I was flipping through the latest Berita MMA magazine (Feb 2012) today and noticed a section on ” SCHOMOS meets Bahagian Perkembangan Perubatan and Bahagian Pengurusan Latihan” http://www.mma.org.my/Portals/0/Schomos%20Feb%202012.pdf. The situation is getting very critical as you can see. Firstly, the new rule says that you need to be in service for at least 5 years ( 2 years HO and 3 years MO) in order for you to qualify for local Master’s application. I had mentioned this earlier in my blog posting https://pagalavan.com/2012/03/01/for-future-doctors-government-doctors-salary/. Our current DG has come up with few more new rules and regulations.
Recently I received an email from a doctor saying that the DG has asked HODs not to sign up for any candidates who wants to sit for MRCP Part 3 if they have not spent at least 1 year in a medical department. I feel it is fair and it is very important for you to undergo adequate training before becoming a physician. In UK, MRCP is just an entrance exam for speciality training. The previous rule of at least 4 years of medical training ( includes 18 months of gazettement) before being gazetted as a specialist still stays but it was not strictly enforced before. I heard, it is being strictly enforced now.
The latest news is that you need to wait for atleast 2 years after gazettement before going for subspeciality training. Initially I thought the 2 years included the gazettement period but I was wrong! Even though it is good for the specialist to master the general speciality before going for subspeciality training, worldwide the duration of training is being shortened. I feel it is way too long.This means that to enter subspeciality training the total duration of service will be a minimum of 8 years for MRCP holders with subsequent 3 years training to become a sub-specialist ( total 11 years minimum), assuming you get your sub-speciality post immediately which is rather unlikely in popular specialities. As for Masters, with the implementation of the above 2+3 criteria, it will take 11 years of service before being able to enter subspeciality training with a total of 14 years to become a sub-specialist!! Remember that other than MRCP( internal medicine), MRCPCH(paediatric) and MRCOG ( Obstetrics and Gynaecology), the only way to become a specialist is via the local Master’s programme.
The SCHOMOS article also says that it is compulsory for newly gazetted specialist to serve rural area , namely Sabah and Sarawak for atleast 6 months as I have written before https://pagalavan.com/2012/02/08/for-future-doctors-panduan-penempatan-dan-pertukaran/. As you can see, what I have been saying all this while is becoming a reality. Our postgraduate education will not be able to cope with the glut of doctors that are being produced. Thus, the knee jerk reaction by our great administrators will be to prolong the training period, force people to serve certain areas and increase the bonding periods ( you will be bonded 5-7 years for Masters and 3-5 years for subspeciality training).
The “Foot in the Mouth syndrome” that is happening for the nurses now, will soon hit the medical field. Then our great minister will say ” we need specialist but the medical colleges are only producing general training doctors. That’s why we have surplus of doctors!!” WTH.
The storm is coming and it will hit us hard. The way I see it, there’s going to be a huge number of “chronic ” medical officers running around without postgraduate opportunity ( only 10% will get it). Of course, many may not even get a job soon!
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thats why I’m doing my MBA and will try to get a job as a “pharma” in Singapore. At least they will appreciate me more.
Dude ure doing ur MBA? Tht is so inspiring.
Good luck with it! 🙂
There will be more storm coming…pray it is not worsen..
next will be hurricane………..
dear dr P,
I spoke to Dato Prof Dr Abu Hassan from d mmc, n even he can’t predict d near future. Upon his advice, I have decided to do my HO first then go abroad if I wish to later to specialize because rules may change from time to time.
I say just go with the flow. The government keeps changing its rule no one knows for sure what’s coming next.
My seniors (5 doctors) who jst finished their HO in the klang valley now got a diff hosp in the klang valley for MO. On the orther hand, my seniors who graduated in 2007 who put down Sabah as a 5th option never got back to the Klang Valley. The previous rule of being sent away doesn’t seem to apply anymore but who knows how long this will last n why those poor doctors at Sabah didn’t get their applications for Klang Valley approved? Nonetheless they seem happy in Sabah :).
Nevertheless, I do agree with u on 2 yrs aftr gazettement before subspecializing. I think that will give us a better in sight on the particular field of interest.
I do have a question though,
– when do we get to do fellowships?
Thank u
you dont get to DO fellowships, it is given on a strict basis by the particular college and there are some criteria, including years since you pass your membership exam. Some take up to 10 – 12 years.
You forgot one thing. In Malaysia, there is something known as “cables”. Those who got it will get to stay where they want to!!
Fellowship is given after 8-10 years of getting MRCP based on your publications, commitment to medical education, proposed by another fellow and good CV.
