In April 2012, I wrote this article in the MMA Magazine https://pagalavan.com/my-mma-articles/unpublished-since-september-2011-madness-is-like-gravitywhat-you-need-is-just-a-little-push/. Unfortunately the madness is continuing and becoming ridiculous at times. Over the last few weeks I have been receiving numerous emails asking me a lot of questions, especially about certain promises that are being made by some medical colleges.
The competition among the medical colleges (34 functioning) is getting very tough and many are struggling to get enough students. They introduced self assessed Foundation studies as a short-cut to attract students but the situation got worst when MMC introduced the minimum entry qualifications in May 2011. I was informed that many colleges did not meet the target number of students this year. Some how, I expected this to happen and it will only get worst when the jobless scenario happens in few years time. Unfortunately, there seem to be a twist in the plot.
I received few emails from budding students that they were accepted into some medical colleges despite not having the minimum qualifications. The college has asked them to pay the deposit and appeal to MMC. Basically, they are asking the students to do their dirty work. Then I received few emails from students who completed Matriculation but did not get a medical seat in local public universities despite scoring a CGPA of 4.0. In about turn of events, these students were offered a special scholarship by JPA to continue their education in private medical colleges. Surprisingly, most of these medical colleges have not even been accredited by MMC or MQA!! Is the government supporting these medical colleges using our taxpayer’s money? Even though I am happy for the students, as many of them are good students but can’t afford to do medicine without scholarship, but sending them to unrecognized and untested medical schools is not the way forward. I presume this JPA issue started due to Perdana University’s special JPA scholarship that was introduced by the PM’s department. Other colleges would have started to demand the same privileges.
Then I received few emails and comments saying that some of these medical schools have guaranteed a job for their graduates in their “soon” to be built private hospitals!! After HUKM was built-in 1990s, the government refused to allow any teaching hospitals to be built. Many public universities like UPM, UNIMAS and UiTM requested to build their own teaching hospital but were rejected. They insist on these universities to use existing MOH hospitals for teaching. MOH always felt that teaching university hospitals are a threat to their service, as many specialists tend to join the university hospitals for better salary and perks. This happened when UH and HUKM was built. The other reason could be to make more money. At that time, the government was already allowing private medical schools to operate. I am not sure how many of you are aware that the medical colleges have to pay certain amount of fee for every student per-year to MOH. When I was with Monash, the figure was RM 500/student/year. On top of that, each HOD of the hospital has to be paid a monthly allowance of RM 600-1200 for facilitating teaching whether they do any teaching or not. If MOH consultants teach the students, they must be paid an allowance per session but not vice-versa. The private medical school’s lecturers are supposed to give free services to the attached hospital. The private college must also provide academic services to the hospital by allowing the usage of library etc and when they do research, large amount of fee must be paid to Clinical Research Centre of each hospital for facilitation and for using MOH patients. It is all about money, I guess.
Now, how can this medical colleges promise a job in their private hospitals? Monash suppose to have the first private teaching hospital known as Monash Medical Centre in Sunway. In fact, the students who were enrolled in 2006/2007 were told that by the time they reach 3rd year, the new private hospital will be ready and they do not need to come down to JB. Many students were upset when it did not materialize. The initial plan of having a 500-bedded private teaching hospital was abandoned or postponed. They found that it is not economically viable and I do agree with them. I always wondered why they couldn’t use Sunway Medical Centre instead of building a new hospital.
Then suddenly the government approved Perdana University’s private teaching hospital, supposedly the first private teaching hospital. Soon after, all other medical schools started to come up with their brilliant idea of setting up private teaching hospitals including UCSI in Port Dickson, AUCMS in Kepala Batas (2 hospitals) and I heard IMU has bought over Pantai Ampang. AUCMS is planning to build 2 hospitals, a 200-bedded hospital in Kepala Batas and an 800 bedded hospital in Bertam!! According to the statistics, the entire Seberang Jaya Utara has a population of only 300 000 with about 18 000 people staying in Kepala Batas!! Why the hell do we need a 200 and 800-bedded private hospital in the same district when we already got a government hospital in Kepala Batas? The largest private hospital in Malaysia is 500 bedded (Lam Wah Ee Hospital) and generally most private hospitals are less than 200 beds. Any right thinking economist will tell you that it is not sustainable and bound to fail.
