It has been 8 months since I wrote my last article, the conclusion of my post-Wawasan 2020 series. The year 2022 started with relaxation of border rules in many countries. Being in Western Australia (WA), which had one of the toughest border rules in the world, we were happy that the border was going to open on 5th of February 2022. Unfortunately, 2 weeks before the date, the WA government decided to postpone the date indefinitely due to rise of Omicron cases all over the world and a new target was set for booster doses before the border opens. I had to postpone my flight that I had already booked for end of February 2022.
By mid-February 2022, the WA government announced that the border will open on 5th of March 2022. However, Malaysia still had a 5-day quarantine rule for those vaccinated. We decided to delay our first trip back to Malaysia in over 2 years, to May 2022, just in time to celebrate Raya in Malaysia. Thank fully, by then, not only the quarantine rule was removed for those vaccinated but also the pre departure PCR test. Thus, on 4th of May 2022, me and my wife stepped our feet onto Singapore Airlines Boeing 787 for the first time in more than 2 years!
It was a smooth flight to KL via transit in Changi airport. Changi airport will always be the best airport I have ever been. This is also the first time since 2014 that I am landing in KLIA. Since I lived in JB, I had always used Changi airport for my international flights. The “Malaysia Boleh” phenomenon hit my face the moment I landed in KLIA! Welcome to Malaysia! We walked towards the Aerotrain upon landing only to see the entire area was cordoned off without any signage to guide us where to go. There was a lady sitting inside the cordoned area but too busy looking at her handphone. All of us were wondering where to go till one of them “woke up” the phone lady and asked her! She pointed the direction to the bus terminal. It was a long walk from there with stairs going down, right at the end, after which you will see the bus waiting. Took the bus to the main terminal where our bags were waiting. The immigration clearance was the fastest as we used auto gate. Then came the custom screening.
1 scanning machine for the entire crowd! Everyone had to que up to scan our luggage, one by one. No green lane. As we finally exited out to the arrival hall, we were looking for the car rental booths. None to be seen! We had already booked the car online, but we could not see any booths or even any signage to direct us to the car rental area. My wife frantically went around asking people who were working at the arrival hall (money changers etc), none seem to be aware! Finally, I found a small signage on the right side of the arrival hall, you can only see it if you pay close attention on small wordings. It took us almost 10-15min of walk out of the terminal, sweating till my entire shirt was drenched like I just got wet in the rain! The efficiency of the car rental company was at another level. It took them almost 30-40min to give us the car. Of all the airports I have ever been (mostly developed countries), I have never seen the car rental booth being situated 10-15 mins walk from the arrival hall into another building. Most will be situated in the arrival hall, and you can collect the keys within 15 min.
Finally, we made it to the highway, heading north to my wife’s place. Cars speeding, motorbikes all over the place brought back my memories. No one follows the rule. Back to my Malaysia. Somehow, I felt the lawlessness has gotten worst. Grabfood and Foodpanda riders don’t seem to care about road rules. Even traffic lights can’t stop them. My 30 years’ experience driving in Malaysia was reactivated. As suggested by my friends, we bought a dashcam before coming to Malaysia. Getting a Touch N Go card was another nightmare. None seem to be in stock and thus we had to use our good old IC as our touch N Go card while we searched around. Finally, we got one from Watson in my wife’s hometown. Along the road, one thing was obvious to us. The maintenance culture has gotten worst. Maintenance of roads, buildings, public infrastructure etc was down the drain. I had always wondered how a tourist would feel when they arrive in Malaysia.
Overall, we had a wonderful time with our family and friends, whoever we had time to visit. From Perak to KL to Seremban to Melaka and finally to JB. Malaysia is always the best place for food! Something we always crave for when we return to Malaysia. Shopping and buying cloths that we are familiar with, is another heaven. Unfortunately, the politics in Malaysia never changes and has turned to the worst. I can clearly see that election is coming very soon. Whenever racial and religious rhetoric goes overdrive, we know election is coming. I can see more people have become poorer. Currency value is dropping day by day. The last I heard 1SGD is now RM 3.20. 1USD is about RM 4.50. The lower the currency falls, the poorer the people will become. After being in Australia for 3 years, I can see how the value of our currency is very important. The stronger the value of the dollar, the lower the cost of living. We left Malaysia after spending 24 days, on 27/05/2022.
