilities are minimal.
The only difference is that you must standby at least RM500K for IMU and 600K for Monash. The fees stated on their website is just the basic fees. There are a lot of hidden fees which they would not divulge initially when you join them. By the time you graduate you need to sit for an exit exam before you can register for HO and both have to queue up under the waiting list for at least a year before you get the post. According to the seminar held at University Malaya on 30th and 31st July recently, the exit exam might start as early as next year in 2016.
Hi Doctor,
I’m currently finishing my A-Levels in Sunway College and thinking of studying Medicine locally. I have 3 offers to study in the UK but I have to decline due to the current exchange rates.
The four main options are Monash, IMU, PMC and Newcastle. Based on the comments previously it seems IMU is the best option but I have gotten feedback from my lecturers and cousin studying there that IMU isn’t really good anymore and have become too commercialised. Monash is my top option but how are the lecturers/quality of education there compared to PMC and Newcastle?
Finally, is it even advisable to study medicine now? The medical scene 5 years time is uncertain, and is there a possibility that I could be jobless? I have a friend who graduated from AIMST end of last year who us still waiting for his housemanship posting. Any comments would be great Doctor.
Yes, IMU’s quality is not as good as before but it is the same for all other universities as well. The fact is there are just too many medical schools around . As for the rest of your questions , please read all the topics under ‘For Future Doctors ‘ page. FYI, the waiting period for housemanship now is 6-8 months.
If you intend to stay back in Malaysia after medical school, you will have to face the problem of oversupply of doctors and limited prospects in securing further training in your profession, this is a fact that Dr. Pagal has predicted few years ago.
Looking at the current scenario and how these issues are being handled, the future for young doctors in Malaysia is not at all bright.
All your options except Monash is not recognized elsewhere (as in you can’t work in other countries right after graduation). Monash is recognized in Aussie but getting an internship job is tough nowadays. I have heard of some Monash graduates who went to Aussie after 2 years of housemanship in Malaysia, probably because they could bypass internship in Aussie and get an RMO post instead, since getting an internship post is very difficult.
Whichever medical school you end up joining, try to do something “extra” and go a step further than anyone else. You might start preparing for foreign exams like USMLE, get a hang of what medical research is like, do some presentations etc. Who knows new opportunities might open up by the time you graduate and the extra hard work you have put into your CV will be paid off.
Hello Dr,
I finished my A-Levels recently and want to do medicine locally. I currently have IMU, Numed and Perdana offer and went to UM and USM medical interviews. I am bounded my scholarship and they do not allow IMU twinning programme so if i were to study in IMU i will be studying the normal degree programme. But, I am in a big dilemma of choosing between UM/USM and IMU. It would be helpful if Dr could give your opinion of these universities in terms of their quality of teaching and quality of graduates produced. Thank You!
I will go for UM or USM anytime as they have their own teaching hospitals
What scholarship are you on?
JPA bursary programme.
Hello Dr,
I finished my A-Levels recently and want to do medicine locally. I currently have IMU, Numed and Perdana offer and went to UM and USM medical interviews. I am bounded by scholarship and they do not allow IMU twinning programme so if i were to study in IMU i will be studying their normal degree programme. But, I am in a big dilemma of choosing between UM/USM and IMU. It would be helpful if Dr could give your opinion of these universities in terms of their quality of teaching and quality of graduates produced.
Thank You!
If I were you, UM would definitely be my first choice.
Reasons being:
– best medical school in Malaysia (I hope it still holds true)
– great faculty strength, promising learning environment
– confirmed masters seat at UM (if you do well in medical school they might offer you this)
– recognized in Singapore (this does not apply to you since you are on scholarship)
Hope this helps. Good luck
Greetings Dr. ,
I am a current A-Level graduate who has an offer from University of Manchester for Medicine. My dilemma now is this. My scholarship to study at the top 20 universities in the world by the JPA has recently been turned into a local scholarship. Hence, they are no longer funding my studies to University of Manchester. They do however sponsor IMU, Monash and NuMED locally with no twinning included, but this includes a 10 year bond period. My parents have agreed to fund my education to Manchester, but before I make the final call, I wish to get clarification on my options down the road in the next 10-20 years, as studying at Manchester costs around RM 1 million, and my family is in the middle income group, with me as the only child.