Firstly, no private hospital has been accredited to conduct housemanship training. You can’t just go to any hospital to do housemanship. It must have enough number of specialists in each discipline. The usual allocation is 5 housemen to 1 consultant in a hospital. Under the Medical Act, private hospitals are not included in housemanship training.
Secondly, as far as I am concerned, private hospitals are NOT suitable for training purposes. If even now, the junior doctors are getting inadequate training, it will only get worst if the government allows the private hospitals to do so. Private patients are also fussy and would not allow any tom, dick and harry to touch them. Private patients go to these hospitals to be treated by the doctor of their choice. We can’t compare our healthcare system to that of US etc where all hospitals are private hospitals.
Thirdly, do you think opening a private hospital is like opening a shopping complex? It will take years (5-10 years) before a private hospital have full load of patients. At the moment, we do not have a National Healthcare System that supports the citizens who get admitted to any hospital. Private patients are either full cash paying patients, paid by employer or personal insurance. In fact, only less than 15% of the patients who gets admitted in a private hospital are cash paying patients. The cost of private healthcare is just too expensive for any middle-income population. I am in an 80-bedded private hospital that opened 2 years ago. Till today, we have just opened 50 beds and the highest number of patients that we have ever had is 40, all disciplines included!! So, do you think these private hospitals going to be able to provide any form of training even if what they promise becomes a reality? And what is the salary that they are going to pay you? I know one medical college that claim that they will give scholarship for half of the tuition fee but the student will be bonded for 15 years with them!! What bond?? Perdana University claims that all their graduates will be given intern post in their private hospital and they can continue with their American style residency training in the same hospital. Now, who gives them the authority to do so? Everyone knows that Perdana has a special connection with the government but what kind of training are these students going to get? I hope MMC will play their role well to prevent such occurrences. BTW, I don’t see these promises in their website which means it is not confirmed. I feel they should not promise something that they are not sure of. Furthermore, all their students are JPA scholars, which means they are bonded with the government.
As I have mentioned many times before, private hospitals do NOT employ HOs and MOs. A few MOs are usually employed to run the emergency department. Consultants are always self-employed. Private hospitals are a business entity and every cent counts. It is profit driven. So, how are they going to employ all these doctors as their HOs and MOs? Private hospitals will take at least 5-7 years to make profit from the investment that they have made. Do you think they have that much of fund to “employ” all these “bonded” doctors? Even if they do, the salary will be pathetic and you can’t say NO as you are legally bonded. One of the medical colleges is also planning to set up 200 polyclinics throughout the country. I presume they will use these “bonded” students as a cheap labour to run these clinics! Private medical colleges are also a business entity and profit driven.
The 1Care system is yet to be implemented. It may likely start in 2014 for the primary healthcare and probably after 3-5 years, it will be extended to tertiary care hospitals. For full implementation, it may take up to 10-15 years. The 1Care system will integrate both the private and public healthcare system that in turn will make more patients to visit private hospitals. Is this the reason why these private medical colleges going into this madness?? Are they assuming that by the time their hospital operates, the 1Care system will support them? This is one of the reasons why many opposed the 1Care system. Why should the public pay to make a private entity rich? It looks more like “piratisation” !!
Well, there are a lot of hanky-panky things going around nowadays. Sometimes I am shocked to hear some of the information given to the budding students by these colleges. Some even claim that their degree is recognized worldwide and you can work anywhere in the world, as dangerous as the agents who send students to unrecognized universities. I pity all those students who believe what these colleges are telling them. I hope they do their own research. Anything, which is not written in black & white, is not valid! Gosh, what has happened to our country?
As I sit and write this piece of article on the eve of our 55th Merdeka Celebration, I wonder what is going to happen in the next 5 years, “Janji Dicapatikan”………………….
God save this country from these madness…………….
Happy Merdeka Day 2012.
