I thought of commenting on some of the amusing news that appeared today in the papers. This news below appeared in the Star from our Ex-Health Minister and the current Health Minister.
Whatever said and done, our ex-Health Minister Dato Dr Chua Soi Lek was the best Health Minister that we have ever had. Being a doctor himself, together with our ex-DG, they did form a good team of administrators running the health ministry. What he said below is the truth, which I have been saying since the last 2 years in this blog. http://thestar.com.my/news/story.asp?file=/2012/7/17/nation/11671578&sec=nation. Oversupply of doctors is a distant reality, which he himself admitted in this article. In fact, he also admits that there is lack of training of junior doctors and this is an unhealthy scenario. Imagine 180 doctors for a 400-bedded hospital, that’s 1 doctor to 2 beds!! As someone said in this blog before, we may have more doctors then patients in some hospitals soon. Most MO post in district hospitals in Peninsular Malaysia is already full. I still have people who do not believe it will happen. I had a budding doctor who said “ doctor don’t die or retire, is it?”. Well, let me explain to you the fact. Yes, doctors do die, retire and migrate but the numbers are less than 1000/year, in fact only about 500-600. On the other hand, we produced almost 5000 doctors last year with only 50% of the 36 medical schools producing graduates. The number will hit almost 8000 by 2016 when all medical schools begin to produce their graduates and later, 10 000 when they produce at maximum capacity. It is increasing exponentially compared to the number of doctors dying, retiring and migrating!
Now, lets come to our “foot in the mouth” syndrome guy, our current Health Minister. When the issue of jobless nurses came into the picture few months ago, our health minister made one of the biggest joke of all time “the nursing colleges are producing general training nurses and not specialized nurses which we are short of”: https://pagalavan.com/2012/02/07/clown-of-the-year-award-part-3/. I thought that was bad enough for a health minister to say but today’s comment by him really made my day “ Private hospitals should start training their own specialist?” http://thestar.com.my/news/story.asp?file=/2012/7/17/nation/20120717175709&sec=nation. I mean, does he know what he is talking about? Does he even know how the private hospitals in Malaysia are run? I seriously feel this guy need proper briefing about the healthcare system of this country. I have written about the pros and cons of using private hospitals for specialist training here: https://pagalavan.com/2012/06/18/specialist-training-in-private-hospitals/. This sentence really made my day: “They should also train their existing doctors to become specialists” What existing doctors??………… I give up!
Just a repeat of what I have said before, private hospitals DO NOT employ specialist. ALL specialists in private hospitals are self-employed and rent’s a room in the hospital to run their service. Private hospitals also DO NOT employ housemen and medical officers (except for emergency department). So, how in the world are these hospitals going to train their own specialist? Can someone explain to me, probably I am too exhausted thinking about the people who are running this country! Since consultants in private hospitals are self-employed, every other specialist is a competitor. So, do you think these consultants would even bother to train anyone to become their own competitor? At least he was right about one thing : we will achieve a doctor: population ratio of 1: 400 by 2020.
And just before we can swallow all this crap, here comes another news http://www.bernama.com/bernama/v6/newsgeneral.php?id=680881. Vinayaka Missions University is going to set up postgraduate medical faculty in Klang Valley!! Gosh, I think I should just stop writing before I blow my top!
Chua: Clinical training needed
By FOONG PEK YEE pekyee@thestar.com.my
BIDOR: Many junior doctors lack clinical training opportunities due to an oversupply of medical practitioners, said MCA president Datuk Seri Dr Chua Soi Lek. Citing a district hospital with about 400 beds and 180 doctors as an example, he said the doctors would not be able to get adequate opportunities for their clinical training.
“Clinical training and experience are very important for doctors.
“The lack of it will have serious repercussions on their abilities,” said Dr Chua.
He added that there were more than 300 recognised universities for medicine and about 4,000 medical graduates from local and foreign universities joining the workforce yearly.
He said those who were not offered medicine at public universities should be given science-related courses instead.
“The same principle should be applied to other types of courses,” he said after opening a karaoke competition and dinner here on Sunday.
Earlier, SMJK Sam Tet student Lee Kee Hon appealed to Dr Chua for help to get into dentistry.
Kee Hon, whose CGPA (cumulative grade point average) is 4.0, had put dentistry as one of his first two choices but was offered a course in food science and nutrition instead.
Meanwhile, an MCA Youth spokesman said students could forward a copy of their appeal to MCA Youth Education Bureau, 7th Floor, Wisma MCA, Jalan Ampang, Kuala Lumpur.
