Since I started this blog almost 3 years ago, one of the commonest questions I get asked from budding doctors is how to become a Neurosurgeon and Cardiothoracic surgeon. I have answered these questions many times in this blog but it keep being asked again and again. I am really not sure why most budding doctors only have these 2 specialties in their mind. Do they really know what these 2 specialties is all about or are they being carried away with what is portrayed in the TV programs? Many feel that these 2 specialties are the top most medical specialty, which comes with glamour, popularity and money. Before I talk about the above topic, let me elaborate a little about what these jobs are all about.
In my entire batch of 180 graduates, only 1 became a Cardiothoracic surgeon and none became a neurosurgeon. Why? It is always better to decide on what speciality you want to do after you start to work. I had many colleagues and friends who wanted to become this and that but ended up doing something else, many even resigned from medical field. Things will change along the way. Only when you get yourself into the working life, you will realize what medicine is all about. Also don’t forget married life and earning money for a living. You can’t be depending on your parent’s money anymore unless you come from a very rich family.
Not everyone can become a Cardiothoracic surgeon. That’s the reason why you don’t see many, out there. It is a very high-risk job and one of the most challenging surgical fields. You need good hands and master various techniques. Furthermore, with advancing techniques applied by cardiologist with various new stents, the need for cardiothoracic surgeons is declining. The entire state of Johor has only 1 Cardiothoracic surgeon in private sector because that’s all you need. There are about 3 in the state government hospital. Most private hospital will only need about 1-2 Cardiothoracic surgeons. I also know a few “so-called” Cardiothoracic surgeons who can’t do any proper surgeries. That’s the reason they remain in government service or in private medical colleges, doing teaching. They do not have the skills to become one but decided to do it anyway!! Probably, the glamour of being called a Cardiothoracic Surgeon is good enough for them. I also know of some cardiothoracic surgeons who have high morbidity and mortality, some even close to 50% mortality rate.
Somewhere in this blog, there was once a comment that claims that his/her relative who is a Cardiothoracic surgeon in a private hospital is earning close to RM 200K/month. It seems many of these budding doctors are only looking at the money rather than the quality of life, skills and the risk involved. The earning capacity can be high but in order for you to earn that amount of money, you need to do at least 1 cardiac bypass surgery every other day. This means that you will be in the hospital for 24hrs/day and 7 days a week. You practically got no life and you will hardly see your children if you do have any. The stress level is extremely high. The same amount of time in any business will yield you the same amount of money. The day you stop operating (e.g: met with accident or illness), your income is zero and no guarantee that you can come back and do surgeries like before! Imagine if you fracture your forearm etc.
Now, let me tell you the pathway to become a Cardiothoracic Surgeon after graduating as a doctor:
1) 2 years Housemanship
2) 2-3 years of Medical Officer (assuming you get your Master’s on first try)
3) 4 years of Master’s in Surgery
4) 6 month’s gazettement process
5) 1-2 years of waiting period
6) 4 years Cardiothoracic subspeciality training
7) at least another 5 years of experience, assuming you have done about 500 CABG surgeries and competent enough to go out to private sector and perform surgeries without any help from superiors.
This basically means that you will need about 15-20 years of government service and training before being able to be competent enough to perform surgeries on your own. When I first told this to a budding doctor, who has not even gone into medical school, she got a shock of her life. She admitted that she never realized that it was that long. Many are still clueless of the pathway, assuming that they can become a Cardiothoracic surgeon immediately after graduating. Again, don’t forget your married life, children etc.
By now, I am sure you know why there are not many of them out there. It is a difficult field, which need a considerable amount of skills and training. Not everyone can become a Cardiothoracic surgeon ………………. unlike our doctors that are being produced by our grandiose medical schools……………….
Next, pathway to Neurosurgery…………………
Pagalavan's Avatar 
Good day,
Truely agree. At the end of the day, very few will even take up the master surgery. I have seen many MO even choose master public health after few years attachment in surgery posting.
Hi Dr Paga.
Just to clarify, is there a minimum period of serving as a medical officer, i.e 2-3 years as mentioned above, prior to applying for the Masters Programme. I do understand that it is extremely difficult to get it at the first try.
Minimum is actually 1 year of MO which means that the earliest will be 4th year of service. But it will get longer with the flooding of doctors.
What was written was the min time one takes to finish the whole thing. There are people applied for multiple times and fail to secure a place. In the future is only going to be more an more difficult. If you are a parents reading this please ask yourself do you want to go throught this, if u are a student please do not do med because of the money and glamor. In real life there is no ‘dr house’ or ‘ER’. In fact, if u are in it for the money and glamor there are only miseries at the end of the tunnel.
Hmm… We have not factored in the bonds from doing the masters as well as the sub speciality training… A loooooong time
Bonded for life…………
As for specialist training under government scholarships, the doctor is bonded for 5 years if he’s taking it as out-campus, 7 years if it is as in-campus.
If you mean it is bonded for life as a doctor…oh well…. 🙂
Yes and another 4-6 years for subspecialist training. Don’t forget the undergraduate 10 years bond if you are under JPA. these bonds run one after another and not concurrently.
If the student takes in-campus, the 5 years bond for specialist training runs after the JPA bond as you mentioned, but if it is out-campus, the 7 years bond is running concurrently with JPA bond. I was told so by SPA. But I’m not sure of the subspecialist training though.
It depends on how many years you spent out-campus. Not all 4 years are done outcampus at times. Subspecialist bond starts after you complete your subspeciality training.
Good day,
Does passing MRCS part A/1 exam really help UKM Master Surgery application ?
What does UKM ask when interviewing applicants of Gen Surgery ?
Among UKM, UM, USM , which one is the least competitive for Gene Surgery application ? Why ?
Do they accept foreign applicant ( my cousin ) too ?
Is there aptitude test too ?
Thanks
Seriously, I think you should go and talk to someone from these universities.
