The letter below appeared in The Sun, 2 days ago: http://www.thesundaily.my/node/77369. I must say that the retiring public university Professor has said it right! I have been saying all theses since I started blogging. The entire medical education in this country is going down, that is the reality. Not only the undergraduate teaching standards is going down but also the postgraduate standards. I am seeing more and more Master’s graduates who are not competent as before. NO wonder our politicians are going overseas to seek treatment!
Again, God save this country! BTW, I don’t think Higher Education Ministry will be bothered. Education Hub mah……………
Urgent issues for Higher Education Ministry
I WRITE in response to “Sub-standard housemen” (Nov 8) and “Continuous efforts to improve housemanship training” (Letters, Nov 16) as a professor at a public university in Malaysia offering medical courses.
I agree that deteriorating standards among housemen are partly due to their attitude. However, a large part of the blame lies with the Higher Education Ministry and public universities. Poor attitude had existed among medical students since the early days of medical education in Malaysia. Then, they were identified and given proper guidance while still at university so that they emerged responsible doctors, because medical education then was a sort of apprenticeship. These days, the sheer number of students and the lack of suitably qualified medical lecturers make individual attention virtually impossible and the learning experience diluted.
Teaching in public universities for more than 20 years has given me a firsthand perspective of the downward spiral of the standard of medical schools in Malaysia. Many fellow lecturers who are experts in their disciplines quit universities to establish their own practices. They were replaced by recently graduated and inexperienced doctors and foreign lecturers from countries like Myanmar, Indonesia and Pakistan. In the past, specialists from the Health Ministry (MOH) would join universities as lecturers while medical officers would join as trainee lecturers. In the last two years, even local doctors have stopped joining universities as lecturers or trainee lecturers.
There are a few reasons for this, the most important being the salary inequality between doctors working in MOH hospitals and those who are lecturers in public universities. This began in March 2009 when Prime Minister Datuk Seri Najib Razak announced a new career pathway with time-based promotion for MOH doctors, giving them an instant increase in salary. This caused a disparity of salaries between the two categories – most marked when comparing a doctor at the MOH (RM6,731.54) with a trainee lecturer at a public university (RM4,907.57), both of the same seniority.
Another reason is the lack of transparency in the promotion of medical lecturers. Some who have worked more than 10 years are still senior lecturers while some junior lecturers have been promoted to associate professors within five years. In contrast, all MOH doctors automatically get promoted after a number of years’ service.
To rub salt into the wound, foreign lecturers at public universities are paid more than locals and most are appointed as associated professors or professors despite being less qualified. Better qualified expatriate doctors would have been appointed as lecturers in countries like the UK, US or even Singapore. A majority of foreign doctors in our public universities are those who have been unsuccessful in their applications to these countries.
In his letter, the director-general of health said the Malaysian Medical Council has set the standard in the recognition of universities offering medical programmes. However, many universities still do not meet these standards. In a recent report by the Malaysian Qualifying Agency, the university at which I currently work failed to conform to these standards.
A lack of urgency by the Higher Education Ministry in addressing these issues will have dire consequences. The next generation of doctors will no longer be the professionals we once held in high esteem. They are going to be the ones caring for us in our old age and our lives will be in their hands.
Retiring Professor
via email
Pagalavan's Avatar 
This is indeed very worrying. Main reasons we have a very POOR peformance educational and health minister in the country. They seems more concern about their political career than Malaysia future.
Pity not a lot of people read The Sun … more people in the system need to let the general public know of the issues that our medical system is facing. Only once there is an upswell of public opinion will the politicians try and do something about it.
i was wondering, why those news never appear in major newspaper like in THESTAR, UTUSAN MALAYSIA…
these things are really scares me because, i’m very less fortune medical student compared to any others because i’m studying in unrecognized university in Philippines. I been reading this blog since last year and i can see the changes in the flow of comments from both positive and negative sides. I’m pretty sure that no one like to comment about unrecognized university because it falls far in the category of consideration by these bloggers.
anyway i’m sure, there will be a solution for any problems. I really looking forward some articles from these blogger in regarding the fate of the unrecognized medical graduates.
I may sounds insane but, i honestly speaking its so painful when seeing the reality. I need know what are the solutions that i can take in order to secure a future.
These news do not appear in mainstream newspaper because they are all owned by ruling political party. Anything that is negative will never get published!
