The official circular on subspeciality training in MOH is finally out. I have mentioned most of it over the last few months but finally it is official. From January 2013 intake onwards, subspeciality training will be done exactly how the Master’s application process is done. MOH will advertise on the application and due date. You need to fill up the application forms and send together with some relevant documents to MOH within the stipulated timeframe. The circular attached below have all the rules and regulations http://latihan.moh.gov.my/uploads/Syarat%20dan%20Borang%20Permohonan%20tawaran%20C.pdf.
These are some of the conditions:
1.1 Mempunyai kelulusan kepakaran yang diiktiraf seperti Program Sarjana Perubatan daripada universiti tempatan atau setaraf seperti MRCP, MRCOG;
1.2 Telah diwartakan sebagai Pakar Perubatan;
1.3 Mempunyai pengalaman sekurang-kurangnya dua (2) tahun selepas diwartakan sebagai Pakar Perubatan kecuali bagi bidang Geriatric, Hepatology, Respiratory Medicine, Palliative Medicine dan Neurology, pegawai hendaklah mempunyai pengalamansekurang-kurangnya satu (1) tahun selepas diwartakan sebagai pakar;
1.4 Laporan daripada Ketua Jabatan berkaitan kesesuaian pegawai untuk mengikuti latihan tersebut dari segi pengalaman, sikap dan minat;
1.5 Terdapat kekosongan tempat latihan bagi bidang subkepakaran yang dipohon;
1.6 Merupakan Pegawai Perubatan Pakar lantikan tetap;
1.7 Merit akan diberikan kepada calon yang bertugas di kawasan pendalaman;
1.8 Berumur tidak melebihi 46 tahun pada tarikh tutup permohonan;
1.9 Mempunyai prestasi cemerlang dengan markah purata Laporan Nilaian Prestasi Tahunan (LNPT) bagi tiga (3) tahun terakhir berturutturut (2009, 2010 dan 2011) tidak kurang daripada 85%. (penilaian genap 12 bulan bagi setiap tahun);
1.10 Tidak pernah menerima sebarang tajaan Kerajaan Malaysia bagi peringkat kursus yang sama;
1.11 Tidak pernah gagal atau menarik diri daripada sebarang kursus tajaan Kerajaan Malaysia;
It is interesting to note that you now need atleast 85% SKT marks for the last 3 years and atleast 2 years postgazettment training except for some subspeciality. Preference will be given for those who have done rural postings and publish papers. The circular also mentions about the bonding period and the amount that you have to pay if you resign early as what I have mentioned before in my blog. One good thing is the fact that they are giving partial scholarship for your training locally of 2 years and full scholarship for the last 1 year overseas training. The bond will be 4-6 years depending on whether you do everything locally or part overseas. Also remember that if you quit subspeciality training halfway, you still need to pay the bond as mentioned here http://latihan.moh.gov.my/uploads/Ikatan%20KontrakPSP.pdf, similar to the Master’s programme!!
I feel that all these rules may be counterproductive. I am already hearing a lot of news lately of specialist resigning from civil service without doing subspeciality. This is because all of them are already at the highest pay scale of U54 and there is nothing to hope for by doing subspeciality. The addition of all these rules and bonding will only make the situation worst. Only those who are really interested in doing subspeciality will procede. The rest will just leave…………………, not to say there is a lot of money in private………..
Circular : Syarat dan Borang Permohonan tawaran C
Pagalavan's Avatar 
I think these are reasonable steps to prevent trained and run away sub specialists. For those who ate willing ti serve, they must be given opportunity. These steps will at least screen out those impatient dr whose invention is after the money.
I meant impatience doctors
yup, the reason is to retain subspecialist. Why must MOH train them when they are not going toserve MOH. However, I am just worried about the selection process ? transparency!! Those who want to make money or do medicine for money will leave anyway. Then they wil realise that private sector is not that greener anyway. Private sector nowadays only interested to take subspecialist.
85% SKT- …u guys just have to suck up to your boss harder. welcome to malaysian world of immeritocracy where with your buy-your-own-degree qualification + daily ass kissing to your superior ,you can actually prosper in medicine.
Don’t worry, if you are willin to work in smaller hospitals or rural area, the ass that you need to lick is very much smaller
Hi Dr Pagavalan,
I have an offer from University of Edinburgh. Now considering whether to accept it or not.