Some of the specialists I know have been offered fellows in the USA n we have a close contact with our alumni. The usmle steps that I have taken will enable me to go there n take it but I needed to know requirement from here.
So ure saying after 8-10 years of finishing my mrcpch?
Are they employed there or just doing attachment as fellows? These are 2 different issues. Remember that MRCPCH is NOT a specialist degree. In UK, it just an entrance exam to speciality training. After you pass USMLE, it is up the medical council in US to decide the post you are going to get.
Err no tht’s not how the usmle works. Look up http://www.usmle-forums.com. And also usmle.org or ECFMG official website. Once u have ecfmg certificate (upon completion of steps 1-3) u are elligible to apply for any post you want (your choice not theirs) but of course if u apply for posts that is impossible to get in, then they do not assign u a posting, u simply don’t get in n have to try for the next year’s match. The MATCH only happens once a year in march n posting starts in July every year. The way the US system works is much faster in just everyway.
And no those specialists are not employed there (although two I know employed there got to do their fellows in intervention cardiology while doing their PGY2 internal medicine residency in cleveland) but did their MRCPOphth in s’pore (part 3) then went to UK (without having to do PLAB because I remember asking how difficult was the exam n they looked baffled as they had no idea what I was going on about) n then after 3 years in UK, one of them contacted me for usmle step 2ck notes as all he needed was a PASSING mark to do a fellowship he was offered (dunno where in US) in the US.
And my supervisor in Indonesia was offered a fellowship is knee arthroplasty as well but didn’t take it because he had to pass his usmle steps which he thought was too much effort but he did do a fellow from UK (and I don’t recall him having any MRCP steps done).
YES, that is exactly what I am saying. When I say post, I am talking about speciality. It does not mean you will get the speciality that you want. Having MRCP etc does not make any difference. You still need USMLE and start from scratch in their residency programme. Very unlikely they will take you in for their subspeciality training programme right away!
Again, attachment and employment is 2 different issues. Even those with our local Master’s degree can go to UK or Australia for their fellowship attachment programme. BUT they will not get an employment unless their degree is recognised. They are usually paid by scholarship. Anyone can do attachment/fellowship anywhere for a limited time. If you have MRCP etc, you can be exempted from PLAB.
it makes me afraid to face the future becoz im just the third medical students.. 😦
Don’t worry, plenty of place in rural areas. N the birth rate cannot be predicted accurately as well. Also d crude death rate. Old ppl in Japan seem to live the longest even with the highest incident of gastric cancer there.
Read a few books from d chain of thr secret n its co authors, without the creation of medicine, there were less diseases. Of course as med personnel we’d believe but hey, it went unnoticed. The point is acutally, try to foresee a better future for yourself not worry too much over matters that may hinder your performance.
Just like during the great recession, it was obviously a big matter for the small minded ppl, but the great ppl namely warren buffet made a fortune out of the loss of others. And not through deceat but the opportunities that those that worried too much laid ahead of them.
So don’t worry be happy (Bob Marley) 🙂
dei chellam u like to praise ur self too much da… u say so u say so… every1 knows. too much stuff happening around tha people don’t give a crap bout who goin to get hired and who not anymo. when there’s overload the system as usual will collapse and rebuild itself. that how life work. may the force be with u child…
Haha. I am not praising myself. When I brought up this issues before, some even almost 4-6 years ago, a lot of people said that I am talking rubbish and I am exaggerating. BUT, almost everything I said is becoming true, one by one…. Not all system that collapse can rebuil itself.
And how do you “rebuild” the system when the damage has already been done…
1. More innocent students absorbed into dubious medical schools
2. Dubious medical exams
3. 1care – crony treatment coming up
4. Jobless doctors
5. Chronic MO not getting post-grad opportunities
6. Deteriorating quality of health care – more mismanagement
It’s like a cascade reaction…
dei master yoda.. seriously.. GTFO. cellar it seems.
Dr Paga can you please comment on the months of delay in medical graduates getting HO posting.
It was due to the SBPA issue likely. Since SBPA has been scrapped today, things will move faster. However, they are also ruNning out of post.
Yeah ure ryte about the ratio of 1:900. I read tht too. But for some time later I read another article sd their stipulation over future ratios may have been slightly wrong as not every year d exact number of doctors who go in, come out as graduates (some drop out, some graduate late). Also not all choose malaysia. I read an article by Dato Dr Mahathir once tht we should come back n serve our country as most doctors are choosing to leave the country (not sure which year was this).