My questions are :
– Is it worthwhile to invest RM 1 million in medical education in the UK instead of being fully funded for a local medical degree at these 3 universities in the long term ? Should I choose University of Manchester, I am guaranteed housemanship training in the UK under their Foundation programme for 2 years.
– If I am to choose Manchester, I would think about applying for jobs in Singapore as a first choice after my Foundation years in the UK. My follow up choices would be Hong Kong. Australia or to remain in the UK. However, what are the current situations for doctors in these countries ? Do they face the same oversaturation issues as Malaysia now face, or is it generally easier to get a job there compared to Malaysia, especially in terms of Singapore.
– What do doctors generally put on their CVs when applying for jobs ? I have yet to hear of med school students going on medical internships., which is unlike engineering or finance students. Henceforth, what work experience would you recommend med students like me focus on during my 5 years in medical school ?
– I have heard that IMU, Monash and NuMED undergrads are not recognised internationally. Hence, what is the pathway of training for these doctors should they wish to specialise in Singapore ? I have read from your blog that it is possible should they pass the MRCP exam. So the question would be what are the differences in applying for a job and the chances of success if I am a Manchester graduate compared to an IMU graduate in Singapore ? I understand Manchester is under the list of recognised schools under the SMC, but not IMU. So how do IMU, Monash and NuMED graduates get to work in foreign countries such as Singapore ?
– Is the fellowship programme only done in Malaysia or is it a programme that is executed by foreign medical councils as well ? I have heard that the fellowship programme in Malaysia was born due to the oversupply of doctors and the insufficient training facilities for specialists, if this is true, what is the specific scenario at the moment ? How is the fellowship pathway like ? Are specialists that graduate from the fellowship pathway recognised anywhere else other than Malaysia ? How are these specialists recognised differently compared to specialists that graduate from the Masters programme ?
– What further costs would I need to incur besides my basic medical degree should I choose Manchester before I can become a specialist ?
– Is it true that graduates from IMU, Monash and NuMED are not eligible to apply for any Masters programme outside Malaysia because their undergraduate clinical training is not recognised ?
– What do they teach in the Masters programme that differs from the fellowship programme ? Is the Masters programme full time, or do these Doctors work while studying ?
Thank you for your time and patience.
All the answers are here in this blog. Or you can buy my book and read.
1) Obviously not worth it unless you intend to migrate.
2) Please read my post on situation in Australia and UK. Singapore is also very selective in their recruitment. I know a few who applied and did not get a job. BTW, another medical school in Singapore will be producing graduates soon. So, situation will be tight
3) Medical INternship is your HOUSEMANSHIP! For housemanship you don’t need CV.
4) If your degree is not recognised in Singapore: you can;t work there. It is the same for any other countries. You can try to sit and pass their entrance exam conducted by SMC but I heard they do not conduct it anymore for foreigners. The other option is to do MRCP/MRCS/MRCOG before applying for a job in Singapore. NO JOB IS GUARANTEED!
5) I don’t think you understand anything about post graduate education. You are confused. Please read my books or relevant sections in this blog. Answers are all there
6) Cost of sitting for postgraduate exams
7) YES
8)ALL POST GRADUATE MEDICAL EDUCATION ARE FULL TIME WORKING, PART TIME STUDYING! AGAIN YOU NEED TO BUY AND READ MY BOOKS AS YOU SEEM TO NOT TO KNOW ANYTHING MUCH ABOUT MEDICAL FIELD :https://pagalavan.com/2016/04/14/finally-my-books-are-ready-hard-truths-of-being-a-doctor-vol-1-2/
Paga, I think he is referring to work experience/industrial partnership internship, as many students do as part of their course. Not relevant for doctors.
Most of the questions are premature, and attempting to predict what will be the situation in 10-20 years is impossible, unless you have a Delorean. So they are irrelevant at this point.
From the particular situation you are in, and to help make a decision on the 2 options, you only need to answer one simple question. Do you intend to work and live outside Malaysia after you graduate? If the answer is yes, then of course, go to Manchester. Otherwise, stay back and take the scholarship.
Finally, people’s mindset may need to change. In the past, the 10 year bond was viewed as a millstone around necks, restricting one’s options. From now on, people should view that as an asset, as it will likely give one an advantage in being employed, in the future scenario of over-supply of doctors, and joblessness.