Pagalavan's Avatar 
Doctor, it is really pathetic. I am so shocked with the JPA scholars in Perdana University. Hopefully MMC is taking action now. But what is seen now is the approval of even more medical university. God bless us.
Hello Doctor,
i know that certain private university, AUCMS. actually i have been offered to do their MD AUCMS programme for this september. i was forced to apply to this place after the uni was advertising itself in the mainstream papers selling its new ‘products’. they even offered me a place before my actual A level result came out. then they forced us to pay 1500 as deposit. although i repeatedly said no but my parents wanted me to become a doctor no matter what. then i was called for a briefing in their campus in kepala batas. upon reaching there i was aghast with the campus. it is not fit to be even called a uni. my 50 year old secondary school looked better. the total fee is 270k. ptptn 150k and the balance is given by maybank 150k. the excess 30k seems to be for our hostel only, which cramps 12 to 14 student in one terrace house. the interest for maybank loan is 2%+BLR WHICH NOW STANDS AT 6.6%. if we scored 3.5 cgpa we are bonded 15 yrs for their private hospital and the maybank loan becomes scholarship. they are requesting the moh to conduct ho in their hospital and it seems they will give us specialist training. what suprised me is the number of students during the briefing which was about 200. seems to be an investment which we will never finish paying for it. i am never setting my foot in that trap. i have no interest in medicine at all. i am more interested in biotech. but the jobless scenario is quite worrying. what doctor think about the career prospect in biotechnology or other life science degree?
Well, said. This is what I am trying to say in my article. Those promises they give will remain as promises only. It will not materialise. Also remember that AUCMS is the only university in the world which runs 5 medical programmes!! Can you imagine that! A truly Malaysia Boleh phenomenon! Others will be laughing at us.
Biotechnology has a good future worldwide BUt in Malaysia, it is still underdeveloped. The government is encouraging more foreign companies to set up companies here for biotech but it will take a few more years for that to happen. If you do biotech in a well established uni, you may get jobs in other countries like Singapore, Australia etc.
Frankly speaking, there are too many graduates in science field in malaysia due to poor human resource planning and too many money making private colleges. The prospect now are more in technical field.
thanks for your comment doctor. regarding biotech, i just thought in life science, a degree is not enough and we have to to postgraduate. foreign branch campuses here are no doubt well established internationally but the fees are too expensive. but what if we do life science degree in local ipts and continue with our postgraduate in ipta or overseas. i have heard some are doing it. is this feasible? my plan is to become a lecturer as i love teaching.
Yes, it is a good idea. If your plan is to teach, then should not be a problem to get a job.
“…it seems they will give us specialist training.”
I always find it hilarious when I hear of private university agents talking about “specialist training”. Most medical students do not even know what “specialist training” really means and entails, let alone non-medical business agents. They seem to think that it is some sort of formal fixed term postgraduate taught course similar to undergraduate degree courses.
Postgraduate specialist training is an apprenticeship. No matter how formalised or regulated on paper, specialist training is fundamentally delivered by a mentor who takes an interest in ensuring their trainee is equipped with the skillset required to be a specialist. No amount of legislation can change this human requirement. Particularly in surgery where hands-on exposure
Specialists are not trained by training programmes. The perception that training programmes (call it “residency” in US, “specialty training” in UK etc) produce specialists is borne from the fact that these programmes confer the certifications of specialist training. But if your mentors don’t care for the quality of the training delivered, or there are insufficient numbers of mentors to provide quality training, then that bit or paper at the end will mean a big fat zero.
Right now, we are primarily focused on the problems with poor quality undergraduate teaching and inadequate training of HO’s. Eventually, this problem will filter upwards to the specialist training stage and we will be left wondering how we are going to train our future specialists.
Of course in Bolehland, the administration still cares nothing for the quality of specialists. All that counts is how many specialists there are, and especially how many of them must be from the master-race.
God Bless Malaysia.