Having MRCS do give some advantage
Ask UKM
None is least competitive
They do take some foreigners under foreigners quota. However, the degree must be recognised in their home country. There is NO guarantee that he/she will get a job here.
Do I have to pass this exam to be eligible to apply Orthopedics Surgery Training at UKM, UM, USM, and IIUM ?
http://www.acadmed.org.my/index.cfm?&menuid=99&parentid=46
How about the quality of master of Surgery training at International Islamic University Malaysia
http://www.iium.edu.my/medicine/programmes-courses/postgraduate/mmed-surgery
Many thanks
Passing the exam will give you a better chance but it is not compulsory.
As for UIA, I am yet to see any of their graduates. So , can’t comment. They do not have their own teaching hospital, thus the training depends on their attachment to Kuantan Hospital.
Do I have to pass this exam to be eligible for Master of Othopedics at UM, UKM, USM ?
http://www.acadmed.org.my/index.cfm?&menuid=99&parentid=46
How about the quality of Master of Orthopedics at Internatinal Islamic Univeristy Malaysia
Thanks
Liang, spot on. Many however, will not listen, and that’s the sad truth.
If you look at the NSR under the foreigner category, there are many Indian specialist with Indian post graduate qualifications teaching at local medical schools. Why can’t we send students direct to Indian Universities for their post graduate studies instead? This will create alot more training spots. Specialist graduating from these schools are teaching here anyways.
There is a Brazilian cardiothoracic surgeon practicing here and he’s registered with MMC and NSR. As far as I know, no Brazilian medical degrees are recognized here, but yet he’s registered with MMC and practicing.
Alot of inconsistencies.
Teaching and practising is 2 different issues. You don’t really need APC for classroom teaching. You only need it for bedside teaching or if you run clinics. Furthermore, Masters from India can be recognised in Malaysia after 5 years experience.
Yes, sometimes in areas of need, MMC and MOH can consider experienced consultants on case by case basis.
..so true..
and i still hope at least there always somebody fall into this medical field in big number.. and get suffer to treat somebody else plus their own colleague from other field. Bigger number better, so at least we can choose the better one…
I really don’t get what you are trying to say. In medicine, how do you know someone is good? So, how are you going to choose?
What if you are not In a position to choose?
Fantastic post! Cant find such post in the whole internet. Lol. I have a question, what about becoming a general surgeon. Do u have another 4 years like the cardiothoracic surgeon for subspeciality training or just 4 years doing masters n gazettement? Also, doctor, if i want to become,say a nephrologist, do i have to do internal medicine specialty first and then nephrology as subspecialty. Does it work that way? . Hehe 😀
For general surgery, Master in Surgery and gazettement will do. For nephrology, yes you need to do internal medicine first. Please read my post on internal medicine sub speciality which I wrote quite sometime ago.
Good day,
Do International Islamic University Malaysia accept non-Muslim applicant for their Master of Surgery, Obstetrics and Gynecology ?
Why there is tuition fee for clinical postgraduate training at Malaysia ? Meanwhile in UK, AUS, ( even in Thaialnd ) etc, all trainees get paid
Is the training site for IIUM postgraduate training at Hospital Tengku Ampuan Afzan ?
Thanks
yes, they do accept non-Muslims
YES, you have to pay a fee for Master’s. You also get paid a salary for working in the hospital as MO.
Yes.
Seem that lots of people do not know how the system work and yet they dream of becoming a super specialist. Typical, everyone wants to drive big car and earn lots of cash. Being a doctor is not about how to ‘cut’ , is about how to care for the fellow human being when they are sick. If u notice most the questions that posted is mainly how to get into training and leave for private.
Yup, that is the reality!
How much is the average resident/ MO year 1 at UM per year ?
Does the resident /MO also receive free accommodation like those residents in UK ?
Somewhere in the this blog says there is “waiting list” several yearsto take postgraduate training. If, for example, I pass the entrance exam ( MCQ, interview, etc from April-June 2013 ) ) and the new intake of postgraduate training is in July 2013, shall I have to wait several years to start residency/ training ? Can I start immediately ( July/ August 2013 ) ?
Can I apply postgraduate training at several specialties and at several universities at the same time ?
Internal Med and Pediatrics at UM, and at the same time O/B and Gen Surgery at USM ?
In the UK, what is the “training number” ?
If there is no future for doctors here ( in Malaysia ), how about going to Iraq and work as a doctor there ?
http://www.abs-cbnnews.com/global-filipino/11/12/12/iraq-eyes-hiring-2000-pinoy-doctors-nurses
Thanks
Don’t understand your first question.
No such thing as free accommodation.
What do you mean by passing MCQ? What MCQ? MAster selection is done by KKM and the universities. Some may need to wait for few years before they are selected. Only when you are selected or short listed, you will be called for exam and interview.
NO, yo can apply for 1 only.
Of course, you can work in Iraq if your degree is recognized there.
http://pagalavan.com
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@dr hore: there is no more free accommodation for FY’s in the UK since the substantial legislated reduction in working hours and change from 24-48 hr on-calls to 8-12 hr shift systems.
There is no such thing as a “waiting list” for specialist training if you mean that one applies and eventually your turn comes up. All postgrad training posts are appointed by competitive selection. There is no guarantee you will ever be offered a post if someone is judged by the selection committee to be better than you. So if you want to be a specialist, get ready to do what it takes to be the “best person for the job”.
In the UK, postgrad training is very tightly regulated for the purpose of manpower planning. The number of Consultants in the country is planned to match the needs of the system. (ie: the idea is to avoid having an excess which would lead to unemployment). Since the idea is that each specialty trainee eventually should become a consultant, the number of trainees must also be planned in similar fashion.
So every specialty trainee has a designated number aka “training number”. When training is completed, the trainee exits the training system and the number becomes available for another appointee. These posts(numbers) are advertised in open competition and there are always are far more applicants than training numbers available.
If you want one, be prepared to work your guts out to be top of the heap.
