Since our new DG took over the Ministry of Health, there seem to be a lot of changes that are taking place. In my last post https://pagalavan.com/2012/05/31/for-future-doctors-recognised-specialist-degrees-and-period-of-training/, I mentioned about the new rules that are being implemented for those who are planning to sit for MRCP or MRCPCH. You need to have at least 4 years of training before even going for the gazettement process.
In 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 gazetted as a specialist. AND during this 2 years, it is compulsory for you to serve rural areas for a minimum of 6 months, mainly in Sabah and Sarawak https://pagalavan.com/2012/02/08/for-future-doctors-panduan-penempatan-dan-pertukaran/.
There was one thing that I did not mention in all these postings : the bond with the government. I am sure everyone knows that all JPA scholars are bonded for 10 years. Almost all local university graduates are JPA scholars as it is offered to all of them. If you do Master’s, an additional bond of about 5-7 years is added depending whether you are doing under open or closed system. Since last year(2011), another new bond has been created for subspeciality training. Every subspeciality training except for cardiothoracic, urology etc is about 3 years. You are required to do 2 years locally and another 1 year overseas or at another centre locally. I was informed that the additional bond is 3 years for the 2 years local training and another 3 years if you go overseas under MOH, a total of 6 years.
Remember that these bonds do not run concurrently but one after another. So, the total number of years bonded will be 21-23 years with the government( if you are an undergraduate JPA scholar). This has created a lot of unhappiness among the doctors in Ministry of Health. Many feel that there is no point doing subspeciality now as they are already sitting at the highest salary grade of U54 and nothing to look forward in terms of salary increment. JUSA post is very much limited. I had written about this in MMA magazine in 2011 here : https://pagalavan.com/my-mma-articles/march-2011-the-great-transformation-revenge-of-the-fallen-to-the-dark-of-the-moon/.
So, with the salary being at the highest grade of U54( with RM300 annual increment for max 10 years), who wants to take another 6 years of bonding for doing subspeciality with no additional benefit? I was informed that many who wanted to go to private are already leaving the service without a plan for subspeciality ( about 100 specialist left MOH last year!). Only those who are genuinely interested in doing subspeciality for their own interest are staying on. I expected this to happen when I wrote the above article in MMA in March 2011. Again, what I said is coming true.
There are also many with MRCP or MRCPCH who are going to Singapore and IJN for a shorter route of subspeciality training. BUT a word of caution for junior doctors: the private sector is getting saturated as well in major towns and the soon to be introduced 1Care system may merge public and private healthcare in the country in near future. So, there will come a time where the income earned by a private doctor may not be much of a difference than a public doctor.
Till then, enjoy the bureaucracy in civil service, the reason I left!
Pagalavan's Avatar 
all true.
But how effective are the subspecialty bonds? Most subspecialties are still very much in demand in private. Unless breaking the bond costs a million ringgit, it isn’t going to stop those with NSR from leaving if they want to leave.
Nowadays, they are strict with the bonds. Two of my specialist have to repay their Master’s bond despite appeals. I know that the JPA scholars who go overseas have to repay the entire amount if they break the bond nowadays.
So, they are keeping tract of the bonds. AND when you join private, especially in new private hospitals, your income is not going to be that high for atleast 1-2 years with the current competitive climate.
20 effing years! and here i thought 6 years of med school is long..sigh
The MOH knows that they control the key to any doctor progressing in the Malaysia now Dr Pagalavan. Unless you want to get your MMC registration done and then open a GP , all other avenues for your progress is determined by some training obtained in the Government service. I think the best option for these your doctors is to get the MMC and leave . If they stay next best option is still MRCP , MRCPH or MRCOG .. All getting tougher and tougher .. If not the above exams then Masters but be prepared to be in it for the long run because no matter what you have to fulfill criteria.
I heard for the subspeciality application , your forms go to Bahagian Perkembangan Professional and is vetted by not one not two but three officers to see that you have the 2 years post gazettement and also the rural posting locked in . If not the forms are just binned and not sent to the subspeciality chairmans . If no one qualifies but there are some applicants the DG has ordered still they should not be layan . So in terms of general surgery and subspeciality the bond is very strict.
I am a surgeon and my wife is a family Medicine specialist , we pray together as muslims do everyday and in my prayers i ask for the normal things such as long life , good health but since 2 years back we always end our prayers with ” please Allah , do not let our children look at us and choose to become doctors, let them live their lives and have time for both themselves and their own families, let them have a fair chance of being happy”
I believe in Malaysia it is truly the wrong profession to be in —at the current moment—.