Dear Dr Pagalavan,
Just for your info, Government has approved two teaching hospital under 10th Malaysia plan under UNIMAS and UMS…..I think as sabah and sarawak per se, it should be a good start for the country and people in east malaysia
Yes, I heard about it BUT not sure whether anything had started.
how about physiotherapy in comparison to nutrition& dietetic?is it a promising discipline for career?As we know today there are loads of private uni offering this course to students. i hope you may help me with this question.thank you 🙂
Frankly speaking, most science field are saturated as there are just too many graduates produced by too many private institutions. There is no proper human resource planning in Malaysia. I presume you are talking about degree programme. There are already too many diploma holders looking for a job. Being a degree holder just gives a slight advantage.
UPU has offered me medical imaging in UM and recently JPA offered me medic in MAHSA. Some of my friends suggested Perak Medic College or even NuMed in Nusajaya. Doc, you have a wide experience in this field, please guide me as I need to make a quick decision. Thanks doc
I would agree that Perak Medical College, IMU, Monash or even Numed will be better. If I am not mistaken, Perak MC offers UM degree.
Perak Medical College no longer offers UM degree starting from last year. Erm, I meant the last batch graduated last year. Currently, the new grads are UniKL degree.
thanks for the info. Probably UM do not want to franchise their degree anymore.
Anyway, I think there is no worries over the houseman glut if selection is given. I’m not sure if I am from the old school, but most(but not all) overseas grad just does not even make the cut! Seriously, some acted as if they had never been to med school before!
To me, if you’re lacking in knowledge, you can made up with hard work and willingness to learn. But some of them just had zero knowledge. As if you are going to train a laymen from scratch.
There was one(1st poster, 2 months old) who even came into O&G who took 9 hours to clerk a patient with PPROM (11am-8pm) and he barely made it to one third of history taking, no speculum done yet, no US scan and of course, no IM dexa. And he was only attending that ONE patient only while the other 2 HO(me, the 4th poster and another 1st poster from local grad) had been running around attending to all the fast paced labor room delivery and clerk from the many tens of pt in the PAC. The horro part was the of course, the fuming husband who had waiting all too long with an empty stomach, of course, who threatened for AOR discharge.
Of course, the breaking point is after assisting in 10 LSCS, he can used the suction to suck on nonsterile area on the table while the surgeon was just barely made an incision at the abdomen, which by the time a bleeding spurter was at the right angle, imagine the whole OT staff (including Anesth) were aghast by what he was doing! By the time they managed to secure the bleeding after a new suction was replaced, there were 2 liters of blood loss.
-.-“
“Of course, the breaking point is after assisting in 10 LSCS, he can used the suction to suck on nonsterile area on the table while the surgeon was just barely made an incision at the abdomen, which by the time a bleeding spurter was at the right angle, imagine the whole OT staff (including Anesth) were aghast by what he was doing! By the time they managed to secure the bleeding after a new suction was replaced, there were 2 liters of blood loss.”
– I don’t know whether to laugh or cry
Dr paga,
Finally the training issue of HO has been published by new sunday times on their frontpage by tittle ‘training blues of housemen’. This is regarding SCHOMOS survey.
Hope the public will also voice out their concern so that the gov will be forced to take action.
1 more thing, currently they are also a group of HO that we called ‘the photostat HO’. I’m sure u can guess wht i mean. This gp of HO not doing their own ckerking and just copy/paste the clerkingship from ED. This is happened in the hospital that using full computerised system.
http://www.nst.com.my/opinion/columnist/doctors-may-end-up-being-under-trained-and-untested-1.128106 …. i wonder what did he smoke when he was in office. sekarang baru nak bising.
He was kicked out for making the noise!
My take on why his tenure was not extended (this is all based on my own analysis and not based on any insider information, just to cover my a$$) was because he had a mind of his own and not a total yes man. So the minister wanted someone ” who will only ” menurut perintah” and not steal the limelight from the m.inister himself
yup
DR… i am 3rd year medical students in AUCMS… what am i supposed to do??