Thank you for your swift reply Dr. Paga & jkl, apologies if I have not thoroughly reviewed this blog. A quick note about the 10 year bond – The JPA have openly told us that we are not to be prioritised in the housemanship selection process. We are expected to undergo the same waiting period like any other fresh graduates. However, they expect us to find work within 6 months of graduation or else start repaying our loan immediately, unless we can give a valid reason to why we are unemployed, and the reason will be decided by JPA if it is sound. So I believe it is fair to say the 10 year bond does not provide an advantage with these current terms and conditions set forth.
It does after you complete your housemanship. In the future, there is no guarantee that you will get your MO post after housemanship. Being a JPA scholar may give you advantage then.
A JPA scholar will have no advantage in the processing for Housemanship, as it is done by the Ministry of Health, purely based on chosen location and that location’s waiting time. However, the ruling for the Bond is that you pay ONLY if you refused to take up the public service job they offer you. If they are unable to offer you a job, they will release you from the bond.
However, you WILL have to take up the public service job, as you will need to do the mandatory 2 years Housemanship, and that can only be done in a government hospital. It is difficult to see into the future, but if the delays persist in 5-6 years time, then they cannot fault graduates who cannot be placed within 6 months.
Scholars will likely have an advantage AFTER Housemanship, when selection into post-HO jobs are done. By that time, it is likely NOT every Houseman will get a job offer to continue with the government. Being a bonded graduate will likely give an edge. Also, when JPA itself place junior doctors (initially on provisional employment) onto permanent appointments.
Greetings Dr. ,
I am a current A-Level graduate who has an offer from University of Manchester for Medicine. My dilemma now is this. My scholarship to study at the top 20 universities in the world by the JPA has recently been turned into a local scholarship. Hence, they are no longer funding my studies to University of Manchester. They do however sponsor IMU, Monash and NuMED locally with no twinning included, but this includes a 10 year bond period. My parents have agreed to fund my education to Manchester, but before I make the final call, I wish to get clarification on my options down the road in the next 10-20 years, as studying at Manchester costs around RM 1 million, and my family is in the middle income group, with me as the only child.
My questions are :
– Is it worthwhile to invest RM 1 million in medical education in the UK instead of being fully funded for a local medical degree at these 3 universities in the long term ? Should I choose University of Manchester, I am guaranteed housemanship training in the UK under their Foundation programme for 2 years.
– If I am to choose Manchester, I would think about applying for jobs in Singapore as a first choice after my Foundation years in the UK. My follow up choices would be Hong Kong. Australia or to remain in the UK. However, what are the current situations for doctors in these countries ? Do they face the same oversaturation issues as Malaysia now face, or is it generally easier to get a job there compared to Malaysia, especially in terms of Singapore.
– What do doctors generally put on their CVs when applying for jobs ? I have yet to hear of med school students going on medical internships., which is unlike engineering or finance students. Henceforth, what work experience would you recommend med students like me focus on during my 5 years in medical school ?
– I have heard that IMU, Monash and NuMED undergrads are not recognised internationally. Hence, what is the pathway of training for these doctors should they wish to specialise in Singapore ? I have read from your blog that it is possible should they pass the MRCP exam. So the question would be what are the differences in applying for a job and the chances of success if I am a Manchester graduate compared to an IMU graduate in Singapore ? I understand Manchester is under the list of recognised schools under the SMC, but not IMU. So how do IMU, Monash and NuMED graduates get to work in foreign countries such as Singapore ?
– Is the fellowship programme only done in Malaysia or is it a programme that is executed by foreign medical councils as well ? I have heard that the fellowship programme in Malaysia was born due to the oversupply of doctors and the insufficient training facilities for specialists, if this is true, what is the specific scenario at the moment ? How is the fellowship pathway like ? Are specialists that graduate from the fellowship pathway recognised anywhere else other than Malaysia ? How are these specialists recognised differently compared to specialists that graduate from the Masters programme ?
– What further costs would I need to incur besides my basic medical degree should I choose Manchester before I can become a specialist ?
– Is it true that graduates from IMU, Monash and NuMED are not eligible to apply for any Masters programme outside Malaysia because their undergraduate clinical training is not recognised ?