Dr.Paga,
After housemanship how much does UD44 earn?
about RM 500 more then what you earn now
sorry malaysia..u made me to decide to stay back in europe…..
Dear Suthan,
Is europe offering good pay and good prospect for specialization? Some friends over there are complaining it is no good and are planning to return home. A few said they are regretting to stay back in UK because they are still on contract basis.
Master students with prior JPA bonds from undergraduate:
5 years for out-campus, 7 years for in-campus training
And if doing out-campus, the years spent during master training is still counted to pay back JPA bonds, then continue another 5 years bonding after completing JPA bond.
If doing in-campus, the years in master training is not counted for anything, and only after graduate then continue pay back previous JPA. After completing JPA bond, then only continue with 7-year bond
Come on now everyone …. bend over … do it for your tanah air
Dr Pagalavan,
Regarding the bond for local Master’s programme, I am wondering whether it is due to the taking up of JPA scholarship for the Master programme fee, or it is due to compulsory service even if we pay the Master programme fee on our own?
If it is due to the JPA scholarship, do we have a choice NOT to take up the scholarship by settling the Master programme fee on our own, hence avoiding the bond?
JPA scholarship is compulsory to enter Master’s. You need to sign it together with your Master’s acceptance. It use to be optional before 2003.
Dear Dr,
You said JPA scholarship is compulsory to enter Master’s. Does it mean even if the said MO is no good, he would still be qualified to enter Master’s?
I don’t think you understand what I wrote. I did not say that JPA scholars will be accepted into Master’s! All Master’s application will be selected by the universities. Once accepted, all will be offered JPA scholarship for the Master’s sponsorship which is compulsory.
Dear Dr,
I understand your explanation now. It is “scholarship” and not “scholars”. It is my mistake. Sorry for that.
Hello Dr Pagalavan,
A very interesting blog that you’ve got. I wished I have known about it earlier before I returned to malaysia.
Wonder what are your thoughts about my situation. I am a specialist trainee registrar in Geriatric medicine in the UK. I graduated in 2005 (UK) and passed my MRCP in 2009. I’ve completed one and a half years out of the 5 years geriatric training in the UK. Due to family reasons, I’ve returned to Klang Valley, hoping to complete my Geriatric training in malaysia. KKM insist that I complete the gazettement before i could apply to subspecialty training. That means i will start of as a Gred U51. Reading about the changes in the gov’s system, it will probably take me another 4-5years just to get into the subspecialty programme.
My other option is through the university route. Might have to spend some time as a contract MO before they get me a ‘lecturer’ post.
Am in a dilemma as to which option is better. Wonder what you think as it seems that you’re well tuned into the malaysian system.
Welcome to Malaysia. This is what I have been saying to those who are self sponsored in UK, complete your speciality there!!
I would advise you to talk to UMMC or HUKM. They may have better option for you. Geriatric is also not widely available at MOH. You may need to wait for long.
Dear Dr. Paga,
Ever since before entering medical school and now I am graduating in December, and God willing, will be going back to Malaysia from Western Australia to work next year, I have heard about the “peanut salary”, “slavery” and “bully” culture in Malaysia that has been tirelessly talked about by many doctors who are “trapped” in the system.
To be honest, I do agree that graduates of reputable medical schools, be it local or overseas should come back to Malaysia and give back, but giving the above mentioned problems, makes many shy away from giving back.
Personally, I think this culture does not nurture new doctors to become good doctors. And based on lots of stories from doctors currently working in the system about the unwillingness of many senior doctors to teach, or if they teach, lessons are given with “maki hamun” and sarcasm, sadly I do not think will nurture good educational development and de-skills new doctors trained in reputable medical schools. In the end, doctors who comes out of the system, will more likely be bitter people who are not only sarcastic, money driven, some will also become racist due to the system. I am not saying that junior doctors should be spoon fed or treated like a queen/king, it is just time for us doctors to adopt a more civilized culture in practicing medicine, seniors should understand that one day their junior peers are going to be replacing them and look after the well being of other human beings. Why not teach them with care and intention which is sincere, so that they become if not as good as you, an even better doctors. This will definitely bring better outcomes to the patient and Malaysia as a whole.
I have a question Dr. Paga, are the voices of the Malaysian doctors not loud enough or are we simply not strong enough because we are not really united to make the government bodies who employ us listen and provide better working conditions?