I received many emails from young doctors asking for advice to migrate, especially after reading my last article. Unfortunately, as I had always said, medicine is the worst profession to be when it comes to migration/moving around. Unless your degree is recognised in the country you are intending to migrate, you need to sit and pass the entrance exam with no guarantee that you will get a job. It is an investment with a possibility of not getting any return. The border closure in Australia resulted in work force shortage in many fields. Covid pandemic also resulted in many states increasing their pool of doctors by creating more post. Unfortunately, they could not fill up this post as borders were closed. Not all local graduates like to work in hospital setting. Many IMG (International Medical Graduates) who were already in Australia manage to get these jobs if they had AMC Part 1. Most of them have been in Australia for years, some even citizens and PRs. Once the border opened, many IMGs with AMC Part 1 were also recruited from overseas. These are all mainly for MO and service registrar position.
My regional hospital advertised for 3 new senior registrar post. There were 15 applications, none from locals/Australia! All were from overseas and almost all of them only had AMC Part 1. They were senior doctors from their country of origin with at least more than 10-20 years of experience. Most of the applications were from India, Sri Lanka, Iran, Turkey and Egypt. It is a risk that you will need to take as the Limited registration will only be given for a maximum of 5 years. By then you must either pass the AMC Part 2 or complete the WBA (12 months ward-based assessment) program in an accredited hospital. Because of this, the hospital can only provide you with a yearly contract. Those who are recruited as GP with just AMC Part 1 have another option of completing your RACGP program to be awarded FRACGP within the 5 years period.
It is a tough life for many of them who come for greener pastures. Some of them were paediatricians, anaesthetist, psychiatrist, surgeons, neonatologist, gastroenterologist back in their home country but willing to sacrifice everything to start from scratch. Even then, there is no guarantee that their contract will be renewed year after year. The more regional you are, the better the chance of getting a renewed contract.
Thus, this is what I advised those who intend to migrate with a medical degree which is not recognised in Australia. Be prepared to start from scratch with no certainty. You must take a gamble. Some may succeed and some don’t. That’s why you will hear some coming back home, not necessarily due to family reason, but they fail to get a job or training post to become a specialist. Be prepared to go to rural and remote areas to get a job.
With the increasing number of queries that I am receiving about migration, I can feel the pain the people on the ground are going through. The contract issue, while has been extended to about 10 years to complete your specialisation, it is very clear that the government will never be able to absorb everyone into permanent civil service. I had written about these many times before. Thus, it is not unusual for MMC to reduce the compulsory service to 1 year. So, now you can leave the service after a total of 3 years (2 years HO and 1 year MO). In fact, even before the announcement by the DG, for the past 3 years MMC has been approving exemption, usually if you have completed 18 months post housemanship. Even JPA has made an announcement that JPA scholars who are under contract since 2016 can break the bond and leave civil service. It is a way of saying “get lost”! But who created this mass in the first place! As for me, this is an inadequate training for any doctor to be able to practise medicine independently after 3 years. With no proper training system in place for GPs etc, we probably giving them a “license to kill”…………………
Oh Gosh, didn’t I predict all these were coming ………………………….
Pagalavan's Avatar 
Dear Pagalavan,
It would appear that a viable route for Malaysian med grads to receive PR in Oz would be to sit for and pass the RACGP exams while in Malaysia, and then apply for PR similar to your family. This would represent a surer path to medical practice with a FRACGP in hand when arrive in Oz — as Oz is very short of GPs esp in rural + regional areas.
Regards, Raymond Yeow FRACGP
https://www.linkedin.com/in/raymondyeow
Unfortunately this is not applicable from 2019 onwards. The new icFRACGP is not registrable in Australia directly.
The results of permanent posts were just released. What was the reaction from the young doctors who did get an offer and their next move?
Sad and disappointed
The results of permanent posts were just released. What was the reaction from the young doctors who did not get an offer and their next move?
In your opinion is it wise for MRCP holders to migrate to Australia?
MRCP is not recognised as a specialist exam in Australia. Thus is does not matter but having MRCP do give an added advantage when you apply for assessment with the college. At the end it all depends on what the college assessment says. If they give you partially comparable status, you can only work as a registrar and may need top up training of 1-2 years and may need to sit for their Part 2 exams.
Does MRCP with CCT help with registration in Australia?
yes, if you have CCT (from UK), you will likely be given substantially comparable status with 12 month’s peer review only.