As for unrecognised university, I think I did mention about it somewhere in my comments along the way. I don’t think you are going to be pleased if I say the truth. Firstly, soon there’s going to be oversupply of doctors in Malaysia. The government has already started to give Housemanship on contract basis since September this year. Being from unrecognised university means that you need to sit for entrance qualification exams which is the final year exams of UM, UKM or USM. The chances of passing this exam is almost less than 50% traditionally. Without passing this exam, there is no way you can practise as a doctor in Malaysia. Since there will be enough doctors soon, you will be least in their priority. That’s the reason I always advise people to go MMC recognised university to make life easier when you return. Also remember that there is a limit on the number of times that you can sit for the entrance exam.
currently, i’m doing ho. i would like to be a cardiac surgeon, so could you please pave me the best way to further on this field…..in malaysia and possibly in united kingdom as i got offer from MARA to get the sponsorship to specialise in this field oversea.
warmest regard,
Mearz
If MARA has offered you sponsorship AND facilitated a placement for you overseas, then great. The times where JPA have done this, they person sent on placement usually goes for 1-2 years near the end of their training and is still payed their Malaysian salary plus some allowance.
Not so easy if you have to sort out your own placement. Firstly, you need a recognised degree. Even then, you may not get a job. In Aus/NZ, you apply directly to the RACS but you need to be working there AND be a citizen/PR. Not so sure in the UK but you probably need to be working in their system.
In Malaysia, you need to go thru the Masters programme. No other way to become a surgeon.
Whoa hold it. Does this affect even private universities also? What are the policies of hospitals and private universities upon this matter? I’m enrolling in Monash next february and this is really disturbing. I’m struggling between a medical officer and veterinarian as my life long career, and this scenario and happenings do not seemed to help me to persuade myself to take on medicine.
I’ve emailed once to Dr Paga, and I’m not really certain if he remembers me well. However, seeing how the system is circulating around in Malaysia, what future does it hold for us when we graduate from med school? Are we going to be able to uphold the professionalism like our predecessors do? Are we going to be as competent? Will the exponential influx of student cost our jobs? ?How good can we get, if our chances to practice the art being halted by “unknown” strings under the table mat?
Even if I were to be a GREAT doctor, these limiting factors surely do not convince me to continue practice the art in Malaysia. What’s worst, with all the increasing unemployment around the globe, I do not think a doctor can easily go anywhere they want. UK is facing riot, Aussie is already sending their medical graduates back to where they came from, Singapore would probably have enough docs when I graduate, and other parts of the world will have equally increasing numbers of doctors.
Hello, bell rang and tells me vet is definitely better than med. Of course, vet does have lesser extent in the matter of prospects.
So seriously, can someone enlighten me on my direction, whether if vet or med is suitable for me, My family members autocratically demand for a medical officer in the family as they claimed that its a great profession, and we wouldn’t be hit down even at economy crisis. How true is that?
It is the same every where in Malaysia. We have too many universities with too few academics. Whether it is private or pubic university, the same scenario happens. In fact, public unis are still better then private.
Whether vet or medicine, it is up to you.
Oh just great. I’m not sure if I still have the passion for medicine after all these stuffs, and after all I’ve been through. The family is still pressuring, and I know the “its your future” talk, but I still need a few more shots to make me decide. Going against my family now means to rebel and cut down all ties with my family. I’m prepared for it, but I just do not wish to have the burden of “It’s your fault your family is in a mess”.
gosh picking s course today is HARD.
Thats not really true,being a doctor is not really superior than other profession.NOTHING IS TOO GREAT ABOUT BEING A DOCTOR
Ask yourself what you really want to do in your life..if you want to become a doctor just because of reputation,you have wrong intention and fix it before you pursue this career
If you really want to have good reputation..become a politician….a good,intellectual,nice,kind and sincere politician
oh nonono, superior is one thing, prestige is another. Seriously, ask the medical students out there, the reason why they want to take up medicine. “Oh because I want to save lives” that is utter bullshit. Maybe up to 1% of the medical student population have that in mind, the others probably go for other prospects such as secured job, prestige, better outcomes, bla bla bla.
I’m going for its prestige. Seriously, 5 years of nonsensical study of the human body, the art of surgery and also medication usage is truly long. However, with the government churning up the whole thing like its just a matter of changing roti kosong to roti bom totally pulled the whole program down to, I don’;t know, you fill in the blanks.