But from what you wrote there is a small sparkle I see that calls out to all of us, THERE AREN’T ENOUGH SPECIALISTS. So I guess don’t waste too much time in Klinik Kesihatan or being a chronic MO (unless surgery is what we want) n get our master/MRCP etc done fast! And perhaps rather than fighting our way through big cities, migrating to smaller in need areas would ensure our safe future and enable us to help many in need. Sabah anyone? (I hear they give an extra RM1k for HO allowance)
Hmm, I think you rather naive. In Malaysia, the passing rate is almost 100% in almost all medical schools. The number of new doctors has already reached 6000 last year and will increase to about 8000 within the next 3-4 years. Remember, there are also atleast 1-2000 graduates coming from oveseas every year. The number of doctors leaving Malaysia is rather small. Forget about what Mahathir said, that was many years ago.
You can’t do Master’s fast as the seats are limited. Yes, serving districts gives you a different type of satisfaction. BUT being too long in districts is detrimental for further progress. You will know what I am taking about once you are back here.
mahathir said that in 2010 when i was sitting for my first usmle exam. if i could find the article i would.
dr P, i feel u dont welcome criticism very well. perhaps ur friend above was ryte, what u say so, u say so…
hmmmmm
If I don’t welcome your criticism, I would not answer your questions, would I? I am trying to tell you the reality but you keep harping on some few instances of success stories which you are really not sure about, but based on some forums etc. Seriously, how many Malaysian do you see going to US to work? You don’t seem to understand the real scenario. Are you sure what your friends telling you are the truths? People will tell you all sort of things but are they telling the truth?
If you want to know the number of doctors who left Malaysia, ask MMC, not Mahathir. Again, Doing fellowship attachment is different then getting employment. I can go and do fellowship attachment anywhere in the world as long as the university/hospital willing to accept me. It does not mean anything other than giving me some training in a specialised field.
Seetal,
What Dr. P said is true. The number of doctors leaving Malaysia is small, and those leaving for US is even small.
According to American Medical Association, (http://www.ama-assn.org/ama1/pub/upload/mm/18/img-workforce-paper.pdf), International Medical Graduates (IMG) mainly originated from India, Philippines. Malaysia can’t even make it into the list!
Well, the problem is, there is still not enough HO’s/ maldistribution! Big cities are still absorbing the extra HO’s with “UNIFI” cable. Peripheral hospitals away from the major cities (KL, Ipoh,Penang) are still in dire need of HO’s. Plus, a lot of HO’s are always “missing” and dropped out out HO’ship. I wonder where are all the grads. With the HO glut reported last year, I still haven’t seen any overpopulation in my hospital and the situation remained barely the same. In fact, if you had the proper qualifications and the right attitude, there is no need to worry of any HO glut.
And don’t worry about the chronic MO’s. Some of them plan to be chronic MO’s for life because they can barely scrape thru housemanship. Some can’t even read a basic ECG, some diagnosed patients with pneumonia from an x-ray with clear lung fields and no symptoms or lab data! What’s best, a surgeon who did green zone locum does not know how to manage dengue and admit patient freely with a sentence of clerking like “Platelet 88, no bleeding tendencies. To admit ward” and with no other blood investigations(apart from the FBC).
Seriously, the standard of doctors are dropping, not just from the HO, but downright to the MO’s and even specialists, regardless of if u r from local or overseas grad. It all depends on your attitude in working.
There is a remarkable amount of reserve when it comes to platelets and bleeding.
Just because it is below the reference range does not mean your tendency to bleed is increased…. It just shows that something is using up your platelets.
Plt in the 80’s does not mean you will be sprouting bleeding diatheses everywhere!
err… again that’s not how it works. yes to practice medicine there u need to do their residency program with a valid ecfmg certificate. but for fellowships its not like that. u contact the respective programs n PRAY n hope u get it. then if u dont have an ecfmg certificate u need to take the steps to do the fellowship. if not u still dont get it. but there are some fellowships that require u do their residency programs first which is 3 to 4 yrs depending. my friend did not have to do his residency there (just one year fellow in retina or some sort). the other friend is still studying for his step 2ck but will get in soon by july this year.
i also know an orthopaedic surgeon who re-did his entire residency in orthopaedics in seattle university back in the 1980s plus a fellowship. but not everyone goes through that hardship. its a general rule for the USA, South USA and Canada, if u wanna work here, u need our residency. BUT NOT ALL PROGRAMS are like that. its a GENERAL not absolute rule.
here’s a link that explains (again, this forum knows ALL it has to know about USMLE)
http://www.usmle-forums.com/img-fmg-forum/20913-ecfmg-certification-having-passed-day1-day2.html
and for those who feel helpless or are scared with the ratios etc, this site will provide some reassurance:
http://www.usmlerockers.net/profiles/blogs/1393035:BlogPost:14837
Again this is exactly what I was saying that The chances of you getting into their fellowship programme is very slim. I think we are talking at a different wave length. MOST of the time, you need to start from residency programme. I don’t think there is any thing such as 1 year fellowship. Most subspeciality is almost 3 years. Most of this type of fellowship of 1 year duration are attachments.