Hello Mr Pagavalan,
Good to hear that you are enjoying your holiday.
I have followed your blog at least 8 – 10 years ago I believe. I have shared your blog to many of my science stream friends who wanted to pursue medicine when we have just graduated from SPM 10 years ago. Most of my friends took your advice and pursue other route instead. Most of them pursue into phamacy, then to marketing, some went to bio enginnering and sadly to say, their talent is not recognized in Malaysia so they had fled to another country. Including my sister who always wanting to be a doctor since young, I told her about your blog 5 years ago. It is very enlightening your you reveal such pain us Malaysians has to go through. Obviously my sister did not pursue becoming a doctor, and she is now working in a top firm consulting company in UK. Now they are all very successful people which I am very proud of them. So thanks to you my sister’s and friend’s life has changed completely now. I cannot imagine if they are doing medicine now – most probably listening to them overworking and underpaid for all the things they do.
For those who are reading this, ask yourself why would you want to take up Medicine. Is it because your parents want you to, or you want to be looked highly upon after, gaji banyak2 can buy bungalow and benz, all that is all fairy tale. Since the pandemic you have to work x3 as hard now unless you have “jalan” or in Singapore we say ” ada lobang”. Medicine is indeed rewarding but looking at how MO HO is being treated, I suggest people should think twice if they want to step into it. Dont please your parents and dont jaga muka sendiri just because all your friends manage to do medicine because they are born with the sliver spoon. Those people are different from us, they have added advantage which they have to do less because they have so many option for them. They can choose whatever they want even if they fail.
Having lived so many years in multiple countries, there are so many opportunity out there waiting for you. Before I left Malaysia, I honestly didnt know there were such opportunity out there for everyone. I will share a very good example – in Europe, engineering (dosent matter what sector), biomed, product managers, medical devices, consulting is a booming sector. Lots of funding are going into R&D. You probably dont even need the native language as English is widely speaking in those industries.
Another tip is what i know is if you study in a specific European country like Belgium, Germany, or Netherlands, you are highly sought after, especially if you have Masters or PHD. They love people with Masters and PhD. If you have some working experience before hand, even better. You can live comfortably in Europe and dont have to worry about whether you can find a job when you graduate. Dont stick to the old ways where you pay almost 1 million to study in UK or Aus to do medicine. Things are away harder and takes longer now, and it is filled with uncertainty.
Do lots of research, listen to experts and finally decide your own path. Whatever you do, perseverance is the key. I understand that it is a dream of many Malaysians wanting to migrate to other countries for a better posture. You can. Just not in medicine anymore.
I also need to add that in this era work life balance is what we are also seeking in our jobs. Malaysia can no longer(or never have been) offering us such luxury. Most countries encourage you to learn or take extra training during work (days at adult school are also being paid). This way you can always sharpen another skill by improving yourself in the market. Humans are meant to learn everyday. This is why some countries are moving forward quickly, good GDP, low turnover employee rate and some are falling behind progressively and never improve.
It is painful for me to say this, dont settle in a country that dosent value education and your private life. It is not worth it.
yes, work life balance is important. As long as the pay is reasonable and everything else (medical and education) is taken care by the state, life should be good.
Thanks for the comment and compliment. As I have always said, many do not know the real life of medicine and think it is all glory and grandiose life!
Hi Dr, my interest is to specialize in either internal medicine or paediatrics. Do you think it’s better to stay in Malaysia and take the parallel pathway or it is better to go Singapore and do houseman there, compete with the locals to get into their master program? (Recently Sg came to recruit HO from M’sia). My concern is once I decided to go Sg, there’s no turning back because as far as I know Malaysia doesn’t recognize Singapore housemanship, so I can only come back after being a specialist and the duration will be at least 10 years. This is a big decision and I hope to get your opinion on this. Thank you.
If your intention is to do internal medicine or paediatrics, there is no difference whether you do it in Malaysia or Singapore. If you are planning to come back to Malaysia, then it is better to stay back and do it over here.
Thank you for your reply Dr.
Is it because in Malaysia I can still take the parallel pathway and become a specialist, without having to go thru master program?
In terms of the contract issues, it does not really affect much right?
Yes and the government has promised to extend the contract to 10 years if you are doing specialist training.