Medical officers do not spend their life dedicating and devoting themselves towards the art just to be told “Hey,its just another job.” Why do we study this hard? Why do spend endless night studying? Why do we make ourselves outstanding from the candidates out there to take up medicine? No doubt there are other programs with excellent personals and brilliants in there, but when it comes to medicine, well at least when I was in high school, the program WAS for the tops. Now it seemed like Tom Dick and Harry can take up medicine whenever and wherever they want.
It brings down the fact and question to us, “Why should we even bother to work that hard? The others got by just like that, with probably lesser effort and less competent.” Is this the kind of environment we wish to immerse in the future as our life long career? What becomes the future of it?
Back to nothing is too great about doctor. Whoa wait, docs save lives. Whether you like it or not, docs are probably the only few possess knowledge and most importantly license to heal. Vets have equal knowledge but they only can operate on animals. Docs, they have the calling and obligation to save another human being, or being if they wish to. Researchers, academicians or pharmacists maybe there as prevention practitioners or vaccine discoverers, but doctors are still the main front line aid force.
These hard works make a doctor reputable, and the job prestigious and noble. If these devotions do not deem a doctor, a medical officer his respect of profession, hello who else does? The chairman of the hospital? Perhaps the politician who plays around with the policies for doctors? Sometimes doctors seemed to be like dolls being pulled by strings, seeing the scenario in Malaysia.
Plus, I do not recall stating doc as a GREAT profession. Vets are equally great. by being a GREAT doctor meaning a competent one, being able to practice the art at a better extend compared to my other counterparts, not just the “seemingly, by reputation” great. Sorry if I got you to the wrong interpretation.
*docs save lives. Whether you like it or not, docs are probably the only few possess knowledge and most importantly license to heal.*
truth to that, to believe it or not, this “license to heal” is more likely a license to “kill and harm” patient in malaysia. Even if we look back in history, doctor is nothing more than someone that can make a more educated guess. We try to logically explain everything we do but, most of the time it is just speculating. We have evidence on quite some management of diseases nowadays but then it will be most likely be outdated in 3-5 years time. My point is — think of what have you have been doing 3 years ago that now is not acceptable for patient care. We have seen examples like these especially in pediatric – Rotashield vaccine leading to increased incidence of intussusception will be a good example.
In adult medicine, what we did 5-7 years ago in Mx of HTN would probably be obsolete now. New medicines and treatment modality that has been in market may even have unknown side effect in next 10-15years time. classic example of what has happened would be use of thalidomide in pregnant women and new antibiotics that will lead to pancreatitis/myositis.
Giving these example, I would just like to emphasize that it is important to understand being a doctor is not as prestigious as you think. The more you are in the field, the more you will learn that what we do sometimes is really just nothing more than guessing and speculation. sometimes we feel that we save life – but we are bearing a lot more weight from the consequences where patient get back a life that has severe morbidity.
Frankly, there is nothing prestigious about being a doctor. The public do not give that much of respect to doctors anymore. the older generations do but not the younger generations. Litigation rate is going up for even minor cases and many are being settled out of court.
Also, there are many people out there who are saving lifes other than a doctor. A doctor is NOTHING without equipments and drugs. Seriously, without drugs we are nothing. And the people who develop these drugs are not doctors. they are researchers, academics and pharmacist.
In response to pgy1:
I would disagree with what a lot of what you posted. You make it sound like the medical profession is just speculating most of the time – we do not; all the “known unknowns” not withstanding. Also, medical treatments do not typically become obsolete in half a decade. eg: We still use beta-blockers in HTN. Omeprazole is now more than 20 years old – still widely used and with great effect.
The examples you quote are terrible exceptions in the history of our profession. They do not change the fact that modern medicine has done far more good than harm. Do not dishonour your medical forefathers and teachers in such fashion. It does not become you.
Medical science does not progress as a continuum so quickly as you imply, but by a sequence of paradigm shifts. When the shifts occur, they sometimes make our previous best practices look foolish (vagotomy? rigid scope? leeches? what the hell were we thinking and doing!). That is the nature of progress. So long as there has been no failure in duty of care, good intent and execution, then provision of treatment was undertaken in good faith based on best practice of the time.
Reading some of these comments, I can’t help but chuckle over how obviously medical (ie: physician) the posters are! But I guess this is the irony of medicine. With rare exceptions, Physicians do not actually cure anyone! After all, a patient with HTN taken off his antihypertensives still has HTN.
Now if one really wanted to cure patients, best to go into infectious disease, surgery or public health. But now I’m getting seriously off topic! Happy New Year to all!