Dr Hore,
Vocational trainees in UK, Aus and NZ also pay annual college and exam fees. Granted, they are not as high as university fees in most cases. They also get paid a salary by their employer, similar to Malaysia.
Small exception in NZ where all postgraduate training costs (college fees, exam fees, textbooks, course fees, accommodation for courses, travel for courses/exams, etc) are reimbursed by your employer, but that is part of their work contract.
Postgraduate training is an investment in your future. You spend a lot of time and effort, working long hours and studying for exams. Some of that investment involves paying fees to a postgraduate college or university.
Dear dr hore, post grad training is not like market place. Post grad training is serious business. There is not such thing like taking a machine gun and shot at the sky hoping a bird will drop death. If u continue to have that kind of mentality, in my humble personal opinion you are not prepare for post grad training. May Iraq is the better choice.
I don’t think this guy is a doctor. The questions he asked is like a layman asking !
Please note that the Welsh Government have agreed that accommodation for F1 doctors training in Wales will continue to be free.
http://www.walesdeanery.org/index.php/en/foundation-recruitment.html
You are talking about internship and not postgraduate. Internship in Malaysia also gets free accommodation.
Sent from my iPad
This is what in medicine is called “the exception that proves the rule”. There will always be exceptions, and in this case, the Welsh govt has decided to continue to provide F1’s with accomodation. This is not all that surprising.
Even within a developed nation as the UK, there are relatively less developed regions and Wales is one of them. Wales has lower population and housing density, and more district hospitals at greater distance from main cities. Combine this with the generally lower desirability and prestige of a Foundation School in Wales (compared with eg. Pan-Thames), then you can see how exceptions need to be made to try to make a job attractive. Otherwise, all you get are the medical graduates from the bottom of the barrel who are only in Wales because they were not competitive enough to get a job anywhere else.
In some hospitals in the more remote parts of Scotland, difficulty with recruitment meant that there were FY postings which included things like a “guaranteed half-day off in each week”. One hospital even provided free membership for FY’s at the local health club. Otherwise, they would have no FY’s!
Notice a prevailing theme in what is said in these forums regarding a career as a postgrad doctor. Be prepared to compete if you want to succeed. In undergrad, it is enough to study hard and pass exams to get the final prize which is the MBBS. After the MBBS, hard work alone and passing exams is barely enough. How much more are you prepared to do to boost your CV so that you can be a standout to get the Masters slot? There are only so many places at the table.
If one is truly committed towards Cardiothoracic surgery, i would recommend – upon graduation, spend 1-2 years in the US, doing research in Surgery, getting contacts, ACE-ing the USMLE.
Then apply and pray to get a surgical residency. Pay is $48-50k USD/year as a trainee.
After 5 years general surg, apply for cardiothoracic fellowship.
Upon finishing, you have no bond.
Total time spent will be 10 years. Cardiothoracic surgeon by 35, and recognized all over the world.
I wonder who else recognizes cardiothoracic surgery Masters from Msia. Anyways, doubt you would want to move anywhere else at the age of 45 when you are done.
Actually, the total number of years will still come to about 15 years after graduation if you include “spending 1-2 years in US, doing research etc” and “hope and pray that you get residency in surgery” and waiting for fellowship !
And also we should not forget that you still need few years of experience after completing fellowship.
I know at least 2 so called Cardiothoracic surgeon trained in US but had a very high mortality when they came back to Malaysia and started operating alone! So, finishing early and having recognized “training” overseas doesn’t make you a good surgeon. It only gives you opportunity to work anywhere.
Jaz on, you are putting it very nice here. Well technically you can fast tract in USA however there is a catch here everyone. You can fast tract provided you get into the residence that is assume you are the only one in the line for job interview. If you gets in, you may fast tract by doing research. Well again presume some prof is dying to get u into their research begging you left right center. Then the best part, you make it in to the training that is you are the only one apply. Well all those will fall into places provided your dad is Obama. The problem is Obama does not have a son. Sorry guys 🙂 put aside the joke, in real world things are not as easy as you think. I know people got 99% in their USmel and still finding it hard to get into their desired training.
Getting 99 in both steps is good but it’s not the only thing that the program directors look at. In fact a lot of IMGs have achieved well above this score when they apply for residency. A 230+ and above is equivalent to 99 and it does not mean that you have scored 99% in the exam nor you are above the 99 percentile among the test takers, it is merely an arbitrary score with 75 as the mean. (Btw double digit score, eg: 99 is no more being reported, they only give 3 digits score nowadays. For step 1, the mean is around 220 with standard deviation of ~20)
From all the information that I have gathered, Good step scores (above 240) with a few months of USCE would fetch you some interviews but this only applies to primary care specialties like IM, Paeds, FM and Psy.
Surgical specialties are not easy to get in. A senior of mine has got only 1 interview this season in general surgery. Her scores are good (240/250/CS first attempt), has 2 papers published and 1 month USCE at Northwestern. With only 1 interview, it is more than likely that she won’t be matched.
This is the time that research experience would come into play. As Jaz has pointed out, 1-2 of research would definitely help if you do it in a big program and under an influential program director who can make calls for you and write you great letter.
correction: for 2 digits score, 75 is the passing score instead of the mean
correction: for 2 digits score, 75 is the passing score instead of the mean
Agree with soulmate on most of the points pointed out yet again it all boils done to IF you are fortunate then we are talking about minimum of 10 years like what was pointed out earlier. The big question is how many people will be that fortunate? I do apologize if my comments negative thought, my intention is to let people know in medicine is either you commits all the way or do not commit at all. I have seen many committed all the way and believe me majority had a big bumpy ride and worse is not all of them get to what they want at the end of the ride. Just to share my thought.
Currently I am in 3rd year MBBS. I have been very interested in doing emergency & trauma surgeon. May I know the pathway to have an emergency & trauma medicine speciality?
You need Masters in Emergency medicine instead of Masters in Surgery. However, you must understand that this degree do not allow you to do any surgeries. As such, the word trauma surgeon is not included.