Singapore no longer recruits HO from Malaysia (unless you are A student from UM or UKM). That has been the case for many years ever since the country has enough junior doctors to run the service
I mean unless you are an ‘A’ student from UM or UKM
I think lately they are having shortage after the covid shut down. I heard they have started recruiting again from UM and UKM.
My anonymous source has found that 16-20 Housemans from UM have just recently left KKM for Singapore MOH.
That is an uptick from the previous 6 in the previous batch.
What is your advice for doctors attempting MRCP UK Part 2 Written ? After passing MRCP Pt 1, I find that MRCP Pt 2 Written is more difficult. Is more rigorous practice doing exam banks sufficient and more preparation time needed.
Part 2 written is more clinical and thus you need clinical experience as well.
What is the recommended duration of time to study for MRCP Pt 2 after passing Pt 1
Hi Dr,
I would like to ask what are the future prospects of working in MOHH, Singapore in comparison to kkm in terms of workload, career progression, our children’s future if settling down there etc etc, thought of applying via mrcp. And what are the chances of getting into residency post in int med.
I’m currently working as mo in kkm.
Thank you. Looking forward to hear from you.
A lot of things have changed in Singapore as they are producing enough doctors for themselves (even though currently they are having shortage due to covid resignations). Singapore is a good place to work and earn a living but not a place I would go for my children’s future. It is just too small with no land. As for residency post, it is becoming much tougher to get in but if you are willing to wait long enough, with good performance, you may still get in. Nothing is guaranteed no matter where you go.
Hi Dr, what would be a possible route to practicing in Australia for someone with the following profile:
– Malaysian medical degree
– completed housemanship in Malaysia
– sat for PLAB UK, went to UK and completed GP training in the UK
if you are fully registered with GMC, you don’t need to sit for AMC exams. If you have completed your GP training and MRCGP, you need to apply via RACGP for specialist GP recognition. You will still need to do 1 year of supervised job before being granted full registration.
What are the pros and cons of working in Ireland with a non-Irish degree? Is it true that that there is no entrance exam ?
You can easily google this information.
if you have completed 2 years of housemanship in Malaysia, you can get general registration in Ireland. Please refer to my talk last year at UKM career course.
Thanks. Regarding Ireland, would PRES Level 3 Clinical Irish exam be simpler than UK PLAB 2 taking into account that Ireland has 1-year internship.Like your webinar suggested, there is scant information on Malaysians who have realised their ambition.
Are the new permanent posts offered this year to contract doctors pensionable or EPF?
I am not sure but usually the choice is given when you are confirmed in service.
There was a recent debate on the Harla Contract Facebook on the selection of permanent medical officers from the category of houseman who do not have the minimum of 5B in the SPM .
These doctors are from overseas universities but the universities are recognized. Would these doctors be treated on the same grounds as other better qualifications in their SPM?
As far as I am aware, the 5B minimum criteria was used since 2012.contract started in 2016,which means all those under contract should have got atleast 5B,if not they by right would not be able to do medicine anywhere and later MMC said that they would not even provide them with registration. Unless you have STPM or certain pre university courses which supersedes SPM. So, I would say that this criteria may be used if needed in selecting permanent positions.
Hi Dr,
I am a fresh grad from a local uni, currently waiting for housemansip. Recently I just received an offer to join the faculty in my uni as an academic staff to be trained to become a clinical lecturer after I finished my HOship later. May I know what are the pros and cons working in KKM vs in teaching universities in Malaysia? This is a big decision for me and I hope to get your view regarding this. Thank you.
Generally both are OK. The gazettement process and NSR registration now has been standardised. The issue is workload and salary. In uni you will be doing administrative, teaching and clinical with same pay as KKM who does mainly clinical only.
Thank you for the reply, Dr. Really appreciate it!
Dear Dr Pagalavan, hope you are doing well. Thank you for your well written, thought provoking articles. It has definitely given myself and friends insight about our whole predicament. I’m almost hitting my 2 year mark as a medical officer in Sugery dept in KKM. In this short time, I guess i could say I’ve had a taste of how government service works, the nature and future prospects. I can’t say I’m very excited, even as a specialist. Contrary to most people who are fighting for a masters program, i think i am not motivated enough to fight for it as i feel very pessimistic about the system as whole.
What are your thoughts about working in KKM as a specialist and what future do you see 10-15 years down the road, is it worth the struggle just to get into another struggle?
I think the important question you should ask is why you became a doctor and what you want to do. If you feel you are not up to the challenge, then find another option. That’s life, it is a struggle all the way!