Private hospitals urged to train own specialists
KUALA LUMPUR: Private hospitals need to train more specialists on their own to assist the government in tackling the shortage of specialist doctors in the country, said Health Minister Datuk Seri Liow Tiong Lai Tuesday.
He said that, at the moment, the country had 5,000 specialist doctors and of this figure, 3,000 specialist doctors were now serving in the public sector.
“Private hospitals should also have their own specialists and should not depend only on government hospitals to obtain the service of specialist doctors.
“They should also train their existing doctors to become specialists,” he told reporters after opening the 20th International Conference and Exhibition on Health Care, here.
He said there were now 35,000 doctors in the country and the government hoped the ratio of one doctor to 400 people could be achieved by 2020.
Meanwhile, Private Hospital Association president Datuk Dr Jacob Thomas said the three-day conference which focused on human capital development in the hospital service sector attracted participants from 30 countries. – Bernama
Pagalavan's Avatar 
Agree with your commentary. But don’t think CSL can escape from blame for the current glut of underqualified docs. Under which idiot’s watch were the avalanche of private & public medical schools approved?
Actually during CSL, there were not many private medical colleges approved. After Monash And UCSI were approved in 2005, there were no new medical colleges approved till 2008. The madness actually started after he left MOH. He was in MOH from 2004-2008.
Doctors with insufficient training. Very soon people question the competence of every single doctors, along with doctors’ credibility. Malaysia is in need of a better healthcare system and also a better regulatory body to ensure the competence of doctors.
This kind of statement will appear in next 10 years ” the medical colleges are producing general training doctors and not specialized doctor which we are short of”….hahahaaa….
Hello Dr. Paga, I’ve been following your blog for a while and I find it really useful and informative. Thank you for sharing all of this with us. I just couldn’t help but to think what would happen to the future doctors, especially the ones that are working hard and passionate about what they do. For those who are striving to be a specialist, only to know that they will be sent off somewhere and to be bonded with the government for years to come, do not make things any easier too. To make matters worse, they would have to fight with the rest of the doctors (be it good or bad) to make a living in the near future. This is really such a sad state to be in.
Unfortunately, that is the reality. No sacrifice no victory
The more I read about your post, the more I get despair…
You need to face the reality some day
Heard that UKM is sending their post graduates to KPJ run hospital for training.
As I have mentioned here https://pagalavan.com/2012/06/18/specialist-training-in-private-hospitals/
KPJ is actually going to run their own program me in collaboration with UKM
There was 18 applicants for urology fellowship this year , last year the number was 2 and it was 0 for the 2 years before that . The other subspecialties are also oversubscribed particularly Upper GI and Breast and endocrine. The more difficult the MOH makes it , it actually becomes more appealing to doctors.
A search on fellowship training all around the world reveals that our post graduate qualification is not recognized and they are closing their doors hard on our applications.
All in all , it looks like the best option is to finish up masters , gazeetement and then leave .. If you get stuck with sub they will lock you in until retirement .
It’s funny , i have a friend who followed me to MAsters but he left after a year because he didn’t like what the program was all about . Went to Australia and became a surgical MO there. He recently landed a urology fellowship position and with the current time frame he would most likely finish before his malaysian counterparts. with a recognized degree that’ll allow him to work anywhere in the world and the best part is no bond.
It is likely because we are seeing more and more doctors in the government sector. It will only get worst. The private sector getting saturated and the market for generalist is also limited. Thus, many have to remain in government sector and do some sort of sub specialist. Why do you think that MOH is daring enough to introduce all these new rules and regulation. Because they know that you got NO choice!!
Really 18 applied for Urology? FYI this year only 3 were selected of which 1 was from MOHE and 2 from MOH. My impression on canvassing the MSurg trainees is that not many are keen on Urology as the total training duration now if you sign up for Urology is now 7 years before you get your NSR. And most will have to wait atleast 3 years post MSurg before getting into Urology based on the current rules enforced by the DG of MOH.
All in all by the time you complete your formal training, gain specialist level work competency and work off your scholarship bond, you will be ready to collect your pension/EPF from Gomen if you are still alive…..still interested in a career in urology mate…..??
Let’s see.. playing with boy bits, scoping narrow pipes, probing tail ends…. what’s not to like! 😉
Oh wait.. I forgot that 30% of patients are female (welcome relief no doubt). But seeing as I’m a dude myself, and it’s only a matter of time before most men will eventually need to go to the loo 6 times a night, I’m rather glad that some surgeons do choose to sub in Urology. Just rather them than me!