There some surgeons who specialise in traumatology. They are usually general surgeons who have undergone further training via a fellowship. As Dr P has mentioned, this is different from Emergency Medicine. In most places, the different surgical subspecialties will take care of the relevant body parts (e.g. vascular, colorectal, orthopaedics, neurosurgery) during a trauma case.
Can someone ( who has trained in
surgery UK 3-year Basic Surgical Training (( BST ) and holding CCBST certificate, MRCS certificate ) work as general surgeon here ( after gazettment, all administrative procedures ) ?
I don’t know if you realise that in the UK, completion of BST and passing the MRCS Diploma are simply the most basic requirements for entry into Specialty Training. It does not guarantee that you will necessarily get into a Specialty Training post where the real practical hands-on cutting experience is acquired. BST is like being a surgery MO in Malaysia (and probably even worse for hand’s on opportunities). Much of a UK BST’s life in theatre is spent holding a retractor or driving the laparoscopy camera for the Specialty Trainee.
MRCS is not a recognised Specialty qualification anywhere in the world and that includes Malaysia. If you return to Malaysia with MRCS only, you will still require to enter a Masters programme to become a surgeon.
One final thing. Most medical students never realise just how long it takes to become a competent surgeon. 3 years as a BST is good for.. well.. not a lot. If you think you can operate independantly as a general surgeon with only Basic Surgical Training, be prepared to get a good lawyer for when you kill a patient. It won’t take long.
Sorry, you can’t unless you got FRCS
Can he skip year 1 ( and year 2 too ) OrthopedicsSurgery Master Program at UM since he has CCBST and year1 and 2 ortho surgery are mainly at gen surgery ?
Will he ( foreign doctor ) with CCBST and MRCS and recognised -by-MMCbasic undergraduate UK medical diploma stand out among other candidate when applying surgery master program ?
Will he ( foreign doctor, non-Malaysia citizen ) get paid as MO while doing postgraduate at UM ?
Thanks
NOPE for all except you do get paid as MO when doing Master’s.
http://pagalavan.com
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Dear dr,
I’m sorry that I can’t find ur email so I hv to leave my question here. I’m going to finish my houseman ship this year, and I wanna do Paeds. The issue is its really hard for me to get into Paeds department at my place. Hence, may I know, by any chance you know any good teaching hospital where I can learn as a MO? My hospital Paeds department inspires me to become one of them, but I’m preparing for the worst as I said, very competitive. I don’t mind strict bosses, as long as they can teach and train me. Any advice will be very much appreciate. I’ll be sitting for MRCPCH part one, or two first papers as they call it now, this year.
Thank you so much.
If I am not mistaken, everyone who finishes housemen will be transferred out of the hospital to districts and rural clinics/hospital. You can sit for your MRCPCH and after you pass your Part 1, you can apply to get back into General Hospital. Whether you can go directly to paediatric department or not, depends on the Hospital Pengarah and post vacancy.
According to http://www.nsr.org.my/qualifications1.html
Master of Surgery from International Islamic University Malaysia is NOT recognized by NSR, why ?
Is it worth taking master of surgery at this university ?
What if I graduate from this univ’s master of surgery next 4 years and NSR does NOT recognise it ?
Because it has NoT produced any graduates yet.
1. Can I apply this June/July 2013 intake at 4 universities at ( almost ) the same time ?Univ Malaya : Orthopedics; UKM : GEn Surg; USM : Ob-Gyn, UII : Gen Surgery
2. How much is the ball-park figure salary of newly qualified surgeon working at goverment hospital ?
Thanks
application for Masters usually opens in October. You are likely too late to apply for this year.
Salary for surgeon: depends on years of service: can range from RM5-10K
So, a newly-qualified surgeons working at government hospital earn 5k,
does it include extra work like if he has to do several laparatomy, near-fatal abdominal and thoracic trauma repair almost every day ? So, is it 5k plus several thousands ?
In government sector, the salary is the same! I had mentioned it several times already
Government employment is a salaried position, not dependent on what you do. There are allowances on top of the basic salary, but that is not dependent on specialty or amount of work, everybody in the same category gets it. So if you work hard, or you are lazy, you still get the same pay.
In other words, the motivation to work is not based on money. In fact, the money is often a great incentive NOT to work too hard.
May I ask – what is the average salary of a general internist working in a private hospital, for example KPJ or Columbia?
There is NO such thing as salary in private sector. You are self employed and earn what you charge the patient. NO patient NO money.
I see. Then based on the average rates that the internist charges, and average profit… how much is the average income for the internist?
And how different is this income compared to general practitioners? Since GPs also see hypertension/DM, and internists also see the same subset of patients. If there is not much difference in income and patient population, is it even worth it to pursue Masters in Internal Medicine or MRCP? Might as well one just gets out after compulsory service and head to a small village and set up a practice.
It depends on what you mean worth?
I have actually answered all these questions in my various post.
Going to private does not mean you are going to make a lot of money. A successful GP can earn more than a specialist in private hospital. The competition is ver great nowadays.
Generally GPs and specialist incomes are dropping gradually. Some GPs are closing shops.
Can you explain what’s the difference of income between internist ( or even rheumatologist, neurologist, (( non-interventional )) dermatologist, and GP as GP ( or even “traditional healaer”, tradtional medicine ( jamu with hidden content of NSAID and steroid), or even pijat ) seller) can treat patient’s symptom like pain in the knee, fatigue, skin rash ?
I saw a lot of jamu seller on the street “practising” as a doctor in term of giving advice and medication.
One private specialist complains that he used to see 10 patient and NOW just 5 patients. What is your comment ?
I had written about this several times before. Pls read my past entries.
Dr Paga, if I am not mistaken, you mentioned that GPs nowadays earn less than RM 10k, on average.
Do internist earn around the same figure as well? On average.
