It’s been 2 weeks since I updated my blog, the last being a day before Merdeka day. I was not only busy but also came down with Chicken Pox. For the first time in 5 years of being in private sector, I had to take MC for a week. Sitting at home alone is rather boring and annoying. I wanted to write about issues concerning GMC over the last few weeks but never had the time.
Over the last 15 years or so, IMU has been running twinning program with UK universities. The students will complete their clinical years in UK. Most of them will do their Foundation Year (Internship) in UK to be eligible for full GMC registration. Most of the self sponsored students do not come back home. Sponsored students especially JPA sponsored, will usually come back home to do their housemanship. However, it means they will not be eligible for GMC full registration. When UK started to have problems with Foundation Year 1 allocation in 2012 as I had written HERE, GMC started to look at the feasibility of allowing foreign students to do foundation year in a foreign country. Basically, GMC took the responsibility to make sure those who graduated from UK universities are eligible for GMC registration since UK may not be able to provide an employment for these students. In UK, Foundation year is still considered as part of the undergraduate medical education where the universities are still actively involved in providing the Certificate of Experience. That’s the reason you can do your Foundation year under student visa and do not need a work permit.
IN October 2013, GMC issued an approval for such arrangement with effective from August 2014. However, certain criteria and regulations were set to allow this to happen. The universities were given the role to facilitate the foundation program training overseas and GMC must be informed prospectively. While I am not sure of IMU twinning program in making use of this approval, Newcastle University Malaysia has adopted the program. In June 2015, NuMed had officially made the announcement that 5 hospitals in Malaysia , namely Hospital Sultanah Aminah, Hospital Sultan Ismail, Hospital Kluang, Hospital Kuching and Hospital Queen Elizabeth will be GMC accredited Foundation year training centres. What does this mean?
Since NuMed degree is recognised by GMC, you can be provisionally registered till you complete your Foundation year. Previously, only foundation program in UK is recognised for full registration. However, since the prevailing immigration law in UK will unlikely provide any work permit for foreigners (Non-EU) to get employment, GMC has now allowed NuMed graduates to complete the foundation program in these 5 hospitals and apply for full GMC registration. Please remember that from April 2015, GMC has limited the length of time a doctor can hold a provisional registration to a maximum of 3 years and 30 days.
Does GMC full registration bring any benefit? This is the question that I am trying to find an answer over the last few weeks. As far as I know, each country have their own accreditation process or a common entry exam (e.g. USMLE in US, Canada etc). For sure, it does not make any difference when it comes to Singapore Medical Council (SMC). Their website clearly says that only degrees listed on their second schedule are recognised and branch campuses are not considered (No 3) :
“Only the campus that was in existence at the time of addition to the Schedule will be recognised. Any new campus that is off-site from the recognised main campus, whether in the same country or a different country and whether the same degree is granted or not, will not be recognised by the SMC.“
The only main advantage of having a GMC full registration is to work in UK, Ireland or EU countries. As mentioned before, getting a job in UK is almost impossible due to their current immigration laws. Ireland has already recognised housemanship training in Malaysia where you are eligible to apply for a post in Ireland without the need to sit for PRES examinations. I had written about the problems that Ireland is facing over HERE. Obviously, not many Malaysian will be interested to work in non-English speaking EU countries. Furthermore, the same immigration laws may apply for foreigners.
What about Australia/New Zealand? This a bit tricky to say the least. Australian Medical Board, under “Competent Authority Pathway” says:
” Graduate of a medical course conducted by a medical school in the United Kingdom accredited by the General Medical Council, AND:
1) successful completion of the Foundation Year 1, or
2) 12 months supervised training (internship equivalent) in the United Kingdom, or
3) if the 12 months supervised training (internship equivalent) is completed in another Board approved competent authority country, approved by that competent authority.”
Unfortunately, Malaysia is not a “Board approved competent authority country“. Thus, it is very unlikely that Australia will recognise GMC registration where the training is done outside UK.
Document: Medical-Board—Criteria—Requirements-for-eligibility-for-the-Competent-Authority-Pathway-2
Please also remember that there is a fee that need to be paid for GMC full registration as well as to maintain the registration every year (annual retention fee). The fees can be seen HERE. Currently 1 pound is about RM 6.80!.