Dr P
also, no offense, but you shouldn’t give out false information about the USMLE when u don’t know enough. anyone who wants USMLE should be redirected to the usmle forums that discuss residency matching and fellowship options on a daily basis.
again no offense hope u dont take that personally. but as someone who is halfway through getting her ECFMG certificate, i would like others to see it as a clear option too and not be mislead.
tq
I am not sure where you got the idea that I am misleading. Did I say anything about USMLE? Anyone can go ahead and do USMLE/AMC etc etc BUT it does NOT guarantee you a job in US or anywhere else!! Please understand that. I think you are totally confused with what we trying to say here. There were many comments in this blog talking about USMLE and I don’t need to elaborate any further. Here is one of the comment in my blog from someone in US which I am sure you would have read:
“Passing your USMLE is no big deal. It does not guarantee the applicant a residency position in the US. You will have to apply for residency position through the ERAS matching program and compete with thousands of americans. The success rate for international graduates (like you) is around 30%. This is because you are also competing against senior doctors (10 years or more) applying from india, syria, middle eastern countries. Application for residency position costs at least 7-11k usd. From taking your USMLE exams (each part costs 700 usd), getting recommendation letters, writing personal statements, application of ERAS token, application to programs, interview travels (airticket, hotel accomodation, cab fares and food). After spending all of that, the matching success rate is 30%. Meaning that there is a large chance you would be left high and dry.
In order to get into california, your USMLE scores have to be near perfect. Plus, you will need to apply for J1 visa for your residency position. Some hospitals in california do not accept J1 visa, they state on their website that only americans are allowed to apply. Not to forget, as an international graduate, most american hospitals will prefer candidates with prior working/interning experience in the US. Also, each state in the US has its own medical licensing board. California state requires their doctors to apply and have their medical license even before you can start working. The medical license in California costs 1.5k usd. Like Nav mention, California is pretty competitive due to its nice weather. Americans love the sun and beaches. But, california is also one of the highest taxed states in the US. Trust me, working in the US does not make you rich. With taxes, rental, health, car and home insurance, utility bills, food bills and all that, you will only get by with a couple hundred saved per month.
I think you should concentrate on passing your MBBS and completing your housemanship then talking about subspeciality training. There is nothing great about US training system. I have seen Cardiothoracic surgeon(Malaysian) trained in US but could not do a CABG! MOH had to send him for supervision after few patients died under his care, post surgery.
From the same forum that you suggested http://www.usmle-forums.com/img-residency-match-forum/5800-fellowships-without-residency.html, it is very clear about what I have been saying all this while that you need residency in US to be able to be employed there. Anyone can do fellowship as an attachment.The following statement is very clear on that :
Fellowship without Residency (Direct Fellowship)
Yes. IMGs can go to fellowship directly. There’s no specific list of specialties that accept IMGs directly because all of them can do that if they wish.
The criteria needed:
You need to be ECFMG certified which means you pass USMLE Step 1, Step 2 CK, and Step 2 CS.
You need to have had some sort of residency training in your country (MD, and MBBS are usually accepted)
Some fellowship programs even require that you pass USMLE Step 3.
How to get it:
Go to the NRMP Fellowship website and look for positions that are unfilled. When you find one, start talking by (email or telephone) to the program director and see if you are eligible or not. I want to remind you that getting these unfilled position is fairly easy because these programs will be losing money and may even face closure if they don’t fill their positions.
What after direct fellowship?
If you want to live or practice medicine in USA then residency is pretty much unavoidable. Because most jobs require you to be board certified and fellowship does not get you that. Therefore, you need to go retrograde into residency after you finish your fellowship in order to be board certified so that then you can practice medicine in USA.
Any advantage of direct fellowship?
One of the advantages for the direct fellowship for the IMG is that if you don’t get residency then it might be easier to get fellowship so that after finishing the fellowship it might be easier for you to get the residency specially in the same hospital where you did the fellowship as the attending and the program director now know you very well and they can get you in to their residency program after finishing your fellowship (but nothing is guaranteed, this is just an assumption).
The other advantage is that some IMG folks are already practicing specialists in their countries and all they are looking for is to get further sub-specialization and then go back to their countries and in that case this route of direct fellowship is a great idea for them.
I think you are totally confused with all the training system.
Dear Dhaliwai,
You might want to recheck the information again.