HI, why don’t you stay back in Western Australia ? Did you manage to get an internship in Australia?
we are simply NOt united!!
Dear Dr. Paga,
Thank you for giving me a really honest and refreshing answer. I am really relieved to learn that despite the dire work conditions in Malaysia, there are still lots of good doctors that actually cares for their colleague’s and patient’s future.
God bless you.
Dr. Pagalavan, do you think the additional bonded years under JPA scholarship is fair?
Other than that, do you think we should continue with the current Masters programme, which is not recognised elsewhere?
Would there be a major difference in the quality of specialty training between Malaysian Masters programme and overseas registrar training?
I understand that for certain specialties in Malaysia, you need to pass Part 1 of the MRCP/MRCS etc exams in order to be considered for the Masters programme. Do doctors need to complete Part 2 and 3 as well?
Just want to hear your thoughts on all these.
As long as the government sponsors you, the bond is fair. Unfortunately, forcing someone to accept the JPA scholarship as a prerequisite to be accepted into Master’s programme is not fair.
What choice do you have if you do not take the Master’s programme. If your basic degree is not recognised elsewhere, you chances getting a post overseas is very slim even if you pass their entrance exams.
The quality depends on the individual and the training centre.
IF you have completed MRCS, your chances of getting into local Master’s in surgery is better. However, it is not a necessity to be accepted into Master
Dear Dr. Pagalavan,
I’m currently in a dilemma. I’ve been offered JPA scholarship for my local medicine programme in one of our research public universities but under the contract, I will be bonded for 10 years after my study, otherwise I will have to compensate 250k in return. JPA will sponsor my entire 5-year course for about 70k including my living expense and tuition fee of which the tuition fee of 3.5k per year is mostly subsidised by our government. My parents can still afford me the entire cost and they just don’t want me to probably end up in rural clinic for a long period of 10 years. For me, I don’t want to lose my opportunity to work in private in major towns.
If I intend to continue my master/specialization later, will I be given priority as a JPA scholar? If I’m self-sponsored under my first degree, is government consent required for me to take up my master/specialization later?
Your advice is much appreciated.
what do you mean by opportunity to work in private sector? Being a GP? Being a GP does not mean anything anymore. I am sure you would have read all the articles in this blog for answers.
To specialise, you need to be in government sector and 10 years is a very short period of time in medicine. Whether you will be sent to rural areas or not depends on availability of post and nothing to do with your bond. The only difference is that you can’t resign without paying the penalty.
No priority is given for JPA scholar for Master’s . However, looking at the future scenario of oversupply of doctors, being a JPA scholar do have an advantage.
If you do not intend to specialise than I would suggest not to take JPA scholarship.
Do note that if you undertake the Masters, irregardless of whether you are under JPA scholarship or unbonded, you will still have to sign on a new bond….
regarding the jpa bond..
is anyone aware of the payment method?
is it by installment? or outright payment?
what is the best way to negotiate??
being bonded for such a long time will implicate not only my life but the people around me…
10 years is nothing lol..hv u started working?
not yet..
there are other priorities in life besides a career for me..
I don’t see how the bonding of 10 years(which is very short in medicine) can implicate your life and people around you! Pls explain?
Hi Dr Paga,
I’m in a dilemma of whether to accept the offer to study Medicine at Monash Sunway under the sponsorship of JPA, or to give a shot for NUS/NTU MBBS? If I were to attempt NUS/NTU, I will have to forego the former offer as the offer expires next week and the Sg unis will only respond in June. I got 4A* in A-Levels. Do you think it’s wise to hope for NUS/NTU MBBS with this result, when I am a Malaysian? Thanks in advance.
NUS is very competitive, difficult to say as only very few Malaysians I know ever got a place in NUS medical faculty. Why don’t you go to Monash first and then wait for NUS?
The main drawback is that I will have to pay JPA the tuition fees in full if I really manage to get into NUS.
How much tuition fee exactly? For the semester? If yes, it would still be worth it, no?
I’m afraid one will have to pay the complete tuition fee, as this is considered as breaking the bond.
Wow, I don’t think JPA will continue to pay your fees if you quit Monash Sunway. I would have thought it would be pay actual costs & various penalties? What does it say exactly in the terms?