So, I welcome any suggestion or informations from anyone who may know more about GMC registration. GMC registration use to be well recognised in commonwealth countries about 30 years ago. But, the situation has changed over the years. Nowadays, each country have their own way of recognising a medical degree obtained outside their country. GMC registration may not mean much anymore in terms of employment but it may still give you some sort of quality assurance, I hope.
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Hmmm… I’d be interested to know what happens next after these graduates get hold of their full registration with the GMC. Will year 2 of the housemanship programme in the Malaysian hospitals be equivalent to the F2 year in the UK as well? And do they proceed on to applying for specialty training programme in the UK like every other doctors do after that?
Nowadays in order for you to get hold of full GMC registration you would just have to pass the PLAB exam, which to a majority of people whom I’ve spoken who’ve passed it is not difficult at all, subjecting the quality of the exam to public scrutiny as to whether a PLAB candidate who’ve passed the exam would perform on par of a UK graduate.
And I don’t really get it. HSA? HSI? Seriously? Don’t get me wrong I’m from JB myself but the GMC really do have better options.
PLAB will soon be replaced with the UKMLA.
The issue is not about passing PLAB or entering speciality training. The issue is getting a work permit to even get employment in UK. That’s the reason why GMC had to agree to this arrangement of doing FY in overseas country. Under the immigration law, Non-Eu citizens will unlikely get a work permit to work in UK. It is mentioned by GMC as well as NuMed website.
PLAB is also going to be made much tougher as written here
Dear Dr Pagalavan,
Good write up! Hope this will generate some useful and healthy discussion.
As for GMC full registration, one has to bear in mind that it does not automatically give them the License to Practice in UK. For that, the GMC will scrutinise the applicant for their CPD records, working experience, work gaps and all kind of evidences, before allowed to practice in UK, even if the doctor has GMC full registration. However it does alleviate the burden of sitting for PLAB; which has put off many specialist from entering subspecialty training in UK.
As for NUMed grads who enrolled into this FY1-Housemanship programme in Malaysia, they will benefit from the chance to enter FY2 in UK especially if the Northern Deanery (Newcastle) support them by slotting them into empty training post, usually left vacant by those on maternity leave/sabbatical/etc. Otherwise, they could complete their 2 yrs HOship training in Malaysia and then try to get into UK training system via Medical Training Initiative (MTI). Its done in collaboration with Royal Colleges. Different college would have different way/style on how they carry this out. Most would require some postgrad paper qualification e.g. Part I, PACES etc..MRCOG Part I holders for example, can already enter this programme. However MTI usually come into UK with Tier 5 visa for a maximum of 2-3 years, after which they have to return to their home country to continue training. This route can be used for basic specialty training, but probably is most useful for subspecialty training; especially from Malaysia’s perspective.
With UK struggling with low number of candidate for their GP training programme, the training opportunity is there for those with GMC full registration holders. Although the cost is quite high to just renew it every year, it might come in handy in time of uncertainty. The prospect of subspecialty training is probably the biggest advantage.
As far as I know, IMU don’t have a strong link with any of the Foundation School in UK to become the patron Foundation School that will assess their graduate that will work in Malaysia as HO. NUMed uses Northern Deanery, which basically equivalent to Newcastle University in the UK. At the end of their 1st year of HOship training in Malaysia, some assessor from Northern Deanery will have to assess these NUMed grads/HOs and decide if they are deemed competent as per Foundation Programme Curriculum and will provide them with the Cert of Experience on behalf of Newcastle University UK. This will then be used to recommend these HOs to the GMC for them to be granted GMC Full Reg.
My two cents..
I think the issue is about getting a work permit to get employment in UK. Based on current immigration law, unlikely a Non-EU citizen will get a work permit to work in UK. That is the very first reason why GMC had to approve doing foundation year overseas. Thus, having a GMC full registration does not make any difference in getting an employment and work permit in UK. NuMed website also says the same
As for MTI, you don’t really need GMC registration per se as it is a temporary registration given for post graduate training, mainly for subspecialty training for a period of 2 years. You don’t need PLAB or even a recognised basic degree.What you need is just MRCP.So, you can be from any university with or without GMC registration.