There are Facebook reports of contracts doctors not having their contracts not renewed.Is that correct? Especially in this situation of reported shortages of staff?
I am not sure but many are not accepting the renewal due to transfers etc.
Is this comment in your blog posted in 2012 still valid :
Last week, I wrote on the situation of internship in Australia . I was also informed via a comment in this blog that Ireland has also shut their doors to international student graduates :
“If you are thinking of working in Ireland, you might just as well forget about it now. The Irish government is so stupid as they dont even take their own Non EU graduates to work with them. They rather employ Non EU students from Polish medical schools. Majority of us, the Non EU students who graduated this year didn’t get a job because our grades are lower from those Non EU who studied in Poland who don’t even know how the Irish system works. To make matter worst, we paid 295 Euros for the application and later found out we didn’t get a job. The irish government is making money from that. They didn’t reply to any of our emails, calls and they treat us like rubbish. SO my advice is, don’t go to Ireland for medical education. Go to anywhere else in europe like Poland, Romania, Slovakia where everything is cheaper, score a first class and apply to Ireland. And dont forget to pay your income tax at 40% per month. Oh, they are increasing the income tax again this year. Good luck and all the best!”
Does this apply for present graduates from Malaysia applying for Ireland?
A lot of changes have happened since COVID. A lot of Irish graduates are coming to Australia leaving a lot of vacant positions in Ireland. So, it is much easier now to get a position in Ireland.
Irish graduate here, things are very good in Ireland in terms of job opportunities, most of my Malaysian batchmates, seniors, juniors get internship right after graduation. Getting into basic specialty training (BST) programme is also fairly easy, I’m doing medical BST now (except if you want to do surgery that’s more competitive but still u can get it if u r good enough), the bottleneck will be at higher specialty training(HST) due to limited seats but the competition is fair/no discrimination against nationality per se, if Ireland is not ur cup of tea (it’s quite boring here) then as Irish graduate we cn apply and get into UK specialty training without much hassle. COVID really opened things up for Non-EU students.
Yes, but it is not going to be long.
Actually Dr Paga the Irish Gov had made commitments to improve job and training for Non-EU Drs, you can check out see this report:
https://www.gov.ie/en/press-release/f5335-up-to-1800-doctors-to-benefit-from-changes-to-immigration-rules/
Last time Non-EU Drs have long been excluded and discriminated by the system in terms of job opportunities and training posts, but with this change it would be a level playing ground for Non-EU Drs to get trained and secure a job just like in the UK. I don’t see how they can U-turn on this, this is not Malaysia.
The HSE (KKM equivalent) medical workforce report outlined that Ireland need more healthcare staffs and hospitals in both urban and rural areas. Lots of major hospitals in Dublin – James’s & Tallaght are undergoing construction for new building, and they are also building new hospitals in rural areas like Mallow. So they definitely will be recruiting more staffs members. The Irish healthcare workforce is actually heavily reliant on immigrants, they don’t produce enough Irish Drs and nurses to cover their need.
I personally think as Malaysian we have better chances to specialize in Ireland and UK than in Malaysia, Aus or Singapore, then after getting trained we have the options of staying here, migrating to UK, Aus, or even going back to Malaysia – which I plan to do, home is home even though it’s flawed, and the FOOD makes it all worthwhile
Additional perk: there is a lot of non-clinical opportunities for Doctors who got tired of clinical work as well, Ireland has the largest groups of big Pharma/med device/digital health company, just do a Master (1-2 years) on something relevant to the industry and you can swoop in nicely to do 9-5 corporate jobs.
The biggest hurdle for aspiring students will be the tuition fees, they are ridiculously expensive at 36000-45000 eur/year but there are scholarships available for us here (Living cost is still a bitch tho)
ALTERNATIVELY, Malaysian doctors can come work at Registrar level after obtaining MRCP, u dun hav to be an Irish graduate to join the Irish medical workforce. I know a permanent MO who quit the KKM and got a job in Ireland recently and planning to apply for specialty training next year.
Just trying to point out an alternative path for doctors who are disappointed in KKM, things are not bad, pay is very good despite high taxation – earning euro and spending RM during holiday in Malaysia makes u feel like a king, work life balance is much better, everybody is very respectful to each other and they value mental health a lot, less than full time training is also available if you have family commitments.