I have heard many reasons on why studying in Malaysia is better than going overseas. Some of them are :
1. Everyone who is back in Malaysia must work in government hospitals for at least 3 years anyway.
2. More diseases in Malaysia, so better training.
3. If students graduated from UK come back to Malaysia to do houseman-ship, they will be treated the same as any local graduates and graduates from not so reputable places.
4. After degree, local graduates can still go to specialise overseas.
How do you find USM, Newcastle University and Monash Malaysia for medicine?
Thanks =)
oh, and one more, Perdana University PU-RCSI for medicine.
If I were you, I will accept UNiversity of Edinburgh offer.
1) Housemanship is compulsory for 2 years and another 2 years compulsory service. It is indeed good to work in government hospitals to get enough experience
2) More tropical disease. The rest is the same
3) Not really
4) NO, local graduates can’t go overseas for postgraduate training unless on attachment basis, usually 1 year. You cannot get any job overseas unless you sit and pass their entrance exams.
UM/USM/UKM are OK. I won’t consider the rest.
Thank you for your reply. (=
Is the training in UK really worth the really high tuition fees for us students and why?
It is an established uni which is difficult to get it. It is also well recognised all over the world.
i think the move is counterproductive as well . As we might be aware , many of us particularly in the surgical fields would not be doing much general surgery work anymore once we’re in subspeciality . Furthermore in some fields such as urology you cannot go back to gen surgery work and if you do,,, can be reported . We spend so long attaining the basic postgraduate degree only NOT to do it anymore once in subspeciality . Our lifespan as doctors and surgeons is very short actually .
A fully qualified general surgeon can hope to do so only by the age of 34 or 35 these days ( without the FRCS ) and upon completion another 3 years before application for subspeciality . Once sub is finished only then the actual career kicks off. Compare this to our japanese, indonesian and even vietnamese counterparts who come to our shores for some attachment. They finish their housemanship and directly go into their field of interest . This makes them very experienced in their respective fields at a very young age and they are able to come up with new techniques and modification of operations far better than us at the same stage of training . If someone says that such fast tract training produces only fast track surgeons and non all rounders i disagree. The fact remains that in this era we treat patients by determining their overall problem and focus their management to areas of speciality available in our respective centers. So in reality our government hospital functions in very specialised subunits but they want to produce holistic specialist . Why not embrace one path and stick to it . If we are heading to era of subspeciality then allow the specialist to do it faster, and if they choose to leave then bid them farewell…the grass is not greener on the other side anymore and furthermore if they leave they continue to serve in their own way…
So in summary , the subspeciality ruling mentioned above would definitely produce more experienced and trained specialist in the long run who by force have to be bonded to the service but in reality
will these subspecialist translate the training to service or part time private work which many are involved in now?
Will it matter actually if you have a subspeciality as after all we all will get 54 and Turus and Jusa positions are limited.
You will have a good 10-15 years to practice your art of medicine before you have to retire .. would you do it in the service or in the private sector.
My humble opinion is simply that our predecessors have benefitted from obtaining training , doing attachments and also improving their self worth all in the name of service but very few have truly served after obtaining all the above . We are paying the price of their selfish actions . THe same selfish people i have mentioned above will not wink an eyelid in pity of what is happening now . They will merely say that they have done their part for service and now it is different .. Hypocrisy at its best i say .
Totally agree. Many countries are shortening their training system unlike Mlaaysia. A very fast tracked subspeciality training is only possible if our emergency department are filled with emergency physicians. In countries like US etc, the cases are already sorted out in the emergency department befre being referred to a subspecialist. Thus, the subspecialist will only come and see their field of expertise. They will not bother about anything else and many more referrals will need to be made for each problems.
In Malaysia, the halthcare system is as such that there are many hospitals which do not have many specialist. It is still not ready for a fast track speciality training.
Qn. Assume I finish 1.5yrs post MRCP in May 2012. Am I allowed to apply in 2013 since I would have had 2 yrs post-gazettement before entering subspecialty training in mid-2014 ? Or do I wait until 2015 in order to apply thus having to waiting for a total of 3 years to enter subspecialty training?
In Malaysia I get the impression that quite a lot of doctors get posted to unpopular places and end up not doing what they want to do, and have to serve for a year or so before being able to apply to what they want to do. So I feel rather frustrated with this new ruling as I will be even older when I eventually complete subspecialty training …
Based on my understanding, you will be eligible to apply end of next year for July 2014 intake.