Yes, the issue is immigration law. As for MTI, you are correct in saying that they don’t really need GMC full registration to qualify for it. But I personally know 2 Malaysian doctors who managed to get employed and given work permit after they had completed their basic specialty training under MTI initiative. Initially they were only given 2 years Tier 5 visa. But subsequently they managed to get into ST training post (ST3) in NHS hospital and appealed for continuation of their visa as work permit. Of course these might be some very isolated cases, but I think there is a loop hole there.
these isolated cases are seen on and off, usually they get a very good recommendation and report from HOD.
I suppose this is a problem unique to NuMed. For those in IMU-PMS, unless one is really in the bottom 5-10%, they will get an F1/F2 post.
that’s because IMU-PMS students graduate from within UK and able to do FY under student visa.
Hi Dr Pagalavan. I just graduated from UCD dublin. I did the full course in dublin, not the twinning programme with PMC. I tried applying for FY1 in UK but I was told because I’m non EU, i dont have the rights to work in the UK. If that is the case what is the use of taking PLAB? Second question, I intend to pursue a career in plastic surgery. I have been accepted for a Masters in Surgery (MCh)in Ireland. But I am also awaiting to be called for housemanship here in Msia. The wait is pretty long and I do not expect to be interviewed until Nov/Dec this year and offered a job no earlier than April next year. I’ll be completing the MCh in june next year. I would very much like to do the masters but just having second thoughts as to whether it would make any difference to my application later for specialist training. I’m not bonded to anyone and the masters would be self funded as well. Just not sure if its a call worth taking. Any advice would be much appreciated
Sorry just recalled that PLAB is a requirement to get GMC registration but getting into the FY1 programme is controlled by UKFPO; the latter who advised me about my nonEU status.
I would appreciate your views on my second issue 🙂 Thanks!
as written in my earlier reply
Yes, as I had mentioned several times in this blog, the current immigration law in UK gives priority to EU citizens after their own citizens. Thus, if you are a non -EU citizen, unlikely you will get a work permit for any employment. Why not you do your internship in Ireland?
Masters in surgery(Mch) is not a specialist degree and not recognised in Malaysia. It is a non clinical, research based Masters. Thus, unless it is for your own self interest, i don’t see any point doing it.
Thanks for the response. I did apply but Ireland is actually worse than the UK in terms of internship opportunities for non EU students. Barely 10 non-EU students got internships in ireland due to a recent law, where no non EU person would be offered an internship until all the EU applicants have secured internships, regardless of the graduating grades/GPA. And nearly all spots this year were taken up by EU citizen with a few who moved to the US etc leaving behind empty spots for very few non EUs.
Yes, that’s why I keep saying everywhere is saturated. Medicine is not something you should do if you intend to migrate. Have you tried Singapore?
Will a MCh not make you more marketable in the future, should you decide to settle in Europe/ UK or anywhere else. A post grad degree will make you more competitive for SpR schemes/ higher specialist training. ?? Will having a MCh make her more competitive when applying for Masters programme in Malaysia (Question to Dr Paga if could kindly clarify).
Just from your post I think you have nothing to do anyway whilst waiting for your housemanship in Malaysia and money is of no concern as you are able to self fund. Why not make use of the time and get a higher post grad qualification. Knowledge gained will never be of waste anyways.
MCh is a non clinical program. How to make her more marketable when she can’t even get a job in UK/Europe? To function and practise as a doctor, you need to complete internship and be eligible for full registration. If you can’t do that , than doing any program is of no value.
As for Malaysian Masters, only MRCS will give you an advantage. Unrecognised degrees from elsewhere does not mean anything.
Clinical post graduate degree can only be done if you are in clinical practise. It is full time working part time studying.
Shalini,
Try contacting Singapore and see whether you can do your internship there since you did your full programme overseas.
For someone already in the system, yes, an additional qualification like the MCh gives you an edge in getting jobs. For someone with no locus standi in the system, it does NOT help in terms of getting the visa to work. This is something many people are confused about. Having a recognisable qualification for registration, is a different matter from having the right to a visa to work. If you are missing one of the 2, you face road blocks.
We are talking here of people with the first, but not the second. There are just as many people with the second, but not the first. These are IMG who has resident rights, but unrecognised degrees.