You can’t do anything
Hello dr. I am currently doing bachelor in medical science at MSU. Dr, i actually wanted to pursue my study in medicine but my A level results did not pass the requirements. Thus, i’m taking medical science so that i can do mbbs later at msu. I can further my mbbs at second year if i could get cgpa 3.5 and above. However, after i read ur previous posts regarding the surplus of doctors in the future, i start to think that medical science can be a good choice for me. It is a new developing field in malaysia. Now, i plan to further master’s degree in medical science at ipta(ukm).
But, my problem is i have inadequate financial assistance in continuing my study at msu currently. And i’m thinking of applying diploma in science at uitm next year and taking mbbs in uitm later. So DR, i really need you to assist me to choose the better ones. Can you help me make the decision? I’m so confused right now. Is that good to study medical science at MSU? Thanks
I think it is up to you. What is your genuine interest? Don’t do medicine just for job security, nothing is secured in the future.Medical Science is good if you want to become a lecturer in universities. It is up to you to make your choice.
*now i plan to pursue master’s degree in medical science at ipta( ukm) after i complete my bachelor’s degree in msu 3 years later.*
hello..
i want to study in medicine but it is only in private university.
so can i have ur opinion regarding the ipts.: lincoln, UNIKL RCMPI, CUCMS, INSANIAH..
All of them are at the bottom of my pecking order.
[…] own teaching hospital, not one but 2, I wrote that it is economically not viable. In 2012, I wrote THIS. From what I gather, Perdana University might abandon their plan to build their own hospital. IMU […]
[…] When the program was first initiated in 2010, I was sceptical as usual. I wrote about it over here and here. I felt that probably JH was not given the true picture of our health care system. I heard the radio interview given by PUGSOM CEO and I can very well say that he is not aware of the healthcare structure of this country. The healthcare system of US and Malaysia are totally different. I received many emails from budding students who were offered “special” JPA scholarship to study at PUGSOM. It was worth RM 1 million per student! Since it is a graduate medical school, generally most students are matured students. The students were told that they will have their own teaching hospital(private hospital) by 2014 and they will even do their residency style training programme in this hospital, upon graduation. Again, I advised these students not to believe on these unless and until it happens. Building a hospital is not like building a shopping complex! Till today, their main campus and the hospital has not even started construction! I had written about this over HERE. […]
[…] I cautioned many students that it is not viable and not to fall into a trap. IN 2012 , I wrote THIS and THIS. However, students being students, they will take whatever offer as long as they do not […]
[…] 4 years ago, i wrote on issues where many private medical colleges were planning to have their own teaching hospitals. I gave my thoughts on the issue and why students should be careful in listening to the college’s marketing guys. None of these promised private teaching hospitals has materialised as of today (Monash, IMU, AUCMS, UCSI, Perdana). The reasons are simple! It is the same as above. I understand UTAR and MSU are now in the process of building a private hospital. No private hospitals employ medical officers to run their inpatient or outpatient services. It is all specialist driven. All patients are paid by insurance. I know one private medical college which has bought over a private hospital but did not use it for teaching medical students. Reality is different and using it for teaching medical students may be suicidal to their reputation. Building a hospital and running it are 2 different issue. It is very much easier to build but to get the return of investment is totally a different story. No private hospital is going to spend money on unnecessary expenses which include paying HOs and MOs. They are not charity organisations. The medical cost is escalating exponentially. […]
Hi Dr Pagalavan. Thank you for creating such an informative blog. I have discovered it
ever since i was a medical student. I am a 2nd year medical officer in kkm and hope if you wouldnt mind guiding me. I have received a contract MO post in UM for one year duration .
1. Would this mean that I would have to quit kkm What is the difference between kkm and ministry of higher education bodies ?
2. If after 1 year the contract is renewed does that mean that i will forever be based in um for the rest of my practising years as a clinician ?
3. What are the other options in um after being for 1 year ?
4. If the contract isnt renewed will i be left jobless ?
5. If im bonded under jpa for 10 years , does it matter whether im in kkm or UM ?
Thank you so much for your time and valuable input
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Yes, you need to resign from KKM as the MOE post is a contract post and not a permanent post. If they don’t renew, means you are jobless. As long as you are in a government owned service, your bond is considered. With the current situation, resigning from KKM is UNWISE.