Check the requirements when the application is made available. Usually it differs slightly
Hi Dr. Pagavalan!
I’m a huge fan of your blog and am thankful for your thoughts that you’ve shared with us. I would like to ask your advice on something though. Thing is, I’ve always wanted to do medicine because I’ve always wanted to save lives and to make a difference in someone else’s life. However, after reading through your post for some time, I did some thinking and I started having my doubts. My passion and intention is still there for medicine, but then again, after hearing all those problems arising especially the increasingly number of doctors and the likeliness of unemployed doctors by 2015 and the deteriorating quality of doctors being produced plus the frustration of the government system in government hospitals, I would like to seek your advice on what would be best. (I want to save lives and help people but then again, I would want to consider the future of it and my life too.) I’ve always put law as a second option after medicine, but right now, I am currently deciding on which to pursue as my career.(Yes, I know that medicine and law are of two different fields but I’ve always put law as my back-up plan and didn’t really consider it as I was in science stream all along since high school.)
However, currently I am facing a dilemma whether or not to take up medicine(If medicine, it would be in USM) or to take up law. I want what’s best for my future and judging from your blog, I can see that you would agree with me that there is no future in medicine field anymore other than the intention of helping people. True enough, I would like to seek your honest advice on whether if I pursue medicine still, by the time i graduate (it would probably be year 2017), would the situation be any worse than now? And so, would it be hard for us graduates to find a job let’s say in a government hospital even? Is it the responsibility of the government to provide us a job after HO or is it ours to apply and wait for the answer after having done our HO.) Or to get a postgraduate training in local Uni? I understand that, in this world, if you’re good, you’re good and you will get there. But having said this, I am really in a confused state of mind in deciding what’s best for me and my future and hopefully I will not regret it. I really hope that you could shed some few words to help me make up my mind. Is the future of doctors in Malaysia really that bleak? Thank you so much for your time spent, doctor.
Dear Aspiring Student,
You are not the first person to ask Dr P the “Should I do medicine?” question, nor will you be the last. It is a big load to place on another person – you are essentially asking him to determine your future.
You have done the right thing by going online to read what people are saying. If you have friends/family who are lawyers or doctors, I would talk to them as well.
The only people I would say to pay no attention to is the family friend whose child is doing medicine (or any other profession) and who can’t stop boasting about how well their child is doing (always exaggerated). Where possible, speak to people themselves.
Will it be more difficult to get a job in 2017? The answer is a big yes. Having said that, it is likely that public uni students will be given preference because the govt has subsidised your medical education and will want a return on their investment. So USM will be a good choice from that perspective.
I am sure you have read everything in my blog which is the reality on the ground. However, I can’t decide for you. If you really have the passion for medicine then go ahead but you must be prepared to face the reality later on. There will be a lot of frustration along the way. No government in this world promises a job for everyone. Same goes to doctors as well. BY 2017, there will be surpluss of doctors and the governemnt have declared that in another way by quoting the doctor:population ratio. BUT they can’t stop people from doing medicine. I would suggest you to do medicine in local public uni or via JPA scholarship as the government will definately give priority to these group of graduates.
Forget about good life and money, that is no more in medicine. You can stll earn a decent amount of money to survive, that’s all, same like any other job. When the 1Care system is introduced, all doctors will be paid by the National health scheme based on what they think is the right fee. So, all doctors may end up earning almost the same.
Thank you to the donkey administrators we have in KKM for destroying the medical profession in this country and also for killing off subspeciality training. Not all doctors pursue money in their career, there are many who have passion but sadly get bogged down by idiotic and discriminating rules. ut what can I say, pray harder and hope that we can at least feed ourselves
Dear All ,
I am a subspeciality trainee and after unnecessarily running around to get my approval for overseas training just because some people conveniently omitted my name in the list of candidates going overseas for training even after getting in the programme, I feel this effort by KKM is to make sure the Bahagian Perkembangan Perubatan, Bahagian Latihan and whoever involved are aware about the details of a subspeciality candidiate. This has nothing to do about destroying or killing the medical profession or sub training. A lot of nonsense has been going on and this will be the first step to regulate the programme. My advise to all the young graduates is, medicine (all fields) is a life long learning program and always advancing, please be in no hurry to specialise and subspecilise, it takes time to gain experience especially in the surgical fields.