In response to Dr Paga:
“Also, there are many people out there who are saving lifes other than a doctor. A doctor is NOTHING without equipments and drugs. Seriously, without drugs we are nothing. And the people who develop these drugs are not doctors. they are researchers, academics and pharmacist.”
With respect, I would point out that despite the current gloomy state of affairs, there remains a big difference between those who build and develop the tools, and those who use and apply the tools.
We may be nothing without the drugs, but we’re still the ones who are best at deciding how to use them. Also, your statement was spoken like a true physician!
(As one of barber descent, I have great appreciation for the way my forefathers undertook their work without the assistance of drugs. Oh wait, is alcohol a drug… ?)
*poke* 😉
Haha, talking like a true surgeon! Agreed. Happy new year.
What I said is probably nothing more than truth.
Given a diabetic patient with HTN is the treatment same now compare to 10 years ago? What would be the first line beta blocker?was there even an appropriate combination of anti hypertensive medications 10 year ago or did doctors back then just pick and choose base on their own reasoning.
I hope everyone understand that I am not disrespecting what our forefather has done and has taught us. Every profession learn the right thing from what had gone wrong in the past. But we have to realize that we are knowing more not because of us, but is from sacrifice of patients who bear the consequences of what we have done in good faith. I want to emphasize that our greatest teacher is not professors and textbook that teach us, but patients we see everyday; and also to remind doctors that every single decision that we do may lead to bad outcome.
as for modern medicine, does it really do any good- of course, especially for those who need it.
But think again and ask yourself these questions,
– when we work in the emergency room/clinic, how often do we admit patients to floor?how often we send them home telling them to manage symptoms? what are the percentage of patients that will recover by themselves whether they come to the doctor or not.
– have you done excessive blood work or investigation on patient, exposing them to radiation and most of all PAIN?
and yes medical science progresses much faster than you think. Not everything you learn in med school will be useless in 3-5 years time but I can guarantee that there will be new information on different topic every 3 years.
Peace=)
In response to pgy1:
“But we have to realize that we are knowing more not because of us, but is from sacrifice of patients who bear the consequences of what we have done in good faith.”
While we do learn from patients, actual medical progress is from research which ultimately needs to be trialed on patients. Some theories/treatments can’t be trialed but accumulation of what some people consider lower levels of evidence, such as case reports, is enough to prove that an intervention works (e.g. intralipid for treatment of local anaesthetic toxicity). This is not the ‘sacrifice of patients’ – this is doctors treating patients so they get better. Large trials cannot pick up everything of course and there have been cases where patients have come to harm (sometimes due to pharmaceutical companies chasing after $ and concealing evidence), but on the whole, patients benefit from our intervention and we ‘know more’ from the advancement of medical research.
“when we work in the emergency room/clinic, how often do we admit patients to floor?how often we send them home telling them to manage symptoms? what are the percentage of patients that will recover by themselves whether they come to the doctor or not.”
Not all patients get admitted, some get sent home. You admit unwell patients that need medical intervention in a hospital, and you send home the ones that get better on their own or on treatment that can be carried out at home. I don’t treat any patient that doesn’t require treatment. Doctors who do so, either do it for monetary gain (e.g. many GPs in Malaysia) or because they practice defensive medicine (e.g. the USA).
“have you done excessive blood work or investigation on patient, exposing them to radiation and most of all PAIN?”
Nope. Not unnecessary interventions. I would’ve gotten a bollicking from my seniors if I did so during my training. Again, doctors who do so, either do it for monetary gain (e.g. many GPs in Malaysia) or because they practice defensive medicine (e.g. the USA).
You have a cynical view of medical practice pgy1, but I wonder if that may be due to the environment you practice in.
“Not everything you learn in med school will be useless in 3-5 years time but I can guarantee that there will be new information on different topic every 3 years.”
Yes, new information is due to progress in medical research. It is happening all the time. I would be worried if that was not the case. Not all information from research is useful, but that is why we do research in the first place.
In fact, the last phase of clinical trials is post-marketing surveillance, and it involves us prescribing the drug to our patients. Probably we are not really aware of this phase as much here Malaysia is because most of the time we are rather “conservative” in the technology and the drugs we have to use.
There is nothing superior nor prestigious about being a doctor. My parents conned me into taking medicine by telling me that ‘by becoming a doctor, you are amongst the top 25% earners in the job market, you have a guaranteed job even in times of crisis, you have a job that is highly respectable by others and that you can pack your bags, leave and settle in another country easily if anything happens in Malaysia – so typical of non-indigineous parental thinking’.