I understand that there are outliers earning a lot, but what I am asking is = on AVERAGE.
It all depends on your reputation. I know some internist only earning less than 15K by working 24 hrs a day! I also know some well established GPs earning more than 50K but these these were GPs who started more than 15 years ago.
The situation has chnged over the years. A surgeon can easily earn more than RM50K 5-10 years ago but only earning less than 30K now.
It all depends on your reputation. I know some internist only earning less than 15K by working 24 hrs a day! I also know some well established GPs earning more than 50K but these these were GPs who started more than 15 years ago.
The situation has chànged over the years. A surgeon can easily earn more than RM50K 5-10 years ago but only earning less than 30K now.
Hi dr paga,
I`m an ardent fan of your blog which I have been following for quite some time. I`m a medical student in a public university in Malaysia who`s interested in doing ophthalmology afer I graduate. I have a few questions and will be most grateful if you could answer them
1)Other than by doing the local masters programme, are there any other pathways available? I know that the MRCS is not recognised as a specialist qualification in Malaysia but I noticed that the FRCS is still on the NSR list and that we can take all 3 parts of the FRCS without formal training in UK as long as we have the required ophthalmology experience. Does passing the FRCS allow you to be a ophthalmologist the same way as passing the MRCP would after a period of gazettement?
2)I have also noticed that a lot of local university graduates have a masters of medicine in ophthalmology from singapore and the Mmed(ophthal) singapore is on the NSR list. Do you have to be a practising doctor in singapore to be able to take this examination or does it function like the MRCP where you can take the exam without being registered by the medical council of that respective country?
3) Are there any other examinations for ophthalmology out there other than the FRCS which local Malaysian public university graduates can undertake whilst being a HO or MO in Malaysia? Thank you
1) FRCS(Opthal) except for Gaslgow, is still recognised in Malaysia. However, only few hospitals in malaysia are recognised training centres. It is not about sitting for exams. You need to be trained in a FRCS recognised instituition in Malaysia. If I am not mistaken, UH and Tun Hussein Onn Hospital are recognised training centres.
2) I am not sure about this. You can enquire with NUH. I have not heard of any
3) NO
[…] first part of this topic received tremendous amount of viewers, reaching almost 1500 views/day since […]
http://www.theborneopost.com/2013/02/06/sgh-heart-centre-has-two-surgeons/
news from today. I think we need more surgeons no? Hehe
Of course we need more Cardiothoracic surgeons but not many. Furthermore this is a public hospital and not private.
Hello Dr.
Is it compulsory to take Master’s in Surgery first before the 4 years cardiothoracic specialty training? And does “4 years Cardiothoracic subspeciality training” refers to FRCS training?
Yes, you need to do basic surgical speciality training before cardiothoracic training. No other options at the moment.
FRCS is not available in Malaysia anymore.
If that’s so, then how do aspiring cardiothoracic surgeons do their 4 years training as you stated?
Also, I’ve seen cardiothoracic surgeons with FRCS behind their names, I wonder how do they get that? I just know that FRCS stands for Fellowship of The Royal College of Surgeons but I still don’t know much on how to get such qualification.
I think I have explained that in my article above. After your Master’s in Surgery and gazettement , you need to apply for the training post via Ministry of Health.
The Cardiothoracic surgeons with FRCS are the older generations. FRCS has been discontinued in Malaysia since 2001.
How much is the salary of newly-qualified general surgeon doing gazzetment ?
About 6-7K
Any other subspecialty like nephrology, cardio etc will also earn the same 6-7k right?
Yes, in government sector. After 9 years of service, you will get about RM10K
Thank you very much Dr!
In public universities (UPM), is it true that when a medical student who did badly or unsatisfactory for his end of posting (say internal medicine or surgery) but manage to pass end of semester exam, will only need to repeat the same posting for just another one week during the holidays (clerk a patient and resubmit report)? Do you think one week is sufficient to improve the relevant skill before promoting to the next higher clinical year? (say from 3rd yr to 4th yr). Thanks.
hi doctor,
i have some doubt to ask:
-is the time taken same if i take the MCRS exam instead of going to Master’s in Surgery?
-what will happen during the gazettement and the 1 to 2 years waiting period? does it mean that i can’t do any procedure during the waiting period?
your information is really helpful. thank you 🙂
I guess to be a surgeon u MUST do ONLY master. Me think.
Yup … can’t do jack with the MRCS, although it may help you get on to Masters.
MRCS is not recognised as a specialist qualification in Malaysia.
MRCS is NOT a specialist degree. It is an entry exam in UK. However, having MRCS gives you a better chance to get into Master’s program. There is no other way to become a surgeon at the moment, in Malaysia. During the gazettment and waiting period, you are allowed to do general surgical cases.
Hello Dr.Pagavalan
As for AUCMS, you’ve mentioned before that it’s a joke as it offers 2 medical degree at the same time but the question that i do like to ask is, what do you think about the ceo(Dr.Zainudin Wazir)? seems like respectable and has very high reputation among the doctors.any comment? Sorry for my english.
No, it offers 5 medical program, 2 of it’s own and 3 more twinning program. It is the first and only university in the world to offer 5 medical programs!! that itself is enough to tell you that something is rotten in the state of denmark!