The true fact is direct is possible but there is no point of doing it if you want to stay in united states. I CAN 200% GUARANTEE THAT YOU WILL NEVER BE ABLE TO STAY BACK AT UNITED STATES TO PRACTICE AT ALL AFTER FELLOWSHIP NO MATTER WHAT STRINGS YOU PULL. But if you want to just go back to whatever country you come from that is totally fine. The 2nd options would be to RESTART residency ALL OVER AGAIN AFTER FELLOWSHIP. There are some options that you do 2 year fellowship and 2 year residency and STILL you will NOT be certified at MOST states. Some states do that 2 year residency IN UNITED STATES as a prelim qualification for board certification but mostly 3 years.
Fellowship tho will prefer 1st American US residency grad, 2nd Non american US residency grad, 3rd canadian residency grad 4th Western world grad 5th IMG residency/doctor who has tons of experience or research, wrote books or multiple publications 6th new IMG residency grad. Visa comes before ANYTHING. If you don’t believe that go check out the fellowship programs (Not usmle site), look at the fellows profile – then tell me how many IMGs graduating from outside US/Canada/western country they take. Even if they do, look at their background. That of course will change a little bit if you want to go to some sub-standard program.
It all comes down to what citizenship or visas you carry. As IMG J1 is probably the best bet to go(If you are still eligible) because most fellowship accepts J1 visa holder. H1 would be ok if you are highly competitive (not usmle score but other background) – at least 30-40% of any subspecialty fellowship programs do not sponsor H1 because they are actually the hardest group to get research grant.
Again no offense hope you don’t take that personally, But as someone who is currently in united states doing residency I would like others the know the truth as well.
tq
Do not be fooled by the forum. Direct fellowships are possible but not a very good pathway. During fellowship years, a fellow is expected to know the duties of a resident and are required to teach residents and medical students. If you did not go through any residency, how competent can you be? Direct fellowships are only good for very senior attendings who practised medicine in their home country for a good amount of years with solid teaching and research experience. Also, most fellowship positions are matched via ERAS and NRMP. Unless you are godly famous, no program would want to take in an applicant with minimal (3-4 years) medical practice experience and no residency. Remember, there are many US resident applicants going after these fellowship spots too, so why do you think the program director will think that you are superior to them?
Dear Seets,
I am afraid dr paga is correct. My husband is applying for fellowship positions at the moment and what i am describing is our experience. Yes, as dr paga and you mentioned, it is POSSIBLE to do a direct fellowship with some programs. The way to do it is to contact those programs that offer such pathway and hope that they give you an interview. However, direct fellowships DO NOT allow the person to practice in the US because they cannot be board certified. In order to be board certified, the person must complete at least 3 years of residency and passed USMLE exam in order to be eligible to sit for the board exam.
One of his colleague is a peds attending in the UK for nearly 10 years. In order for him to work in the US, he had to start all over again, from residency program.
Also, not many programs offer direct fellowship positions. And, i hope that you are aware that fellowship application is also similar to residency. The applicant must apply through ERAS, pay for a token, submit 3-4 letters of recommendation, personal statement, CV etc. Then, you apply to programs enlisted in the ERAS. Wait for individual programs to offer you an interview via e-mail and then arrange your flights and sometimes hotel stay to interview at various programs.
After the interview season, applicants are required to rank their program via NRMP. NRMP will then sort and match applicants to the program and release the information on match day. Direct fellowships are possible but limited to individual selected areas of specialization only. Most fellowship positions in the US are still matched via ERAS and NRMP.
Please visit the ERAS and NRMP sites for more information regarding which fellowship programs are participating in the match and also for match statistics. I tried to paste the links via the comment box but wordpress would not allow me to do that.
Madam Elly, could I get yout contact as I would like to talk to you on USMLE and things related to it.Thanks
My Email is eerengming@gmail.com
This is an interesting forum. I stumbled upon it accidentally whilst browsing through FB.
I am currently a Foundation 2 Trainee in UK, having being trained in a medschool here and have secured a run through paediatric training post for 8 years.
From what I can see on the forum, there seems to be a lot of confusion regarding the completion of membership exams, training posts and fellowship posts etc.
I cannot comment on other training systems, but the way it works in the UK; if you are a non-uk/EU trainee, you will need to pass the PLAB first to enable you to work in the UK. You may / may not qualify for our GMC full registration dependng on clinical experience. If you do not qualify for full registration, you will have to undergo the Foundation Programme (similar to Housemanship) for 1 year, get your full registration and progress to Foundation year 2 (similar to MO).