I do not totally agree about fast tracking training especially in surgical fields, it takes time to gain the experience and knowledge, as one Burmese surgeon I knew used to say, “Rome was not built in one day” . I know specilaists who have fast-tracked their training and became a specialist at a young age, but cannot cope with the stress of work and had to quit to look for a less stressed job!!!! I feel junior doctors should not be complaining about the income but rather work harder, gain knowledge and experience for their benefit in future. 85% SKT is not impossible to achieve, to me only bosses who are real assholes give a specialist less than 85% annually unless the person (being assessed) is a real problematic person!!!
Cheers
Yup, agreed!
Hai Dr Pagal…thanks a lot for such a rich-pouring-information in your articles.By now, we all acknowledge that the IPO listing of IHHH (by Khazanah, third largest IPO after Facebook and FGVB)in both Malaysia and Singapore stock market. Do you think this ( I read that many new upcoming private hospitals will be built as a result of huge capital) will give significance change/impact in our healthcare landscapes? thanks again..p/s: huge apology for posted this question which not related to your above topic…
Private hospitals are profit driven. They will continue to build hospitals. However, the cost of healthcare is becoming too high to the extent that not all private hospitals are making profit. EVen KPJ has few loss making hospitals.
This is one of the reason why some oppose the 1 Care healthcare as they feel that it will only benefit the private hospitals. I do agree with this opinion. However, most private hospitals are now owned by GLCs. So, the government need to support them to make money for the government. It is basically money from RT to LT pocket!!
hi Dr P,
would like to ask any alternative way to become a dermatologist (specialist) besides MRCP or FMS? If using MRCP … do i still hav to complete all d gazement posting ( which includes 4 years in the medical department pre gazzement) before sub specializing into dermatology ( which includes working in a dermatology department? )
hope to hear from u
thx!
The only way is via MRCP or Master’s in Internal Medicine.
YES, the same rule applies for ALL subspeciality.
how bout taking FMS and entering Advanced Master of Dermatology UKM? it that possible ? would it be better / faster ?
It is the same. FMS and doing Master’s in INternal Medicine is the same.
Dear Dr Pagavalan,
May i ask your opinion regarding the prospects of emergency medicine in Malaysia, be it at government or at private sector. What do u think of the masters programme of emergency medicine offered by some of the local unis in Msia????
Secondly, as far as I know, u will be obtaining a title called “Emergency Physician” after completing MMed( Emergency Medicine). My question is, does emergency physician really considered as a true physician? and can they set up their own private clinics, calling themselves as physicians??????? Or can they work in private hospitals, playing the role as a physician??????????? I mean by seeing/ treating and charging patients in ward??? (maybe not now， how bout in future???)
Thirdly, is there any external papers which is some sort like mrcp/ mrcog which u can take for emergency medicine, besides going through the local masters programme?????
Im truely concerned regarding the future prospects of emergency medicine in Malaysia.
Hope you can give me some guidance. Thank you very much and hope to hear from you again.
Questioning whether or not Emergency Doctors are “true physicians” is really quite demeaning and displays a profound lack of understanding and respect for the specialty.
The prospects for emergency medicine as a specialty are good because Malaysia is short of them. Having said that, there is a huge resistance to hiring them in private hospitals from the other physicians there because they are viewed as competition.
I will give you an example: If a patient came in one evening to a private hospital Emergency Dept (ED) with high blood pressure, the MO in ED will call the private cardiologist to see the patient. The cardiologist will tweak the patient’s medication and admit them overnight and see them again the next morning before discharging them. The patient gets charged for the 2 cardiology consults (maybe RM200-250 each) and the ward costs, which go directly to the hospital.
If there was an Emergency Physician employed by the private hospital, he could adjust the patient’s medication himself and send the patient home. Patient probably pays RM100 to the private hospital for services in ED. The Emergency Physician himself is payed a salary by the hospital, much like the MOs that work there (obviously more then the MO).
The presence of an Emergency Physician who can relocate bones and treat medical emergencies without the supervision of other specialists is a threat to the income of those private specialists. That is why it is very difficult to find emergency physicians working in Malaysian private hospitals. I know an ED MO in a well-established private hospital in the Klang Valley who told me that the physicians in that hospital protested strongly when the hospital suggested hiring an Emergency Physician.