So if she manages to publish a few papers in journals with some weight during her 1 year research MCh this will not be considered as extra points in her application in future for Surgery Masters in Malaysia?? Will she not be at an advantage compared to a colleague who lack any post grad qualifications? Does a MCh not indicate keen commitment to the specialty, and completion of it demonstrate at least some know how of research methodology and actual experience in research?
Just interested to know how the Masters programme selection is in M’sia?? How important is research to gain entry??
I think you have forgotten that you are talking about Malaysia! No one knows for sure how Master’s selection is done. It is never transparent.
Yes, research which has been published in well reputable journals may give some additional points but there are many other “hidden” factors that decides. A better option is MRCS
If I’m in your situation, I would go ahead with MCh in Ireland and reapply for internship post in Ireland at the same time (cos some Irish intern go on leave/drop out to migrate to Australia/NZ, etc). You might be able to get in next year. At the same time, continue with your application for housemanship in Malaysia.
If you managed to get into the housemanship earlier than June next year, then defer the offer until July/August. If by then you did not get the offer for internship in Ireland, then come back to do your housemanship in Malaysia. Complete your 2 years in Malaysia, and then you have two options:
1) apply back to Ireland for full registration (you don’t have to sit for PRES) and become SHO there, after 1 year you can apply for training post. Subsequently can try to gain entry into UK for further specialty training.
2) Apply for Masters programme. I don’t think MCh qualification will give you much advantage, but publications/research done during your MCh will definitely help. Plus, sit for MRCS. That will definitely carry some weight.
All the best!
As a full UCD graduate why not look at Singapore? If you intend to pursue a surgical career in Ireland, unless you have EU work rights, you will face the same issues again at entry into basic and higher specialist training (or the run through surgical program), inevitably ending up in service jobs that do not count to formal training recognition.
Very helpful discussion. While there are extensive limitations for many specialty trainings in the UK because of its immigration laws, there are a few specialties that are supposedly still open to all aka Shortage Occupation List eg Emergency Med, Psychiatry, Paediatrics.
Yet I’ve not heard of many who have tried to pursue those paths into the UK. Anyone have a realistic view about the feasibility of applying into those programmes?
it still depends on whether you will get a work permit. I know those who manage to get foundation program in UK after graduating from UK universities, did manage to get into training programs. But coming from overseas is difficult.
Let me explain.
Those who graduate from UK Med schools will automatically get the right to apply for FY jobs, and there is no significant immigration issues, as they use the same Tier 4 visa they used as students. While there has been problems with insufficient F1 jobs in recent years, all internationals who wants F1 jobs have gotten them eventually, so far.
Past FY, your Tier 4 visa lapses. You are however, eligible for a Tier 2 visa if you get an offer of a job paying more than 20,800 pounds a year. To get that you need to be offered a full time job. For doctors, past the FY, that means getting either a CT1 or ST1 or GPVTS job.
Is that possible? Yes it is. People within the system, ie already in FY, are NOT discriminated against (aren’t they so fair!) whether UK residents, EU residents or internationals. It is based purely on merit, ie you references, testimonials etc. So you perform well, get good referees, and get a CT/ST/VTS offer, you then just apply for a Tier 2 visa.
On the other hand, those from outside the system, it will be almost impossible, as the UK is still a very much “old boys” network society. That means that while NUMed graduates can now perform their F1 equivalent in the specified Malaysian hospitals and get full GMC registration, getting a job offer after that in UK, while theoretically possible, will be practically almost impossible, with Malaysian referees they are not familiar with.
It would be interesting to hear views/comments from NUMed on this matter…
(unless they don’t want to disclose too much in case it backfire on their marketing scheme)
It seems that the primary intention to get GMC is migration or earning British pound!
I don’t think people want GMC registration for anything else!
In the old days, it was for training. Malaysians can get a 4 year visa to stay and work, UM grads (till1989) can register with GMC, and many did go work and train, and then return to Malaysia. Not many stayed back then.
The pay for junior doctors in the NHS isn’t really that high, and British weather is atrocious. The choice migration destinations are still Australia and NZ.
I think for the current students (and their parents), it more of wanting more options, since they have spent so much money. But I think students (and parents) have to be realistic, and assume that if they enrol in a local medical programme (including branch campuses), they are destined for local practice.
Does anyone know how is the medical program in NUMed? How’s the lecturer thr? And also does it prepare one to be come a competent doctor?