On completion of your F2 year, you will then progress to specialty training. Most people will apply for specialty training whilst in F2 itself. So, on completion of F2, you will progress straightaway into training if you have a post.
Most Foundation doctors will also have completed Part 1 of their respective membership exams.
Training posts in the UK are divided into Specialty Training and Core Training. Specialty training are run-through posts where you are guaranteed a post until you are fully qualified as a consultant ; Specialty training 1-8 (e.g paeds, obs and gynae, radiology etc). Core Training are posts where you do 2-3 years (Core training 1-3) and then re-apply for Registrar training for another 4-5 years (Specialty training 3-8) (e.g Medicine, Surgery, Anaesthetics etc).
For those who are not fortunate enough to get Training posts, there is something called LAT (locum appointed training) where you can get a stand-alone post for 6 months -1 year which may be counted towards your specialty training. These posts are created for filling gaps where Specialty trainees have taken time out for maternity leave etc.
Fellowship, like many of you have mentioned are NOT training posts. If I am not mistaken, they do NOT count towards your specialty training. However, they provide an invaluable stepping stone / fodder to beef up your CV.
I hope this is helpful.
Hi Jiayi, i am a malaysian studying in India (MBBS). As u have mentioned in your comment, there are 2 foundations before taking up post-graduate course in the UK. i m currently doing my housemanship in India, for a duration of 1 year, can it be consider as 1st foundation, so that i can proceed with Foundation 2 in the UK after passing PLAB? Or i should complete 2 years housemanship in Malaysia first, so how is it like?
If u are not sure, where can i find out or whom can i speak to? The rep from British council ? Thanking you.
As far as I know, your housemanship in Malaysia or India will not be considered. After passing PLAB, you need to redo housemanship (FY1) in UK in order to be eligible for full registration by GMC.
If that so, what would you recommend, Dr.P?
Should i complete housemanship 2 years in Malaysia then sit for PLABs or do i have an option to sit for PLAB after completing internship in India….? What would it be like later, as i do plan to come back to malaysia after achieving what i need with PLAB?
If you plan to come back to Malaysia then it is better to complete your housemanship in Malaysia
Sir, are you suggesting that i complete my 2 years housemanship then only sit for PLAB ? I am chasing time. It is too long to wait in Malaysia before taking up post-graduate, be it alone the gazzetement etc etc etc…. such tedious process….(when the truth indicates that malaysia requires more healthcare providers!)
i do’t mind hardships and if it will cost me staying away from home if i could achived what i have been planning since i started medical school and knowing the continuous process of learning and, in the long run, i could make my mum happy and myself happy by giving back to the needy people. In india, right after 1 year of internship, my friends can sit for the annual entrance PG exams. of course one has to get a good rank to get a desirable seat. otherwise paying for a seat is an option which is costly. i do’t mind to pursue further on my medical education here after 1 year completion, unfortunately malaysia doest recognise Indian PG degree since the days of my father!
You can sit for PLAB during your housemanship in Malaysia. BTW, do you think that specialist training in UK is shorter? Even if you do get a job in UK, you need to do FY1 and subsequently may not even be able to secure a job, what more a specialist training post. Priority will always be given to locals and Eu citizens. Don’t assume that the training is shorter. The competition is great and very little chance for you to get a post unless you are outstanding. Local graduates will also be given priority.
Dear Jiayi, can u help me in clearing some doubts regarding medicine field in UK since you are now in FY1.
Dr.P, i am not suggesting that the UK will take shorter time to be a individual consultant as i am aware that in the US it takes 4 years which is shorter than the UK. What i meant was, one had gone through 5.5 yrs for MBBS again for postgraduation especially to those who graduated from abroad one has to wait 5-7 years again! instead of going for 3-5 yrs working in malaysia as a sub-resident in order to qualify for postgraduate courses, why not immediately after my internship for eg. that i start my PLAB and continue the process till i am a certified consultant specialist. Later with shorter waiting time, i can give service to people in need. when and if there is an option to avoid the wait, i do’t think there is any harm….?
Actually, you are assuming that you will get into the training post in UK as soon as possible but that is not the case all the time unless you are a graduate from UK. That is what I am trying to say. The wait will end up the same if you are unlucky.
P.S , Membership exams are like what Dr P said, they only qualify you to start training as a registrar ( second on-call) e.g ST 3 and above.
jiayi,
fellowship in the UK is not a training post. But, the same term – fellowship refers to sub-specialty training in the US after 3-4 years of residency. I think many people are confused as to what fellowship is referred to. Different location, different meaning.
I predicted that in near future our great private medical colleges will be able to offer part 1 or even te whole master program for medical specialist courses. Consider that money is their priority, this is not impossible!