Who does the HO and MO job in private hospitals if they are not employed?
Private hospitals do not have HOs and MOs. Some MOs are employed to take care of the emergency department. The consultants do all the HO and MO job in private hospitals.
i just heard the funniest comment about medicine in malaysia from my parents. They have a friend whose daughter is currently sponsored by JPA to study medicine in UK. She just finished year 1 of medical school and her parents are working in the government sector and are able to pull strings for her to get her scholarship (the parents owned up to this). Her parents believe that JPA will sponsor their daughter to specialize in UK after her graduation. And they do not know anything about the glut of doctors in Malaysia. They would not believe anything i try to tell them. They say i am trying to pull them down because the mainstream newspapers and radio stations keep saying there is a lack of specialist doctors in malaysia. Hah!!! the innocence and ignorance.. if only they knew…
Haha, firstly she will not even get a post in UK. All JPA scholars have to return upon completion of their studies. I am sure this is stated in their agreement!
I beg to differ.
Many JPA scholars don’t return to Malaysia to work, and the government is not doing anything.
How do I know this? I can list at least 10 names of JPA-sponsored medical students who continued working in UK, Australia and New Zealand after graduation.
Yes, I know about it BUT over the last 2 years JPA has been quite strict. They go after the guarantors. Worst still, now they have to repay the total amount the government spent if they don’t come back.
PReviously JPA do allow a maximum of 4 years to stay back in UK to get training.
Hello Dr. Paga! It has been a while after the last time I have dropped by and read your blog. Hope you are in the pink of health.
A question rather than a comment for today, is it possible for the government to re-evaluate the already accredited private/public medical schools and force those not up to standard ones to be closed down?
I have put a lot of thought into this, it seems like the only good solution in the long run is not to only prevent new medical schools from opening up, but to close down incompetent medical schools, and to make intake of medical students in medical schools purely regulated by the government rather than “pay money can go in basis” regardless of your results.
In Australia, even with the small number of medical schools, they are struggling to accommodate incoming interns for training, and in Western Australia, 1 uni has relentlessly tried to open up their own medical school but was strictly rejected time and time again. This is an example of a government which overseas and prevents problems from arising.
In Australia, not only you have to do well in your studies and take an entrance exam, then interviewed prior to even be considered to do medicine anywhere.
I think, honestly, it is about time for real action,to be taken rather than keep blaming others, finding short term solutions which just covers their asses when they are in power to pass the problem to the next set of leaders.
Unfortunately, everything is about money in this bolehland. If you look into the board of directors off all these medical schools, you will know the answer! However, I feel that when the situation gets critical by 2016, some of these medical schools will not be able to sustain and they may have to close shop or merge with other schools. In fact, as we speak now, some of the private medical schools could not get enough number of students this year and they are beginning to offer to students who do not have the minimum qualifications and then asking the student to appeal to MMC!!
In Australia, everything is monitored closely by AMC unlike our MMC who do not have power to approve medical schools. The juridiction comes under Ministry of higher education which is not run by medical people.
I heard from a few MARA scholar sponsored to study medicine in our local private university.
They said that if they wanted to break their bond, they would only have to repay 10% of the total sum which they were sponsored.
Any comments on this? It was shocking when I first heard it.
THis is well known. MARA do not give scholarship but sponsorship/loan. There is NO bond involved. They can stay and work wherever they want and they just need to pay back 10% of the total loan. If they get 1st class , everything is waived. Again, THEY ARE NOT BONDED like JPA.
Welcome to Malaysia, always a 2 system country with certain privileges for certain community.
Dear Dr,
I will be starting housemanship soon. I know what I’d like to specialise in.
I was advised by a consultant to do the mrcp part 1 as soon as I complete 1st year HO and that it will give me the opportunity to stay put in general hospital for further specialist training if recommended by HOD. Is this true? Will it be more time consuming and difficult to get back into general hospitals for further training if I am posted out as a 1st year MO to rural/district hospitals.
Thank you in advance
It doesn’t matter anymore. Nowadays, everyone who completes HO will be posted out. However, it you have MRCP. Part 1, you can request to transfer back after 1 year.
As you know, with the current glut, most hospitals in peninsular are almost full with MOs. You may not even get the same state after completing your HO.
What do you think of hosp batu pahat and hosp taiping
OK
Thank you dr. Please continue to write more of your thoughts
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