Now, about the CEO, are you sure he is respectable and has high reputation?? I don’t hear the same. Pls ask people in penang hospital!
quote from businessweek.com
Background*
Dato Dr. Zainuddin Bin Md. Wazir established Benih Tulin Sdn Bhd, which is responsible for setting up the WorldLab Tissue Culture Centre, a Research & Development centre for mass production of tissue culture. Dato Dr. Bin Md. Wazir served as Cardiothoracic Registrar at General Hospital of Kuala Lumpur, Monash Medical Centre in Victoria, Australia and Alfred Hospital in Melbourne Australia from 1984 to 1994. Dato Dr. Bin Md. Wazir served as Head of Cardiac Surgery at General Hospital Pulau Pinang from 1994 to 1998. He served as the Head of Department of Cardiac Surgery at the Penang General Hospital in 1995 and later became a Consultant Cardiothoracic Surgeon at Island Hospital, Penang. He serves as an Executive Chairman of The Synergy Group. Dato Dr. Bin Md. Wazir has been Independent Non Executive Director of Pentamaster Corp. Bhd February 22, 2006. He serves as a Director of Lipo Corporation Berhad. He holds Doctor of Medicine (M.D) and Master of Surgery (General) (MS (Gen)). He also manages the Allianze College Of Medical Sciences (ACMS). He is an active committee member of the Penang Malay Chamber Of Commerce and the Treasurer of Malaysian Islamic Chambers Of Commerce. He obtained Master of Surgery from University Kebangsaan Malaysia. He specialist training at the Monash Medical Center, Australia and at the Alfred Hospital, Australia in from 1992 to 1994.
By the way about the medical programs that they offer,as far as i observe,all of the students is sponsored by MARA,JPA. M.D UKM over there also is not bad as my batch currently studying there in 5th year,they said the workload is still the same as student in md ukm,plus the exam paper is checked by the lecturers in UKM itself. I agree with you that 5 medical programmes in 1 uni is too much,where in the future,whos going to teach them once they do their last 3,4 years in Malaysia? Thank you very much for your time doctor and i really appreciate it
Don’ t get carried away with all this paper qualifications and CV. Do you know how many surgeons I know who have excellent CV on paper BUT cannot do any surgery??
Yes, of course. All private medical schools in Malaysia are owned by cronies. That’s why it is a money making business. That’s why their students are all sponsored by JPA and MARA!! You must know how politics works in Malaysia to understand what I am talking. As for MD UKM, there is still some quality control from UKM but the degree is NOT recognized in Singapore unlike MD UKM from main campus
In other words, he is a businessman……lol
dear doctor, nice to follow your informative blog. its a great step you’ve taken to give us, the future and the current medics alot of info that we actually yearn to know. salutations to you doctor!
doctor, i have a question to you since researches online have never given me complete answers to a few of my questions. im pretty sure you’re the right one to crack this hard nut. 😀
doctor, im a 4th yr medical student currently doing my clinicals in padjadjaran university in bandung, indonesia. its my long time ambition and passion to be a surgeon but after reading your post on cardiothoracic and neuro surgery, i have learned that its not that easy to be a surgeon in malaysia. doctor, is it possible with the degree of my university, i pursue my surgical training in other countries like the UK, US, australia or india? and if its possible how will the path be? thank you doctor! hope to get a reply from you very soon
Your degree is NOT recognised in UK, US, Singapore or even India. This means , you can’t work in these countries without sitting and passing their entrance exams with NO guarantee that you will get a job!
thank you doctor! btw, what kind of entrance exams will those be doctor? is it like USMLE? does this mean studying surgery in these countries is actually working? is it not like enroling in a university for a surgical study programme?
I must say that I am rather surprised that you ask this questions when you are already a 4th year medical student! Yes, it is like USMLE and each country has their own entrance exam. BUT passing these exams do not mean you will get a job over there.
There is NO such thing as FULL time studying in medicine! That only happens for the 5/6 years undergraduate program. After that it is FULL TIME working with part time studying. How are you going to become a surgeon by just reading but not doing any clinical work or surgery??
Dont forget its hard to enter.
The entrance exams vary from country to country, in terms of their format and content. They are at the standard that they expect their own medical graduates to be at. Passing the exam is one thing – still no guarantee of a job or a training post, especially in surgery which tends to be quite popular.
Just about all medical postgraduate training involves working while studying for exams. Training may be administered by a national college (e.g. UK, Ireland, Australia/NZ) by a university (e.g. Malaysia, India) or by a body that accredits individual hospitals for residencies (e.g. US and now Singapore). Regardless of the mode, you are still working full time (50-80 hours/week depending on the training programme and country). It is not like medical school.
By the way, surgical training in India is not recognised in Malaysia for specialist registration.
Hey Paga, I am first-year Malaysian medical student studying in Australia nw. I am new to this blog and I must say tat I am taken aback by all the simple yet invisible truths in medical field outlined by you in the posts that I have read. I am keeping fingers crossed tat I can hopefully become a CT Surgeon someday. (rest assured tat money is nt my main motive, sincerely) I would like to ask a question that I hope u might be able to answer; After graduating wif an Australian degree, completing my 5 yrs of HOMO in M’sia, how can I proceed to Singapore to continue with the pathway? What I am asking is which part of the pathway can I fit into the S’pore system or is it just totally the same as Msia? (Considering that i prefer to stay at S’pore as short as possible) I knw its still early but I would just love to have a rough picture of how the layout will be. Thanks in advance.
If your Australian degree is recognised in Singapore, I would advise you to go straight to Singapore after your internship in Australia. Unless you are a government scholar.
Unfortunately I am a government scholar with a bond of 10 years. So, what are your recommendations? (I am sorry for taking your time off asking this early about such detailed issues) If possible, can you list your recommended pathway? I hope I can do my specialist training outside M’sia btw. Thanks.
Since you are bonded for 10 years, you got no choice but to do your training in Malaysia. It is not inferior to other countries!
My 10-year bond will include my HOMO period so I think by the end of gazettement as General Surgeon, my bond has ended. Anyway, I apologize if I sounded like I have offended the specialty training in Malaysia but in no way I mean that. Its just that I have heard from doctors saying, “Go abroad and learn the specialties and bring the skills or techniques back to Malaysia.” Well, anyway, my journey has just begun and its a long, long way to go. I will just move on with wherever the path leads me and hopefully make the right choice of pathway, whether locally or abroad. Thank you Dr. Paga.
If you do the local Master’s program, which is the only pathway to become a general surgeon in Malaysia, you will be bonded another additional 7 years.
“Unfortunately..a government scholar”
Really?