Now after spending a decade in medicine, I discovered that doctors can hardly survive on their income after taking away cost for membership, professional commitments, exams, courses etc. You don’t even have a guaranteed job in times of peace, let alone in times of crisis, all you need to do is just open your eyes and look at the specialty application in medicine, not just in Malaysia, but anywhere in the world, there are always insufficient places regardless of what specialty you choose and therefore somebody is bound to lose out. There were times when being a doctor is respectable, but those times were long gone. These days, being a doctor is just like any service industry, you are expected to deliver what you are paid for, but unlike the chap in McDonalds who can guarantee to produce what they are paid for, doctors more often cannot guarantee the outcome expected by patients, afterall, there is only so much so that you can do.
So why study so hard then ? Afterall, others get away with a lot less effort, and even if you don’t, in Malaysia, you won’t be held accountable for your mistakes. To me, it is simple, so that you can have the peace of mind every night that you have done your utmost best for the person you cared for, but of course, there are people who can sleep peacefully at night knowing conciously that their own incompetency has cost lives.
Robinn: I’m going for its prestige. Seriously, 5 years of nonsensical study of the human body, the art of surgery and also medication usage is truly long. However, with the government churning up the whole thing like its just a matter of changing roti kosong to roti bom totally pulled the whole program down to, I don’;t know, you fill in the blanks.
—————————————
1) The study of the human body makes sense. A lot of sense. Ok, some things you learn like are really just about never used in practice…but without a basic understanding of physiology and anatomy one simply cannot be a doctor.
2) You dont learn surgery in med school – you only really get to have surgical experience once you’re working as a doctor.
3) Pharmacology is a significant part of the medical curriculum, but you have ignored the principal role of the doctor.
What am i talking about? At the end of the day, a doctor is a patient’s advocate. It is a responsibility to look after someone else. All that talk about being able to take competent histories and presenting patients coherently is not for nothing. It is a main part of what doctors do. Doctors are effectively managers. We take input from our patients, figure out what to do, set things into motion, and work the system for our patient’s benefit.
You’ve got all the bog standard tasks like documenting patient histories, admissions/discharges, cannulas, admissions/discharges, medication reconcilliation forms, legal documentation (death certs, the occasional coroner’s referral), and dealing with departments (path/imaging), more admissions/discharges, and other fellow doctors (usually specialists for opinions).
At the end of the day, all work is work, and I do not find it prestigious. It will be a matter of time before it becomes well… work. The novelty of dealing with patients will rub off. Work is work. Good doctors tend to find the job greatly rewarding…and learn tangentially due to a genuine interest in medicine. This is the only real way to learn medicine… tangentially… from patients presenting with real problems.
Those who are in it only for the “prestige” will find themselves greatly demotivated in their first year out as an intern.
Medicine is a respectable profession, no doubt. The pay is DECENT, but not outstanding. The overachieving type-A personalities who shine and earned a place in medschool will shine no matter where they are put…and will make tons more in investment banking compared to medicine.
To say medicine is about prestige, or to have the audacity to claim that you are in it for prestige casts the profession in poor light… and I have a feeling you will be disappointed.
PS: I do not know of any medical students (undergrad level) who have ever said that cliche “I want to save lives” in the med school interview. Think about that for a second…
If you really want to save lives, go into politics or NGO’s that work to improve things like sanitation and water quality. You will be surprised… The thing that reduced mortality worldwide the most was NOT medical knowledge. It was sanitation, the invention of sewer systems, and water treatment technology.
RE: Hypertension
For those interested in primary health care and harm reduction, here is an interesting video on youtube… about a http://www.youtube.com/embed/aUaInS6HIGo Made by a doctor, professionally illustrated, and backed up by hard science. A simple remedy not given enough emphasis as it is not funded by any pharmaceuticals!
Copy pasted from Robinn’s blog.
Hmm, lets do the balancing of courses now:
Med Pros
1- Wow you are a human doc! Salute its hard!– the respect
2- Thanks doc! I feel so much better!– The gratitude
3- Let’s get this bed to the OT fast! Go Go go!!! — The satisfaction
4- You’re earning bucks man! When’s the next outing?– The money
5- Oh my son’s a doc, so proud la– the mum.