– What do they teach in the Masters programme that differs from the fellowship programme ? Is the Masters programme full time, or do these Doctors work while studying ?
Thank you for your time and patience.
Hey dude, I read your comment and I understand your predicament. I was in a similar position as you last year. You need to RESEARCH the ongoing crisis happening in the UK right now. There’s a strike and huge backlash from houseman doctors, and the immigration policies are facing a lot of changes in the next year which will affect our ability to get work permits in the UK. Plus, with now there being more graduates than foundation programme vacancies, why are you under the impression that you will be “guaranteed” a position? Do take note of this. It’s more than 1 million, factoring in your living expenses and accommodation. Better not waste over a million ringgit, only to end up waiting in the UK for 2 years or so post graduation for a job, and then returning to Malaysia and WAITING for your housemanship post here. If you’e thinking of migrating, medicine is probably the LAST option as a career, because there are so many different laws and legislation involved with regards to degree recognition and level of training required. Also take note of the saturation of doctors in the UK and Australia right now. Hope it helps, and please think through your options again.
I believe the strikes are over for now as there has been a new contract agreed between the BMA and the govt, and BMA members vote whether to accept or reject, the results of which will be known on July 6th.
Medical graduates from overseas will be under student Tier 4 visas during F1 and F2, and then Tier 2 for the next 2 CT years.
I doubt a medical grad “will end up waiting in the UK for 2 years or so post graduation for a job…”. They are mostly placed, even those who didn’t do terribly well.
But yes, RM1 million is a lot of money.
That would be a bit of scaremongering! While it is true that for the last 5 years, there were more applicants than FY positions, in all years, every International student who wanted to stay for FY had been given jobs. And in some hospitals, FY positions remain unfilled, and locums used. There is no issue with doing FY as it falls under an extension of the Tier 4 visa, outside the jurisdiction of EU laws.
So yes, as at this point, and over the next few years at least, based on projected numbers, the FY is assured for International students. Changes in EU laws, and God-forbid, Brexit, may change all these.
jkl, what about the article on this blog titled ‘For Future Doctors: Australia, UK, Ireland and soon…………. Malaysia!’ which was written on August 17, 2012 by Dr. Pagalavan which states how up to 1000 doctors could face unemployment because they couldn’t get into the Foundation programme in the UK ? Is that article still applicable for the current situation in the UK ? What has changed since then ?
Quoted from the article written by Dr. Pagalavan in 2012 :
“It is not only medicine that is affected, now graduates from all other courses in UK (international students) are affected, as the UK government had closed their Tier 1 (post study work) since 5 April 2012. They cannot stay on to gain some overseas (UK) working experience before returning to their home countries. Many (especially those graduated in June 2012) are very disappointed”
However, I understand the FY programme for international medics is now under the Tier 4 visa category instead of Tier 1 as stated in the quotation above. Does this mean that the FY programme was once in Tier 1 visa category when the article was written in 2012 ?
Yes, in the past. International students staying back either use Tier 1 or Tier 2 visas. They removed Tier 1 visa about 5 years ago (Tier 1 is an open visa, you don’t need to have a job offer to get it) and work visas are now Tier 2, which is an employer sponsored visa.
By extending the students Tier 4 visa for another 2 years to cover FY, they have circumvented EU labour laws. However, once you finish FY, your subsequent jobs will have to be Tier 2. The chances of getting into CT or ST and thus getting a Tier 2 visa is much higher after completing FY than if you are applying from outside the FY stream.
Like I said, all International students who applied for FY from 2012 till this year all got placements, albeit some having to wait for later rounds.
Many sincere thanks jkl. I also have a query on work experience. What kind of exposures are available or ones you would recommend medical students like me be involved in during the holidays ?
There is no such thing as “work experience” for medicine, just a formal Elective, and unofficial attachments if you want. The rest of the holidays, go holiday lah! Even the Elective, everybody knows, is an excuse to visit and holiday in some exotic place you like to visit. Non of these will count for anything much when you start work.
By the way, what is the status of the 1Care system ? Is the implementation of it to be finalised already ? I’ve only come across this word for the first time after reading this blog, and after some further reading on it being part of a greater scheme to streamline our nation’s goal to achieve developed nation status by 2020, it sounds like a great deal. Yet I still feel I yet to fully understand its full impacts, hence what are the major changes that are to occur in our health industry, and how would it affect future doctors like me should I choose to stay back as a JPA scholar ? Many thanks.