“Mara was still capable of sponsoring its 210,000 overseas students and also had additional fund for the purpose.”
Gosh! There are so many government sponsored bumi overseas students, not yet including others (e.g. SLAB, RLKA, State-fund etc). The Ringgit depreciation assists to expose the figure.
http://www.themalaysianinsider.com/malaysia/article/mara-will-not-reduce-overseas-students-despite-ringgits-fall
Nothing new! They have been sponsoring students left, right and centre but when it comes to JPA, everything is limited.Quality is another issue. Even those students who are kicked out of any universities overseas are brought back and enrolled in this country for the same course!!
A sizeable number of them are even sent to Egypt, Jordan, Indonesia etc. for medicine. No better option for them?
MARA is still capable….
but those 9A+ bursarians from SPM 2014 and onwards are no longer guaranteed for their 1st degree scholarship by JPA. Interview will be reintroduced based on social economic background and other factors. Medicine, dentistry, pharmacy, dietetics & architecture are restricted to local program in Malaysia. Total JPA scholarships for local and oversea program have been reduced from 10,000+ to 1,000 places only. What a pity!!
https://drive.google.com/file/d/0B5qVTUF0YlkyY0ZrbVk0cldiXzQ/view?pli=1
210k overseas students “only”. Don’t forget that they haven’t counted the mara local scholars!
hello dr,
i enjoyed reading your articles that are mostly related on medical purposes.
doctor has been my passion since young age and right now i am currently a third year medical student from russia, and i still have 3 years more to complete my studies.
after reading few articles relating on doctor future job prospect, i began to open up my eyes and yet in a dilemma either to stay in medical field, or to stop and do something else.
a few question pop out right from my mind that i would like to ask..
1) what do u think, could happen 4years onwards for doctor to be employed by gov? will there be hopes for us , as late graduates?
2) will there be somehow insufficient places to do Housemanship?
3) and if yes, what will be your best advice for me, as 3rd year medical student?
i hope to u hear from u soon doctor. much appreciated! 🙂
Ask yourself why you wanted to do medicine! Is it just for job security or passion. If you have real passion, why worry. No job is guaranteed. Do engineering students, law students ask the same questions? The government will provide housemanship but the waiting period will get longer. It is already 6-8 months now. May hit 1 year by 2016. However, whether you will get a job after housemanship is another question.
hello dr,
i enjoyed reading your articles that are mostly related on medical purposes.
doctor has been my passion since young age and right now i am currently a third year medical student from russia, and i still have 3 years more to complete my studies.
after reading few articles relating on doctor future job prospect, i began to open up my eyes and yet in a dilemma either to continue in medical field or to stop and do something else..
a few question pop out right from my mind that i would like to ask..
1) what do u think, what could happen 4years onwards for doctor to be employed by gov? will there be hopes for us , as late graduates?
2) will there be somehow insufficient places to do Housemanship?
3) and if yes, what will be your best advice for me as 3rd year medical student?
i hope to hear from u soon doctor. much appreciated ! 🙂
Good day Doctor,
Can I have your email to get some opinion for my further study?
Thanks.
Lim
pagal72@gmail.com
Dr Pagalvan, i wanted to ask . I am doctor , 6 yrs working experience.
Just left government service, i wish to do neurosurgery.
Since i left govt service , i will do it overseas.
Seen many uni and their programs , Russia, Ukraine , India , Indonesia , Iran , Turkey , etc. What do you think ?
I dont see any of them in the NSR ?
So if i do graduate i apply via NSR and need for gazzettement and can work in private directly ?
Or need gazettement in gove hospital before shifting to private ?
Firstly, if they are not listed in NSR, it is not worth doing!It will not be recognised in Malaysia. All gazettement (if your degree is recognised) can ONLY be done in government sector/university hospitals.
Quiting government service before doing post graduate is a mistake unless you go overseas and work there for years with a recognised post graduate degree before coming back.However, to work in a another country, your basic degree must be recognised and you must be accepted into the training post.