I think you should feel fortunate that you are a government scholar to study medicine in overseas. You are still in your early days of your medical career. But if you are a government scholar then i would urge you to go back to Malaysia to serve the nation (Unless government cannot provide you a job) If you really want to become a CTS, I am sure Malaysia would be a good place to start since I would expect more hands-on in Malaysia as compared to other western countries.
Teoh,
The Malaysian government is actually very considerate. You can write to them and ask them to allow you to extend a few years overseas to do your housemanship before returning to Malaysia. It is assessed on a case by case scenario.
Besides it is for the good of the country for you to gain some experience overseas prior to returning to Malaysia. Especially now that they is an overload of housemen in Malaysia.
All the best in your medical school. Many things may change by the time you graduate so don’t worry too much about the future. Concentrate on passing your exams first.
Well done on getting a scholarship btw!
I don’t think they entertain such request anymore
Teoh,
You are quite lucky to get Australia to further your studies. Imagine some scholars were sent to Russia etc. to study medicine . And as Dr Paga has mentioned, even if you want to be a General Surgeon in Malaysia, you do have another 7 year bond too. Anyway, the thing is that you are still early in your medical career. By the time you graduate, anything can happen really.
Thanks everyone. I am aware that anything might happen and I might not even further till CTS but its my dream since young really, and I would just like to get a clearer picture of how things will line up for me. I don’t want to be in the dark over what might happen and get a shock once I graduate. Anyway, thanks once again to everyone’s comments. Yea, I am very thankful for the scholarship that I have received and thats why I feel I have a mission to serve the Malaysian people (taxpayers) who have funded my studies.
Teoh can I ask you a question?
Does Jpa still give out scholarships after SPM?
I am thinking of my cousin who is exceptionally outstanding in studies and extracurricular activities.
Yea sure. I will be glad to answer this. Basically, if you achieve a minimum of 9A+ in SPM, u will be under the Ministry of Education’s ‘Bursary Programe’. There is no need to apply for this (applications not entertained) because you will automatically get it based on your results and MOE will contact you. Under this programe, MOE fully funds your pre-university studies (only limited to Form 6, A-Levels, IB and Matriculation in selected institutions). You will also be given an allowance every month.
For ‘Bursary Programe’ students, once you finished your pre-university, if you are accepted into a foreign university that is listed under Public Service Department’s (JPA) sponsored universities (top 50 universities in the world for most courses and 10 selected universities for Medicine), you will automatically be sponsored fully for university studies as well. If you do not receive offer from foreign university and are accepted into a local university, you will be sponsored for your local university studies as well. Apart from full tuition fees, you receive an allowance each month.
All being said, the most vital part of this whole process is getting a minimal 9A+ in SPM.
I hope I am clear enough. =)
Is this Bursary still in existence? This was the pre-election goodies that the government gave to all top scorers in 2012.
Yes, but it’s now 9A+ minimum. At least it’s not a blanket scholarship, but extension beyond Pre-U conditional on getting good enough Pre-U results, and getting into top universities overseas. SPM is really too early for scholarships.
BTW, for A Levels, they will only pay for 3 subjects.
Thank you Teoh.
That’s good to know 🙂
I hope my cousin achieves the necessary grades for sponsorship.
KPM Bursary Program started in 2012 for top SPM students with 9A+ in SPM 2011 to study their LOCAL pre-university and then continue with their undergraduate degree either in OVERSEAS or LOCAL IPTAs. Under the program, Those top SPM students are authomatically eligible for LOCAL pre-university programs only as specified by KPM.
However, this year’s sponsorship for the undergraduate degree for those top students of SPM 2013 after their pre-university in 2015/2016 is NO longer guaranteed by JPA unlike the previous years i.e. 2012 & 2013. Students are encouraged to look for whatever scholarships available by private and public sponsors after their pre-university. Of course, JPA is still one of the main government sponsors but the total numbers of overseas sponsorship are expected to be reduced due to our current budget deficit.
From the above comments, probably things have changed in one year. But as for my batch of SPM 2011 students, we are sponsored even for 4 A-Level subjects. And we are guaranteed of scholarship as long as we are accepted into university in JPA list.
That was a pre election promise. Things will always change in Malaysia
Teoh,
During my time which was around year 2002, I was sponsored for 5 A level subjects. And we can apply to any universities in Britain and Ireland without any restrictions. For those that didnt get into overseas universities, they will be sent to IMU for twinning programmes. My year was the first year the national scholarships were opened to all races based on meritocracy. I think it was the brain child of Dr. Mahathir, the PM of the time.
Brain child of Mahathir ?? I think you don’t know the history. Mahathir was the one who abolished scholarship for Non-Bumis to go overseas, especially for medicine. In 1980s, even if you are top scorer, JPA scholarship to do medicine overseas was only reserved for BUMIs ( I was one of the victim). This will be told to you when you attend the interview. He was also the one who reserved MARA colleges and matriculation for only Bumiputera students. In 1970s, both this institutions do take non-Bumis. It was after 1999 election that Mahathir allowed 10% intake quota for non-Bumis in MARA colleges and Matriculation. This was because it was the non-malays vote that made BN win the election in 1999. MCA then pushed Mahathir to do this and open up more scholarship for non-Bumis.
A relative is one of the recipients of the biasiswa nasional, awarded to the top 50 students, and will be aiming for medicine abroad.
Sorry Dr P, I don’t know the politics behind it in detail but all the top scorers of the country were invited to putrajaya for dinner with Dr M, all expenses paid for. Thought that was very kind of him.
Jaz1, well done to your relative. I wish him every success. I m sure he/she will be fine if he can score 9A+ or better in SPM. Even British students find it hard to do that well in their GCSE.
Dr P, I think we have to send students to top universities overseas despite plenty med schools in Malaysia because these students deserve the best education. It will be a reward for their hard work. Besides they will be serving the country in the future. It will benefit the citizens of the country, I hope.