Med Cons
1- Fark study like mad for 5 yrs — the non-stop study
2- Fark damn stress I just killed another patient!– the stress
3- Fark so many other docs! I’m just another, doc!– the exponential increase
4- Fark I wanna go somewhere else, somewhere else …..— the lifeless
5- Fark I can’t find any job in 5 yrs time!– the increase, again
6- Fark, I totally should have continued with vet– the regret
7- Fark, 450k, not cheap man!– the money
============================================
Im out of words…
haha seriously? you have to go that far to put this up? Well, at least that was how I’ve analyzed it here and there. It might be superficial, childish, shallow, bame all the adjectives you want but at this point its how I’ve felt.
By out of words you have had to to insert some emoticons or some sort its the cyber space man! add in *frowns* or *roll eyes* or something I have utter no response to be given here!
“To say medicine is about prestige, or to have the audacity to claim that you are in it for prestige casts the profession in poor light… and I have a feeling you will be disappointed.”
tell that to my mum. I’ve lost much passion for medicine ever since I’ve seen the medical education scenario in malaysia going from haywire to oblivion. I’m totally out of breathe to convince her I am close to giving up on taking medicine school. She still believes medical officers can go far, and will be able to take part vigorously in healthcare, such as SLIMMING CENTERS and BEAUTY SALON WTHELL.
It’s all about passion for the work people say, if we were to take and choose medicine. But I see myself nowhere near to claim passion for this course today, I have no idea why.
spent about a minute at your site, using google “site:YOURSITE.com keyword”. Just giving perspective on where your opinions are coming from. You represent the prospective med students who have been disenchanted by the state of affairs in the system, and hence your views are valuable to this thread.
If you want to start slimming centres and beauty saloons, you don’t need to spend RM 400K and 5 years of education to do that. A simple diploma will do. I hope your mother understands that.
Muahahaha! This reminds me of Bandar Baru Klang where the shophouses seem to be alternate lots of slimming/beauty salons and coffee shops/restaurants! Oh the irony… 😀
Of course there’s the other potential consideration that “service oriented” establishments (beauty salons, relaxation spas, massage ‘therapists’) are simply a means of faciliating the vice trade or money laundering, but it would be unfair and improper for me to sully this fine blog with such filthy suggestions…
lol healthcare with a “happy ending” 😉
Not only do we have sub-standard housemen, we also have sub-standard practicing doctors.
In western countries (like the States), every 10 years, each qualified specialist need to resit the same final year board exam which they took when they end their specialist training. If they fail, their license to practice will be revoked.
The same thing should be applied to Malaysia.
As a medical student, I did an attachment with a very famous GP in town. The few things that shocked me about his practice include :
1) Recycling used needles by autoclaving it
2) Screening and diagnosing diabetes based on presence of glucose in the urine
These were the practices of the “good old days”. And I am afraid to speculate how many other licensed doctors in Malaysia have these “good old days” practices.
That is just the tip of the iceberg that you have seen. I know GPs who even recycle sutures !You will still see Gps who give Salbutamol tablets to asthmatics and not inhalers! In Malaysia, doctors do not even need to have minimum CME points to renew license, what more an exam!
recycled sutures !!??
While these are indeed practices of the ‘good old days’, there is actually nothing fundamentally wrong with sterilising needles for reuse. We sterilise surgical equipment for reuse all the time. The only concern is that handling used sharps is potentially dangerous (as a cause of needlestick injury) so it’s safer to dispose of them properly and just use new needles, especially since needles are cheap these days. Also, I wonder how many GPs in small towns actually have access to a medical waste disposal system – they can’t just throw needles away with regular waste.
Nothing wrong with using urine glucose as a screening tool. Again, not all patients/GPs have access to a blood lab. I do agree that treatment should not be initiated until a formal diagnosis is done thru a blood test.
If your GP is based in the Klang Valley though, then I find it hard to justify those practices.
Hi Doctor Paga, my parents advised me to choose medic right after my spm last year ( i scored 11A’s; 8 A+), but i disagreed.. i want to study east asean studies coz i;m really interestd in language but now after a few months in asasi life science i fell in love in Bio and scored high results, suddenly i’ve the strong urge to take medic later for my degree… but after i read some articles in yr blog i think… should i choose language and forget about this ‘ medic love?’
again, it is up to you. Loving biology and loving medicine is 2 different thing. Medicine is not the same as biology although biology is part of medicine. Choose what you are interested in. You can read throu my blog postings under “For future doctors” page and decide.