Just FYI,
http://www.telegraph.co.uk/news/nhs/11887308/How-much-are-junior-doctors-paid-and-why-are-they-threatening-to-strike.html
Dear Dr.Pagal
I just noted in the Oct 2015 MMA issue, MIGHTY education is inviting Medical Doctors in Private sctor to postgraduate?? is this a tuition or course to study or are they sponsoring for postgraduate eudcation.. I am confused. It is not easy to get a well recognised training post in UK and MIGHTY shouws an easier approach?? Thanks in advance
Yes, I saw that. It is just a course conducted by this centre. Funds are provided by the government under some initiative announced by PM in RMK 11. So, they claim it is a scholarship!
However, they might have forgotten that passing these exams do not make you a specialist. You need to undergo adequate years of training under supervision to be gazetted as a specialist. This can only be done in government hospitals. If not, you will not even be able to sit for Part 2/3 of the exams.
It is not about going to UK!
There are even mistakes on their advert! It is not FRCS but MRCS!
Dear Dr Pagalavan
I am now in a confusion state as to decide which medical shool: NUMED and UCD, Dublin.
My parents want me to go UCD. However, Ireland does not provide internship.
Dr Pagalavan. Pls help me. Need your advice ASAP.
Thanks.
Liz Ng
Ireland does provide internship at the moment but it is highly competitive. HIGHLY.
If there is no intention to work outside Malaysia, or the reality makes that unlikely, then just go to NUMeD.
Read:
http://www.theborneopost.com/2017/02/03/immediate-solution-needed/
Dear Dr Pagalavan,
I am interested in dermatology specialisation. One has to do MRCP-masters UKM but I understand it is very difficult to get into masters. Are there any other pathway options I can look into (UK, Aus, US) to specialise in dermatology? for example MRCP-MTI in UK, is it easy to get into dermatology subspeciality training there?
Thanks in advance
MTI is only part of your training. You still have to enroll yourself into our MOH subspecialisation program after gazettement as a MRCP specialist. Then once you complete your 2 years training here, you can apply for MTI for the last 1 year training.
Dear Dr Pagalavan,
May i ask, as of now, given the Brexit situation, is it wise to enroll in NUMed Malaysia and spending about half a million for a chance at GMC full/provisional registration? Especially since GMC registration does not guarantee you work in UK but just gives you a chance. Also, GMC registration opens only UK to you.
ps. (maybe other EU non english speaking countries also, but i do not intend to work there la)
Also, do you know, if there is a time limit to apply for provisional registration following graduation from NUMed Malaysia?
Lastly, in your opinion, given Brexit again, would UK be harder or easier to obtain work compared to Ireland? (after registration, that is)
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As long as you have a recognised degree, you should be able to get GMC provisional registration. However, it is only valid for 3 years, by which time you must be fully registered.
The whole issue of BREXIT is migration!. Too many EU citizens figthing for jobs in UK. With brexit, it could worsen shortage of doctors situation in UK but you may still be able to get a limited non-training post. BUT non-training post may not benefit you in long term(can’t specialise) except that it may make you eligible to practise in Australia, NZ after some years. BUT getting a job in these countries are also becoming very limited.
Ok, thank you for the reply, but just to confirm, your reply basically means that there should be no time limit for APPLICATION of provisional registration, except that there is a time limit AFTER application?
Also, you mentioned “worsen shortage of doctors situation in UK”, does this mean now there is already a shortage and that is good for IMG’s who wish to work there?
Thank you.
Shortage is in rural areas. That’s why you don’t get training post. I know atleast 2 who got a non training post but returned back as unable to get a training post.
Hi i am an old doctor, i graduated in 1995 and completed 6 months of house job and then got a job as medical officer (in those times house job/internship was not mandatory). Now i intend to apply for full GMC registration through sponsorship from NHS (i have an offer). Is it possible to get full GMC registration although i have continuous work experience since then but house job/internship certificate of only 6 months. Please advise.
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Hi,
I have an offer for training in NHS through sponsorship. I did graduation in 1995 and 6 months house job at that time and got a job as medical officer (in those times house job was not required to get a job or even register with local registering body in my country). Since then i am continuously working in my speciality without any break. Is it possible to get full GMC registration without completing this requirement of 12 months of internship but completing their reqirement of continiuing to practice for the last 5 years (in fact it’s been all the time since i got the job). Kindly advise.
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You need to ask GMC
I wonder why Ireland has still has shortage of doctors when so many EU doctors are available to work in Ireland?
Due to their economic situation. many left Ireland
Thanks for your reply.