You cannot “open your own clinic” because you need to work in an emergency department to function effectively, not a clinic. They also do not see/treat/charge patients on the ward – not now and not in the future.
So in short, prospects are very good in the govt service as it is a emerging specialty. You will not be short of a job. Prospects in private are unknown as things may always change in the future (e.g. if the hospitals decide to do what they want).
One last piece of advice: specialise in something you enjoy, not what you think will make you the most money. You will not be poor in our profession, whatever you specialise in. On the other hand, you will never be happy if you specialise only for money.
The country still lacks emergency physician but your scope of being a emergency physician is very much limited. You are definately needed in the government sector to run the emergency department. However, the prospect of private hospitals accepting you is very slim. This is because the way our private hospitals are functioning. You must understand that private hospitals do not pay you a salary. Thus all consultants in private hospitals are self employed. So, even if you are employed by the private hospitals to manage the emergency department ( equivalent to an MO) , you will not be allowed to treat patients by running a clinic or seeing patients in the ward. Your scope will be like any MO in a emergency department. There are a few private hospitals which are doing this and has caused a lot of unhappiness and war with the consultants. It will only change if the private hospitals begin to employ consultants with a fixed salary which I don’t see it coming within the next 10 years. If you set up private clinics, you will be functioning as a GP.
Training as a emergency medicine specialist is mainly involves treating and stabilising emergency cases. You are not actually trained to see chronic medical conditions and diagnosing complicated cases.
BTW, other then Master’s , there is no other way of doing emergency medicine.
doctor,
what about MCEM?
i realise this is an old post so i hope you will still reply.
is MCEM accepted in Malaysia? and also, being in KK for the past 6 months, will it have a negative impact on me if i decide to pursue Emergency Medicine? Thank you.
I don’t think it is a recognised degree in Malaysia.
[…] Comments « For Future Doctors: Subspecialist training in MOH: New Rules and Regulations […]
hi, I’m almost completing my ho’ship another 1 department to complete, and now the dilemma streaks, i ain’t sure of what is my next step, i’ve decided on working in KK first while deciding, i have a few questions of specialization, what is the future prospects of pediatrician? is master’s a good option of trying out the mrcpch? and is there any other way to pursue dermatology without going thru the long journey? thank you.
Don’t stay too long in KK, you will loose your interest! Paediatricians are still needed in this country. Either MRCP or Master’s will do. There is no shorter way to become a dermatologist. It is a subspecialty of internal medicine.
Dear Dr,
Will preference be given to local graduates (vs overseas trained graduates) on entry to Master’s ? So does it means someone must be medical employed here in Malaysia for at least 3 years and above (due to the 85% SKT) ?
no preference but preference will be given for those who are working in Malaysia
pekeliling is just meant to be dikeliling-lilingkan (no pun intended)
there are doctors not even get gazettement let behold finished a year or two of post gazettement service already submit the subspecialty applications form.
and these are the people that will be taken in
just nice smoochy and sweet talk will get you a long way
yup, this was happening before but anymore! Now, the subspeciality selection process comes directly under MOH, headed by DG and KSU. ONly offer letter signed by DG and KSU is considered official.
Dear Dr Pagalavan,
Thnak u for your insightful knowledge. I need guidance.
I graduated from Ireland and worked there for 4.5years. I have completed the MRCPuk n am now working in Australia.
Due to personal circumstances i am planning a move back. What should I do? What r my chances of getting a cardiology subspeciality? I really want that and nothing else as I was doing angiograms before. Is it bleak? Are there a lot of bias against overseas graduates? Will I still be posted to rural areas? Work crazy housemen hours?
I am at a crossroads now. You replies would be most appreciated. Thanks so much
I would suggest to apply to university hospitals (UKM/UH) or IJN. If you apply to Ministry, the same rule that applies to everyone(as above) applies to you.
You don’t need to do Housemanship but no guarantee you will be posted where you want to.
Sorry, IJN is probably out as you need to serve the government for 4 years(compulsory service).
Dear Dr Pagalavan,
I am wondering if you could provide any insight on any job opportunities for doctors in the public health with masters in public health to work in the UK,Australia or New Zealand ?
Master’s in public health from Malaysia is not recognised elsewhere.