At the moment the 1Care system is postponed indefinately due to political climate. ON paper it is a good system to intergrate public and private sector. But this will lead to corporatisation of public sector. This will lead to doctors being appointment on contract basis and drop in GP’s income.
Dear Dr.,
Hello, I’ve just finished my A-level and received my final results. Several months ago, I received an offer to study medicine at the University of Edinburgh, but with the JPA Overseas Scholarship turned JPA loan for local unis, I’d no choice but to decline the offer. In search for a cheaper alternative, I’d applied to UM but was sadly rejected without interview. The only options left are private med schools (they are way beyond my financial capability as I hail from a low-income family). Should I take up the JPA loan, and do not secure a Housemanship within 6 months which is very improbable as you were quick to emphasize in your blog, I am required to pay back the full amount, with reference to https://drive.google.com/file/d/0B1_AcbUqzhincHpMYUFUYmI5NGc/view published by JPA in the http://esilav2.jpa.gov.my/ website.
As I have to make a decision soon, I find myself being pulled in different directions just to arrive at dead ends. Could you please kindly advise me on how to proceed?
I don’t think there is going to be an issue as far as housemanship is concerned as it must be a civil service job. So, as long as SPA has offered you a job, 6 months may not be mandatory to convert to loan. The only issue is the fact that since the 10 years bond is not mandated anymore in your agreement unless you receive a civil service job( from my calculation, it should be 7.5 years bond), the introduction of “contract” HO post may affect your loan. Read my latest post for issues on contract HO post.
Thank you for the prompt reply Dr.
However, (Please correct me if I’m wrong) it is uncertain that SPA will offer me a job within the window of 6 months upon my graduation. I’ve read your post on the contractual HO post, and I felt that the overly simplistic rules drafted by JPA pertaining to the terms & conditions of the loan are absolutely insufficient to address the convoluted issues. This may give rise for various misconducts in terms of the handling of the loan agreement under arbitrary reasons.
We are entering the unknown. Rules have changed, and it is unsure how each change will affect other changes. The contract HO jobs would mean the JPA scholarship/loan guideline is now redundant and needs reviewing. NOBODY can be offered a FULL civil service job within 6 months of graduation in this scenario, and hence NOBODY can satisfy the scholarship criteria.
However, I think the principle should remain the same, and as long as you are willing to serve your bond, in whatever form it will take in 5-6 years time, you should be considered as complying with the bond and scholarship.
Hi doctor, im a jpa scholar who is currently studying in AIMST University. However, i intend to pursue medicine course in another university after i have completed my foundation program in AIMST as i hv heard complains from seniors that AIMST is facing a shortage of lecturers. Students are left on their own during the clinical years with minimal guidance due to insufficient lecturers. Besides, most lecturers do not possess the qualifications required to teach the course. So, i would like to ask you a few questions doctor.
1) Is it advisable to study medicine course in AIMST?
2) Is it really important to study in a good medicine school??Is it true that being a good medical professional requires experience rather than knowledge acquired during medicine course?? If so, can i try to catch up with other students during housemanship or to accumulate experience by working in government hospital??
3) My other options r IMU n Monash. Is it better to study in IMU or Monash compared to AIMST??
4) Will studying in a below par medical univeristy greatly affect my chance of obtaining a seat for specialty training?? Do students from government unis (UM UKM USM) or established foreign unis stand a better chance due to their much superior knowledge??
Of course being in a good medical school is important but the interest of the student in medicine is also important. All medical schools in Malaysia is having shortage of lecturers, nothing new. Most depend on foreign lecturers. As long as you graduate from a recognised medical school, post graduate training is available for all. It does not matter which uni you graduate from.
Is Taylor’s uni suitable for mbbs course? Coz their lecturers and facilities look nice and well-equipped
They just produced their first batch in 2015. Difficult to comment on quality at the moment.
Among all private uni’s, which of them r the most suitable to pursue mbbs? Even though i am now studying pre-u course in CUCMS, but i need to compare the quality.
Tq, doc
The most established ones are still the better ones
Which is private University is a better choice if plan to work in Malaysia;
IMU, Monash University, Melaka Manipal College or Penang Medical College
All are ok