Yup, I agree. I suspect IMU will be the first one to be allowed to do this because it is now a GLC. In 5 years time is my guess.
Having said that, Perdana thinks it can do American-style residency training in their private teaching hospital in the future. Good luck getting ACGME accreditation for that.
Dear Nav,
It seems KPJ will be the first one. see link http://thestar.com.my/education/story.asp?file=/2012/6/17/education/11466151&sec=education
Yes, thanks for posting it.
It will be interesting to see how private patients react to being treated by a trainee instead of a specialist, especially with the fees involved.
It sounds like they will just use the UKM postgrad curriculum. No need to invest in their own in-house medical education team that way. They could even use the same exams. No real innovation/investment so will keep their own costs down – KPJ is listed on the KLSE after all and its main aim is to make $$$ for Johor Corp.
I find it very intriguing though that Tan Sri Dato’ Dr Abu Bakar Suleiman (with whom I’ve personally had a conversation about medical education in Malaysia, and seems like a nice guy) is on the Board of KPJ and is also the President of IMU. I still suspect IMU will eventually offer postgrad programmes due to IHH links with Pantai.
At the moment only government universities are allowed to conduct Master’s programme. However, soon our great leaders may allow private colleges to conduct it as well, another knee jerk reaction. Already we can see deteriorating quality of our Master’s graduates, GOD knows what’s going to happen then!
Dear Dr,
What is your opinion ?http://thestar.com.my/education/story.asp?file=/2012/6/17/education/11466151&sec=education
I heard about this quite some time ago and was waiting to be announced. I did comment about this in one of my posts. There are pros and cons to it. How many consultants will actually train these trainees? Would they even allow this trainees to do any surgeries? Most likely the government will pay for these trainees. KPJ will make the money. Hpw will the quality be controlles? what exams will they be sitting? Many questions to be answered
Malaysia is one of the rare country that doesn’t encourage post graduate training early… unlike singapore, and other developed nation, who upon completion of HO, is encourage to start a residency programme to specialise in their field of interest, so that they can specialise fast and do speciality early to improve the healthcare system… Malaysia is the other way around.. Malaysia puts so much red tape on entering masters… first they prolonged the housemanship training from 1 year to 2 years, giving empty promises that it will not effect masters application… now, instead of 3 SKTs, they want to make it a total of 5 years wait??? you must be kidding me… don’t the government see that we are actually lacking in specialists??? Are we moving forward, or backward?
Jocelyn… u surely know whats the reason for this right?? Cmon la.. its an open secret in this country. Our best brains never specialized. period. ITs a pity. As a result, a lot of these guys opened clinics and are minting money as they are putting their ‘brains’ to the business side of things. Look around, some clinics see 90-100 patients per day and the ‘GPs’ drive Passats and 3 Series.
Blame the bloody system for allowing these doctors to drain to the private side instead of retaining them in the gov to provide service to society.
Yout theory about GPs is not true anymore. I just heard another GP closing shop in my town. The established GPs are doing well but the newer ones are struggling unless you open in housing area which is far from any government clinic and hospitals.
The problem now is MOH has no control on the private medical colleges approved by the Higher Education Ministry. The MOH is obliged to received whatever number of doctors produced by these medical schools PLUS those graduated overseas. Thus there is a massive surge of doctor supply in Malaysia. MOH had to come out with ideas to absorbs these doctors. So they need to prolonged the HOship, build more hospitals, create more posts etc but these are just temporarily measure, sooner or later, MOH will be overwhelmed and they simply do not have any posts for new doctors. With such large supply of new doctors, naturally the Master program will not be able to take so many candidates. Unlike the undergraduate program, Master program or even the oversea exams need training posts to complete the program and thus the limitation to increase the number of new trainee. Because the mismatch of supply and demand, universities will have the ‘luxury’ to select those with the most experience and best. Even those with cable will have difficulty to get seats because you really need a very big and solid cable to ensure you can have the shortcut as a lot of people now have different kind of cable as well.
Malaysia is always moving backward! Frankly speaking, Malaysia is not prepared yet for a residency type training. Our healthcare system is totally different from developed countries where every hospital have subspeciality services. Thus general internal medicine, general surgery etc etc is still important in Malaysia. Saying that, we should be moving forward and not backward.
Chellam… That’s what happen when kids this days pass a paper and put extreme high hopes of getting whatever they want. They don’t realise that truth in reality is different with the truth in text(Forum)… regarding usmle stuff up there… may the force help the confused seetal.