The problem is , most of these students will not come home if they are able to get a job overseas. Secondly, top students should be retained within the country. That’s what most countries do. BUT you can sponsor them for post graduate studies overseas.
@2 cents, please don’t compare GCSE to SPM. SPM has suffered very bad reputation in recent years. However, my relative has consistently done well, scoring high 80s and 90s in form 4 and 5, so hers is “legit” and she was active in extra curricular activities. I am quite sure she will excel in a levels as well. Of course admission into medical schools in UK and Aus, need more than just academic prowess, so hope she knows what it takes to secure a place.
Even Singapore sends their top students overseas for undergraduate courses. There is no reason why we can’t do the same and only send student for post graduate degrees overseas.
Singapore attracts the top students from other countries to study in their university. Do Malaysia do that? Furthermore, you go to jail if you don’t come back to serve your bond
The contract for national scholarship holders was too lenient in the past. In order to break the bond, one only has to pay 10% of the full amount. A number of my friends have done so and are now free to work anywhere they want. Some have got married to caucasians as well and become citizens of another country.
But I understand the new scholarship holders will need to pay the full amount one sum if they wish to break the bond. So the government is taking the right step to ensure that the scholarship is not abused.
Jaz1, maybe the standard of SPM has dropped, but I used to have high respect for it. I used to think that SPM exam is of a higher standard than GCSE. With my background of SPM exam, I actually find A levels relatively easy. (The difficulty initially is the change of language from Malay to English.) A level Math is one paper I didnt have to study because I have covered most of the syllabus in Additional Maths in SPM. I honestly do feel SPM had given me a good foundation. That was in year 2000. Straight As students were far and few in between at that time because there was no national scholarships for non-malays yet.
If your relative has been scoring above 80s and 90s in her exams and being active in extra curricular activities, she will have no problem getting into a med school in the UK. Being a people person is an important criteria as well. Hence the importance of charity work etc. All the best to her!
Don’t confuse between the content, and the marking system, of SPM. Indeed, the syllabus of SPM is quite broad and deep, and many students did feel they have no problem coping with A levels after SPM.
However, the grade inflation over the last 15 years indicate the grading system has been ‘dumb downed’ significantly, so the number of A grades has increased enormously. They had to add the A+ grade to stratify the A grade further. I do not believe any cohort of students is any smarter than previous ones, although they may get better at answering exam questions. Perhaps the Australian system of relative ranking within a cohort is a better way of benchmarking a person, than absolute grade.
Similar problem is encountered in Britain – they are thinking of revamping their pre-U A levels course. Now they have the A* grade in A levels too (It used to be just A, B or C..). So Malaysia is not alone in introducing A+ in their SPM exam.
The requirement to get into the UK medical school has also increased. The minimum grades required used to be ABB (about a decade ago), but now in every medical school, they require AAA as the minimum entry requirement.
I think students nowadays know how to play the game – the teachers are better at teaching the students to recognise exam questions pattern too. Unless they change the system, there will be more and more straight As students every year, and it will be hard to separate the best from the reasonably good.
I am not familiar with the australian system. I know a few friends who sat for SAM (South Australian Matriculation) and I was told you have to be the top 1% of the year to apply for medicine. sounds much harder than A levels to me!
as in theory of evolution, each generations will become smarter than the previous. Thus, the exams should also get tougher and not easier!
The conditional offers for some is already A*AA. When you realise that 18% of A-Level students obtain 3As or better, 3As doesn’t really select the best. Yes, in Australia, the cut offs are like ATAR99.55 (top 0.45%) for Monash, and perhaps 98 for some lower ranked Med schools. (For perspective, note that almost 4% of A-Levels students get 3A*). More than 1/2 of their Med schools are graduate entry too, which makes the undergraduate entry ones all the more competitive.
Personally, I think AAA in A levels is good enough for medicine. The other selection criteria should be based on one’s attributes such as leadership quality, communication skills, ability to think laterally etc.
A student who can score AAA, to me, is deemed capable of handling the academic side of medicine.
Unlike other science courses, medicine includes the non-academic side as well, hence the importance of life skills and a good personal character.
An experienced interviewer will be able to tease out such information and attributes from his/her candidates.
On a separate note, it is not necessarily to go to the top 10 universities in the world to be good doctors. Many times, these universities produce researchers rather than clinicians.
Hi…if someone is in a rush to earn money, this definitely is not the choice…but, I think if positive points are added like there’s job satisfaction, a bliss that comes out of it…then may be the budding doctors will not be demoralised…nice blog, but felt some positives should have been added…
Unfortunately most people do medicine for wrong reasons. This blog is to tell them the reality. Everyone knows the good thing about medicine. I don’t have to write about it. Those who are really interested in medicine for what it is, will never be demoralized
Ya thats true…I respect your perspective, but the thing I said is choosing the path may dwindle,, I am sorry if I said too much,, thank you for the reply Dr.
Nothing wrong with what you said. Medicine should only be done by those who are willing to sacrifice!
What do you gain by doing Msc for example Msc in Surgery (Research), and Ive looked up a bit that to apply for it you just need MBBS and some years of service in the hospitals.
It is a research based degree. It does not make you a specialist.
is that pathology is trivial job?
Depends on you
Doctor paga, do you know what’s the pathway of becoming a psychiatrist in Malaysia? (After 2 years of housemanship+2 years of compulsory service)What’s next?Thank you.
Master’s in Psychiatry. I heard MRCPsy is recognised in Malaysia but you need to go to Uk for the exams.
If our doctors follow Dr Pagalavan advice most of us will become nothing but the highest achievement could be just a rheumatologist. His advice full of demotivation & hatres as he has been treated such as this time. Pathetics.
Oh my english! I don’t think anyone understands what you just wrote. I write facts and reality out there, up to you whether you want to believe it or not.
Dr Pagavalan can you do cardiothoracic training in Institute Jantung Negara? In your opinion is the training good?
yes, of course. It is the premier cardiac centre in Malaysia.