NUS emphasize more on your English proficiency test. A friend with 4A and 1A- in A levels got the offer (although he changed to engineering after that due to change of interest) as he had MUET Band 6 while many of my friends who had 5A’s in STPM or A-level could not get in due to Band 5 in MUET. Having said that, they also conduct interview and only one or two Malaysians do get in on annual basis or so I heard.
NUS merely looks at the best 3 subjects, having more As doesn’t really make a difference. Seemingly a Band 6 in MUET is a must to get in! I wonder if Malaysians can use IELTS instead of MUET? Hopefully the equivalent band for IELTS is not 9.0 …
Well that’s not surprising when MMC doesn’t even recognize a medical degree from Imperial College.
NTU is not recognised by MMC.
Well that’s not surprising when MMC doesn’t even recognize a medical degree from Imperial College.
MMC does not attempt to recognise any new medical school until the first batch is in their final year. NTU/Imperial med school just took in the first batch last year, and will not graduate till 2018. Hence the earliest the NTU med school can be recognised is 5 years from now. Being a foreign med school, with zero JPA/Mara scholars, it may be even later. And it’s academic really, it is doubtful any Malaysian in the NTU/Imperial med school will ever want to return to Malaysia to work.
They will in dilemma if they couldn’t get the job and visa to work later.
All graduates from NTU WILL get jobs in Singapore.
Singapore is still OK but not UK
Hi Dr.Pagalavan. I’m currently studying undergraduate medic at one of our local university. Is it wise for me to take jpa our not? I’m quite confused.
At the moment , the best option is to take it if you want a guaranteed job
Dr paga,
What will happen if i completed my housemanship but want to quit during the first 2 years of MO. My full registration? My APC ? JPA bond? Thx
You will get your Full registration but not APC, unless you compete your 2 years compulsory service after HO. For JPA, you need to pay the penalty for breaking the bond. You need to negotiate with JPA.
Hi Dr. Paga . I’m in dilemma whether to choose between usm without taking JPA scholarship and Monash Sunway with JPA scholarship . My concern is if I have taken JPA scholarship , the 10 year bond will delay my specialist training and my goal is to work overseas . So if I am only be getting my specialist at quite an old age I think foreign countries won’t give working permit tat easy anymore . PLEASE give some advice . 😊
Your 10 year bond do not prevent you from doing speciality training. You can’t work overseas with any of our local degree. Even for MOansh sunway, you can only get your AMC registration if you undergo internship in Australia. Thus with JPA scholarship, you will be bonded in this country. Furthermore, with the internship crisis in Australia, unlikely you will get a place.
So if I wanna work as a specialitist overseas which choice is more suggestible ..?
Graduate from overseas
Honestly Emily, by the time you graduate most if not all developed countries like Australia, UK, NZ, would be already self-sufficient with their own graduates and would not need any more foreign trained junior doctors, let alone providing them with specialty training even if they may secure a job in their countries.
IMHO, Your best bet is to finish your specialty training in Malaysia, be gazetted as a specialist and then apply overseas to be specialists. Of course, at that point of time, you would be gauged by relevant postgraduate colleges on your competency to practise as a specialist in their country and of course, immigration laws apply too.
Does this means that even I am graduated from monash sunway I can’t practise medicine in Australia once I’m not undergoing internship in Australia ? If this is true , then will it be better for me to take usm without jpa scholarship then after that only seek chances for overseas postgraduate since I have freedom for not being bonded with gov ..?
Yes. You can only do postgraduate degrees overseas if your degree is recognised there. Otherwise, you will not get a job
GP regarding your suggestion , then it is better for me to be not bonded with gov and as soon as I finished with specialist training in Malaysia i am free to seek chances overseas compared to having to finish that 15 years bond only can start finding overseas opportunities ..?
None of the local Master’s program is recognised overseas. Thus you will not be recognised as a specialist in other countries. However, some countries do recognise MRCP And MRCS for registra post.
Some foreign postgraduate degrees like MRCP, MRCS can be done fully locally after housemanship and then you may apply for a SHO/registrar post in UK AT THE MOMENT. Bear in mind that although you may get a registrar post, that does not mean that you may get specialist training in UK, as this depends competition with the local UK grads .immigration rules etc.
Also, alternatively, with UK postgraduate diplomas as above, you can even work in Singapore and then try to get into their speciality training.
Bear in mind, by the time you graduate, finish your housemanship, all of the above may change.
Dr Pagalavan, may I have your email address ? I have some issue that I would like to ask you personally. Thank you.
pagal72@gmail.com