If you want to get a fellowship in US directly without residency,choose the non competitive programs( non surgical, non interventional), the good and competitive programs are usually taken by the US grads and all those who have done their residency there,be prepared to spend RM50k for all the steps, and nrmp application, interviews, paperwork etc. after you have prepared the groundwork, pray hard that you get interviews. Do research like crazy and try to publish as much as possible. If you want competitive programs, make sure your CV looks like this: 99 in your USMLE steps, a few publications in good journals, recommendations by well recognized physicians( Physicians who publish a lot), eloquent and confident personality, perfect command of spoken english. Always have an alternative route to go if you are unsuccessful, Dr P is talking more realistically and seetal is not wrong either. Both of you are painting different parts of a picture. Take the advice of an experienced physician.
I do agree with Dr Pagalavan that too many doctors in our country and life as a doctor became unpredictable. I was still lucky enough to become a houseman officer automatically after graduated from a medical school, i did not need to go through the interview to get a job. I was still given a chance to write down the 3 choices where i want to work ( although i might get a forth choice- to be sent to elsewhere).
I realize that quality of doctor are dropping. Compare to senior 2-3 year older than me, i can see huge different between us. For example, during their HO time, maybe just 2 HO allocated in one 30- 40 patient ward,during my time it is 15 HO per ward. So, training is lacking.
Then, we also realize that our future was really unpredictable. After you complete your housemanship, where will you choice to go? I also find out that majority of the doctor will choose field which had relax life, they don’t mind to be a chronic MO, such as at KK, district hospital, or some posting with no active call like ENT, radiology, pathology, opthalmology, psychiatry. So, these posting become hot posting when it come to the time to apply as a medical officer there. When these posting are full of the chronic MO, then, it was a bit unfair for those who really had interest in the field and plan to be specialist there, because when a department is full, you will had to go to other department which you don’t really like.
Then come to the time when you want to further your study, master programme had a limited place, and you have to have good SKT marks for that, you might be ended up working in a department for 4- 5 years and still cant go into master programme, or some of them still get stuck in other department, district hospital. For those who are interested in medicine/paediatric, they can try to take the exam like MRCP/MRCPCH, but it is not easy way either, and after you get your degree, you have to do your gazettement 18 months, being sent to Sabah/Sarawak, before you become a true specialist.
This is what I have been saying but some people still refuse to believe. Probably soon, whoever who do not get Master’s programme may not be able to stay in a big hospital. You may be thrown to a district or Sabah/Sarawak
For all housemans…Gaining entry into local master’s programme doesn’t guarantee anything. Good news is, the current trend shows an increased in masters intake annually, more hospitals are allowed to take in masters students as an open system
However, please bear in mind a strong family support with huge amount of dedication and sleepless nights are paramount to passing the exams. For most of us, its a great challenge trying to care for young children, going on calls and finding time to study simultaneously. I’m sure most will agree , our health care training system makes it difficult for family and work balance esp for medical officers training in hospitals. Sadly, I can’t help but foresee increasing numbers of masters dropout locally. Here’s the catch, there is usually a 5-7 yr service bond or pretty huge sum of money to pay if you fail the exams repeatedly or dropout.
This is the main reason why most medical officers delay specialisation or decide straight on to move to private sectors, eg: opening GP clinics, medical reps, or working as temp or permanent locums.
Any career can be rewarding and succesful be it specialisation in hospitals, owning a GP practice or being a medical/pharma rep. It all depends on the level of commitment and hard work put into practice and of course good clinical acumen and management skills.
The number of Master’s post is very small even if it increases each year compared to the number of graduates coming in. By 2015, Master’s allocation will increase to about 1000 which means only about 10% of the doctors will be eligible. Yup, I agree that no matter what job that you do, you can earn a decent leaving if you are hard working. You don’t need to be a doctor to do that.
There’s is another catch: additional 3-5 years bonding if you do subspeciality. All this bond do not run concurrently. It is one after another from your undergraduate bond ( if you have any).
BTW, the number of Master’s drop out is actually decreasing as the standards are also dropping. In Internal medicine, the drop out/failure rate use to be 50% in 1990s, now almost 80-90% graduates.
[…] March 2012, I wrote this https://pagalavan.com/2012/03/07/for-future-doctors-the-storm-is-coming-part-2/ where the new rule says that you can only apply for subspeciality training 2 years after you are […]
[…] “The storm is coming , Mr Wayne…………” Well, I just watched Christopher Nolan’s ”Dark Knight Rises” movie last friday and I must say that it will go down as one of the best movie trilogy ever made. A superb ending for the Batman trilogy. I have written twice on this topic above https://pagalavan.com/2011/11/07/for-future-doctors-the-storm-is-coming and https://pagalavan.com/2012/03/07/for-future-doctors-the-storm-is-coming-part-2 […]